ABSTRACT
The normal function of vascular endothelial cells is an important foundation for maintaining vascular permeability， restricting inflammatory activities of the vascular wall， and balancing the coagulation and fibrinolytic system. Endothelial dysfunction caused by persistent damage from pathological factors is considered as an early and prominent event of diabetic macroangiopathy. In traditional Chinese medicine， the classical theory of "restraining excessiveness to acquire harmony" was originally a condensed generalization of the rule of generation， restriction， replacement and evolution in the natural world， revealing the internal regulation mechanism of the stable operation of things. Then it gradually evolved into an important rule to explain the physiological phenomena and pathological mechanism of human body and guide the treatment. Corresponding to the nature， the body homeostasis also requires to achieve a state of strong viscera function and inexhaustible Qi and blood generation under the rule of restriction and generation. The pathogenesis of diabetic macroangiopathy is the process of "the predominant one failing to restrict and the hyperactive one becoming harmful". The loss of restriction and generation of the five organs leads to powerless Qi transformation and， as a result， the Qi， blood and body fluid cannot be dispersed. Therefore， the Qi， blood and body fluid turn into phlegm and blood stasis， such as glucose and lipid metabolism disorder， oxidative stress， inflammatory response and high blood viscosity， and finally block the veins. Excessive phlegm and blood stasis cannot be resolved， instead they become harmful and invade the blood vessel， causing endothelial dysfunction and further resulting in diabetic macroangiopathy. Under the guidance of the theory of "restraining excessiveness to acquire harmony"， the method of "harmonizing viscera， eliminating pathogen and removing turbidity" can effectively regulate the function of vascular endothelial cells， thus playing a positive role in preventing and treating diabetic macroangiopathy. The mechanism may be related to reducing oxidative stress， inhibiting inflammation， limiting vascular smooth muscle proliferation， and reducing platelet adhesion.
ABSTRACT
A good neural microenvironment is an important basis for improving the damaged nerves and promoting axonal repair and regeneration. The destruction of neural microenvironment， closely related to the lack of neurotrophic factors， microcirculation disorders and immune abnormalities， is the key pathogenesis leading to diabetic peripheral neuropathy （DPN）. In traditional Chinese medicine， disharmony between Ying and Wei is considered as the key pathology in the development of DPN. It may be manifested as Ying and Wei deficiency， or Ying and Wei impassability， or Ying， Wei， Qi and blood intersection disorders， all of which may cause body fluid condensed into phlegm， blood into blood stasis， further leading to the mutual knot of phlegm and blood stasis， meridian obstruction， numbness and pain of limbs. "Regulating Ying and Wei and tonifying spleen and stomach" is the main therapeutic idea to promote intersection between Ying and Wei and unblock Qi and blood. The method has a significant effect on DPN. However， the current studies on the mechanism of regulating Ying and Wei in the treatment of DPN are still in lack of in-depth discussion， and the studies are mostly limited to the microcirculation disorders. Numerous studies have confirmed that the courses and distribution， physiological characteristics， functions of Ying and Wei are closely related to nerve， immune， metabolic substances and microcirculation. Based on the modern medicine essence of Ying and Wei， the author thinks that the discussion on connotation of the Ying and Wei from the perspective of neural microenvironment has a scientific basis， and regulating Ying and Wei is not only inherited from the traditional Chinese medicine theory， but also conforms to the modern understanding on DPN pathogenesis and treatment. Regulating Ying and Wei and smoothing middle-jiao can improve neural microenvironment and give play to the role of restoring damaged nerve， and its mechanism may be related to regulating neurotrophic factors， immune active substances， metabolites， and microcirculation dysfunction.
ABSTRACT
The gut microbiota and its metabolites play a critical role on health maintenance, because they are involved in the absorption and metabolism of nutrients in the human bodies. This is also similar to traditional Chinese medicine (TCM) view that the ascending and descending of Qi movement affects Yin-Yang, Qi-blood, pneuma and body fluid, viscera and meridians of our bodies. More and more studies have demonstrated that gut microbiota is closely related to the development and progression of diabetes and its complications. Gut microbiota disorder could affect host metabolic signaling pathways, thereby promoting the formation and development of diabetes. The smooth ascending and descending of Qi movement is the basic form of maintaining host metabolic homeostasis, whose dysfunction however can lead to internal environment disturbance. Based on the theory of ascending and descending of Qi movement, this paper focuses on the pathogenesis of imbalanced intestinal flora in the process of the induction of diabetes mellitus from a dynamic perspective. It is assumed that the imbalance of Qi ascending and descending may act as a trigger for such symptoms as lung Qi impairment, spleen deficiency to dissipating essence, liver Qi stagnation and kidney Yang deficiency. Under this circumstance, gut microbiota will be out of balance, which will further lead to the nutrient substance metabolic disturbance in the body, and thus induce diabetes. Thus, it is significant to explore the regulatory mechanism of gut microbiota and its metabolites on diabetes based on the theory of ascending and descending of Qi movement, so as to reveal the scientific connotation of TCM in regulating substance metabolism homeostasis in the body.
ABSTRACT
The accommodating intraocular lens (AIOL) is designed to simulate the accommodation of the crystalline lens and satisfy patients by its ability to focus on an object at any distance independent of spectacles.However,near vision in the short-term or long-term future of some patients with AIOLs is not good in clinical practice and there is still no consistent conclusion as to whether they can restore sufficient accommodation.Most clinical evaluations of AIOL performance have been based on visual function, such as the testing of near visual acuity and subjective measurements of accommodation,but these tests may not determine whether the lenses are actually working according to the principle of their design.With the rapid development of imaging technologies, the performance of AIOLs can be observed from the perspective of morphology.This article described the biometry of the anterior segments in the subjects with AIOL during accommodation in order to understand the actual clinical effects of AIOLs.
ABSTRACT
Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.
ABSTRACT
Accommodation of the human eye ian extremely complex and dynamiprocess,which iaccomplished by the interaction between the central nervousystem and variouoculastructurethaare relevanto accommodation.Varioumechanismof accommodation have been puforward since the beginning of the 19th century,among which Helmhohz'theory ithe mosfamous.However,iistill challenged by othetheories.So far,the mechanism of accommodation hanobeen fully understood.The mosdirecmethod to study accommodation ito observe changein the biometry of the oculastructureduring accommodation,which ialso the mosobjective interpretation of accommodative mechanisms.The rapid developmenof imaging technologiein regardto ophthalmology makethipossible.Thiarticle aimto describe the use of variouimaging technologiein oculaaccommodative studiein vivo from the perspective of morphology.