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Objective To observe the effects of repeated intravitreal injections of ranibizumab and aflibercept on cor-neal morphology of patients with neovascular age-related macular degeneration(nAMD),diabetic macular edema(DME)or retinal vein obstruction(RVO).Methods In this prospective study,64 patients(64 eyes)who underwent therapy in the injection center of the Ophthalmology Department of our hospital from June 2021 to June 2022 were enrolled,including 19 nAMD patients,20 DME patients and 25 RVO patients.Among these patients,29 were treated with aflibercept(40 g·L-1)and 35 were treated with ranibizumab(10 g·L-1).Monocular injections were adopted for all patients,and 3+pro re nata(PRN)therapy was used.Confocal microscope was used for corneal nerve examination,and corneal endo-thelial microscope was used to measure corneal thickness(CT)and corneal endothelial cells.The CT,corneal endothelial cell density(ECD),coefficient of variation(CV),average cell size(ACS),proportion of hexagonal cells(Hex%),cor-neal nerve fiber length(CNFL),corneal nerve fiber density(CNFD)of patients with nAMD,DME and RVO after repeated intravitreal injections of anti-vascular endothelial growth factor(VEGF)drugs were compared,and those parameters at 1 month after injection of different anti-VEGF drugs were compared with the baseline.Results Before injection,ECD in the DME group was lower than that in the nAMD and RVO groups,and the ACS in the DME group was higher than that in the nAMD and RVO groups(all P<0.05).There was no significant difference in the other indexes among the three groups(all P>0.05).After 3 injections of anti-VEGF drugs,the ECD in the DME group was lower than that in the nAMD and RVO groups,the ACS in the DME group was higher than that in the nAMD and RVO groups,and the CNFL in the DME group was lower than that in the nAMD and RVO groups(all P<0.05).The ECD decreased compared with that before injection from the 2nd injection of aflibercept in the nAMD group(all P<0.05).Hex%decreased significantly after each injection compared with the baseline(all P<0.05).Other indexes have no significant differences from the baseline(all P>0.05).In the RVO group,ECD decreased from the 2nd ranibizumab injection compared with the baseline(all P<0.05).Conclu-sion Repeated intravitreal injections of anti-VEGF drugs can reduce the Hex%and ECD to a certain extent.After injec-tions,CNFL in the DME group is significantly lower than that in the nAMD and RVO groups.
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Objective:To explore the changes in morphology and function of meibomian gland and the expressions of inflammatory factors and lipid metabolic factors in meibomian gland of diabetic mice.Methods:Fifty 8-week-old male C57BL/6 mice of clean degree were divided into normal control group ( n=20) and diabetes model group ( n=30) according to a random table.Diabetes model was established by the intraperitoneal injection of streptozotocin (60 mg/kg, 10 mg/ml). Mouse tail vein blood glucose ≥16.7 mmol/L was considered as successful modeling.Blood glucose was measured weekly, and body weight was compared between the two groups.Ten mice were randomly selected for fluorescein sodium staining of the cornea to evaluate the integrity of the corneal epithelium from both groups at an interval of 4 weeks.Five mice were randomly selected from the two groups and were sacrificed via anesthesia to collect meibomian gland tissue for hematoxylin and eosin staining in order to observe morphological changes at 8 and 16 weeks after modeling, respectively.At 16 weeks following modeling, mebomian gland of 5 mice randomly selected from both groups was stained with oil red O staining to observe the distribution of lipid.Real-time fluorescence quantitative-PCR was performed to detect the relative expressions of tumor necrosis factor (TNF)-α, pigment epithelium derived factor (PEDF), peroxisome proliferators-activated receptor γ (PPARγ), and adipose differentiation-related protein (ADFP) mRNA in meibomian gland.The use and care of animals complied with the ARVO statement.This study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University Eye Hospital (No.TJYY20190630009). Results:The successful modeling rate of diabetes in mice was 100%, and the survival rate was 83.3% (25/30). The weight was significantly lower and the blood glucose level was higher in diabetes model group at 8 and 16 weeks after modeling in comparison with normal control group (all at P<0.05). There were significant differences in corneal fluorescein staining score among different time points in diabetes model group ( F=27.155, P<0.05). In diabetes model group, thinner wall of meibomian gland duct, enlarged lumen of the duct, dilated acini and oil red-stained lipid deposition in most acini were observed.At 16 weeks after modeling, the expressions of TNF-α, and PPARγ mRNA in meibomian gland of diabetes model group were 3.33±0.91 and 1.55±0.25, which were significantly higher than 1.00±0.16 and 1.00±0.27 of normal control group (both at P<0.05). The expression of PEDF mRNA in diabetes model group was 0.42±0.08, which was significantly lower than 1.00±0.34 in normal control group ( P<0.05). There was no significant difference in the ADFP mRNA expression between the two groups ( t=0.943, P=0.38). Conclusions:Inflammatory factors and lipid metabolic factors such as TNF-α, PEDF, and PPARγ may be involved in the pathogenesis of meibomian gland dysfunction induced by diabetes.
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Difficult-to-treat asthma is a complex disease with poor response to high-dose inhaled corticosteroids plus a second controller or need high levels of treatment to maintain control.Difficult-to-treat asthma represents a significant clinical challenge and a heavy medical burden due to its heterogeneity.Identification of the phenotypes and endotypes in difficult-to-treat asthma is very helpful for individualized therapy.This review summarizes the latest studies on the classification of difficult-to-treat asthma in order to provide evidence for the diagnosis and treatment of difficult-to-treat asthma in children.
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Bronchopulmonary dysplasia(BPD)is one of the most common respiratory diseases in premature infants, and many factors affect the development of premature lung.Recent studies have shown that pulmonary macrophages play an important role in the occurrence of BPD.The number of macrophages in the lung increases in the process of BPD, and classically activated M1 cells dominate, which causes excessive production of pro-inflammatory cytokines such as interleukin-1 and oxidation substances such as reactive oxygen species, promotes the apoptosis of lung cells, and affects the development of alveolar structure and pulmonary microvasculature.Besides, the decrease of autophagy activity of neonatal alveolar macrophages contributes to the occurrence of BPD, but the mechanism is still unclear.This article reviews research progress on the role of pulmonary macrophages in bronchopulmonary dysplasia, in order to further explore the significance of them in diagnosis and treatment of BPD and improve the quality of life of children with BPD.
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Objective To observe the clinical features ofuveal effusion syndrome (UES) and the efficacy of sclerectomy in the treatment of UES.Methods A retrospective case series.Twenty patients (36 eyes) of UES with sclerectomy were enrolled in this study from June 2012 to December 2016 in Beijing Tongren Hospital.Among them,there were 12 males (22 eyes) and 8 females (14 eyes),with an average age of 37.8 years.All patients suffered from bilateral diseases,including 4 patients in single eye group and 16 patients in double eye group.Visual acuity,intraocular pressure,indirect ophthalmoscope,UBM,FFA combined with ICGA,A/B ultrasonography,axial length (AL) and scleral thickness were measured.All patients underwent lamellar sclerectomy,and those with exudative retinal detachment underwent four quadrant lamellar sclerectomy,followed by four quadrant full-thickness sclerectomy with the size of 1 mm × 2 mm in the center of the scleral bed.The follow-up time after operation was more than 6 months.Visual acuity,intraocular pressure and fundus examination were performed 1,3 and 6 months after operation with the same equipment and methods before operation.Results There was no obvious inflammation in the anterior chamber of all eyes,and intraocular pressure was 24-28 mmHg (1 mmHg =0.133 kPa) in 4 eyes (11.1%).Axial length of 8 eyes (22.2%) were 16-18 mm (true microphthalmia).12 eyes (33.3%) had scleral thickness > 1.0-1.8 mm.Visual acuity ranged from hand movement to 0.05 in 20 eyes,0.1 to 0.3 in l0 eyes and>0.3 in 6 eyes.Fundus examination showed peripheral choroidal and ciliary detachment;UBM examination showed annular peripheral ciliary and choroidal detachment.32 eyes (88.9%) were complicated with exudative retinal detachment.FFA examination showed that 14 eyes (38.9%) had leopard spot changes.Compared with preoperative vision,the visual acuity improved in 28 eyes (77.8%) and remained unchanged in 8 eyes (22.2%) after surgery.Thirty-two eyes with different degrees of retinal detachment were found before surgery.After surgery,ciliary body detachment,choroidal detachment and retinal detachment were restored.Six eyes (16.7%) recurred and underwent sclerectomy again.Conclusions The mild symptoms and recurrent attack are the characteristics of UES.Sclerectomy is an effective method to treat UES.
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Objective To assess the treatment outcomes of anterior segment optical coherence tomography(OCT) assisted excimer laser phototherapeutic keratectomy (PTK) for fungal corneal ulcer.Methods Twenty-four patients (24 eyes) suffered from fungal corneal keratitis were collected by a retrospecive chart review with at least 6 months of follow-up data available.All corneal ulcer depth did not exceed 1/3 corneal thickness and were resistant to local and systemic medication therapy for at least 1 week.Patients were divided into 2 groups.14 patients with 14 eyes were taken PTK and 10 patients with 10 eyes were treated with lamellar keratectomy.Follow-up time was at least 6 months.Visual acuities,corneal thickness,confocal microscope,healing of the epithelial defect and inflammation and complications were recorded.Results The postoperative visual acuity in two groups were significantly improved,visual acuity of PTK treatment group improved significantly better than the control group (P < 0.05).Healing time of PTK treatment group (19.43 ± 5.68) days was shorter than that of the control group (34.40 ± 5.38) days,the difference was statistically significant (P <0.05).There was no significant difference in the residual central corneal thickness between the PTK treatment group and the control group (P > 0.05).Residual mycelium after operation in the treatment group was significantly decreased than that of control group.Healing time of epithelial in PTK treatment group (4.0 ± 1.1) days was shorter than that of the control group (6.20 ± 1.39) days,the difference was statistically significant (P < 0.05).There was no corneal dilation in two groups.No recurrence in PTK treatment group was occurred.3 cases in control group had recurrence after 6 months,drug control was effective in 1 case,and other 2 cases undertook corneal transplantation.Conclusion Anterior segment OCT assisted PTK for corneal ulcer can effectively clear the lesion,accelerate epithelial healing,provide a new choice for the treatment of early superficial fungal corneal ulcer.
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Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.
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BACKGROUND: Bone morphogenetic protein in combination with hol ow porous titanium al oy can improve the affinity with surrounding bone tissues. OBJECTIVE: To observe the effects of bone morphogenetic protein 2 on growth and osteogenic differentiation of bone marrow mesenchymal stem cel s cuftured on a hol ow porous metal prosthesis scaffold. METHODS: Passage 3 Sprague-Dawley rat bone marrow mesenchymal stem cel s were directly inoculated onto a hol ow porous metal prosthesis, and then the scaffold was cultured in DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2, respectively. At 6, 12, 24 and 48 hours after inoculation, cel adhesion was detected by MTT assay. Cel osteogenic differentiation was detected by alizarin red staining at 18 days. Besides, Transwel culture was put on the scaffold, and 5x108/L bone marrow mesenchymal stem cel s were added into the upper chamber, and DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2 were added into the lower chamber to observe cel migration capability after 0, 6, 12, 24 and 48 hours culture. RESULTS AND CONCLUSION: After 6-48 hours of inoculation, different mass concentrations of bone morphogenetic protein 2 promoted adhesion of bone marrow mesenchymal stem cells in a time-dependent manner. After 18 days of inoculation, bone marrow mesenchymal stem cells induced by different mass concentrations of bone morphogenetic protein 2 changed from fusiform to polygon, and arranged in a multilayer and overlapped form. Numerous calcified nodules could be found, which were stained red by alizarin red. Additionally, within 6-48 hours of culture, bone morphogenetic protein 2 could promote the migration of bone marrow mesenchymal stem cells in a concentration-and time-dependent manner. In conclusion, bone morphogenetic protein 2 can enhance the adhesion, osteogenic differentiation and migration of bone marrow mesenchymal stem cells cultured on the hollow porous metal prosthesis.
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Background The incidence of dry eye is growing.However,the early diagnosis of dry eye is still difficult up to now.Keratograph 5M analyzer,a novel noninvasive ocular surface analyzer for dry eye may offer important parameters.Objective This study was to evaluate the clinical value of Keratograph 5M analyzer for clinical diagnosis of dry eye.Methods An observational study was proceeded with 88 cases who accepted myopia diagnosis in Tianjin Medical University Eye Hospital from October to December 2013.A series of conventional dry eye-related examinations were performed on the patients,including tear film break-up time (TBUT),corneal fluorescein staining scoring,Schirmer Ⅰ test (S Ⅰ t),and then Keratograph 5M analyzer-related examinations were subsequently carried out,including noninvasive tear film break-up time (NITBUT) and conjunctival hyperemia scoring.The correlations between conventional dry eye-related examinations and Keratograph 5M analyzer-related examinations were assessed by using Spearman rank correlation analysis.Results A total of 88 patients were recruited with male 32 and female 56.No significant difference in age was found between different genders (P =O.34).In 88 patients,Keratograph 5M analyzer showed the non-dry eyes in 15 patients,suspicious 44 patients (50.0%) and dry eyes in 29 patients (33.0%).However,the non-dry eyes were checked out in 39 patients and dry eyes were in 49 (55.7%) based on China Dry Eye Clinical Diagnosis and Treatment Consensus.The first NITBUT (NITBUTf) was less than the average NITBUT (NITBUTav) (P =0.00),and a positive correlation was seen between them (rs =0.62,P =0.00).Dry eye grade was significantly correlated with NITBUTf or NITBUTav or conjunctival hyperemia scoring (rs =-0.60,P =0.00 ; r,=-0.89,P =0.00 ; rs =0.24,P =0.02).A negative correlation was found between the conjunctival hyperemia scoring and NITBUTav (rs =-0.24,P =0.02).However,no significant correlation was seen between conjunctival hyperemia scoring and NITBUTf,TBUT,S Ⅰ t or corneal fluorescein staining scoring (rs=-0.13,P=0.22;rs=0.16,P=0.14;rs =-0.16,P=0.13;rs=-0.08,P=0.44).No significant difference was found between TBUT and NITBUTf (P =0.71).And TBUT was correlated with NITBUTf (rs =0.23,P =0.03),but not NITBUTav (rs =0.18,P =0.09).In addition,no significant correlations were seen between S Ⅰ t and NITBUTf or NITBUTav (rs=0.20,P=0.07;rs=0.05,P=0.66).Conclusions NITBUTav has an important significance in assessing overall ocular surface conditions.The conjunctival hyperemia score is one of refrent indicators to judge ocular surface status.
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Objective:To investigate the mechanisms of paeoniflorin on T cells in Bovine Collagen-induced arthritis ( CIA) model.Methods:CIA were established with Bovine Type Ⅱ collagen in DBA/1J mice.From day 21,after divided into two groups at random,mice were treated with PBS or paeoniflorin and recorded arthritis scores every day;the inflammation of CIA was evaluated with HE staining of the joints;the proliferations of splenocytes and CD4+T cells stimulated either by CD3 antibody and CD28 antibody or CII were examined by 3 H-TdR incorporation assay;the ratio of Th1 and Th17 subsets in CD4+T cells were examined by flow cytometry;the concentration of IFN-γand IL-17 in the culture supernatants of splenocytes were detected by ELISA.Results: The administration of paeoniflorin alleviated the symptoms( P<0.05) and inhibited the inflammation response of CIA;paeoniflorin not only inhibited the pro-liferation of CD3/28 antibodies-stimulated splenocytes and CD4+T cells(P<0.05),but also inhibited the proliferation of CII-specific splenocytes and CII-specific CD4+T cells(P<0.01);paeoniflorin modulated the ratio of Th1 and Th17 subsets(P<0.01);paeoniflorin reduced the levels of IFN-γand IL-17 in the culture supernatant of splenocytes ( P<0.05 ).Conclusion: Paeoniflorin may alleviates clinical symptoms of CIA via inhibiting pathogenic T cell proliferation, balancing inflammatory T cell subsets and reducing pro-inflammatory cytokines.
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BACKGROUND:Polyvinyl alcohol is a biocompatible and biodegradable polymer. It is widely used in clinical areas because of its water-soluble, film forming, emulsification, adhesiveness, tasteless, and nontoxic. OBJECTIVE:To review the applications of polyvinyl alcohol and its composite materials in bone, cartilage, skin, vessels and other tissue engineering scaffolds. METHODS:A computer-based online search of CNKI database from January 2000 to December 2011, PubMed database and Elsevier (ScienceDirect) database from January 1980 to December 2012, was performed by the first author with key words of“poly(vinyl alcohol), composite material, tissue engineering scaffold”both in Chinese and English. Literatures concerning polyvinyl alcohol and its composite materials in bone, cartilage, skin, vessels and other tissue engineering scaffolds were included, and repetitive research was excluded. RESULTS AND CONCLUSION:Although there are not enough strength, complications and other shortcomings in vivo, due to its good biocompatibility and biodegradable properties, polyvinyl alcohol and its composite materials have made great progress in tissue engineering applications from the laboratory to the pre-clinical research. But its long-term effects need further research. It wil be a main research aim of scaffold materials in the future to improve the interaction of cel s with the scaffold materials by surface modification, to prepare biomimetic materials by cel microenvironment simulation, to improve the hydrophilicity, the adhesion of cel s, and cel differentiation and proliferation, to bionic the structure and function of the natural extracel ular matrix by building three-dimensional porous structure and control ing the release of cel growth factors, to meet the need of tissue regeneration by congruity or harmony of degradation and mechanical strength.
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Objective To explore the association of CD22 gene T>A locus (SNPrs2267574) with the development of systemic lupus erythematosus (SLE) and SLE phenotypes in Southern Chinese Han people.Methods Two hundreds fifteen cases and 216 normal controls were enrolled with the aim of case-control design,and the genotype was determined by PCR-RFLP.We calculated X2 and ORs for association study.Results In CD22 gene T>A locus,there was significant difference of genotypes distribution between cases and controls (X2=6.086,P<0.05).The frequency of AT genotype was higher in cases than in controls (OR=1.68,95%CI:1.08~2.60,P=0.021 ),and A allele had a higher proportion in cases (OR=1.58,95%CI:1.09~2.29,P=0.015).Meanwhile,the frequency of A allele in patients with positive anti-SSA was higher than in patients with negative anti-SSA (OR=3.69,95%CI:2.08~6.52,P<0.01 ).Conclusion In Southern Chinese Han population,CD22 gene T>A locus is associated with the development of SLE and the A allele has positive association with anti-SSA.