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1.
BMC Musculoskelet Disord ; 25(1): 285, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609902

RESUMO

OBJECTIVE: To investigate the effect of bone cement on the vertebral body and biomechanical properties in percutaneous cement discoplasty (PCD) for degenerative lumbar disc disease. METHODS: Three-dimensional reconstruction of L2 ~ L3 vertebral bodies was performed in a healthy volunteer, and the corresponding finite element model of the spine was established. Biomechanical analysis was performed on the changes in stress distribution in different groups of models by applying quantitative loads. RESULTS: Models with percutaneous discoplasty (PCD) showed improved stability under various stress conditions, and intervertebral foraminal heights were superior to models without discoplasty. CONCLUSION: Cement discoplasty can improve the stability of the vertebral body to a certain extent and restore a certain height of the intervertebral foramen, which has a good development prospect and potential.


Assuntos
Escoliose , Humanos , Escoliose/diagnóstico por imagem , Escoliose/cirurgia , Análise de Elementos Finitos , Cimentos Ósseos/uso terapêutico , Coluna Vertebral , Voluntários Saudáveis
2.
J Immunol Res ; 2024: 9927964, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38590608

RESUMO

Background: Psoriasis, a systemic disorder mediated by the immune system, can appear on the skin, joints, or both. Individuals with cutaneous psoriasis (PsC) have an elevated risk of developing psoriatic arthritis (PsA) during their lifetime. Despite this known association, the cellular and molecular mechanisms underlying this progression remain unclear. Methods: We performed high-dimensional, in-depth immunophenotyping of peripheral blood mononuclear cells (PBMCs) in patients with PsA and psoriasis vulgaris (PsV) by mass cytometry. Blood samples were collected before and after therapy for a longitudinal study. Then three sets of comparisons were made here: active PsA vs. active PsV, untreated PsV vs. treated PsV, and untreated PsA vs. treated PsA. Results: Marked differences were observed in multiple lymphocyte subsets of PsA related to PsV, with expansion of CD4+ T cells, CD16- NK cells, and B cells. Notably, two critical markers, CD28 and CD127, specifically differentiated PsA from PsV. The expression levels of CD28 and CD127 on both Naïve T cells (TN) and central memory CD4+ T cells (TCM) were considerably higher in PsA than PsV. Meanwhile, after treatment, patients with PsV had higher levels of CD28hi CD127hi CD4+ TCM cells, CD28hi CD127hi CD4+ TN cells, and CD16- NK cells. Conclusion: In the circulation of PsA patients, the TN and CD4+ TCM are characterized with more abundant CD28 and CD127, which effectively distinguished PsA from PsV. This may indicate that individuals undergoing PsV could be stratified at high risk of developing PsA based on the circulating levels of CD28 and CD127 on specific cell subsets.


Assuntos
Artrite Psoriásica , Psoríase , Humanos , Artrite Psoriásica/diagnóstico , Estudos Longitudinais , Leucócitos Mononucleares , Antígenos CD28 , Psoríase/diagnóstico
3.
J Environ Manage ; 351: 119873, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38159311

RESUMO

A significant milestone in China's carbon market was reached with the official launch and operation of the National Carbon Emission Trading Market. The accurate prediction of the carbon price in this market is crucial for the government to formulate scientific policies regarding the carbon market and for companies to participate effectively. Nevertheless, it remains challenging to accurately predict price fluctuations in the carbon market because of the volatility and instability caused by several complex factors. This paper proposes a new carbon price forecasting framework that considers the potential factors influencing national carbon prices, including data decomposition and reconstruction techniques, feature selection techniques, machine learning forecasting techniques for intelligent optimisation, and research on model interpretability. This comprehensive framework aims to improve the accuracy and understandability of carbon price projections to respond better to the complexity and uncertainty of carbon markets. The results indicate that (1) the hybrid forecasting framework is highly accurate in forecasting national carbon market prices and far superior to other comparative models; (2) the factors driving national carbon prices vary according to the time scale. High-frequency series are sensitive to short-term economic and energy market indicators. Medium- and low-frequency series are more susceptible to financial markets and long-term economic conditions than high-frequency series. This study provides insights into the factors affecting China's national carbon market price and serves as a reference for companies and governments to develop carbon price forecasting tools.


Assuntos
Carbono , Governo , Aprendizado de Máquina , Políticas , China , Previsões
4.
Front Med (Lausanne) ; 10: 1308923, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38046408

RESUMO

Background: This study aimed to develop deep learning models using macular optical coherence tomography (OCT) images to estimate axial lengths (ALs) in eyes without maculopathy. Methods: A total of 2,664 macular OCT images from 444 patients' eyes without maculopathy, who visited Beijing Hospital between March 2019 and October 2021, were included. The dataset was divided into training, validation, and testing sets with a ratio of 6:2:2. Three pre-trained models (ResNet 18, ResNet 50, and ViT) were developed for binary classification (AL ≥ 26 mm) and regression task. Ten-fold cross-validation was performed, and Grad-CAM analysis was employed to visualize AL-related macular features. Additionally, retinal thickness measurements were used to predict AL by linear and logistic regression models. Results: ResNet 50 achieved an accuracy of 0.872 (95% Confidence Interval [CI], 0.840-0.899), with high sensitivity of 0.804 (95% CI, 0.728-0.867) and specificity of 0.895 (95% CI, 0.861-0.923). The mean absolute error for AL prediction was 0.83 mm (95% CI, 0.72-0.95 mm). The best AUC, and accuracy of AL estimation using macular OCT images (0.929, 87.2%) was superior to using retinal thickness measurements alone (0.747, 77.8%). AL-related macular features were on the fovea and adjacent regions. Conclusion: OCT images can be effectively utilized for estimating AL with good performance via deep learning. The AL-related macular features exhibit a localized pattern in the macula, rather than continuous alterations throughout the entire region. These findings can lay the foundation for future research in the pathogenesis of AL-related maculopathy.

6.
Sci Immunol ; 8(88): eabi6887, 2023 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-37831760

RESUMO

Despite robust literature associating IL-31 with pruritic inflammatory skin diseases, its influence on cutaneous inflammation and the interplay between inflammatory and neurosensory pathways remain unmapped. Here, we examined the consequences of disrupting Il31 and its receptor Il31ra in a mouse model of house dust mite (HDM)-induced allergic dermatitis. Il31-deficient mice displayed a deficit in HDM dermatitis-associated scratching, consistent with its well-established role as a pruritogen. In contrast, Il31 deficiency increased the number and proportion of cutaneous type 2 cytokine-producing CD4+ T cells and serum IgE in response to HDM. Furthermore, Il4ra+ monocytes and macrophages capable of fueling a feedforward type 2 inflammatory loop were selectively enriched in Il31ra-deficient HDM dermatitis skin. Thus, IL-31 is not strictly a proinflammatory cytokine but rather an immunoregulatory factor that limits the magnitude of type 2 inflammatory responses in skin. Our data support a model wherein IL-31 activation of IL31RA+ pruritoceptors triggers release of calcitonin gene-related protein (CGRP), which can mediate neurogenic inflammation, inhibit CD4+ T cell proliferation, and reduce T cell production of the type 2 cytokine IL-13. Together, these results illustrate a previously unrecognized neuroimmune pathway that constrains type 2 tissue inflammation in the setting of chronic cutaneous allergen exposure and may explain paradoxical dermatitis flares in atopic patients treated with anti-IL31RA therapy.


Assuntos
Dermatite Atópica , Inflamação Neurogênica , Animais , Camundongos , Citocinas , Imunidade , Pyroglyphidae , Pele/imunologia , Interleucinas/imunologia , Interleucinas/metabolismo
7.
Retina ; 43(10): 1673-1679, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37721725

RESUMO

PURPOSE: To explore the predictive roles of the morphologic features of neovascularization in the prognosis of myopic choroidal neovascularization. METHODS: In this retrospective case series study, quantitative morphologic features of neovascularization were obtained from the optical coherence tomography angiography images. According to the number of anti-vascular endothelial growth factor injections administered within 1 year, the eyes were classified into a stable group (≤2 injections) or an unstable group (>2 injections). Best-corrected visual acuity was recorded before the treatment and at the 1-year follow-up. RESULTS: Overall, 50 eyes with treatment-naive myopic choroidal neovascularization were included; 26 in the stable group and 24 in the unstable group. Multivariate analysis showed that the eyes in the unstable group were associated with a larger lesion area (odds ratio = 2.596, P = 0.012), higher junction density (odds ratio = 1.611, P = 0.014), and higher end point density (odds ratio = 1.435, P = 0.023).The area under the receiver operating characteristic curve of the multivariate model was 0.865, with 91.7% sensitivity and 65.4% specificity. The final best-corrected visual acuity was significantly correlated with the lesion area (ß = 0.152, P = 0.032) after adjusted for age, sex, and baseline best-corrected visual acuity. CONCLUSION: Lesions with larger areas and higher end point and junction densities tended to have more frequent anti-vascular endothelial growth factor injections and worse visual outcomes in eyes with myopic choroidal neovascularization.


Assuntos
Neovascularização de Coroide , Tomografia de Coerência Óptica , Humanos , Fatores de Crescimento Endotelial , Estudos Retrospectivos , Prognóstico , Angiografia , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico
8.
Front Bioeng Biotechnol ; 11: 1166840, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37485322

RESUMO

Objective: To investigate whether mineralized collagen modified polymethyl methacrylate (MC-PMMA) bone cement impacts the implanted vertebral body and adjacent segments and the feasibility of biomechanical properties compared with common bone cement in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods: A healthy volunteer was selected to perform a three-dimensional reconstruction of the T11-L1 vertebral body to establish the corresponding finite element model of the spine, and the changes in the stress distribution of different types of cement were biomechanically analyzed in groups by applying quantitative loads. Results: The stress distribution of the T11-L1 vertebral body was similar between the two bone types of cement under various stress conditions. Conclusion: Mineralized collagen modified bone cement had the advantages of promoting bone regeneration, good biocompatibility, good transformability, and coupling, and had support strength not inferior to common PMMA bone cement, indicating it has good development prospects and potential.

9.
Helicobacter ; 28(3): e12960, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37042045

RESUMO

BACKGROUND: Geographic differences exist in the antibiotic resistance patterns of Helicobacter pylori. Personalized treatment regimens based on local or individual resistance data are essential. We evaluated the current status of H. pylori resistance in Ningxia, analyzed resistance-related factors, and assessed the concordance of phenotypic and genotypic resistance. METHODS: Strains were isolated from the gastric mucosa of patients infected with H. pylori in Ningxia and relevant clinical information was collected. Phenotypic antibiotic susceptibility assays (Kirby-Bauer disk diffusion) and antibiotic resistance gene detection (Sanger sequencing) were performed. RESULTS: We isolated 1955 H. pylori strains. The resistance rates of H. pylori to amoxicillin, levofloxacin, clarithromycin, and metronidazole were 0.9%, 42.4%, 40.4%, and 94.2%, respectively. Only five tetracycline-resistant and one furazolidone-resistant strain were identified. Overall, 3.3% of the strains were sensitive to all six antibiotics. Multidrug-resistant strains accounted for 22.9%, of which less than 20% were from Wuzhong. Strains isolated from women and patients with nonulcerative disease had higher rates of resistance to levofloxacin and clarithromycin. Higher rates of resistance to metronidazole, levofloxacin, and clarithromycin were observed in the older age group than in the younger age group. The kappa coefficients of phenotypic resistance and genotypic resistance for levofloxacin and clarithromycin were 0.830 and 0.809, respectively, whereas the remaining antibiotics showed poor agreement. CONCLUSION: H. pylori antibiotic resistance is severe in Ningxia. Therefore, furazolidone, amoxicillin, and tetracycline are better choices for the empirical therapy of H. pylori infection in this region. Host sex, age, and the presence of ulcerative diseases may affect antibiotic resistance of the bacteria. Personalized therapy based on genetic testing for levofloxacin and clarithromycin resistance may be a future direction for the eradication therapy of H. pylori infection in Ningxia.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Humanos , Feminino , Idoso , Claritromicina/farmacologia , Claritromicina/uso terapêutico , Metronidazol/farmacologia , Metronidazol/uso terapêutico , Levofloxacino/farmacologia , Levofloxacino/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Estudos Retrospectivos , Furazolidona/uso terapêutico , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Amoxicilina/uso terapêutico , Tetraciclina/farmacologia , Tetraciclina/uso terapêutico , Resistência Microbiana a Medicamentos , Farmacorresistência Bacteriana
10.
Eye (Lond) ; 37(17): 3565-3573, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37117783

RESUMO

BACKGROUND/OBJECTIVE: Pathologic myopia (PM) is a major cause of severe visual impairment and blindness, and current applications of artificial intelligence (AI) have covered the diagnosis and classification of PM. This meta-analysis and systematic review aimed to evaluate the overall performance of AI-based models in detecting PM and related complications. METHODS: We searched PubMed, Scopus, Embase, Web of Science and IEEE Xplore for eligible studies before Dec 20, 2022. The methodological quality of included studies was evaluated using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2). We calculated the pooled sensitivity (SEN), specificity (SPE) and the summary area under the curve (AUC) using a random effects model, to evaluate the performance of AI in the detection of PM based on fundus or optical coherence tomography (OCT) images. RESULTS: 22 studies were included in the systematic review, and 14 of them were included in the quantitative analysis. Of all included studies, SEN and SPE ranged from 80.0% to 98.7% and from 79.5% to 100.0% for PM detection, respectively. For the detection of PM, the summary AUC was 0.99 (95% confidence interval (CI) 0.97 to 0.99), and the pooled SEN and SPE were 0.95 (95% CI 0.92 to 0.96) and 0.97 (95% CI: 0.94 to 0.98), respectively. For the detection of PM-related choroid neovascularization (CNV), the summary AUC was 0.99 (95% CI: 0.97 to 0.99). CONCLUSION: Our review demonstrated the excellent performance of current AI algorithms in detecting PM and related complications based on fundus and OCT images.


Assuntos
Neovascularização de Coroide , Miopia , Humanos , Inteligência Artificial , Sensibilidade e Especificidade , Neovascularização de Coroide/diagnóstico , Cegueira
11.
BMC Ophthalmol ; 23(1): 160, 2023 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-37072736

RESUMO

PURPOSE: To investigate early changes in the intraocular pressure (IOP) and macular microvascular structure in eyes with branch retinal vein occlusion (BRVO) treated with intravitreal Ranibizumab injection. METHODS: This study enrolled 30 patients (one eye per patient) who received intravitreal injections (IVI) of ranibizumab for macular edema secondary to BRVO. IOP were measured before, 30 min (min) and 1 month following IVI. Changes in macular microvascular structure were examined via assessment of foveal avascular zone (FAZ) parameters, vascular density (VD) of superficial vascular complex (SVC), and deep vascular complex (DVC) in whole macula, central fovea and parafovea area which were measured automatically by optical coherence tomography angiography (OCTA) on the same time as IOP examinations. Paired t test and Wilcoxon test were used to compare pre- and post-injection values. The correlation between IOP and OCTA findings was assessed. RESULTS: IOP Measurements at 30 min post-IVI (17.91 ± 3.36 mmHg) increased significantly from baseline (15.07 ± 2.58 mmHg, p < 0.001), then became similar with baseline after 1 month (15.00 ± 3.16 mmHg, p = 0.925). 30 min past the injection, the parameters of VD of the SCP significantly decreased in comparison to baseline, then became similar with baseline after one month, while there were no significant changes in other OCTA parameters, including parameters of VD of the DCP and the FAZ. At 1 month after IVI, in comparison to baseline, no significant changes were observed in all of the OCTA parameters (P > 0.05). There were no significant correlations between IOP and OCTA findings no matter 30 min or 1 month post-IVI (P > 0.05). CONCLUSIONS: Transient IOP elevation and decreased superficial macular capillary perfusion density were detected 30 min post-IVI, however, no potential continual macular microvascular damage was suspected.


Assuntos
Ranibizumab , Oclusão da Veia Retiniana , Humanos , Ranibizumab/uso terapêutico , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/tratamento farmacológico , Oclusão da Veia Retiniana/complicações , Vasos Retinianos , Pressão Intraocular , Injeções Intravítreas , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos
12.
Osteoporos Int ; 34(4): 749-762, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36738335

RESUMO

To establish a risk prediction model for residual low back pain after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures. We used retrospective data for model construction and evaluated the model using internal validation and temporal external validation and finally concluded that the model had good predictive performance. INTRODUCTION: The cause of residual low back pain in patients with osteoporotic vertebral compression fractures (OVCFs) after PKP remains highly controversial, and our goal was to investigate the most likely cause and to develop a novel nomogram for the prediction of residual low back pain and to evaluate the predictive performance of the model. METHODS: The clinical data of 281 patients with OVCFs who underwent PKP at our hospital from July 2019 to July 2020 were reviewed. The optimal logistic regression model was determined by lasso regression for multivariate analysis, thus constructing a nomogram. Bootstrap was used to perfomance the internal validation; receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to assess the predictive performance and clinical utility of the model, respectively. Temporal external validation of the model was also performed using retrospective data from 126 patients who underwent PKP at our hospital from January 2021 to October 2021. RESULTS: Lasso regression cross-validation showed that the variables with non-zero coefficients were the number of surgical vertebrae, preoperative bone mineral density (pre-BMD), smoking history, thoracolumbar fascia injury (TLFI), intraoperative facet joint injury (FJI), and postoperative incomplete cementing of the fracture line (ICFL). The above factors were included in the multivariate analysis and showed that the pre-BMD, smoking history, TLFI, FJI, and ICFL were independent risk factors for residual low back pain (P < 0.05). The ROC and calibration curve of the original model and temporal external validation indicated a good predictive power of the model. The DCA curve suggested that the model has good clinical practicability. CONCLUSION: The risk prediction model has good predictive performance and clinical practicability, which can provide a certain basis for clinical decision-making in patients with OVCFs.


Assuntos
Fraturas por Compressão , Cifoplastia , Dor Lombar , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Humanos , Cifoplastia/efeitos adversos , Fraturas por Compressão/cirurgia , Fraturas por Compressão/complicações , Estudos Retrospectivos , Dor Lombar/etiologia , Dor Lombar/cirurgia , Nomogramas , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/cirurgia , Fraturas por Osteoporose/cirurgia , Fraturas por Osteoporose/etiologia , Vértebras Lombares/cirurgia , Vértebras Lombares/lesões , Resultado do Tratamento , Cimentos Ósseos
13.
Pain ; 164(1): 43-58, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-35442931

RESUMO

ABSTRACT: Altered bone morphogenetic protein (BMP) signaling is associated with many musculoskeletal diseases. However, it remains unknown whether BMP dysfunction has direct contribution to debilitating pain reported in many of these disorders. Here, we identified a novel neuropathic pain phenotype in patients with fibrodysplasia ossificans progressiva (FOP), a rare autosomal-dominant musculoskeletal disorder characterized by progressive heterotopic ossification. Ninety-seven percent of these patients carry an R206H gain-of-function point mutation in the BMP type I receptor ACVR1 (ACVR1 R206H ), which causes neofunction to Activin A and constitutively activates signaling through phosphorylated SMAD1/5/8. Although patients with FOP can harbor pathological lesions in the peripheral and central nervous system, their etiology and clinical impact are unclear. Quantitative sensory testing of patients with FOP revealed significant heat and mechanical pain hypersensitivity. Although there was no major effect of ACVR1 R206H on differentiation and maturation of nociceptive sensory neurons (iSNs) derived from FOP induced pluripotent stem cells, both intracellular and extracellular electrophysiology analyses of the ACVR1 R206H iSNs displayed ACVR1-dependent hyperexcitability, a hallmark of neuropathic pain. Consistent with this phenotype, we recorded enhanced responses of ACVR1 R206H iSNs to TRPV1 and TRPA1 agonists. Thus, activated ACVR1 signaling can modulate pain processing in humans and may represent a potential target for pain management in FOP and related BMP pathway diseases.


Assuntos
Miosite Ossificante , Neuralgia , Ossificação Heterotópica , Humanos , Mutação com Ganho de Função , Ossificação Heterotópica/genética , Ossificação Heterotópica/metabolismo , Ossificação Heterotópica/patologia , Miosite Ossificante/genética , Miosite Ossificante/metabolismo , Miosite Ossificante/patologia , Células Receptoras Sensoriais/metabolismo , Neuralgia/genética , Mutação/genética , Receptores de Ativinas Tipo I/genética , Receptores de Ativinas Tipo I/metabolismo
14.
Cancer Discov ; 13(2): 332-347, 2023 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-36259929

RESUMO

The development and regulation of malignant self-renewal remain unresolved issues. Here, we provide biochemical, genetic, and functional evidence that dynamics in ribosomal RNA (rRNA) 2'-O-methylation regulate leukemia stem cell (LSC) activity in vivo. A comprehensive analysis of the rRNA 2'-O-methylation landscape of 94 patients with acute myeloid leukemia (AML) revealed dynamic 2'-O-methylation specifically at exterior sites of ribosomes. The rRNA 2'-O-methylation pattern is closely associated with AML development stage and LSC gene expression signature. Forced expression of the 2'-O-methyltransferase fibrillarin (FBL) induced an AML stem cell phenotype and enabled engraftment of non-LSC leukemia cells in NSG mice. Enhanced 2'-O-methylation redirected the ribosome translation program toward amino acid transporter mRNAs enriched in optimal codons and subsequently increased intracellular amino acid levels. Methylation at the single site 18S-guanosine 1447 was instrumental for LSC activity. Collectively, our work demonstrates that dynamic 2'-O-methylation at specific sites on rRNAs shifts translational preferences and controls AML LSC self-renewal. SIGNIFICANCE: We establish the complete rRNA 2'-O-methylation landscape in human AML. Plasticity of rRNA 2'-O-methylation shifts protein translation toward an LSC phenotype. This dynamic process constitutes a novel concept of how cancers reprogram cell fate and function. This article is highlighted in the In This Issue feature, p. 247.


Assuntos
Leucemia Mieloide Aguda , RNA Ribossômico , Humanos , Animais , Camundongos , RNA Ribossômico/genética , RNA Ribossômico/metabolismo , Leucemia Mieloide Aguda/patologia , Ribossomos/genética , Ribossomos/metabolismo , Metilação , Fenótipo , Células-Tronco Neoplásicas/metabolismo
15.
Bioconjug Chem ; 33(12): 2299-2306, 2022 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-36450158

RESUMO

1-Iodoalkynes and 1,3-diynes are versatile chemical intermediates and pharmaceutically valuable ingredients. In this study, copper mediated on-DNA alkyne iodination and Cadiot-Chodkiewicz coupling are developed for the first time. This generates diverse, systematic, and unprecedented topographic structural features, which could be invaluable as molecular recognition agents for drug discovery in DEL screening.


Assuntos
Acetileno , Alcinos , Alcinos/química , Halogenação , Di-Inos/química , DNA
16.
Trials ; 23(1): 736, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056443

RESUMO

BACKGROUND: At present, intraocular injection of anti-VEGF (vascular endothelial growth factor) drugs has replaced traditional laser therapy as the first-line treatment for DME (diabetic macular edema). However, ranibizumab, a commonly used anti-VEGF drug, is expensive and requires multiple intraocular injections. It places a heavy economic burden on patients with DME. Micropulse laser is safer than conventional laser and can reduce edema. Combined treatment with anti-VEGF may reduce the number of intraocular injections. This study will compare the efficacy of micropulse laser combined with ranibizumab treatment to ranibizumab monotherapy in the treatment of DME, providing a new regimen for future DME treatment. METHODS: This study is a prospective randomized double-blind controlled clinical trial (RCT) in patients with DME. After 1-year follow-up, visual acuity and macular edema regression will be compared between micropulse laser combined with ranibizumab group and ranibizumab monotherapy group to determine whether the efficacy of micropulse laser combined with ranibizumab treatment was not lower than that of ranibizumab monotherapy in the treatment of DME. Visual acuity measured by the ETDRS chart is the primary outcome measure. The secondary outcome measures are CMT (central macular thickness) measured by OCT (optical coherence tomography) and the number of injections of two groups. Changes in visual acuity and CMT of the two groups will be compared at 12-month follow-up. Before patients are recruited, we provide them with informed consent, in which we explain to them the purpose and process of the study. DISCUSSION: Micropulse laser combined with anti-VEGF drugs in the treatment of DME can reduce the number of intravitreal anti-VEGF injections, not only relieve the pain of the patients, but also ease the economic and psychological burden of patients, bringing great benefits. However, there is no treatment consensus for the parameters and specific methods of micropulse laser treatment for DME. There is a lack of clinical research data reference of micropulse laser combined with anti-VEGF therapy in clinical practice. This study intends to provide a new direction for clinical DME treatment and also provide a realistic consideration for the application of micropulse laser in DME treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT03690947. Registered on 1 October 2018.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Terapia a Laser , Edema Macular , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Terapia Combinada , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/terapia , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/terapia , Humanos , Edema Macular/tratamento farmacológico , Edema Macular/terapia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Ranibizumab/uso terapêutico , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular
17.
J Ophthalmol ; 2022: 8945467, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36035899

RESUMO

Background: To study the changes of retinal vascular density (VD), retinal thickness (RT), and their correlations with visual acuity (VA) in branch retinal vein occlusion (BRVO) patients with retinal atrophy after resolution of macular oedema (MO). Methods: This is a retrospective study consisting of 46 patients diagnosed with BRVO at Beijing Hospital from 2015 to 2019. Patients' 46 affected eyes and 39 fellow eyes were included. The affected eyes were further divided into the atrophy group and the nonatrophy group. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images obtained when MO completely resolved after treatment with ranibizumab were analyzed. We quantitatively measured foveal avascular zone (FAZ) parameters, the disruption extent of ellipsoid zone (EZ), RT, and VD of superficial vascular complex (SVC), and deep vascular complex (DVC) in central fovea and the minimal-VD quadrant. Paired t-tests, independent t-tests, Mann-Whitney U tests, Wilcoxon tests, Pearson correlation analyses, Spearman correlation analyses, and single and multiple linear regression models were adopted. Results: Compared with nonatrophy eyes, the minimal-VD quadrantal (quadrantal for short) SVC-VD (25.76 ± 4.57% versus 36.21 ± 6.47%, P < 0.001) and quadrantal DVC-VD (27.72 (17.23) % versus 38.95 (11.05) %, P = 0.001) of atrophy eyes decreased significantly. Quadrantal SVC-VD and quadrantal DVC-VD were strongly correlated with quadrantal full RT (r = 0.763 and 0.698, both P < 0.001). The disruption length of EZ was significantly correlated with quadrantal full RT (r = -0.406, P = 0.005) and quadrantal SVC-VD (r = -0.298, P = 0.044). In multiple linear regression analysis, the disruption length of EZ and VA before treatment and age showed significant correlations with VA with complete resolution of MO (P = 0.020, 0.033, and 0.002). Conclusions: The retinal VD on the affected area correlates well with the corresponding full RT when BRVO-MO completely resolves, suggesting that VD may predict the final RT. Severe decrease in VD may result in retinal atrophy, which may cause VA loss indirectly with the intermediate influencing factor of EZ defects.

18.
Chemosphere ; 307(Pt 1): 135718, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35842043

RESUMO

The graphite-phase carbon nitride (g-C3N4) photocatalytic materials were prepared by one-step calcination method to degrade methylene blue (MB) and potassium butyl xanthate (PBX) under visible light irradiation. The prepared g-C3N4 photocatalytic materials were investigated in detail by various characterizations, and the experiments showed that the graphitic phase carbon nitride photocatalytic materials were successfully prepared by the one-step calcination method. The material possesses excellent optical properties and strong visible light absorption, thus achieving photocatalytic degradation of MB and PBX. The catalyst dosage, pH, the initial concentration of pollutants have important effects on photocatalytic activity of MB and PBX. The photocatalytic degradation efficiency was 98.99% for MB and 96.83% for PBX under the optimal conditions (catalyst dosage, initial pollutant concentration and pH value were 500 mg L-1, 20 mg L-1 and 7, respevtively). The photocatalytic mechanisms on MB and PBX were elucidated. ·OH was the key specie for MB, while ·O2- was the key specie for PBX. This study advances the development of photocatalytic technology for mineral wastewater.


Assuntos
Poluentes Ambientais , Grafite , Catálise , Grafite/química , Luz , Azul de Metileno/química , Nitrilas , Compostos de Nitrogênio , Potássio , Águas Residuárias
19.
Retina ; 42(9): 1665-1672, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35594547

RESUMO

PURPOSE: To identify baseline morphological predictors of lesion shrinkage in eyes with myopic choroidal neovascularization (mCNV) treated with anti-vascular endothelial growth factor. METHODS: This retrospective study included 46 eyes (41 consecutive patients) with active mCNV receiving anti-vascular endothelial growth factor treatment. Optical coherence tomography angiography was performed at baseline and 1 year after treatment. Quantitative features were obtained from optical coherence tomography angiography images using AngioTool software. Eyes were classified as "high shrinkage" or "low shrinkage" according to the median relative change in lesion area. Baseline quantitative morphological features associated with mCNV shrinkage were identified in univariate and multivariate analyses. RESULTS: The mCNV area was significantly smaller after 1 year ( P = 0.013), with a median relative change of -16.5%. The relative change in mCNV area was -48.3% in high-shrinkage eyes (n = 23) and -5.2% in low-shrinkage eyes (n = 23). High-shrinkage eyes had a smaller mCNV area ( P = 0.013), shorter total vessel length ( P = 0.023), and higher end point density ( P < 0.001). Multivariate analysis showed significant associations of high shrinkage with end point density (ß = -0.037, P = 0.043) and previous anti-vascular endothelial growth factor treatment (ß = 0.216, P = 0.029). CONCLUSION: Morphological features of neovascularization detected by optical coherence tomography angiography can predict lesion shrinkage in eyes with mCNV receiving anti-vascular endothelial growth factor therapy. Higher end point density contributed to shrinkage, particularly of treatment-naive lesions.


Assuntos
Neovascularização de Coroide , Miopia Degenerativa , Inibidores da Angiogênese/uso terapêutico , Corioide/patologia , Neovascularização de Coroide/complicações , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico , Fatores de Crescimento Endotelial , Angiofluoresceinografia/métodos , Humanos , Injeções Intravítreas , Miopia Degenerativa/complicações , Miopia Degenerativa/diagnóstico , Miopia Degenerativa/tratamento farmacológico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Fator A de Crescimento do Endotélio Vascular
20.
J Pers Med ; 12(2)2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-35207663

RESUMO

Rapid methodological advances in statistical and computational genomics have enabled researchers to better identify and interpret both rare and common variants responsible for complex human diseases. As we continue to see an expansion of these advances in the field, it is now imperative for researchers to understand the resources and methodologies available for various data types and study designs. In this review, we provide an overview of recent methods for identifying rare and common variants and understanding their roles in disease etiology. Additionally, we discuss the strategy, challenge, and promise of gene therapy. As computational and statistical approaches continue to improve, we will have an opportunity to translate human genetic findings into personalized health care.

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