Pathogenesis and surgical outcomes of different types of myopic traction maculopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the pathogenesis and surgical outcomes of different types of myopic traction maculopathy(MTM)using optical coherence tomography(OCT).METHODS: A total of 193 patients(210 eyes)with MTM were retrospectively included, of which 74 eyes(35.2%)underwent vitrectomy combined with internal limiting membrane(ILM)peeling. The patients were categorized into three groups: foveal detachment(FD), foveoschisis(FS)and lamellar macular hole(LMH). Based on the central foveal thickness(CFT)at baseline(M0), eyes with FD were classified into two subgroups: extensive FD and limited FD. Outcomes included best-corrected visual acuity(BCVA), CFT, posterior staphyloma height(PSH), the presence of epiretinal membrane(ERM)and ILM detachment. Risk factors for BCVA at 6mo after vitrectomy(M6)were analyzed using linear regression.RESULTS: At M0, ERM was highly present in eyes with LMH(rs=0.28, P<0.001). Eyes with FD and FS were characterized by higher incidence of ILM detachment(rs=-0.25, P<0.001). After vitrectomy, CFT and BCVA significantly improved in all eyes(P<0.001). Eyes with extensive FD were characterized by a thicker CFT(rs=0.56, P<0.001), a lower incidence of ILM detachment(rs=-0.25, P=0.034)and a thicker nasal PSH(rs=0.27, P=0.024)than eyes with limited FD. Eyes with extensive FD were associated with a worse BCVA at M0(P=0.013)and M6(P=0.030)than eyes with limited FD. Extensive FD(β=-0.295, P=0.042)and BCVA at M0(β=0.669, P<0.001)were risk factors for a worse BCVA at M6.CONCLUSION: There are several pathogenetic mechanisms in MTM. ILM detachment may exert a dominant role in the development of FD and FS, while ERM may have a role in LMH. Vitrectomy combined with ILM peeling improved functional and anatomical outcomes in MTM patients. Eyes with extensive FD may carry a poor prognosis.

Macular vessel density and thickness in highly myopic eyes with peripapillary intrachoroidal cavitation / 中华眼底病杂志

Objective:To observe the changes of retinal blood flow density and thickness in the macular region of eyes with high myopia (HM) combined with peripapillary intrachoroidal cavitation (PICC).Methods:A cross-sectional study. From March 2019 to May 2021, 65 patients (65 eyes) diagnosed as PICC (HM+PICC group) in Eye Hospital, China Academy of Chinese Medical Sciences, sex-and age-matched 69 HM patients of 69 eyes (HM group) and 65 healthy people of 65 eyes (control group) were enrolled in this study. The optical coherence tomography angiography was used to scan macular areas in 3 mm×3 mm, and measure the macular fovea and optic disc on superior, inferior, nasal, temporal superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density in the foveal and parafoveal region, and macular retinal ganglion cell complex (mGCC) thickness, full retinal thickness. One-way analysis of variance were used to test the difference of the index values among three groups, and then two groups were compared with Bonferroni test. A paired t-test was used to test the difference of the macular vessel density and thickness between the superior and inferior hemifield in three groups. Pearson partial regression analysis was used to calculate the correlations between them at same sites. Results:PICC was located most frequently at the inferior temporal disc border, followed by the inferior nasal region, superior temporal region, and superior nasal region in the HM+PICC group on 57(87.7%, 57/65), 25(38.5%, 25/65), 3(4.6%, 3/65) and 1(1.5%, 1/65 ) eye. There were significant differences in the global and regional full retinal thickness, mGCC thickness, SCP and DCP vessel density among 3 groups ( F=29.097, 51.929, 16.253, 6.135; P<0.001). The macular SCP and DCP vessel density except in the fovea, all regional macular full retinal thickness and mGCC thickness in the HM+PICC group were significantly lower than those in the normal group ( P<0.05). Compared to the HM group, the HM+PICC group had lower all regional mGCC thickness and SCP vessel density, as well as full retinal thickness in the inferior hemifield and DCP vessel density in the foveal region ( P<0.05). Macular vessel density and thickness in the inferior hemifield were significantly lower than those in the superior hemifield ( t=6.356, 11.693, 6.212, 2.936; P<0.01). Pearson partial regression analysis showed the SCP vessel density was positively correlated with corresponding mGCC thickness and full retinal thickness ( r=0.584, 0.534, 0.592, 0.496, 0.485, 0.517; P<0.001). However, there was no significant correlation between the DCP vascular density and mGCC thickness ( P>0.05), and only a weak positive correlation between the DCP vascular density and the full retinal thickness in the inferior hemifield ( r=0.319, P=0.014). However, no association with average and superior full retinal thickness ( r=0.066, 0.002, 0.125, 0.184, 0.016, 0.319; P>0.05). Conclusion:The macular SCP vessel density, mGCC thickness and the full retinal thickness in the inferior hemifield in PICC eyes are lower than those in the HM eyes, especially the mGCC thickness and SCP vessel density in the inferior hemifield, and there is a strong positive correlation between them.

Correlation of mean platelet volume with diabetic macular edema in type 2 diabetic patients / 眼科新进展

Objective To investigate the relationship between mean platelet volume (MPV) and diabetic macular edema (DME) in type 2 diabetic patients.Methods The study included 4 patient groups:40 healthy control as group 1,40 diabetic patients without diabetic retinopathy(DR) as group 2,40 DR patients without DME as group 3,and 40 DR patients with DME as group 4.Then the collection of general information,fundus photograph and OCT were conducted for the measurement and comparison of serum levels of platelet parameters including platelet count (PLT),MPV,platelet distribution width (PDW) and plateletcrit (PCT).Results Significant differences were found in MPV and PDW among the four groups (all P ＜ 0.05),but there was no significant difference in PLT and PCT levels (all P ＜ 0.05).Furthermore,MPV and PDW level was (11.07 ± 1.06)fL and (13.57 ±2.25)fL in group 3,as well as (11.27 ±0.85)fL and (13.89 ± 1.76)fL in group 4,respectively,which were both significantly higher than those in group 1 [(10.41 ±0.63)fL and (11.93 ± 1.22)fL] as well as in group 2 [(10.38 ± 0.51) fL and (12.33 ± 1.28) fL] (all P ＜ 0.05).Both MPV and PDW levels of group 4 were higher than those of group 3,but there was no significant difference (P =0.254,0.388).As for males,MPV level was increased gradually in group 2 [(10.29 ±0.58)fL],group 3 [(10.67 ± 1.08)fL] and group 4 [(11.42 ±0.90) fL] (all P＜0.05),but there was no significant difference between group 1 [(10.27 ± 0.55)fL] and group 2.For females,MPV level was (11.37 ± 0.69) fL in group 3 and (11.13 ± 0.79) fL in group 4,both which were significantly higher than that in group 1 [(10.55 ± 0.70) fL] and group 2 [(10.42 ± 0.49) fL],respectively (all P ＜ 0.05),but there was no significant difference between group 3 and group 4 (P ＞ 0.05).Conclusion High MPV level may be an important risk factor for the development of DME in DR patients.Platelet parameter surveillance can aid in the monitoring of this disease.

Sinus Tarsi Approach Internal Fixation in the Treatment of Sanders Type Ⅱ and Ⅲ Calcaneum Fracture / 中国微创外科杂志

Objective To explore the efficacy of internal fixation in the treatment of intra-articular calcaneum fractures via the sinus tarsi approach . Methods A retrospective study was made on 55 feet with intra-articular calcaneum fractures in 51 patients treated with open reduction and intemal fixation via sinus tarsi approach from January 2010 to June 2015.According to the Sanders classification, there were 15 feet of type Ⅱfractures and 40 feet of type Ⅲfractures. Results All the patients were followed up for a mean period of 15.7 months (range, 6-33 months).The fractures were completely healed .According to the Maryland Foot Scores , the operative effect was excellent in 43 feet, good in 7 feet, fair in 4 feet, and poor in 1 foot.The excellent and good rate was 90.9%(50/55).The postoperative width of the calcaneum , B?hler angle, and Gissane angle were significantly improved than before operation (P=0.000). Conclusion Open reduction and internal fixation via sinus tarsi approach is a simple and effective method for minimally invasive treatment of Sanders type Ⅱand Ⅲintra-articular calcaneum fractures .

Effects of rhubarb on the intestinal barrier function of patients with acute myocardial infarction-heart / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To clarify the intestinal barrier function (IBF) state of patients with acute myocardial infarction-heart failure (AMI-HF), and to compare the therapeutic effects of rhubarb and Pantoprazole (proton pump inhibitor).</p><p><b>METHODS</b>Enrolled were 107 AMI patients from ICU, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from May 2008 to April 2010. Of them, 47 AMI patients without HF were recruited as the control group, while 60 AMI-HF patients were randomly assigned to the rhubarb group (30 cases, treated by rhubarb + Pantoprazole) or the Pantoprazole group (30 cases, treated by Pantoprazole + routine treatment). All patients were treated till the 14th day of the onset. The fecal occult blood (FOB) test was performed daily. The occurrence of the digestive tract hemorrhage on the 14th day after onset was compared. The N-terminal pro-brain natriuretic peptide (NT-proBNP), serum D-lactic acid, plasma glutamine (Gln), endotoxin and cytokines [high sensitive C reaction protein (hsCRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10)], and heart function were compared among the three groups before and after treatment.</p><p><b>RESULTS</b>There was no statistical difference in the case number of using aspirin, clopidogel, low molecular weight heparin, ACEI/ARB, statins, insulin, and antibiotics among the 3 groups. The case number of using beta-blocker was obviously lower in the two medication groups than in the control group (P < 0.05). The case number of using diuretics was obviously higher in the two medication groups than in the control group (P < 0.05). There was no statistical difference in the incidence of digestive tract hemorrhage (P = 0.413). Compared with the control group before treatment, Gln and ejection fraction (EF) were both lowered, NT-proBNP, D-lactic acid, endotoxin, hsCRP, TNF-alpha, and IL-10 increased in the two medication groups (P < 0.01). There was no statistical difference in each index between the two medication groups (P > 0.05). Compared with before treatment, NT-proBNP, D-lactic acid, endotoxin, hsCRP, TNF-alpha, and IL-10 decreased in the Pantoprazole group (P < 0.01), and no obvious change in Gin or EF was found (P > 0.05). Gin and EF increased in the rhubarb group after treatment, and they were higher than those of the control group. Blood NT-proBNP, D-lactic acid, endotoxin, hsCRP, TNF-alpha, and IL-10 decreased in the rhubarb group after treatment, showing statistical difference when compared with the control group (P < 0.01, P < 0.05).</p><p><b>CONCLUSIONS</b>Impaired IBF and endotoxemia existed in AMI-HF patients. Rhubarb not only could prevent the digestive tract hemorrhage, but also could reduce endotoxemia, inhibit inflammatory reactions, and improve the heart function through ameliorating the IBF.</p>

Effects of behind legs vibrations on erectile function in male rabbits / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effects of behind legs vibrations on erectile function in male rabbits through the concentration of plasma reproductive hormone and the expression of nitric oxide synthase (eNOS), endothelin-1 (ET-1) mRNA in vibrated male rabbits.</p><p><b>METHODS</b>30 male adult rabbits were assigned randomly to A group (vibration power: 3.02 m/s(2)), B group (vibration power: 6.13 m/s(2)), C group (vibration power: 12.26 m/s(2)) and control group. The concentration of expression of eNOS, ET-1 mRNA were measured with RT-PCR after rated for 30 days.</p><p><b>RESULTS</b>(1) Compared with 0 days vibration, after exposure to vibration for 10, 20, 30 days, the A, B, C group concentration of plasma T, LH are much lower (P < 0.05), the concentration of plasma E2 is much higher. (2) Compared with control group after exposed for 30 days, the expression of ET-1 mRNA [B group:(17.39 +/- 4.59) x 104; C group: (36.21 +/- 13.13) x 104 ] were much higher and expression of eNOS mRNA [A group: (19.11 +/- 6.83) x 104; B group: (11.86 +/- 3.15) x 104; C group: (4.68 +/- 3.26) x 104] was much lower, there were significant differences (P < 0.01).</p><p><b>CONCLUSIONS</b>The vibration of behind legs in rabbits resulted the concentration of plasma T, LH are much lower, the concentration of plasma E2 is much higher, increased the expression of eNOS mRNA, decreased the expression of eNOS mRNA, then vary the erectile function.</p>

Effect of human bone marrow mesenchymal stem cells on allogeneic regulatory T cells and its possible mechanism / 中国实验血液学杂志

The study was purposed to investigate the immune regulatory effects of human bone marrow mesenchymal stem cells (hMSCs) on Foxp3 expressing CD4(+)CD25(+) regulatory T cells and to explore the mechanism of immune modulation by hMSCs. Human MSCs were isolated and expanded from bone marrow cells, and identified with cell morphology, and the phenotypes were assessed by immunohistochemistry. Human peripheral blood mononuclear cells (hPBMNCs) were prepared by centrifugation on a Ficoll Hypaque density gradient. The hMSCs (1 x 10(3), 1 x 10(4), 1 x 10(5)) were added into wells containing hPBMNCs (1 x 10(6)) from an unrelated donor in the presence of rhIL-2. After 5 days of co-culture, the percentage of CD4(+)CD25(+) T cells was detected by flow cytometry. T cell proliferation was assessed by [(3)H] thymidine incorporation using a liquid scintillation counter. The expression of Foxp3 in CD4(+)CD25(+) T cells was detected by reverse transcription polymerase chain reaction (RT-PCR). Cytokines (TGF-beta, IL-12, IFN-gamma, IL-10) concertrations of cultured supernatants were measured with ELISA. The results indicated that in all the experiments, the presence of hMSCs with hPBMNCs resulted in a statistically significant decrease in T cell proliferation, in dose-dependent manner. The increase of percentage of CD4(+)CD25(+) T cells in the peripheral CD4(+) T cell was observed after coculturing lymphocytes with hMSCs (p < 0.01). The expression of Foxp3-mRNA (Foxp3/beta-actin) in hMSCs groups was significantly higher than that in the control and was negatively associated with the value of CPM representing T proliferation. The levels of TGF-beta and IL-10 were higher in hMSCs groups than that in the control, and the levels of TGF-beta and IL-10 correlated positively with Foxp3-mRNA expression and the percentage of CD4(+)CD25(+) T cells. However, the secretion of IL-12 and IFN-gamma was significantly attenuated by hMSCs coculture, and there was no correlation with Foxp3-mRNA expression and the percentage of CD4(+)CD25(+) T cells. It is concluded that the Foxp3 expressing regulatory T cells may play an important role in the immune regulatory by hMSCs. Its mechanism is related to that the hMSCs-mediated TGF-beta and IL-10 convert CD4(+)CD25(-) T cells into CD4(+)CD25(+) T regulatory T cells, which specifically inhibits the proliferation of T cells.

Mechanism of the angiogenic effect of bone marrow stromal cells implantation on acute myocardial infarction / 中国应用生理学杂志

<p><b>AIM</b>To study the mechanism of the therapeutic angiogenesis effect of bone marrow stromal cells (BMSCs) implantation on rat acute myocardial infarction models.</p><p><b>METHODS</b>The rat acute myocardial infarction models were made by coronary artery ligation and divided into 2 groups at random. In the experiment group, twice passaged BMSCs were labeled with BrdU and then implanted into the infarction region of the recipients in 4 weeks. The control group was the model rats received only DMEM injection. In control group, the hearts were harvested on the day 3, 7, 14, 28, 42 and 56. The infarction regions were examined to identify the angiogenesis and the expression of the VEGF and bFGF. In experiment group, the hearts were examined on the day 42 and 56 after AMI (the day 14 and 28 after cells implantation).</p><p><b>RESULTS</b>Viable cells labeled with BrdU could be identified in host hearts. Histologic examination found most donor cells within the infarction region expressed fibroblastic and endothelial phenotype. The transplantation regions had a greater capillary density than the control regions did (14 +/- 4.7/HPF vs 6 +/- 2.4/HPF, P < 0.05). In the control group, the expression of VEGF and bFGF within the infarction regions peaked on day 7, and then decreased over time. In the experiment groups, the expression of bFGF and VEGF on the day 42 and 56 had a higher level than the control group did.</p><p><b>CONCLUSION</b>The expression of VEGF and bFGF is significantly increased after cells therapy during the late phase of AMI. It indicates that BMSCs implantation promoted the angiogenesis is mediated by its differentiation into endothelium and the increased release of VEGF and bFGF.</p>

Epidemiological survey of chronic vascular complications of type 2 diabetic in-patients in four municipalities / 中国医学科学院学报

<p><b>OBJECTIVE</b>To provide an epidemiological description and risk factors of chronic vascular complications of type 2 diabetic in-patients in four municipalities including Beijing, Shanghai, Tianjin, and Chongqing.</p><p><b>METHODS</b>Data of the study came from 3,469 Type 2 diabetic in-patients from 1991 to 2000 in 10 medical centers of Beijing, Shanghai, Tianjin, and Chongqing. A variety of parameters of in-patients were evaluated retrospectively to know the prevalence and risk factors of chronic vascular complications in the study patients.</p><p><b>RESULTS</b>Overall, the detailed prevalence of chronic vascular complications is listed as follows: diabetic retinopathy 31.5%, diabetic nephropathy 39.7%, diabetic neuropathy 51.1%, hypertension 41.8%, coronary heart disease (CHD) 25.1%, cerebral vascular disease (CVD) 17.3%, vessel complication of lower limbs 9.3%. Multivariate logistic regression analysis shows that diabetes family history, duration of diabetes (> 5 years), and systolic blood pressure (> 125 mmHg) are the risk factors for diabetic retinopathy; duration of diabetes (> 5 years), systolic blood pressure (> 125 mmHg), LDL-C (> 3.12 mmol/L), and triglyceride (> 1.70 mmol/L) are the risk factors for diabetic nephropathy; age (> 45 years), duration of diabetes (> 5 years), HbA1C (> 7.0%), systolic blood pressure (> 125 mmHg), and LDL-C (> 3.12 mmol/L), are the risk factors for CHD; age (> 45 years), duration of diabetes (> 5 years), systolic blood pressure (> 125 mmHg), and triglyceride (> 1.70 mmol/L) are the risk factors for CVD.</p><p><b>CONCLUSION</b>In order to improve patients' outcome, multiple metabolic controls in type 2 diabetic patients are urgently needed, which include decreasing glycemia, reducing hypertension and improving lipid levels.</p>

Establishment of a model of the vascular endothelial cell injury in SD rats / 中国临床药理学与治疗学

Aim To establish a model of the vascular endothelial cell (VEC) injury in SDrats.Methods SD rats were randomly divided into the control and the modelgroups. The model rats were injected with adrenaline diluted to 2. 5 times 0. 05 mg?100 g-1 (tid) for 5 d continously. From the 4th d, they were irritated for 5 min in the0℃ cold-water in the middle between adrenaline injections.The control rats weregiven 0. 9% NS as above. At 6th d, blood samples were taken from carotid arteries ofthe rats and the CEC counts, t - PA、PAI activities, 6-keto-PGF1? concentrations andthe platelet aggregation rate(max) were detected respectively. Results In the modelgroup, as compared with those in the control group, t - PA activity and 6-keto-PGF1?concentration decreased significantly(P