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AIM:To evaluate the application effect of artificial intelligence(AI)assisted diagnosis system in screening diabetic retinopathy(DR)in Yinchuan Community, Ningxia Hui Autonomous Region.METHODS:From July 2020 to July 2021, fundus photograph of 2 707 eyes from 1 358 diabetic patients with type 2 diabetes in two communities of Ningxia and Yinchuan were included in this study. The Eye Wisdom AI assisted screening and diagnosis system was used to analyze automatically and detect the characteristic changes of DR, such as hemorrhage, microaneurysms and retinal microvascular abnormalities. The results of fundus photograph were automatically graded according to the standard of DR international stage standard. The manual analysis group gave feedback after image interpretation, analyzed the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of the AI-assisted screening system for DR diagnosis, and compared the consistency between AI and manual analysis. Kappa consistency test was performed for the results of AI screening system and manual analysis.RESULTS:Compared with manual analysis, the sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of AI were 91.84%, 99.06%, 8.16% and 0.94% respectively. The Kappa value of consistency analysis of the two diagnosis results was 0.817(P<0.001). Compared with manual analysis, the sensitivity and specificity of AI group to diagnose non-DR were 99.06% and 91.84% respectively. The sensitivity and specificity of mild NPDR were 85.36% and 98.52% respectively. The sensitivity and specificity of moderate NPDR were 81.53% and 98.55% respectively. The sensitivity and specificity of severe NPDR were 70% and 99.51% respectively. The sensitivity and specificity of PDR were 86.67% and 99.63% respectively. The Kappa value of the consistency analysis of DR staging diagnosis was 0.878(P<0.01).CONCLUSION: The AI remote screening system adopted in this study showed good consistency with the results of manual analysis, which can meet the needs of DR screening and provide a new effective prevention and treatment mode for DR patients in the community.
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Objective:To observe the changes of protein expression of apoptosis signal pathway in prefrontal cortex of rats with post-stroke depression(PSD) after lateral ventricle injected of brain-derived neurotrophic factor precursor(proBDNF).Methods:Among 55 healthy adult female SD rats, 25 rats were randomly selected as PSD group, and the other 30 rats were randomly divided into normal group ( n=10), depression group ( n=10) and stroke group ( n=10). The middle cerebral artery occlusion(MCAO) model was established by thread occlusion in the stroke group, the chronic stress depression model in the depression group was established by the combination of chronic unpredictable mild stress(CUMS) and the solitary feeding method.And the rats in the PSD group were established MCAO model first, then they were received CUMS stress and solitary rearing one week later so as to establish PSD model.Two weeks after the establishment of the model, 15 rats in PSD group were randomly divided into proBDNF group, rats in tPA group and NS control group.One week after buried tube of lateral ventricle, rats in tPA and proBDNF were injected into the lateral ventricle for one week.The protein expressions of c-Jun N-terminal kinase(JNK), p-JNK, p53, p-p53 and Bax in prefrontal cortex of rats in each group were detected by Western blot at the 4th and 8th week after modeling.SPSS 17.0 software was used for data analysis, one-way ANOVA was used for comparison between groups, and SNK- q was used for pairwise comparison. Results:The expressions of p-p53, p53, p-JNK, JNK and Bax in prefrontal cortex of normal group, depression group, stroke group and PSD group were significantly different at the end of 4th and 8th week after MCAO modeling ( F=3.426-90.355, all P<0.05). Post-hoc analysis showed that, compared with the normal group, the expressions of p-JNK (0.378±0.042) and Bax (0.478±0.054) in the prefrontal cortex of PSD rats increased significantly at the end of the 4th week(both P<0.05), and the expressions of p-JNK(0.411±0.056), p-p53 (0.286±0.083) and Bax (0.471±0.008) in the prefrontal cortex of PSD group increased significantly at the end of the 8th week(all P<0.05). After lateral ventricle injection of proBDNF, there were significant differences in the expression of p-p53, p53, p-JNK, JNK and Bax among proBDNF group, tPA group and NS group ( F=16.915-287.039, all P<0.01). Post-hoc analysis showed that, compared with NS group, the expressions of p-JNK (0.35±0.01)and p-p53 (0.31±0.01)in prefrontal cortex of proBDNF group increased significantly(both P<0.05). After lateral ventricle injection of proBDNF, there were significant differences in body weight, sucrose preference rate, horizontal movement distance among proBDNF group, tPA group and NS group ( F=18.741-76.305, all P<0.01), and compared with tPA group and NS group, behavioral indexes of proBDNF group (body weight (224.36±3.23) g, sucrose preference rate (69.83±1.72)%, horizontal movement distance (57.93±2.09) blocks, vertical movement distance (19.79±1.81)) decreased significantly(all P<0.05). Conclusion:The proBDNF promotes the activation of apoptosis signal pathway in the rats with PSD.
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Objective:To investigate the effect of liquiritin on the apoptosis of amygdala cell and the expression of apoptosis-related factors Bax and Bcl-2 protein in rats with post-stroke depression (PSD).Methods:Sixty rats were randomly divided into normal control group, stroke group, PSD group, citalopram group, liquiritin group, and normal saline control group ( n=10 in each group). The middle cerebral artery was occluded with a suture method to induce focal cerebral ischemia, and the PSD model was established by chronic and unpredictable mild stress stimulation and orphanism. At the same time every week after the model was made, the weight of rats in each group was measured and the depression behavior was evaluated, including sucrose water test and open field test. At 6 weeks after the model was made, TUNEL staining was used to detect the apoptosis of amygdala cell, immunofluorescence staining was used to detect the expression of Bax and Bcl-2 in the amygdala, and Western blot analysis was used to detect the protein expression of Bax and Bcl-2 in the amygdala. Results:Compared with the liquiritin group, citalopram group and normal control group, the body weight and sucrose solution preference of rats in the stroke group, PSD group and normal saline control group were decreased, and the horizontal and vertical movements in open field test were decreased; the differences were statistically significant (all P<0.01). TUNEL staining results showed that compared with the liquiritin group, citalopram group and normal control group, the number of apoptotic cells was significantly increased in the stroke group, PSD group, and normal saline control group; the difference was statistically significant (all P<0.01). The results of immunofluorescence staining showed that compared with the liquiritin group, citalopram group and normal control group, the number of bcl-2 immunoreactive cells in amygdala of the stroke group, PSD group and normal saline control group was significantly decreased, while the number of Bax immunoreactive cells was significantly increased; the difference was statistically significant (all P<0.01). Western blot analysis showed that compared with the liquiritin group and citalopram group, the expression of bcl 2 protein in amygdala of the stroke group, PSD group and normal saline control group was significantly decreased, while the expression of Bax protein was significantly increased; the difference was statistically significant (all P<0.01). Conclusion:Liquiritin can alleviate the symptoms of PSD, and its mechanism may be related to inhibiting the apoptosis of amygdala cells and regulating the expression of apoptosis-related factors.
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Objective To choose a reasonable non-drug treatment program for women with postpartum breast pain. Methods Based on an adequate assessment of the patients′ condition, the clinical questions were proposed and the references were searched in a series of databases, such as Cochrane Library, PubMed, Ovid, CINAHL, CNKI, Wanfang, Weipu, CBM. Results A preliminary search of 484 articles on cabbage therapy for postpartum breast pain was carried. Through rigorous preliminary screening and screening, 11 articles were finally included, including 2 systematic reviews, 2 randomized controlled trials and 7 quasi-experiment. Through the analysis of the inclusion literature, the data was extracted, and the evidence and summary evidence were strictly evaluated.According to the results of evidence, based on the patients′ condition and the wishes of the family, the cold and hot cabbage leaves were alternately applied to the breast of 10 postpartum women with breast engorgement, the breast distended pain were improved. Conclusions The method of evidence-based nursing can provide safe and effective treatment for postpartum women with breast engorgement.
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Background Retinitis pigmentosa (RP)is a common hereditary blinding eye disease in ophthalmology.Current researches documented that RP may have the common pathophysiologic basis to Alzheimer disease and chronic neurodegenerative disease.Understanding this mechanism will offer a new therapeutic target for RP.Objective The purpose of the present study was to investigate the roles of cyclin-dependent kinase 5 (Cdk5)/P25 activation in the apoptosis of retinal neural cells of RCS rats.Methods Eighteen SPF RCS rats and 18 RCS-rdy+ rats were randomized into 17-,25-and 35-day groups respectively and 6 rats for each.The rats were sacrificed at corresponding time points and retinal hemogenete was prepared.Expressions of CdkS,P35,P25 and tau phosphorylation in the retinas were detected by Western blot,and the kinase activity of Cdk5/P25 was analyzed by quantitative colorimetric assay.Results The expressing level of P35 protein(A340) in the retinas of 17-day-old RCS rats was near that of 17-day-old RCS-rdy+ rats(t =0.52,P＞0.05).In 25-and 35-day-old RCS rats,the expressing levels of P35 protein were 2.20±0.48 and 1.23±0.14,which were higher than those of RCS-rdy+ rats(1.43±0.13 and 0.93±0.10),showing significant differences between them(t =3.78,4.28,P＜0.05).The expression of P25 was undetectable at postnatal 17 days in RCS rats and RCS-rdy+ rats,but it showed significantly higher in RCS rats(0.300±0.003 and 0.230±0.004) than that in RCS-rdy+ rats(0.040±0.004 and 0.070±0.004) at postnatal 25 days and 35 days(t=121.81,77.51,P＜0.01).No significant difference was found in the expression of Cdk5 in RCS rats and RCS-rdy+ rats at different ages (t =-0.60,0.19,1.62,P＞ 0.05).The kinase activity of Cdk5/P25 did not show significantly different between RCS and RCS-rdy+ rats at postnatal 17 days(t =0.19,P＞0.05),but significantly higher kinase activity of Cdk5/P25 was seen in RCS rats (0.0058 ±0.0005 and 0.0056±0.0004) than that in RCS-rdy+ rats(0.0038±0.0003 and 0.0032 ±0.0007) at postnatal 25 days and 35 days (t =8.07,5.97,P＜ 0.01).No expression of tau phosphorylation was detected in RCS rats at postnatal 17 days,but significantly higher tau phosphorylation level was seen in RCS rats at postnatal 25 days and 35 days(1.80±0.22 and 1.23±0.17),which were significant different in comparison with RCS-rdy+ rats at postnatal 25 days and 35 days(1.60 ±0.20 and 1.04 ±0.12)(t=4.71,3.17,P＜0.05).Conclusions The Cdk5/P25 kinase activity shows a consistent trend with theexpressions of P25 and tau phosphorylation in the RCS rats,indicating that the upregulation of P25 induces the enhance of enzyme activity of Cdk5,which phosphorylate its substrates to result in more apoptosis of retinal neural cells.
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Background Retinitis pigmentosa (RP) is a monogenic inheritance and blinding disease of fundus oculi.There is not an effective therapeutic method now.Objective This work was to identify the mutations of RP1 gene in Chinese RP patients in Ningxia area and to explore the potential interactions in the pathogenesis of RP.Methods The periphery blood of 3-5 ml was collected from 110 individuals with RP(35 ADRP and 75SRP)and 100 normal controls in Ningxia area.Polymerase chain reaction (PCR) and direct DNA sequencing were used to screening the sequence alterations in the entire coding region and splice sites of RP1 gene.Multivariate analysis and two web-based programs( PolyPhen and SIFT) were used to analyze the results.Results Eleven mutation locus were detected in the exon 4 of RP1 gene including two novel sequence variants:p.Lys1152Lys without a higher mutation rate in comparison with normal control group(x2 =9.12 P＜0.01 ),but c.* 247A＞C with a higher mutation rate in comparison with normal control group(x2 =12.77,P＜0.01 ) and c.* 247A＞C mutation was thought to be correlated with RP( r=1.11,P＜0.05 ).The other ten mutation locus were reported as single nucleotide polymorphisms (SNP).The mutation rate of p.Gln1725Gln was found to be higher in the RP patients than the normal controls (x2 =42.09,P＜0.01 ),but no the significant correlation was seen between the pathogenesis of RP and mutation of p.Gln1725Gln(r=1.74,P＞0.05).p.Lys1152Lys mutation was found in only 1 patient.Three SNPs( p.Arg872His,Ala1670Thr,Ser1691Pro) were always occurred in the same 83 RP patient and the relevance ratio was higher than controls ( P＜0.01 ).The age of night blindness on patients with concurrent three mutations was (30.54± 13.68 ) years,and the best corrected visual acuity (BCVA) was 0.50 ± 0.38.The age of night blindness on patients without concurrent three mutations was(21.06± 16.24) years,and the BCVA was 0.40 ±0.33 and were higher than controls ( t =2.11,P ＜ 0.05 ).Conclusions In this study,the prevalence of RP1 mutations among the RP patients in Ningxia population was lower than other populations (＜ 1％ ).The alliance of SNPs (p.Arg872His、p.Ala1670Thr、p.Ser1691Pro) may play a protective role on RP patients and reduce the frequency of mutatiaon in RP1 gene.