Relationship between obstructive sleep apnea hypopnea syndrome and inflammation in children / 解放军医学杂志

Objective To investigate the clinical efficacy of anti-inflammatory therapy (intranasal corticosteroids combined with oral leukotriene receptor antagonist) in pediatric mild to moderate obstructive sleep apnea hypopnea syndrome (OSAHS),and analyze the relationship between OSAHS and inflammation factors.Methods Fifty patients with mild to moderate OSAHS,diagnosed by polysomnography (PSG) during Jan.to Nov.2016,were enrolled in present study.The patients' medical history,data of special physical examination,paryngorhinoscopy,PSG and OSA-18 questionnaire were collected.Patients received the therapy of intranasal corticosteroids combined with oral leukotriene receptor antagonist for 12 weeks.Special physical examination,paryngorhinoscopy,PSG and OSA-18 questionnaire were reviewed and the data before and after treatment were compared.Results Of the 50 subjects,37 were with mild OSAHS and 13 with moderate OSAHS.A total of 19 cases (38％) were cured including 17 mild OSAHS and 2 moderate cases.Other 19 cases (38％) got therapeutic effect but not be cured.Twelve cases (24％) were invalid or aggravated.There were 10 patients (20％) who received surgical treatment after drug treatment.The average values of obstructive apnea index (OAI) and mixed apnea index (MAI) decreased significantly in mild group and only OAI decreased in moderate group.After treatment,the average volumes of adenoids and tonsils were significantly reduced in mild OSAHS children but not in moderate OSAHS children.The OSA-18 questionnaire score declined only in mild group.No obvious correlation existed between the change of tonsil volume and the parameters of PSG.Conclusion Anti-inflammatory therapy of intranasal corticosteroids combined with oral leukotriene receptor antagonist may obviously reduce the volumes of adenoids and tonsils,improve the PSG indexes and the life quality of OSAHS patients,especially for those children with mild OSAHS.

Application of avastin in vitrectomy for proliferative diabetic retinopathy and its mechanism / 中华实验眼科杂志

Background Researches demonstrated that avastin-assisted vitrectomy for serious proliferative diabetic retinopathy can decrease intra-operation complication and bring down difficulty of surgery.It is speculated that this is associated with suppression of avastin on neovascularization.However,the evidence of its pathology is lack.Objective The aim of this study was to evaluate the application and mechanism of avastin in vitrectomy for severe proliferative diabetic retinopathy. Methods Twenty-four eyes from consecutive 24 patients with vitrectomy for severe proliferative diabetic retinopathy were enrolled in this study.Fourteen eyes received all intravitreal injection of 0.06 ml avastin(1.5 mg)14 days prior to vitrectomy。And the other 10 eyes underwent only vitrectomy without avastin injection as controls,Preretinal membranes were collected during vitrectomy for histopathologic examination by hemotoxylin and eosin staining.The differences in the density of the neovessels and micro-neovessels between the two groups were observed by detecting the expression of CD34 in vesse]endothelial cells using immunohistochemistry.Written informed consent was obtained from each patient before surgery. Results No statistically significant differences were found in the demography and eye manifestations between only vitreetomy group and avastin+vitrectomy group(P＞0.05).The neovessels with grade three was in 10 eyes in only vitrectomy group and 1 eye in avastin+vitrectomy group(P＜0.01).More capillary-like neovascularization with single vascular endothelial cells,obvious hemorrhage and inflammatory cells infiltration were observed on preretinal membranes in vitrectomy group.However,there were less hemorrhage,ceUular components and few capillary-like neovascularization but more hyaline degeneration of fibrous tissue were observed in avastin+vitrectomy group under the light microscope.Immunochemistry revealed that CD34 was positively expressed in vascular endothelial cells on preretinal membrane in both two groups.The neovessels density and miero-neovessels density were 15.40±7.42/field and 1.88±1.70/field in avastin+vitrectomy group and those in vitreetomy group were 18.00±3.80/field and 0.45±0.56/field respectively,showing significant differences between these two groups(neovessels density:Z=-4.102,P＜0.01;micro-neovessels density:Z=-4.137,P＜0.01).Conclusion As an adjunct drug during the vitrectomy for proliferative diabetic retinopathy, avastin can improve the successful rate of surgery by inhibiting the neovascular formation and alleviating retinal edema.

Expression of stromal cell-derived factor-1 in diabetic retinopathy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neovascularization can cause vision loss in proliferative diabetic retinopathy (PDR) and may be affected by many factors. Stromal cell-derived factor-1 (SDF-1) is a potent stimulator of angiogenesis. The study was aimed to investigate the expression of SDF-1 and its correlation with vascular endothelial growth factor (VEGF) in the eyes with diabetic retinopathy.</p><p><b>METHODS</b>The levels of SDF-1 and VEGF were measured by enzyme-linked immunosorbent assay in the vitreous of 41 eyes of 41 patients with PDR and 12 eyes of 12 patients with idiopathic macular hole (IMH). Vitreous fluid samples and fibrovascular preretinal membranes were obtained at vitrectomy. SDF-1 and VEGF were localized using immunohistochemistry.</p><p><b>RESULTS</b>The vitreous concentration of VEGF was significantly higher in eyes with PDR ((2143.7 +/- 1685.21) pg/ml) than in eyes with IMH ((142.42 +/- 72.83) pg/ml, P < 0.001). The vitreous level of SDF-1 was also significantly higher in eyes with PDR ((306.37 +/- 134.25) pg/ml) than in eyes with IMH ((86.91 +/- 55.05) pg/ml, P < 0.001). The concentrations of both VEGF and SDF-1 were higher in eyes with active PDR than in eyes with inactive PDR. Panretinal photocoagulation (PRP) could decrease the SDF-1 levels in the vitreous of PDR patients. The vitreous concentration of SDF-1 correlated with that of VEGF in eyes with PDR (r = 0.61, P < 0.001). The costaining of SDF-1 and VEGF was confined to the vascular components in preretinal membranes.</p><p><b>CONCLUSIONS</b>SDF-1 protein is highly expressed in both the vitreous and preretinal membranes of PDR patients; SDF-1 may be correlated with VEGF in angiogenesis in PDR.</p>

Current progress of Chinese medicinal treatment of endometriosis / 中国结合医学杂志

Endometriosis (EM) is one of the common and frequently encountered gynecological diseases that seriously influences women's health. Its morbidity reaches 10%-15% in women at reproductive ages, and shows an evident rising tendency. In recent years, the Chinese medicine treatment of EM has won favorable therapeutic effects with few adverse reactions. A brief review on this topic has been made through analyzing and summarizing recent pertinent literatures in terms of treatment depending on syndrome differentiation, cycle treatment, external treatment, integrative medicinal treatment, so as to try to know the status quo of Chinese medicine treatment on EM, and to provide some instructive views for clinical treatment and research.

Caspase-dependent retinal ganglion cell apoptosis in the rat model of acute diabetes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neural apoptosis is generally believed to be mediated by two distinct pathways, caspase-dependant and caspase-independent pathways. This study investigated the apoptotic pathways involved in retinal ganglion cells in acute diabetes in rats.</p><p><b>METHODS</b>Diabetes was induced in male Wistar rats by a peritoneal injection of streptozotocin (STZ). Expression and localization of caspase-3 and apoptosis-inducing factor (AIF) proteins in the retina of diabetic rats was examined by Western blotting and immunohistochemistry analyses. Terminal transferase dUTP nick end labeling (TUNEL) assay and immunofluorescent staining specific for caspase-3 and AIF were applied to analyze for apoptosis of retinal ganglion cells. In addition, a caspase-3 inhibitor DEVD-CHO was injected intravitreally to further determine the apoptotic pathways of retinal ganglion cells triggered in acute diabetes.</p><p><b>RESULTS</b>Two weeks after induction of diabetes, a significant increase in caspase-3 protein expression and localization occurred in the nerve fiber layer, ganglion cell layer, and inner plexiform layer of the retina. Four weeks after the onset of diabetes, the increase in caspase-3 expression was profound eight weeks postinduction of diabetes (P < 0.05). Meanwhile, no AIF protein expression was detected in this study. In addition, intravitreal administration of the caspase-3 inhibitor DEVD-CHO reduced apoptosis of retinal ganglion cells by its direct inhibitory action on caspase-3.</p><p><b>CONCLUSION</b>Caspase-dependent apoptotic pathways may be the main stimulant of STZ-induced retinal ganglion cell apoptosis in acute diabetes.</p>