ABSTRACT
AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.
ABSTRACT
AIM: To explore the dynamic expression of high mobility group box 1(HMGB1)in scar tissues after glaucoma drainage valve implantation, and to further reveal the role and possible mechanism of HMGB1 in scarring after glaucoma surgery.METHODS: A total of 60 New Zealand white rabbits were randomly divided into control group(n=20), model group(n=20, silicone implantation under conjunctival sac)and model with drug administration group(n=20, silicone implantation under conjunctival sac combined with 5-fluorouracil injection). The conjunctival tissues were collected at 4 and 8 wk after surgery. HE staining and Masson staining were used to detect the proliferation and distribution of fibroblasts and collagen fibers in conjunctival tissues. Immunohistochemistry was utilized to detect the distribution and changes of HMGB1, transforming growth factor(TGF)-β1, Smad3 and α-smooth muscle actin(SMA)in conjunctival tissues. RT-PCR and Western blot were adopted to detect the mRNA and protein expression of HMGB1, TGF-β1, Smad3 and α-SMA in conjunctival tissues.RESULTS: HE staining and Masson staining showed that the proliferation of inflammatory cells, fibroblasts and collagen fibers in the model group was significantly higher than that in the control group at both 4 and 8 wk. Meanwhile, the proliferation of fibroblasts and collagen fibers in the model with drug administration group was significantly lower than that in the model group. Immunohistochemical staining showed that the expression of HMGB1, TGF-β1, Smad3 and α-SMA protein was observed in the conjunctival tissues of the model group both 4 and 8 wk, with brown and significantly deeper staining of the model group at 8 wk. Meanwhile, the positive staining in the model with drug administration group at both 4 and 8 wk was significantly lower than that in the model group. There was positive correlations between the number of fibroblasts stained with HE and the expression of HMGB1 in the conjunctival tissue of the model group at both 4 and 8 wk(r=0.602, 0.703, all P<0.05). RT-PCR and Western blot revealed that the mRNA and protein expression levels of HMGB1, TGF-β1, Smad3 and α-SMA in the model group were significantly higher than those in the control group at both 4 and 8 wk(all P<0.05). Meanwhile, the mRNA and protein expression levels of HMGB1, TGF-β1, Smad3 and α-SMA in the model with drug administration group were significantly lower than those in the model group(all P<0.05). There was positive correlations between mRNA expressions of HMGB1 and TGF-β1, Smad3 in the model group and the model with drug administration group(all P<0.05).CONCLUSION: The expression of HMGB1 increased at a time-dependent manner after glaucoma valve implantation. HMGB1 acts an indispensable role in the initiation and progression of scar formation after glaucoma surgery, which may be involved in the regulation of TGF-β/Smad signaling pathway.
ABSTRACT
Objective:To investigate the clinical efficacy and safety of laparoscopically assisted ventriculoperitoneal shunting for the treatment of hydrocephalus in older adult patients.Methods:Sixty-four older adult patients with hydrocephalus who received treatment in Yiwu Fuyuan Private Hospital from June 2017 to December 2019 were included in this study. They were randomly divided into study and control groups, with 32 patients in each group. The control group was given ventriculoperitoneal shunting and the study group was given laparoscopically assisted ventriculoperitoneal shunting. The Fugl-Meyer assessment of motor recovery, the activity of daily life score, hydrocephalus grading score, excellent and good efficacy rate, and incidence of complications were compared between the two groups.Results:After treatment, the Fugl-Meyer score and activity of daily life score in the study group were (77.05 ± 18.54) points and (84.83 ± 17.75) points, which were significantly higher than (63.25 ± 16.18) points and (63.76 ± 15.04) points in the control group ( t = 3.17, P = 0.002; t = 5.12, P < 0.001). Hydrocephalus grading score in the study group was significantly lower than that in the control group [(3.77 ± 2.41) points vs. (6.61 ± 2.75) points, t = 4.39, P < 0.001]. Excellent and good efficacy rate in the study group was significantly higher than that in the control group [93.75% (30/32) vs. 75.00% (24/32), χ2 = 4.26, P < 0.05]. The incidence of complications in the study group was significantly lower than that in the control group [9.38% (3/32) vs. 40.63% (13/32), χ2 = 8.33, P < 0.005]. Conclusion:Laparoscopically assisted ventriculoperitoneal shunting can accurately locate the catheter and is more effective in the treatment of hydrocephalus in older adult patients compared with ventriculoperitoneal shunting. It can accelerate the recovery of neurological function and is highly safe.
ABSTRACT
Objective: To observe the clinical effect of clustered non-invasive mechanical ventilation strategy in the treatment for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with hypercapnia encephalopathy(HE) so as to evaluate the safety and effectiveness of the scheme. Methods: According to the inclusion criteria, 164 patients with AECOPD complicated with HE were divided into the observation group(74 cases) and the control group (90 cases) as the random method. The patients of observation group were treated with clustered non-invasive ventilation(NIV), and the patients of control group were treated with invasive mechanical ventilation(IMV). The blood gas indexes of the two groups before and after 2 hours of treatment were observed, and the improved situations of the two groups were evaluated by KPS score. Besides, the hospitalization time and the mechanical ventilation time of the two groups were observed, and the incidence of adverse events and case fatality rate of 1 year in the two groups were counted and analyzed, and the reliability of the clustered NIV scheme was further evaluated. Results: Before treatment, there were no significant differences in pH, oxygenation index(PaO2/FiO2), partial pressure of carbon dioxide in artery (PaCO2) level and KPS score between the two groups(t=1.021, t=1.301, t=0.985, t=1.017, P>0.05). Although these indicators were obviously improved after these patients of two groups were treated, the differences of them between before and after treatment were no significant(t=2.017, t=1.825, t=1.163, t=1.520, P>0.05). On the other hand, the differences of time of mechanical ventilation, the hospitalization time and the times of intubation between the observation group and the control group were significant(t=7.018, t=8.523, t=7.954, P<0.05). In the observation group, there were 12 cases were failure, and 4 patients died in hospital, while the number of died in hospital were 18 cases in control group, and the difference of the number of died in hospital between the two groups was significant(x2=5.631, P<0.05). Besides, the difference of complication between the two groups was significant(x2=7.014, P<0.05). And the difference of case fatality rate of 1 year between the two groups was no significant. Conclusion: It is safe and effective for patients with AECOPD complicated with HE to implement cluster noninvasive mechanical ventilation strategy on the basis of meeting the condition of non-invasive mechanical ventilation. And it has clinical application value.
ABSTRACT
Aim To investigate the effect of sevoflurane preconditioning on spinal cord ischemia-reperfusion in-jury ( SCIRI ) of miR-199a-5p in rats. Methods Twenty-four SD rats were randomly divided into: group of sham ( Sham group) , group of ischemia-reperfusion ( I/R group ) , and group of sevoflurane and control ( SEVO+I/R group) . Sham group received the same operation, but did not inhale sevoflurane or close the aortic arch; SCIRI model was established after 14 min of the aortic arch of the non-invasive arterial clip in I/R group. SEVO+I/R group, before the establishment of SCIRI model, was inhaled 2.4% sevoflurane for 3 h. Basso Beattie Bresnahan scoring method was used to evaluate neuromotor function and TUNEL staining to observe apoptosis. Evans blue ( EB) was used to de-termine blood-spinal cord barrier ( BSCB) permeabili-ty; real-time qPCR to detect miR-199a-5p content;Western blot to measure the levels of caspase-9 and Bcl-2 in spinal cord tissues. Results Compared with sham group, the score of neuromotor function in I/R group decreased, cell apoptosis rate increased, BSCB permeability increased, miR-199a-5p expression de-creased, caspase-9 expression increased, and Bcl-2 expression decreased; compared with I/R group, the neurological motor function score of SEVO+I/R group increased, the apoptotic rate decreased, the BSCB per-meability decreased, the expression of miR-199a-5p increased, the expression of caspase-9 decreased, and the expression of Bcl-2 increased. Conclusion Sevoflurane pretreatment may reduce BSCB permeabili-ty and neuronal apoptosis by up-regulation of miR-199a-5p and protection of SCIRI in rats.
ABSTRACT
Background Experimental autoimmune uveitis (EAU) is a common animal model of uveitis.Natural killer (NK) cells have been confirmed to be a type of strong inflammation-causing cells,but its role in EAU is still studing.Objective This study was designed to explore the role and mechanism of NK cells in the pathogenesis of EAU.Methods Thirty-six SPF Lewis rats were randomly divided into expeimental control group and EAU 6-,9-,12-,16-,and 21-day groups (6 rats for each group).Rats in EAU group received subcutaneous injection interphotoreceptor retinoid binding protein (IRBP) combining 5 mg/ml tubercle bacillus with complete Freund's adjuvant (CFA) emulsion in foot pads,and then 400 ng pertussis toxin was intraperitoneally injected to extablish EAU models in the EAU 6-,9-,12-,16-,and 21-day group,and normal saline solution combined with CFA and 400 ng pertussis toxin was used in the same way in the experimental control group.The inflammatory response was observed by slit lamp daily after modeling and scored based on Caspi criteria.The eyeballs were extracted in 6,9,12,16 and 21 days after modeling for retinal histopathological examination,Immunofluorescent double-staining was employed to detect and locate the expression of NK cells in the retina.In addition,25 model rats were divided into EAU 0-,3-,6-,9-and 12-day groups,with 5 rats for each group,and eyeballs were extracted to prepare tissue homogenate.The expression of CXCL10 mRNA,and CXCL12 mRNA NK cell chemokines,in the tissue homogenate was assayed by real-time quantitative PCR.The use and care of the rats followed Regulations for the Administration of Affair Concerning Experimental Animal by State Science and Technology Commission.Results No inflammatory sign in ocular anterior segment of the rats was seen in the experimental control group.The expansion of rat iris vessels was found in the EAU 6-day group,and exudes and hypopyon of the anterior chamber occurred in the EAU 9-day group and the inflammation peaked in the EAU 12-day gorup.The rat retinal structure was normal in the experimental control group,and the arrangement disorder of retinal structure,the cell separation in outer nuclear layer and damage of photoreceptors were found under the optical microscope in different degree in various EAU groups,with the most serious change in the EAU 12-day group.Immunofluorescent double staining showed normally arranged nucleus in the experimental control group,and a lot of NK infiltration was seen in the EAU 6-day group and peaked in the EAU 9-day group.The expression level of CXCL10 mRNA in the EAU 9-day group was 34.298 ± 16.689,which was significantly higher than that in the EAU 3-,6-and 12-day group,respectively (1.390 ± 0.660,3.359 ± 2.581,4.711 ±1.387) (all at P＜0.01).No significant differences were found in the relative expression of CXCL12 mRNA among different EAU groups (F=2.851,P＞0.05).Conclusions Retinal NK cell infiltration occurs in the early stage of EAU,and the severity of NK cell infiltration is consistent with the inflammatory process and CXCL10 expression,suggesting NK cells play an important role in the early stage of EAU,and CXCL10 is an important chemokine of NK cells in EAU rats.
ABSTRACT
Imatinib has been recognized as the frontline therapy drug in chronic myeloid leukemia (CML), however, only limited patients could achieve complete molecular remission (CMR). Recent clinical and basic proofs indicated an improved treatment outcome by the combination of interferon and Imatinib. This study was purposed to evaluated systematically the efficacy and safety of interferon plus Imatinib in patients with CML. Data from relative clinical trials were from clinical trial of gov and Cochrane Collaboration. A comprehensive literature search was performed from data bases such as pubMed and EM. The results indicated that 7 clinical trials and 12 research papers met the criteria enrolled in study, included 697 cases in total. The combination group had higher complete cytogenetic remission (CCgR) rate than imatinib alone at 6 months (58% vs 42%; P = 0.0001) and 12 months (74% vs 68%; P = 0.004). The major molecular remission (MMR) rate was also higher in the combination group at 6 months (58% vs 34%; P = 0.0001) and 12 months (66% vs 47%; P < 0.0001). Furthermore, compared with single drug, the combination group had superior CMR rate at 6 months (13% vs 2%; P = 0.0002) and 12 months (14% vs 5%; P = 0.0009). The major adverse effects of combination therapy were rash, asthenia, edema and musculoskeletal events, and combination therapy was more prone to inducing neutropenia, thrombocytopenia and mild anemia. It is concluded that compared with Imatinib alone, the combination of interferon and Imatinib has better clinical efficacy in treating CML with earlier cytogenetic and molecular remission. It is also a safe therapy in spite of slightly weaker tolerance than single drug therapy.
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Benzamides , Imatinib Mesylate , Interferons , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Drug Therapy , Piperazines , Pyrimidines , Treatment OutcomeABSTRACT
Objective To explore the changes of the cardiac enzymes in the critical patients after operation and to analyze their relationship with the patient's condition level and the prognostic.Methods Fittyseven critical patients after operation were enrolled to observation group,and 55 small operation patients acted as control group.Their cardiac enzymes in three days after operation were detected and compared.Results The cardiac enzymes of the observation group increased significantly when compared with the control group(aspartate aminotransferase (AST) (153.1 ± 211.0) U/L vs (54.7 ± 39.0) U/L,t =3.404,P ＜ 0.01) ; lactic acid dehydrogenase(LDH) (381.0 ± 216.1) U/L vs (194.6 ± 75.3) U/L,t =6.050,P ＜ 0.01) ; creatine kinase (CK) (882.9 ±630.7) U/L vs (130.1 ± 71.8) U/L,t =8.796,P ＜0.01) ;creatinine kinase,MB isoenzyme (CK-MB)(314.3 ± 164.2) U/L vs (164.9 ± 87.7) U/L,t =5.979,P ＜ 0.01) ; α-hydroxybutyrate dehydrogenas(α-HBDH) (410.1 ± 327.6) U/L vs (27.8 ± 36.3) U/L,t =8.605,P ＜ 0.01) ; The fatality ratio was 24.6％ (14/57) in the observation group.The cardiac enzymes of the survival group existed significant difference compared with the death group(AST:(81.3 ± 40.5) U/L vs (373.6 ±342.1) U/L,t =5.585,P ＜0.01) ;LDH:(303.6±134.0) U/Lvs (618.6±250.1) U/L,t=6.064,P＜0.01) ;CK:(658.5±328.0)U/Lvs (1572.0±829.4) U/L,t =6.001 P＜0.01) ;CK-MB:(303.2±184.3) U/Lvs (738.6±445.6)U/L,t=5.242,P＜0.01) ;α-HBDH:(254.1±118.6) U/Lvs (499.3 ±147.6) U/L,t=6.320,P＜0.01).Conclusion Elevated myocardiac enzymes are common in the critical patients after operation.The change of the cardiac enzymes is related with the degree of disease and the wound.
ABSTRACT
Interrupted aortic arch is a rare congenital vascular malformation associated with a high mortality rate in infancy, and is therefore very unusual in adults. We report a case of interrupted aortic arch in a 42-year-old male hypertensive patient who was found to have a disruption of aorta continuity distal to the left subclavian artery with massive collateral circulation into the descending aorta by computed tomography angiography. The patient was discharged after the blood pressure was controlled by antihypertensive therapy. This case suggests the necessity of careful auscultation for young patients with hypertension. Once murmur in the chest and back is heard, computed tomography angiography should be performed at once to avoid missed diagnosis and misdiagnosis.
Subject(s)
Adult , Humans , Male , Aorta, Thoracic , Pathology , Aortic Diseases , HypertensionABSTRACT
Objective of this study was to evaluate the effectiveness and safety of autologous cytokine induced killer (CIK) cells combined with IL-2 in treatment of elderly patients with myelodysplastic syndromes (MDS). Peripheral blood mononuclear cells were isolated from 6 elderly MDS patients and were stimulated by cytokines in vitro to form CIK cells. The autologous CIK cells were then infused back into the corresponding patients. The regimen was repeated every 4 weeks. Effector cell proportion changes, adverse effects, effects on inflammation, hemoglobin level and blood transfusion were assessed after treatment. The results showed that after autologous CIK cell infusion, the percentages of CD3(+), CD3(+)CD8(+) and CD3(+)CD56(+) increased significantly (p < 0.05). No severe adverse effects were observed in all patients. It also significantly reduced inflammation frequency and shortened high fever duration. During stable stage of disease, the CIK cell infusion could reduce the red blood cell infusion amount and stabilize hemoglobin level. However, the natural course of transformation from myelodysplastic syndromes to high-risk subtypes could not be changed by CIK cell treatment. It is concluded that the autologous CIK cell infusion is a safe and effective therapy for geriatric myelodysplastic syndrome.
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Cytokine-Induced Killer Cells , Immunotherapy, Adoptive , Lymphocyte Transfusion , Myelodysplastic Syndromes , TherapeuticsABSTRACT
Objectives To investigate the effect of carbon dioxide pneumoperitoneum on postoperative cognitive dysfunction and the level of serum NSE and S-100β protein in female patients undergoing gynecological laparoscopy. Methods 60 ASA physical status Ⅰ patients were divided two groups, group Ⅰ received no insufflation andconventional abdominal surgery ( n = 30) and group Ⅱ received abdominal insufflation and gynecological laparoscopy ( n =30). MMSE was recorded at several different time points, including one day before operation, 1, 6, 24, 48, 72h after operation, and before discharge. Serum S-100β protein and NSE was measured by ELISA before the beginning of operation ( or carbon dioxide pneumoperitoneum) and 1h after operation (or carbon dioxide pneumoperitoneum). Results MMSE values at 1,6,24,48,72h decreased significantly in group Ⅱ (24. 67 ± 1.47,25.97 ± 1.50,26. 77 ± 1.61,27.07 ± 1.87,27.37 ± 2. 06) after operation, compared with group Ⅰ (27.63 ± 1. 33,27.27 ± 0. 87,28.37 ± 0. 85,28.73 ±0. 78,29. 23 ±0. 86, P <0. 01 ). And the baseline value (29. 17 ±0. 76) of serum S-100β[(0. 114 ±0. 012,0. 086 ±0. 009) μg/L] protein and NSE [( 13. 720 ± 1. 330,12. 093 ±0. 697) μg/L] increased significantly at 1h after operation in group Ⅰ and Ⅱ compared with before operation [(0. 035 ±0. 030,0. 035 ±0.024;5.753±0.889,5.831 ±0.967)μg/L, P <0.01]. Serum S-100 β protein[(0. 114 ±0.012) μg/L] increased significantly at 1h after operation in group Ⅱ, compared with group Ⅰ [(0. 086 ±0. 009) μg/L,P < 0. 05], whereas NSE showed not difference [( 12. 093 ± 0. 697,13. 720 ± 1. 330) μg/L, P > 0. 05].Serum of S-100β protein and MMSE were significantly correlated w group Ⅰ and Ⅱ ( r = 0. 6412,0. 8126, P <0.01). Serum NSE was not correlated with the MMSE score in group Ⅰ ( r =0.4397, P >0.05),whereas NSE and MMSE had significant correlation in group Ⅱ ( r = 0. 7111, P <0. 01 ). Conclusions Carbon dioxide pneumoperitoneum in patients with gynecological surgery might affect postoperative cognitive function, and MMSE score was negatively correlated with serum S-100β and NSE proteins.
ABSTRACT
· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.
ABSTRACT
Aim To study the effect of polysaccharides from Gastrodia elata Blume(GEP) on levels of superoxide dismutase(SOD),malondialdehyde(MDA) and nitric oxide(NO);and the retinal morphology after rat retina ischemia reperfusion injury.Method Retinal ischemia was induced in SD rats by increasing the intraocular pressure to 16 kPa for 60 min via cannulation into the anterior chamber.SD rats were divided into five groups randomly: Small dose GEP group,Middle dose GEP group,Large dose GEP group,Vitamin E group and Negative contral group.At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD,MDA and NO in rat retinas were measured,and histopathologic changes were observed.Results At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD in rat retinas in middle,large dose GEP groups were significantly higher than that in negative control group(P