ABSTRACT
AIM: To explore the clinical features, diagnosis and treatment experience and the distribution characteristics of pathogenic microorganisms of primary canaliculitis, and provide reference for its diagnosis and treatment. METHODS: Retrospective clinical study. A total of 119 cases(120 eyes)diagnosed as primary canaliculitis in the department of ophthalmology of Wuxi No.2 People's Hospital from June 2019 to February 2023 were included. The treatment methods were mainly divided into conservative treatment(removing canaliculus stones through lacrimal punctum combined with injecting antibiotic eye ointment into the tube)and surgical treatment. The inspection methods of pathogenic microorganisms included secretion smear microscopy and microbial culture.RESULTS: Primary canaliculitis was more common in middle-aged and older female, mainly manifested by long-term red eye and increased secretion; however, the majority was not accompanied by tearing. Totally, 118 cases(99.2%)had monocular disease, while 63 cases(63 eyes; 52.5%)had inferior lacrimal canaliculus disease. Laboratory examination: Among 119 cases(120 eyes), 4 cases(4 eyes)did not undergo laboratory examination, and the other 115 cases(116 eyes)were as follows: Gram staining microscopy of secretion smear showed that Actinomyces were detected in 102 cases(103 eyes; 88.8%), while no fungus was detected; Microbial culture: 85 cases(86 eyes; 74.1%)were positive for bacterial culture. A total of 111 bacterial strains were cultured, which contained 26 types of bacteria. Among them, 32 strains were aerobic(28.8%); 26 strains were anaerobic(23.4%); and 53 strains were facultative anaerobic(47.7%). The most common bacteria were streptococcus(20 strains), staphylococcus(13 strains), Propionibacterium(10 strains), and capnocytophaga(10 strains). Only 4 cases(4 eyes; 3.4%)of microbial cultures were positive for Actinomyces. Fungus was negative in all microbial cultures. Treatment: Of the 119 cases(120 eyes), 114 cases(115 eyes; 95.8%)were cured by conservative treatment of removing lacrimal canaliculus stones through lacrimal punctum and intracanalicular ointment infiltration(IOI), while 5 cases(5 eyes)were not effective in conservative treatment; however, all of them were cured after surgical treatment, and the cure rate for primary canaliculitis was 100.0%.CONCLUSION: The incidence of primary canaliculitis is low, and it is prevalent in middle-aged and older female. Single lacrimal canaliculus is more common, which could be missed and misdiagnosed in clinic. Actinomyces is the major pathogen observed mostly in mixed infections, with heterogeneous strains, mainly anaerobic or facultative anaerobic bacteria. Streptococcus and Staphylococcus are the most common whereas fungal canaliculitis is rare. The cure rate of primary canaliculitis is high after diagnosis, and IOI method is recommended as the initial treatment of canaliculitis.
ABSTRACT
At present, clinical interventions for chronic kidney disease are very limited, and most patients rely on dialysis to sustain their lives for a long time. However, studies on the gut-kidney axis have shown that the gut microbiota is a potentially effective target for correcting or controlling chronic kidney disease. This study showed that berberine, a natural drug with low oral availability, significantly ameliorated chronic kidney disease by altering the composition of the gut microbiota and inhibiting the production of gut-derived uremic toxins, including p-cresol. Furthermore, berberine reduced the content of p-cresol sulfate in plasma mainly by lowering the abundance of g_Clostridium_sensu_stricto_1 and inhibiting the tyrosine-p-cresol pathway of the intestinal flora. Meanwhile, berberine increased the butyric acid producing bacteria and the butyric acid content in feces, while decreased the renal toxic trimethylamine N-oxide. These findings suggest that berberine may be a therapeutic drug with significant potential to ameliorate chronic kidney disease through the gut-kidney axis.
ABSTRACT
Objective:To investigate the effect of catheterin-related antimicrobial peptides(CRAMP)on the damage of cardiac microvascular endothelial cells induced by high glucose.Methods:Adult mouse heart microvascular endothelial cells were isolated and cultured.A model of microvascular endothelial cell injury was established by high glucose culture.The endothelial cells were randomly divided into 4 groups as the following.In the control group, 27.5 mmol/L mannitol was given as isoosmotic control as compared with the high glucose group.In the high glucose group(HG group), cells were cultured with 33.3 mmol/L high glucose for 48 h, and then treated without CRAMP.In 0.15 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose for 48 h, followed by 0.15 mg/L CRAMP treatmen for 24 h. In the 0.5 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose treatment for 48 h, and then treated with 0.5 mg/L CRAMP for 24 h. Cell proliferation was examined by staining with CKK-8 cell counting kit.The secretion of inflammatory factors in microvascular endothelial cells was detected by ELISA kit.Reactive oxygen species assay kit detects the level of reactive oxygen species in cells.Cell apoptosis was detected by apoptosis kit.Tubule formation and tubule number were measured by cells cultured on the matrix glue membrane, then detected by microscopic observation.The nitric oxide(NO)test kit measures levels of NO.The expression of nitric oxide synthase(eNOS)was detected by western blotting.Results:The cell proliferation activity was significant lower in the HG group than in control group[(52.2±5.4)% vs.(100.0±7.3)%]. The cell proliferation activity was higher in the 0.15 and 0.5 mg/L CRAMP groups than in the HG group[(72.0±3.4)% vs.(52.2±5.4)%; and(84.2±5.8)% vs.(52.2±5.4)%( F=75.300, P<0.001)]. The expression of tumor necrosis factor-α was significantly higher in the HG group than in the control group and in 0.5 mg/L CRAMP group[HG group of(239.1±32.1)μg/L, the control of(22.1±3.7)μg/L, 0.5 mg/L CRAMP of(84.6±9.4)μg/L]( F=197.300, P<0.001). The level of reactive oxygen species was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(20.8±2.4)in HG group, (4.8±1.7)in control group, (10.2±1.5)in CRAMP group]( F=105.700, P<0.001). The number of apoptotic cells was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(21.2±3.1)% in HG group, (2.2±0.6)% in control group(9.5±1.2)% in CRAMP group]( F=141.900, P<0.001). The length and number of tubules were lower in the HG group than in control group and in CRAMP group[for the length: (87.8±9.1)μm in HG group, (337.0±37.2)μm in control group(206.5±16.3)μm in CRAMP group( F=160.800, P<0.001); for the number: (9.1±1.9)in HG group, (22.0±3.4)in control group, (16.8±2.2)]in CRAMP group( F=36.200, P<0.001)]. The level of NO was lower in the HG group than in control group and in CRAMP group[(0.25±0.05)in HG group, (1.05±0.16)in control group, (0.75±0.06)in CRAMP group( F=83.200, P<0.001)]. The protein expression and mRNA levels of endothelial nitric oxide synthase(eNOS)were lower in the HG group than in the control group and in CRAMP group[for eNOS protein: (0.07±0.03)in HG group, (0.81±0.05)in control group, (0.54±0.07)in CRAMP group, F=275.700, P<0.001; and for eNOS mRNA: (0.11±0.07)in HG group, (1.00±0.22)in control group, (0.57±0.12)in CRAMP group, F=50.600, P<0.001]. Conclusions:CRAMP protein can inhibit the damage of cardiac microvascular endothelial cells by increasing eNOS-mediated NO signal pathway.
ABSTRACT
The progression of hyperuricemia disease is often accompanied by damage to renal function. However, there are few studies on hyperuricemia nephropathy, especially its association with intestinal flora. This study combines metabolomics and gut microbiota diversity analysis to explore metabolic changes using a rat model as well as the changes in intestinal flora composition. The results showed that amino acid metabolism was disturbed with serine, glutamate and glutamine being downregulated whilst glycine, hydroxyproline and alanine being upregulated. The combined glycine, serine and glutamate could predict hyperuricemia nephropathy with an area under the curve of 1.00. Imbalanced intestinal flora was also observed. , , , , and other conditional pathogens increased significantly in the model group, while and , the short-chain fatty acid producing bacteria, declined greatly. At phylum, family and genus levels, disordered nitrogen circulation in gut microbiota was detected. In the model group, the uric acid decomposition pathway was enhanced with reinforced urea liver-intestine circulation. The results implied that the intestinal flora play a vital role in the pathogenesis of hyperuricemia nephropathy. Hence, modulation of gut microbiota or targeting at metabolic enzymes, , urease, could assist the treatment and prevention of this disease.
ABSTRACT
OBJECTIVE: To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11C-methionine positron emission tomography (11C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. MATERIALS AND METHODS: Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. RESULTS: The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. CONCLUSION: The combination of MRS and 11C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11C-MET PET approach in clinical applications.
Subject(s)
Humans , Diagnosis , Electrons , Glioma , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Methionine , Positron-Emission Tomography , Sensitivity and SpecificityABSTRACT
Objective To identify abnormal cerebral glucose metabolism characteristics in patients with corticobasal degeneration (CBD) using 18 F-fluorodeoxyglucose (FDG) PET imaging. Methods From January 2014 to January 2017, resting-state brain 18 F-FDG PET imaging was performed in 10 CBD patients (5 males, 5 females; average age: (63.4±6.2) years) and 20 age-matched healthy subjects (8 males, 12 female; average age: (63.6±6.2) years). Voxel-based statistical parametric mapping (SPM) was used to analyze images to obtain the CBD-related brain metabolic characteristics. The regional cerebral metabolic rate of glucose (rCMRglc) was compared between 2 groups by two-sample t test. Results Compared with healthy controls, CBD group demonstrated asymmetrically decreased glucose metabolism mainly in the cere-bral hemisphere opposite to the more clinically affected body side, including the superior, middle and inferi-or frontal gyrus, the precentral gyrus, the superior and inferior parietal lobule, the angular gyrus, the supra-marginal gyrus, the precuneus, the middle occipital gyrus, the middle and inferior temporal gyrus, Heschl gyrus, the fusiform gyrus, the insula and the thalamus. And relatively increased glucose metabolism was present in ipsilateral precentral and postcentral gyrus, hippocampus, insula and putamen, bilateral cerebel-lum, paracentral lobules and pontine. The rCMRglc in those regions was significantly different between CBD patients and healthy controls (t values: 4.236-9.044, all P<0.01). Conclusion The asymmetric cerebral glucose metabolism features in CBD based on 18 F-FDG PET imaging contribute to the differential diagnosis between CBD patients and healthy subjects.
ABSTRACT
Objective To investigate the effect of serum CYFRA21-1 and SCCAg levels on the prognosis of patients with cervical cancer radiotherapy.Methods 100 cases of cervical cancer were diagnosed by pathological examination in our hospital from October 2008 and October 2011,Using radioimmunoassay(RIA) in detection of serum CYFRA21-1 and SCCAg level,Pearson and Spearman correlation is used to study the relationship between serum CYFRA21-1 and SCCAg level and cervical cancer patients with clinical features,using the Cox regression model of CYFRA21-1 and SCCAg level and uterine cervix cancer death or recurrence and metastasis of the relationship.Results 100 cases of patients with cervical cancer,endpoint events in 21 cases,LNR4 patients appear higher risk of endpoint events about 44.3%,CYFRA21-1 and SCCAg levels were with cervical cancer patients with CA-125 values,tumor staging,depth of tumor invasion into positive correlation,and the age of patients,no significant correlation,tumor differentiation(P=0.013),serum CYFRA21-1 levels(P=0.02),serum SCCAg levels(P=0.03),depth of tumor invasion(P=0.04) is cervical cancer patients with endpoint events independent risk factors.Conclusion CYFRA21-1 and SCCAg levels were closely related to the prognosis of patients with cervical cancer radiotherapy.
ABSTRACT
Objective@#To study the feasibility of 18F-fluoro-L-dihydroxyphenylalanine positron emission tomography/Computed tomography (18F-DOPA PET/CT) scanning in the localization and differential diagnosing of focal versus diffuse form of pancreas lesions in patients with hyperinsulinemic hypoglycemia (HH).@*Method@#Twenty-four patients were diagnosed with HH between January, 2016 and February, 2017 in the Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children′s Hospital of Fudan University using an integrated clinical and biochemical diagnostic protocol, domestic 18F-DOPA PET/CT imaging technique were applied after MRI and ultrasound failed to detect pancreas lesions. Pancreas 18F-DOPA standardized uptake values (SUV) were measured, and pancreas′ lesions were dually analyzed via visual method and pancreas percentage SUV method. Among these patients, 9 patients received surgical pancreatic lesion resections, the correlations among surgical outcomes, histopathological findings and 18F-DOPA PET/CT scan results were analyzed.@*Result@#Seven patients were detected with focal form of pancreas lesions, the mean peak of SUV was 4.7±1.7(2.6-7.1), and 17 patients were found to have diffuse form lesions after 18F-DOPA-PET/CT scanning. Among the 24 cases, 9 patients (7 showed focal and 2 showed diffuse 18F-DOPA PET/CT pancreatic uptake)were euglycemic without any medical support after surgery; the resected pancreatic tissue histopathological results were consistent with that of PET/CT imaging. Only one patient, who responded to medical treatment before surgery, had temporary hyperglycemia after operation.@*Conclusion@#Domestic 18F-DOPA PET/CT could successfully locate and differentiate the pancreatic lesions and thus improve the success of surgery.
ABSTRACT
Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome.Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI,n=72),unstable angina pectoris group(UAP,n=76),and stable angina pectoris group(SAP,n=64).The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded.Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group,(154.42±16.50)ng/L in UAP group,and(143.87±9.80) ng/L in SAP group,with statistically significant differences (F =99.818,P =0.000).Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474,P =0.000;r=0.350,P=0.049).Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome (OR =1.049,P =0.022).The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887 ± 0.028 (P =0.000),with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L,sensitivity of 0.635,specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events[(168.57±7.24)ng/L vs.(156.92± 6.53) ng/L],with statistically significant difference (t =16.100,P =0.000).Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21,as an independent and effective marker,can predict acute coronary syndrome.
ABSTRACT
Objective To investigate the relationship between Clq/tumor necrosis factor (TNF)-related protein 9 (CTRP9)and coronary heart disease.Methods A total of 232 patients diagnosed with coronary heart disease(CHD)by coronary angiography at our hospital were selected as the CHD group,and 90 cases with normal coronary angiography served as the control group.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine serum CTRP9 levels.Results Serum CTRP9 levels were lower in the CHD patients than in the controls [(116.9±19.5)ng/ml vs.(142.3±17.9)ng/ml,t＝-5.404,P＝0.000].SerumCTRP91evelswere negatively correlated with body mass index,fasting plasma insulin,fasting blood glucose,insulin resistanceindex(IRI),triglyceride and TNF-α(r＝-0.230,-0.225,-0.267,-0.235,-0.230and-0.222,P＝0.017,0.011,0.002,0.010,0.011 and 0.022).Multiple logistic regression analysis revealed that uric acid,IRI,CTRP9,and TNF-α were independent influencing factors for CHD,of which CTRP9 was a protective factor for CHD occurrence(OR ＝ 0.907,95％C1:0.854～0.963,P＝ 0.001).Conclusions Decreased serum levels of CTRP9 are associated with coronary heart disease,indicating that CTRP9 may play a protective role in coronary heart disease occurrence.
ABSTRACT
With the widespread use of high-resolution spectral-domain OCT (SD-OCT) in clinical practice,one of the greatest progresses to the ophthalmologists is more dctailed image analyses of outer retina in the macular region.There are four clear hyper-reflective bands of outer retina in the SD-OCT images,instead of three bands in the time-domain OCT (TD-OCT),the bands from inner to external are external limiting membrane (ELM),inner segment/outer segment (IS/OS) junction,cone outer segment tips (COST),and retinal pigment epithelium (RPE),respectively.From a perspective of corresponding retinal histological structure,all of the three bands of ELM,(IS/OS) and COST are within the photoreceptor cells.Therefore,the integrity of the three bands correlates well with the status and function of photoreceptor cells.It is one of the hot topics to study the status and function,as well as injury and repair of the photoreceptor cells using SD-OCT.This article reviewed the relevant clinical studies about the three bands of ELM,IS/OS and COST,including macular hole (MH),idiopathic epiretinal membrane (IERM),rhegmatogenous retinal detachment (RRD) and age-related macular degeneration (AMD).
ABSTRACT
@#Carbon dots(CDs)were firstly prepared via a simple pyrolysis route using citric acid as the carbon precursor and glycine as modifier. The obtained CDs were further purified by n-butyl alcohol, which made the particle size more uniform and the fluorescence intensity stronger. When excited at 380 nm, the maximum emission wavelength of the CDs was about 480 nm, with a quantum yield of 47%. Based on fluorescence quenching, a novel method for chloramphenicol assay was developed with glycine-passivated CDs. This method is simple and rapid. A linear relationship between the change of fluorescence intensity and the concentration of chloramphenicol was obtained with a relation coefficient of 0. 999 7. The recovery was in the range of 99% to 101% with a relative standard deviation of 0. 3%, which shows CDs′ potential application in drug detection.
ABSTRACT
In either type 1 or type 2 diabetes,there is significant loss of β cell mass.Understanding the changing of β cell mass in the course of diabetes would provide important information for diagnosis and treatment.Functional imaging like magnetic resonance imaging or positron emission tomography (PET) can provide safe and noninvasive detection of loss of β cell mass in the course of diabetes.Among them,radio-labelled imaging is the most sensitive imaging procedure of the β cell ; For dihydrotetrabenazine PET imaging aiming β cell mass,there has been some primary outcome.For the key factor causing type 2 diabetes,18 F-6-deoxy-6-fluoro-D-glucose (18F-6-FDG) PET imaging is an effective tracer to study the glucose transporting condition in vivo.Further development of functional imaging will be of great value in diagnosis and treatment of diabetes.
ABSTRACT
Objective To find the optimal scanning time window and then set up the normal binding potentials (BPs) of 2β-carbomethoxy-3β-(4-fluorophenyl)-(N-11C-methyl) tropane (11C-CFT) DAT PET/CT imaging.Methods Thirty-one healthy volunteers (20 males,11 females,average age:(55.7±2.3) years),who all gave written informed consent,were divided into three age and gender-matched groups according to block randomization.Each group underwent static PET/CT scan in different time windows from 40-60 min,60-80 min to 80-100 min after 11C-CFT injection.To determine the best scanning time window,the ratios of caudate and putamen of all volunteers were analyzed using automatic ROI method (caudate (putamen)/parieto-occipital cotex-1) and compared by one-way analysis of variance and the least significant difference (LSD) t test.The ratio of the same area between different age-groups and gender-groups was compared with independent two-sample t test.Results Ratios of left caudate (2.08±0.06,1.75±0.07and 1.77±0.12 respectively),right anterior putamen (2.33±0.06,1.95±0.09 and 2.08±0.12 respectively)and bilateral posterior putamen (left:1.88±0.66,1.55±0.88 and 1.72±0.09; right:1.98±0.07,1.61±0.09and 1.69±0.12) were all different in three time windows (F=3.588,3.345,4.479,3.557,all P＜0.05).There were significant differences in ratios of left caudate,right anterior and bilateral posterior putamen between 40-60 min and the 60-80 min (all P＜0.05),as well as the ratios of left caudate between 40-60 min and the 80-100 min group (P＜0.05).While no valid differences in ratios of those areas were shown between the groups of 60-80 min and 80-100 min scanning time window (all P＞0.05).DAT densities in right and left side of caudate,anterior and posterior putamen were significantly lower in the group over 60 years of age than those under 60 years (t=-3.260,-3.090,-3.270,-3.190,-2.270,-3.110,all P＜0.05),but were not different between gender-groups (t =0.367,0.522,0.144,0.524,0.166,0.004,all P＞0.05).Conclusions Sixty min after injection of 11C-CFT,the BPs achieve stable stage,so the best scanning time window of 11C-CFT DAT PET imaging was 60-80 min after injection.Identification of normal DAT distribution and understanding of normal BPs of 11C-CFF are necessary before its clinical application.
ABSTRACT
Regarding the prevention and treatment of hepatocellular carcinoma (HCC) recurrence after curative resection,surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical resection.Therefore,postoperative HCC recurrence patterns were reviewed in this article,including differentiating intrahepatic metastasis (IM) and multicentric occurrence (MO),which play a key role in manifesting recurrence and patient prognosis.Additionally,the definitions of small HCC and curative resection,and the prophylactic and therapeutic values of anatomic resection and repeated hepatectomy in patients with recurrent HCC were reviewed.Fully understanding these issues might allow for a more objective,precise,and consistent clinical assessment of HCC.