Clinical and Transcriptional Profiles Reveal the Treatment Effect of Adalimumab in Patients with Initial-Onset and Recurrent Vogt-Koyanagi-Harada Disease.

PURPOSE: We aimed to evaluate adalimumab efficacy in patients with initial-onset or recurrent Vogt-Koyanagi-Harada (VKH) syndrome. METHODS: A retrospective clinical study was performed to examine the therapeutic effect of adalimumab in 22 VKH patients,16 with initial-onset and six with recurrent VKH. Another 22 patients with initial-onset VKH who did not receive adalimumab were included as controls. The main observational parameters included the central macular thickness (CMT), subfoveal choroidal thickness (SCT), best-corrected visual acuity (BCVA), anterior chamber cell grade (ACC), glucocorticoid dose (GCD), and the development of sunset glow fundus. MRNA sequencing was used to profile the tumor necrosis factor (TNF)-α pathway in peripheral blood mononuclear cells obtained from nine patients with initial-onset VKH disease, six patients with recurrent VKH, and eight healthy controls. RESULTS: In the initial-onset group, adalimumab therapy significantly improved the BCVA, CMT, SCT, and ACC. Furthermore, adalimumab significantly decreased GCD in patients with initial-onset. In patients with recurrent VKH, the SCT significantly improved after adalimumab treatment, but no significant changes in BCVA, CMT, and ACC were observed. All six patients experienced relapse during follow-up. The TNF-α pathway exhibited a significant increase in initial-onset VKH when compared with that in both healthy controls and recurrent patients. Conversely, it was suppressed in recurrent VKH when compared with that in the initial-onset or healthy control groups. CONCLUSIONS: In patients with initial-onset VKH, adalimumab effectively reduces glucocorticoid dependence. However, adalimumab may not be effective for preventing relapse or providing long-term inflammation relief in patients with recurrent VKH.

Affecting factors for abdominal incisional tension in surgery of dogs and cats.

OBJECTIVE: Proper assessment of intraoperative abdominal incisional tension helps to select the appropriate sutures and suture method. Wound tension is usually thought to be associated with wound size, but few relevant articles have been reported. The aim of this study was to investigate the core factors influencing abdominal incisional tension and construct regression equations to judge incisional tension in clinical surgery. METHODS: Medical records were collected from clinical surgical cases at the Teaching Animal Hospital of Nanjing Agricultural University from March 2022 to June 2022. The data collected mainly included the body weight, and the incisional length, margin, and tension. The core factors affecting abdominal wall incisional tension were screened by correlation analysis, random forest analysis, and multiple linear regression analysis. RESULTS: Although correlation analysis showed that multiple same and deep layer abdominal incision parameters and body weight were significantly correlated with abdominal incisional tension. However, the same layer of abdominal incisional margin had the largest correlation coefficient. In random forest models, the abdominal incisional margin had the main contribution to the prediction of the same layer's abdominal incisional tension. In the multiple linear regression model, all incisional tension could be predicted by the same layer of abdominal incisional margin as the only independent variable, except for canine muscle and subcutaneous. The canine muscle and subcutaneous incisional tension were binary regressions with the same layer's abdominal incision margin and body weight. CONCLUSION: The same layer's abdominal incisional margin is the core factor positively related to the abdominal incisional tension intraoperatively.