Multimodal imaging characteristics of Best vitelliform macular dystrophy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the multimodal imaging characteristics of Best vitelliform macular dystrophy(BVMD).METHODS:The clinical data of 30 patients(60 eyes)diagnosed as BVMD at stage Ⅰ to Ⅳ in Nanjing Medical University Affiliated Eye Hospital from June 2016 to October 2022 were collected for a retrospective analysis, and all patients are binocular involved. All patients underwent best corrected visual acuity(BCVA), slit lamp microscopy, indirect ophthalmoscopy, intraocular pressure, fundus photography, spectral-domain optical coherence tomography(SD-OCT), fundus autofluorescence(FAF), fundus fluorescein angiography(FFA), electro-oculogram(EOG)and optical coherence tomography angiography(OCTA).RESULTS: A total of 30 patients(60 eyes)were included, with 8 eyes at stage Ⅰ, 24 eyes at stage Ⅱ, 22 eyes at stage Ⅲ and 6 eyes at stage Ⅵ. The imaging characteristics of fundus photography, FAF, FFA and SD-OCT were basically consistent with previous literature reports. EOG showed Arden ratio <1.55. OCTA could detect early lesions, observe the location of vitelliform substance, external segment of photoreceptor, fluid and choroidal neovascularization(CNV).CONCLUSION: Multimodal imaging assisted in diagnosing BVMD, reducing missed diagnosis and misdiagnosis, among which OCTA had significant advantages over other examinations, and fast and non-invasive were its biggest advantages.

Correlation between baseline aqueous humor cytokine levels and anti-vascu-lar endothelial growth factor treatment in patients with macular edema sec-ondary to retinal vein obstruction / 眼科新进展

Objective To analyze the effect of baseline cytokines in aqueous humor in predicting the improvement of the central macular thickness(CMT)and best corrected visual acuity(BCVA)of patients with macular edema secondary to retinal vein obstruction(RVO-ME)after anti-vascular endothelial growth factor(VEGF)treatment for 3 months.Meth-ods Totally 30 eyes of 30 patients initially diagnosed with RVO-ME in the Affiliated Eye Hospital of Nanjing Medical Uni-versity from October 2021 to January 2023 were enrolled.Aqueous humor was collected by anterior chamber puncture be-fore the anti-VEGF drug injection.The levels of 11 cytokines in aqueous humor,including VEGF,intercellular adhesion molecule(ICAM)-1,interleukins(ILs)and interferon-γ(IFN-γ),were measured by Luminex xMAP technology.The cor-relation between baseline aqueous humor cytokine levels and CMT,BCVA(logMAR)as well as their changes(difference between baseline and anti-VEGF treatment for 3 months)in RVO-ME patients was analyzed;the correlation between CMT and BCVA(logMAR)was analyzed at baseline and 3 months after anti-VEGF treatment.CMT and BCVA responders were defined as patients with 50％or more reduction in CMT and BCVA(logMAR)from baseline to the third month.A Logistic regression model was used to analyze the relationship between baseline aqueous humor cytokines and RVO-ME patients be-coming CMT or BCVA responders after 3 months of anti-VEGF treatment.Results Compared with baseline,the CMT sig-nificantly decreased and BCVA significantly improved in RVO-ME patients after anti-VEGF treatment for 3 months(both P＜0.001).The CMT was positively correlated with BCVA(logMAR)of RVO-ME patients at baseline and after anti-VEGF treatment for 3 months(P=0.026,0.002).At baseline,the levels of VEGF and IL-8 of RVO-ME patients were positively correlated with CMT(P=0.032,0.035);the levels of IL-6 and IL-8 were positively correlated with BCVA(logMAR)(P=0.018,0.002).The baseline IL-8 level in RVO-ME patients was negatively associated with the change in CMT(P=0.024).Logistic regression analysis showed that elevated baseline ICAM-1 level could increase the risk of RVO-ME patients becom-ing BCVA non-responders after 3 months of anti-VEGF treatment(P=0.023).Conclusion Baseline IL-8 and ICAM-1 may be predictors of CMT and BCVA improvement after anti-VEGF treatment of RVO-ME.

Observation on the distribution of macular cone in healthy adult using adaptive optics scanning laser ophthalmoscope system / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the distribution of cone in the macular of healthy adult in different ages using adaptive optics scanning laser ophthalmoscope(AO-SLO)system, and analyze its relationship with age.METHODS: A total of 100 healthy examinees(200 eyes)in our hospital from June to July 2023 were selected, and they were divided into four groups according to their age, with 25 cases(50 eyes)in each group, including 18-30 years in group A, 31-40 years in group B, 41-50 years in group C, 51-65 years in group D. AO-SLO was performed in both eyes and cone density was measured.RESULTS: The density of cone in the foveal eccentricity of 3° and 2.4°×2.4° in each group was different(P<0.001), and the cone density in each area showed a relatively regular distribution characteristics, with the highest density in the temporal side, and the temporal>nasal>inferior>superior sides from high to low. The mean cone density in the macular area of both eyes was 14 144.38±1 082.40, 13 241.24±535.32, 12 930.29±727.73, and 10 907.50±490.86 cell/mm2, respectively(P<0.001), indicating that the cone density decreased with age. The correlation analysis showed that the mean cone density in the macular area was negatively correlated with age(r=-0.578, P<0.001).CONCLUSION: AO-SLO is a quantitative non-invasive detection of cones, and there is a negative correlation between cone density and age in healthy human. Furthermore, density of cone in healthy people over 50 years was significantly decreased.

Efficacy of 25G pars plana vitrectomy with Conbercept intravitreal injection at the end of surgery for early proliferative diabetic retinopathy with vitreous hemorrhage / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy and safety of intravitreal injection of Conbercept combined with 25G minimally invasive pars plana vitrectomy(PPV)at the end of surgery for early proliferative diabetic retinopathy(PDR)with vitreous hemorrhage.METHODS: A total of 60 patients(60 eyes)with PDR complicated with vitreous hemorrhage requiring PPV at the Affiliated Eye Hospital of Nanjing Medical University were retrospectively analyzed. Based on the injection timing of Conbercept, the patients were divided into 3 groups: 20 patients(20 eyes)injected at the end of the surgery(group A), 20 patients(20 eyes)injected preoperatively(group B), and 20 patients(20 eyes)without injection(group C). The differences in pre- and post-operative visual acuity, intraocular pressure, intraoperative conditions, prognosis, and complications were analyzed among the 3 groups.RESULTS: There were no significant differences in the preoperative conditions and operation time among the patients. There was no iatrogenic retinal hole or silicone oil tamponade during the operation in the 3 groups, and no recurrent retinal detachment occurred after the operations. Best corrected visual acuity(BCVA)at 1, 3 and 6mo of all groups were improved compared with those before the surgery(P<0.05), and the injection groups(group A and group B)had a significantly better postoperative improvement than the non-injection group(group C), and there were significant differences(P<0.05). The incidence of postoperative late vitreous hemorrhage(1mo after operation)in group A was significantly lower than those in groups B and C(P<0.05). The central retinal thickness of the operated eyes in the injection groups(groups A and B)was significantly lower than that in the non-injection group(group C)at 1, 3 and 6mo after operation(P<0.05).CONCLUSION: Conbercept injection at the end of the surgery and preoperative injection are both safe and effective for early PDR and can significantly improve postoperative visual acuity. However, Conbercept injection at the end of surgery can reduce the risk of late vitreous hemorrhage recurrence, leading to better PPV outcomes and improving patients' retinal and visual function and quality of life.

Macular microvasculature in central retinal artery occlusion with paracentral acute middle maculopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the changes in the macular microvasculature in eyes with central retinal artery occlusion(CRAO)and paracentral acute middle maculopathy(PAMM).METHODS: Retrospective study. A total of 27 cases(27 eyes)who diagnosed with CRAO-PAMM and 29 patients(29 eyes)diagnosed as CRAO but with no PAMM were hospitalized in our hospital from January 2020 to December 2021. There were 33 normal people(33 eyes)who underwent physical examination in our hospital selected as control group. Optical coherence tomography angiography(OCTA)was used to measure retinal blood flow and thickness parameters in the 3 mm×3 mm area of the macula. The correlation among macular retinal blood flow density, retinal thickness, foveal avascular zone(FAZ)area, FAZ perimeter, acircularity index(AI), flow density in a 300-μm-wide region around the FAZ(FD-300)and lesion area, best corrected visual acuity(BCVA)in the CRAO-PAMM group was analyzed.RESULTS: Among the three groups, there were significant differences in the overall and parafoveal blood flow density of superficial capillary layer(SCP)and deep capillary layer(DCP), foveal thickness, FAZ area, FAZ perimeter, AI and FD-300(all P&#x003C;0.05). In the CRAO-PAMM group, the lesion area was negatively correlated with DCP overall and parafoveal blood flow density(r=-0.569, P=0.002; r=-0.543, P=0.004), and positively correlated with the parafoveal thickness(r=0.606, P=0.001); BCVA(LogMAR)was negatively correlated with DCP foveal and parafoveal blood flow density(r=-0.433, P=0.024; r=-0.515, P=0.006), and positively correlated with FAZ area, perimeter and lesion area(r=0.484, P=0.011; r=0.531, P=0.004; r=0.417, P=0.030).CONCLUSION:Patients with CRAO and PAMM have lower macular blood flow density, heavier macular edema and poorer visual acuity, and BCVA may be influenced by both lesion area and FAZ area.

577nm subthreshold micropulse laser combined with Conbercept for the treatment of diabetic macular edema after vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical effect of 577nm subthreshold micropulse laser(SML)photocoagulation combined with intravitreal injection of Conbercept in the treatment of diabetic macular edema(DME)after vitrectomy in patients with proliferative diabetic retinopathy(PDR).METHODS:A retrospective analysis was performed on 29 cases(30 eyes)of PDR patients who had DME after vitrectomy in our hospital from January 2019 to June 2021. They were divided into two groups according to different treatment methods: 14 cases(14 eyes)in the single injection group received intravitreal injection of Conbercept, and 15 cases(16 eyes)in the combined treatment group received 577nm SML photocoagulation in the macular area combined with intravitreal injection of Conbercept. The changes in best corrected visual acuity(BCVA)and central macular thickness(CMT)before and at 6 and 12mo after treatment, as well as the changes of multifocal electroretinogram(mfERG)before and at 12mo after treatment were compared between the two groups.RESULTS: The BCVA(LogMAR)of patients in both groups improved and CMT decreased after treatment for 6 and 12mo(all P&#x003C;0.001). There were no significant differences in BCVA(LogMAR)and CMT before treatment and 6mo, 12mo after treatment between single injection group and combined treatment group(all P&#x003E;0.05). Compared with the combined treatment group, the amplitude was slightly lower(23.02±3.13 vs. 26.50±3.33 μV/deg2)and the latency time was prolonged(38.75±1.62 vs. 34.21±3.06ms)in single injection group at 12mo(all P≤0.001). The average injection times in single injection group was 8.14±1.46, and 5.05±1.51 in combined treatment group at 12mo after treatment(P&#x003C;0.05).CONCLUSION: 577nm SML photocoagulation combined with intravitreal injection of conbercept can effectively relieve macular edema, improve BCVA and visual function of macular area and reduce the injection times of conbercept for DME patients.

Effects of Chaihu Shugan Powder on behaviors and expression of 5-HT2A and BDNF in brain region of a rat model of post-stroke depression / 中成药

AIM To investigate the effects of Chaihu Shugan Powder on the behaviors rat models of post-stroke depression(PSD)and the expression of 5-HT2A and BDNF in prefrontal cortex and striatum.METHODS The rats were randomly divided into the blank group,the sham operation group,the model group,Chaihu Shugan Powder group,the fluoxetine group and the combination drug group,with 9 rats in each group.The PSD rat models were established by the right middle cerebral artery occlusion(MCAO)by thread embolism method followed by further exposure to 4 weeks chronic and unpredictable mild stimulation.Subsequently,the rats started their corresponding regime of normal saline 5 mL/kg,Chaihu Shugan Powder 2 mg/kg,fluoxetine 12.5 mg/kg,and Chaihu Shugan Powder 2 mg/kg and fluoxetine 12.5 mg/kg(the combination group),respectively,and had their body mass measured and their behaviors(sugar water preference test,open field test and Morris water maze test)assessed simultaneously during the trial.After the experiment,the rats had their 5-HT2A and BDNF in prefrontal cortex and striatum detected of the mRNA expressions by RT-qPCR;of their expressions of the positive cells by immunohistochemical staining;and of their protein expressions by Westren blot.RESULTS Compared with the blank group,the model group displayed no improvement of depression-like behaviors,and decreased in mRNA expressions,positive cell expressions and protein expressions of 5-HT2A and BDNF(P<0.01).Compared with the model group,the groups intervened with Chaihu Shugan Powder,fluoxetine and combination drug showed improved depression-like behaviors,and increased mRNA expressions,positive cell expressions and protein expressions of 5-HT2A and BDNF as well(P<0.01).CONCLUSION Chaihu Shugan Powder can improve the depression-like behaviors in the PSD rat model,and its mechanism may be associated with the improvement in the expressions of 5-HT2A and BDNF in prefrontal cortex and striatum.

Multimodal imaging features of dome-shaped macula with subretinal fluid in adolescents with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the multimodal image features of dome-shaped macula(DSM)with subretinal fluid(SRF)in adolescents with high myopia, and investigate its typical features and identification methods.METHODS: This is a retrospective study. A total of 21 adolescent patients(39 eyes)who were diagnosed as DSM in high myopic eyes with SRF in the macula area in our hospital from January 2021 to May 2022 were selected. All patients underwent color fundus photography(CFP), fundus autofluorescence(FAF), spectral-domain optical coherence tomography(SD-OCT), optical coherence tomography angiography(OCTA)and electro oculography(EOG). Among them, 18 patients(36 eyes)underwent fundus fluorescein angiography(FFA), and they were followed-up for 12mo to record the change of the central macular thickness(CMT).RESULTS: Fundus examination showed tessellated retina in affected eyes, and the deposition of granular material could be seen in the fovea of the macular area. SD-OCT showed a dome-like bulge of the whole layer in the macular area, localized detachment of the subfoveal nerve epithelial layer, the medium and high reflection attachment on the inner surface of the outer membrane, and the heterogeneous reflection of the retinal pigment epithelium(RPE)layer. FAF showed a mild “bull's eye sign” change in the macular area. FFA showed granular transmitted fluorescence around the foveal avascular zone. En face of OCTA could see a clear boundary of the neuroepithelial detachment zone. When the tangential line corresponds to the ellipsoid zone-RPE layer, the granular high reflection in different sizes scattered in the neuroepithelial detachment zone could be seen, and no obvious choroidal neovascularization(CNV)was formed. During the follow-up of OCTA, SRF in the macular area can be spontaneously increased or absorbed irregularly. EOG indicates that the ratio of light peak to dark trough(LP/DT, i.e. Arden ratio)was normal, with an Arden ratio&#x0026;#x003E;1.55. CMT at 1, 3, 6, 12mo(247.10±13.03, 246.62±12.23, 248.05±14.00, 247.92±11.66 μm)during follow-up period were compared with baseline(246.95±11.46 μm), and the difference was not statistically significant(F=0.144, P=0.965).CONCLUSION: Multimodal imaging is helpful in the clinical diagnosis of DSM with SRF in the macula area in high myopic eyes of adolescents, and plays an important role in the differential diagnosis of the early stage of typical Best disease.

Advancements in the application of adaptive optics-based retinal imaging technology / 国际眼科杂志(Guoji Yanke Zazhi)

Adaptive optics(AO)is a technique used to optimize the functionality of optical systems through the reduction of wavefront distortion and optical aberrations. AO-based retinal imaging reduces the occurrence of optical aberrations in the refractive system, consequently improving the resolution and overall quality of retinal imaging. As a result, AO-based retinal imaging has potential wide-ranging application in ophthalmology. A combination of AO, fundus camera, scanning laser ophthalmoscope, optical coherence tomography technique and optical coherence tomography angiography, can be applied to observe the distribution, morphology and function of retinal cone cells in the healthy retinal, and to comprehend the shape and perfusion of retinal vessels in the fine vascular layer. With this technique, it can also possible to perform qualitative and quantitative analysis of the number and shape of cells in the ocular fundus, the cribriform plate, and the microscopic structures of the retinal microvascular system and nerve tissue. It can be expected as a novel tool for the early diagnosis, follow-up of therapy effects, and identification of progression of ophthalmic diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma and hereditary retinal diseases.

Evaluation of the predictive effect of parafoveal blood flow density of macula on the number of intravitreal Conbercept injections in patients with branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate blood flow density within 300μm(FD-300)around the foveal avascular zone(FAZ)in optical coherence tomography angiography(OCTA)of patients with macular edema(ME)complicated with non-ischemic branch retinal vein occlusion(BRVO), and to explore and evaluate the predictive effect of this parameter on the number of intraocular drug injections.METHODS: A retrospective case study. A total of 50 patients(50 eyes)who were diagnosed as non-ischemic BRVO combined with ME and received intravitreal conbercept(IVC)in the Affiliated Eye Hospital of Nanjing Medical University from January 2021 to March 2022 were selected, and they were treated with 3+PRN regimen. The 25 cases(25 eyes)treated with intraocular injection ≤5 times were classified as group B, and 25 cases(25 eyes)treated with intraocular injection &#x003E;5 times were classified as group C, and 25 fellow eyes were randomly selected as control group A. OCTA was used to scan the macular area in 3mm×3mm to collect images of retinal blood flow, the central macular thickness(CMT)and FD-300. The CMT, best-corrected visual acuity(BCVA), and FD-300 were compared between the two groups at baseline, 1, 3, 6 and 12mo after the third injection.RESULTS: The BCVA(LogMAR)of the affected eye in both groups B and C at 1, 3, 6 and 12mo after the third injection was significantly lower than baseline(all P&#x003C;0.05); the CMT and FD-300 were significantly lower than baseline(all P&#x003C;0.05). Pearson correlation analysis showed that the change of BCVA(LogMAR)was positively correlated with the baseline FD-300 and CMT(group B: r=0.77, 0.70, all P&#x003C;0.01; group C: r=0.89, 0.78, all P&#x003C;0.01). The number of intraocular injections was negatively correlated with the baseline FD-300(group B: r=-0.63, P&#x003C;0.01; group C: r=-0.71, P&#x003C;0.01). Logistic regression analysis showed that the FD-300 at baseline is a factor that affects the number of intraocular drug injection.CONCLUSION: IVC can effectively alleviate macular edema of the affected eye,improve visual acuity and reduce FD-300. The eyes with worse BCVA and lower FD-300 at baseline may require more injections of anti-VEGF. Observation of FD-300 with OCTA can better predict eventual vision recovery of non-ischemic BRVO with ME before treatment.

Mechanism of BCL2L2-PABPN1 expression induced by sodium arsenite and its metabolites in 16HBE cells / 中国职业医学

@#Objective - - （BCL2L2）- （ ） To investigate the differential expression of the fusion gene BCL 2 like protein 2 poly A （PABPN1） （ ） binding protein nuclear 1 induced by sodium arsenite SA and its methylated metabolites in 16HBE cells and the Methods ） ， related mechanism. i The 16HBE cells exposed to SA at concentrations of 1.5 3.0 and 4.5 µmol/L were set as -， - - low medium and high dose arsenic exposure groups. The 16HBE cells exposed to 4.5 µmol/L monomethylarsonic acid （ ）， （ ） ， MMA dimethylarsonic acid DMA and SA were set as MMA group DMA group and SA group. The 16HBE cells without ， BCL2L2-PABPN1 toxic stimulation were set as control group. After the cells were cultured for 48 hours the expression of was - （ - ） ） （ ） detected by quantitative real time polymerase chain reaction qRT PCR . ii Two small interfering RNA siRNA silencing 基金项目：国家自然科学基金（ ）； 年云南省科技厅昆明医科大学应用基础研究联合专项面上项目 82160607 2021 （ ） 202101AY070001-054 作者简介：施雅（ —），女，在读大学本科生，主要从事劳动卫生与环境卫生学研究；尹锦瑶（ —），女，在读劳动卫生与环境卫 2001 1995 生学硕士研究生，主要从事劳动卫生与环境卫生学研究；施雅和尹锦瑶为共同第一作者 通讯作者：何越峰教授，博士研究生导师，- ： E mail heyuefeng@kmmu.edu.cn中国职业医学 年 月第 卷第 期 ， ， ， · · 2022 10 49 5 Chin Occup Med October 2022 Vol.49 No.5 523 BCL2L2-PABPN1， - fragments were designed and transfected into 16HBE cells to knockdown which were set as siRNA 1 group - - BCL2L2-PABPN1 and siRNA 2 group. Non transfected control group without knockdown of transfection was set up. After ， BCL2L2-PABPN1 - culturing for 48 hours the expression level of in the three groups of cells was detected by qRT PCR. The cell - survival rate and early apoptosis rate were detected by MTS method and JC 1 mitochondrial membrane potential detection ， （ ） ， method respectively. The apoptosis was detected by Hoechest33342/propidium iodide PI double staining and the expression - Results ） level of P53 signaling pathway related proteins was detected by Western blotting. i The relative expression of BCL2L2-PABPN1 （P ） BCL2L2- in 16HBE cells increased with the increasing SA doses <0.01 . The relative expression of PABPN1 - ， - - in high dose arsenic exposure was higher than that in control group low dose and medium dose arsenic exposure （ P ） BCL2L2-PABPN1 ， groups all <0.05 . The relative expression of in SA group was higher than those in control group MMA （ P ） BCL2L2-PABPN1 group and DMA group all <0.05 . The relative expression of showed no significant difference between ， （ P ） ） BCL2L2-PABPN1 control group MMA group and DMA group all >0.05 . ii The relative expression levels of and cell - - - （ P ） survival rate in siRNA 1 group and siRNA 2 group were lower than those in non transfected control group all <0.05 . ， （P ） However there was no significant difference in the early apoptosis rate among the three groups >0.05 . The results of - Hoechest33342/PI double staining showed that the number of nuclear shrinkage and early apoptotic cells in siRNA 1 group and - - ， - siRNA 2 group was higher than that in non transfected control group. The relative protein expression levels of P53 phospho ， - - ， - - （ P ） p53 BCL 2 associated death promoter P21 and cytochrome C in siRNA 1 group and siRNA 2 group were higher all <0.05 , - - P and the relative protein expression levels of P53 up regulated modulator of apoptosis were lower (all <0.05), when compared - Conclusion with the non transfected control group. SA may block the apoptosis of 16HBE cells by inducing the expression of BCL2L2-PABPN1 fusion gene . The mechanism may be related to the activation of P53 signaling pathway. The SA methylated BCL2L2-PABPN1 BCL2L2-PABPN1 - metabolites MMD and DMA had no effect on the expression of . may affect anti apoptosis BCL2L2 PABPN1 through affecting the synergistic effect of and genes.

Parafoveal exudative vascular anomalous complex and its characteristics of multi-modal imaging in 11 cases / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the imaging characteristics of multi-modal imaging in perifoveal exudative vascular anomalous complex(PEVAC).METHODS: A retrospective case analysis. There were 11 patients(11 eyes)diagnosed as PEVAC by multi-modal imaging in our hospital included in this study from February 2021 to February 2022. All patients underwent the examinations of best corrected visual acuity(BCVA), fundus photography, fluorescein fundus angiography(FFA), spectral-domain optical coherence tomography(SD-OCT)and optical coherence tomography angiography(OCTA).RESULTS: On fundus examination, six out of eleven eyes presented as a unilateral and isolated lesion with diameter ≥150μm, five out of eleven eyes presented as multiple lesions(ranging from 2 to 4)and the diameter of each lesion &#x003C;150μm, seven eyes with retinal edema and/or hard exudation. FFA revealed an oval-like hyper-fluorescent lesion of parafoveal in the late phase with enhancement but no leakage. Late peripheral telangiectasia leakage is seen with oedema. OCTA examination revealed a parafoveal small mass hyper-reflex showed aneurysmal dilation in the superficial and deep capillary, and capillary rarefaction was observed around the lesion. B-scan showed strong blood flow signal inside. Anti-vascular endothelial growth factor(VEGF)therapy was performed in 4 patients with macular edema. However, there was no notable improvement after treatment.CONCLUSION: Multi-modal imaging can help confirm the diagnosis and differential diagnosis of PEVAC, there is a poorly response to anti-VEGF therapy.

Inhibitory effects and mechanisms of cryptotanshinone on the growth of tamoxifen resistant breast cancer cells / 药学学报

This study investigated the inhibitory effect and mechanisms of cryptotanshinone (CPT) on tamoxifen resistant cell MCF7-TAMR. The inhibitory effect of CPT on the viability of MCF7-TAMR cells was evaluated using the MTT assay. We found that CPT significantly inhibited the growth of MCF7-TAMR cells in a dose- and time-dependent manner. The half inhibitory concentration (IC50) is 15.14 ± 2.82 μmol·L-1 at 24 h. CPT induced cell cycle arrest of MCF7-TAMR cells at G0/G1 phase, and promoted apoptosis of MCF7-TAMR cells by upregulating intracellular levels of reactive oxygen species (ROS). Transwell results showed that CPT significantly inhibited the migration of MCF7-TAMR cells. Furthermore, CPT decreased the CD24-/lowCD44+ cell population in MCF7-TAMR cell-derived microspheres. Western blot results showed that CPT effectively inhibited the phosphorylation of estrogen receptor α (ER-α), and reduced the expression of phosphatidylinositol 3-kinase (PI3K-p85), serine-threonine protein kinase (Akt) and multidrug transporter ATP-binding cassette superfamily G member 2 (ABCG2). These results showed that CPT can induce cell apoptosis, cause cell cycle arrest, inhibit cell migration and inhibit ER-α phosphorylation, inhibit PI3K/Akt signaling pathway, reduce the number of CD24-/lowCD44+ cells and the expression of ABCG2, overcome cell drug resistance.

Efficacy of subthreshold navigated laser photocoagulation and micropulse laser for chronic central serous chorioretinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To comparatively analyze the efficacy of subthreshold laser photocoagulation with the NAVILAS&#x0026;#xAE; Laser system and subthreshold micropulse laser for patients with chronic central serous chorioretinopathy(cCSC).METHODS: A retrospective clinical study. A total of 36 patients(40 eyes)with cCSC were recruited from January 2020 to January 2021 diagnosed at the Affiliated Eye Hospital of Nanjing Medical University. There were 19 patients(23 eyes)treated with subthreshold navigated laser photocoagulation(the Navilas group), and 17 patients(17 eyes)treated with subthreshold micropulse laser(SML)(the SML group). There was no significant difference in baseline data between the two groups(P&#x003E;0.05). The best corrected visual acuity(BCVA, LogMAR), central macular thickness(CMT), subretinal fluid(SRF)height, vessel densities of the superficial capillary plexus(SCP), the deep capillary plexus(DCP)and area of the foveal avascular zone(FAZ)were collected at 2wk, 1, 3 and 6mo before and after treatment.RESULTS: The BCVA of the two groups were significantly higher than that before treatment at 3 and 6mo after surgery(P&#x003C;0.05),which was significantly reduced at 2wk after treatment in the Navilas group and was reduced at 1mo after treatment in the SML group(P&#x003C;0.05). In both groups, there was significant decrease compared with that before treatment at 3 and 6mo after treatment(P&#x003C;0.05),but there was no significant difference between the two groups(P&#x003E;0.05). The difference in SRF absorption between the two groups was statistically significant(P&#x003C;0.05), and the complete absorption rate of SRF in the Navilas group was higher than that in the SML group. SCP, DCP, the area of the FAZ were not significantly different from each time ofbaseline in the two groups(P &#x003E;0.05).CONCLUSION: Subthreshold laser photocoagulation with the NAVILAS&#x0026;#xAE; Laser system can rapidly improve the retinal morphology and shorten the course of cCSC to improve the recovery of visual function with its rapid effect, high cost-effectiveness, non-invasiveness and high repeatability, which can be a new clinical method for patients with cCSC.

Significance of Lymphocyte-to-Monocyte Ratio and Corrected Levels of Serum Calcium as Prognostic Markers in Patients with Newly Diagnosed Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the significance of peripheral blood lymphocyte to monocyte ratio (LMR) and corrected levels of serum calcium (cCa) as prognostic markers for the newly diagnosed multiple myeloma (MM) patients.@*METHODS@#The clinical data of 114 newly diagnosed MM patients in the Second Affiliated Hospital of Kunming Medical University from January 2013 to March 2020 were retrospectively analyzed. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value, and the patients were divided into high LMR group and low LMR group (LMR≥3.35 and LMR < 3.35). Moreover, the patients were divided into four groups according to initial diagnosis LMR and LMR after four courses of treatment (LMR4): Group A (LMR≥3.35, LMR4≥3.35), Group B (LMR≥3.35, LMR4 < 3.35), Group C (LMR < 3.35, LMR4≥3.35), and group D (LMR < 3.35, LMR4 < 3.35). The simple prognosis model was established by combined with LMR and cCa, the patients were divided into Group a (no risk factor), group b (1 risk factor) and Group c (2 risk factors). Independent sample T-test, Pearson Chi-square test or Mann-Whitney U test were used to evaluate the differences between various parameters, and Kaplan-Meier method and Cox regression were used for survival analysis.@*RESULTS@#The median follow-up time was 13.05（0.1-72.5）months. Survival analysis showed that the patients with low LMR predicted poor prognosis, the overall survival (OS) time of the patients with low LMR was significantly shorter (17 vs 50.5 months, P=0.006) than the patients with high LMR, the difference was also significant between group A and Group D (56.5 vs 30.5 months, P=0.043). The OS of the patients was also significantly shorter in the high cCa group (≥2.75 mmol/L) compared with normal group (8.5 vs 34 months, P=0.006). Multivariate survival analysis showed that LMR < 3.35 (P=0.028) and cCa≥2.75 mmol/L (P=0.036) were the independent risk factors affecting prognosis of MM patients. The comparison of risk factors showed that the median OS of Group a, b and c was 50, 20, and 8.5 months, respectively. The prognosis of the patients without risk factors was better than that of patients with 1-2 risk factors (Group a vs Group b, P < 0.0001; Group a vs Group c, P=0.002).@*CONCLUSION@#LMR and cCa are the independent risk factors affecting the prognosis of newly diagnosed MM patients, and the development of a simple prognosis system combining them can quickly identify the prognosis of newly diagnosed MM patients.

Multidetector CT Characteristics of Fumarate HydrataseDeficient Renal Cell Carcinoma and Papillary Type II Renal Cell Carcinoma

Objective@#To investigate the multidetector computed tomography (MDCT) features of fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) with germline or somatic mutations, and compare them with those of papillary type II RCC (pRCC type II). @*Materials and Methods@#A total of 24 patients (mean ± standard deviation, 40.4 ± 14.7 years) with pathologically confirmed FH-deficient RCC (15 with germline and 9 with somatic mutations) and 54 patients (58.6 ± 12.6 years) with pRCC type II were enrolled. The MDCT features were retrospectively reviewed and compared between the two entities and mutation subgroups, and were correlated with the clinicopathological findings. @*Results@#All the lesions were unilateral and single. Compared with pRCC type II, FH-deficient RCC was more prevalent among younger patients (40.4 ± 14.7 vs. 58.6 ± 12.6, p < 0.001) and tended to be larger (8.1 ± 4.1 vs. 5.4 ± 3.2, p = 0.002). Cystic solid patterns were more common in FH-deficient RCC (20/24 vs. 16/54, p < 0.001), with 16 of the 20 (80.0%) cystic solid tumors having showed typical polycystic and thin smooth walls and/or septa, with an eccentric solid component. Lymph node (16/24 vs. 16/54, p = 0.003) and distant (11/24 vs. 3/54, p < 0.001) metastases were more frequent in FH-deficient RCC. FHdeficient RCC and pRCC type II showed similar attenuation in the unenhanced phase. The attenuation in the corticomedullary phase (CMP) (76.3% ± 25.0% vs. 60.2 ± 23.6, p = 0.008) and nephrographic phase (NP) (87.7 ± 20.5, vs. 71.2 ± 23.9, p = 0.004), absolute enhancement in CMP (39.0 ± 24.8 vs. 27.1 ± 22.7, p = 0.001) and NP (50.5 ± 20.5 vs. 38.2 ± 21.9, p = 0.001), and relative enhancement ratio to the renal cortex in CMP (0.35 ± 0.26 vs. 0.24 ± 0.19, p = 0.001) and NP (0.43 ± 0.24 vs. 0.29 ± 0.19, p < 0.001) were significantly higher in FH-deficient RCC. No significant difference was found between the FH germline and somatic mutation subgroups in any of the parameters. @*Conclusion@#The MDCT features of FH-deficient RCC were different from those of pRCC type II, whereas there was no statistical difference between the germline and somatic mutation subgroups. A kidney mass with a cystic solid pattern and metastatic tendency, especially in young patients, should be considered for FH-deficient RCC.

A new seco-prezizaane-type sesquiterpene lactone from stems and branches of Illicium ternstroemioides / 中国中药杂志

Three seco-prezizaane-type sesquiterpene lactones, one phenylpropanoid, and two lignans were isolated from the 95% ethanol extract of stems and branches of Illicium ternstroemioides with silica gel column chromatography, ODS column chromatography, and preparative HPLC. Based on the spectral data, they were identified as burmanicumolide D(1), veranisatin A(2), veranisatin B(3), dihydroconiferylalcohol(4), pinoresinol(5),(-)-matairesinol(6), respectively. Among them, compound 1 was a new seco-prezizaane-type sesquiterpene lactone, and 2-6 were obtained from this plant for the first time. None of these compounds display antiviral or cytotoxic activities.

Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to develop web-based nomograms to precisely predict survival outcomes in patients with non-metastatic nasopharyngeal carcinoma (NPC) in an endemic area. @*Materials and Methods@#A total of 10,126 patients who underwent radical intensity-modulated radiotherapy at Sun Yat-sen University Cancer Center (SYSUCC) from 2009 to 2015 were analyzed. We assigned patients into a training cohort (SYSUCC-A, n=6,751) and an internal validation cohort (SYSUCC-B, n=3,375) based on computer-generated random numbers. Patients collected from Wuzhou Red Cross Hospital (WZRCH) between 2012 and 2015 were used as the independent external validation cohort (WZRCH, n=450). Concordance index (C-index) was used to determine predictive accuracy and discriminative ability for the nomogram. The web-based clinicopathologic prediction models for predicting survival were based on Cox regression. @*Results@#The C-indexes for SYSUCC-A, SYSUCC-B, and WZRCH cohorts for the established nomograms to predict 3-year overall survival (OS) was 0.736, 0.715, and 0.691. Additionally, C-indexes to predict 3-year distant metastasis-free survival (DMFS) was 0.717, 0.706, and 0.686, disease-free survival (DFS) was 0.713, 0.697, and 0.656, local relapse-free survival was 0.695, 0.684, and 0.652, and regional relapse-free survival was 0.672, 0.650, and 0.616. The calibration plots showed great agreement between nomogram-predicted 3-year survival outcomes and actual 3-year survival outcomes. Moreover, C-indexes of the nomograms for OS, DMFS, and DFS were significantly superior than TNM stage (p< 0.001 for all). @*Conclusion@#These user-friendly nomograms can precisely predict survival endpoints in patients with non-metastatic NPC. They may serve as a useful tool for providing patient counseling and help physicians to make individual follow-up plans.

Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to develop web-based nomograms to precisely predict survival outcomes in patients with non-metastatic nasopharyngeal carcinoma (NPC) in an endemic area. @*Materials and Methods@#A total of 10,126 patients who underwent radical intensity-modulated radiotherapy at Sun Yat-sen University Cancer Center (SYSUCC) from 2009 to 2015 were analyzed. We assigned patients into a training cohort (SYSUCC-A, n=6,751) and an internal validation cohort (SYSUCC-B, n=3,375) based on computer-generated random numbers. Patients collected from Wuzhou Red Cross Hospital (WZRCH) between 2012 and 2015 were used as the independent external validation cohort (WZRCH, n=450). Concordance index (C-index) was used to determine predictive accuracy and discriminative ability for the nomogram. The web-based clinicopathologic prediction models for predicting survival were based on Cox regression. @*Results@#The C-indexes for SYSUCC-A, SYSUCC-B, and WZRCH cohorts for the established nomograms to predict 3-year overall survival (OS) was 0.736, 0.715, and 0.691. Additionally, C-indexes to predict 3-year distant metastasis-free survival (DMFS) was 0.717, 0.706, and 0.686, disease-free survival (DFS) was 0.713, 0.697, and 0.656, local relapse-free survival was 0.695, 0.684, and 0.652, and regional relapse-free survival was 0.672, 0.650, and 0.616. The calibration plots showed great agreement between nomogram-predicted 3-year survival outcomes and actual 3-year survival outcomes. Moreover, C-indexes of the nomograms for OS, DMFS, and DFS were significantly superior than TNM stage (p< 0.001 for all). @*Conclusion@#These user-friendly nomograms can precisely predict survival endpoints in patients with non-metastatic NPC. They may serve as a useful tool for providing patient counseling and help physicians to make individual follow-up plans.

Effect of row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage / 中国针灸

OBJECTIVE@#To observe the effect of conventional acupuncture combined with row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage.@*METHODS@#A total of 60 patients with peripheral facial palsy at recovery stage were randomized into an observation group and a control group, 30 cases in each one. Acupuncture was applied at affected Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Jiache (ST 6), Dicang (ST 4), Hegu (LI 4), Taichong (LR 3) and Zusanli (ST 36) in the control group. On the basis of the treatment in the control group, row-like puncture was applied at sternocleidomastoid (1 needle was punctured at muscle origin and insertion respectively, 3 to 4 needles were row-like punctured at the connection line of muscle origin and insertion). The treatment was given once a day, 5 times were as one course, with 2-day interval, totally 4 courses were required in the both groups. The house-brackmann (H-B) facial nerve function grade, facial nerve function rating system-dynamic view rating scale score and facial disability index (FDI) scale score [including scores of FDI physical function (FDIp) and FDI social life function (FDIs)] before and after treatment were observed, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#After treatment, the H-B facial nerve function grades were improved compared before treatment in the both groups (@*CONCLUSION@#Compared with conventional acupuncture, combination therapy with row-like puncture at sternocleidomastoid can improve the therapeutic effect of peripheral facial palsy at recovery stage.