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Acute-on-chronic liver failure has complex conditions, rapid progression, and a high mortality rate, and further studies are still needed to clarify its pathogenesis and etiology. The establishment of animal models for acute-on-chronic liver failure can not only provide a good basis for exploring the pathogenesis of acute-on-chronic liver failure, but also provide an experimental basis for clinical treatment. Through a literature review, this article summarizes the methods commonly used to establish the animal models of acute-on-chronic liver failure, including carbon tetrachloride combined with LPS/GaIN, thioacetamide combined with LPS, serum albumin, and bile duct ligation. This article analyzes the characteristics of various animal models, so as to provide documentary and experimental bases for further exploration of more ideal animal models.
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Rotator cuff injury often leads to shoulder pain and dysfunction. For the injured rotator cuff tendon without continuous interruption, conservative treatment is often used. However, the shoulder is used frequent in daily life, which makes that the rotator cuff injury generally shows gradual aggravation and eventually progresses to complete tear due to poor blood supply of the rotator cuff tendon tissue and weak repair ability. In order to reverse the pathophysiological changes after rotator cuff injury and promote the repair of injured rotator cuff tendon, a series of conservative treatments for rotator cuff injury have been explored. Extracorporeal shock wave therapy (ESWT) is one of the representative treatments, but its molecular biological mechanism in promoting rotator cuff repair is still unclear. Therefore, the authors review the progress of ESWT for rotator cuff injury from aspects of the molecular biological mechanism and clinical application status, so as to provide a reference for future researches and clinical application of ESWT.
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Objective:To explore the risk factors related to death in patients with tuberculosis complicated with sepsis in an intensive care unit, in order to provide reference for the clinical treatment of patients with tuberculosis complicated with sepsis.Methods:A retrospective case-control study was conducted to collect the general clinical data of 384 patients with tuberculosis complicated with sepsis in intensive care unit of Public Health Clinical Center of Chengdu from March 2020 to November 2022. Multivariate logistic regression model was used to analyze independent risk factors for death in patients with tuberculosis complicated with sepsis.Results:Among 384 patients with tuberculosis complicated with sepsis, the 28-day mortality rate was 43.2%(166/384). Multivariate logistic regression analysis showed that age ≥60 years old (odds ratio ( OR)=1.924, 95% confidence interval ( CI) 1.033 to 3.585, P=0.039), body mass index (BMI) <18.5 kg/m 2 ( OR=4.496, 95% CI 2.242 to 9.016, P<0.001), acute physiology and chronic health evaluation (APACHE) Ⅱ ≥20 points ( OR=2.133, 95% CI 1.093 to 4.162, P=0.026), blood urea nitrogen-to-albumin ratio>5.945 mg/g ( OR=20.886, 95% CI 10.883 to 40.084, P<0.001) and septic shock ( OR=6.137, 95% CI 2.852 to 13.209, P<0.001) were independent risk factors for death in patients with tuberculosis complicated with sepsis in intensive care unit. Conclusions:Age≥60 years old, BMI<18.5 kg/m 2, APACHE Ⅱ≥20 points, blood urea nitrogen-to-albumin ratio>5.945 mg/g and septic shock are independent risk factors for the death in patients with tuberculosis complicated with sepsis. Early attention should be paid to these patients and cluster therapy should be started as soon as possible in order to shorten the disease process, and to improve the prognosis and reduce mortality.
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The spatiotemporal distribution of growth factors in bone tissue-engineered repair and reconstruction is critical. Growth factors can be used in bone tissue engineering through different encapsulation methods. Different encapsulation methods make growth factors have different release kinetics. At present, the common physical entrapment, easily degradable carrier and simple spatial structure usually result in poor sustained release of growth factors by burst release. The optimization of release methods of growth factors enables their release at different times and spaces in a biomimetric manner, which is conducive to improving the effect of tissue repair and avoiding the adverse effects of excessive factors. Starting from the necessity of spatiotemporal sustained release of growth factors, the authors summarize growth factors can attain spatiotemporal sustained release by being directly immobilized on the surface of the carrier, encapsulated in the carrier, encapsulated in the microparticles and encapsulated in the carrier by the microparticles and review the spatiotemporal sustained release of growth factors in different encapsulation methods, so as to provide a reference for optimizing spatiotemporal release of growth factor in bone tissue engineering.
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Plasma exchange therapy is applied for treatment of severe immune diseases of multiple organ systems and severe liver diseases by removing pathogenic factors and regulating immune function. Regional citrate anticoagulation has no effect on systemic coagulation function and does not increase bleeding risk, and it is one of the optional anticoagulation methods for plasma exchange therapy. This article reviews recent literature on simple plasma exchange therapy with regional citrate anticoagulation to provide a reference for clinical application of this therapy.
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Objective:To investigate the clinical effect of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon.Methods:A retrospective case control study was conducted to analyze the clinical data of 43 patients with moderate full-thickness supraspinatus tendon tear admitted to First Affiliated Hospital of Xi 'an Jiaotong University from January 2018 to June 2020,including 17 males and 26 females,aged from 41 to 68 years[(55.9±8.2)years]. All patients had arthroscopic shoulder supraspinatus tendon suture and acromioplasty,including 22 patients underwent surgery within 1 month after persistent shoulder pain and motion limitation in early group and 21 patients between 1 month and 3 months in late group. The duration of operation and intraoperative blood loss were recorded. The visual analogue scale(VAS),American Shoulder and Elbow Society(ASES)score and Constant-Murley score were assessed before operation and at postoperative 3 weeks,6 weeks,3 months and 6 months. The complications were detected with 6 months after operation. Results:All patients were followed up for 6-7 months[(6.4±0.4)months]. There was no statistical significance in operation duration and intraoperative blood loss between the two groups( P>0.05). At 3 weeks,6 weeks,3 months and 6 months after operation,there showed significant decrease of VAS but significant increase of ASES and Constant-Murley scores compared to preoperation( P<0.05). At 3 weeks and 6 weeks after operation,the VAS in early group[(4.4±0.9)points,(3.7±0.8)points]was lower than that in late group[(5.5±1.0)points,(4.8±1.1)points];while the ASES score[(49.1±4.6)points,(56.8±4.1)points]and Constant-Murley score[(54.1±4.8)points,(64.1±4.4)points]in early group were higher than those in late group[ASES score:(45.2±5.4)points,(50.3±5.4)points;Constant-Murley score:(50.5±3.3)points,(58.2±3.9)points]( P<0.05). At 3 months and 6 months after operation,the two groups showed no statistical significance in these scores. There were no postoperative complications such as infection or nerve injury in both group within 6 months. Conclusion:For moderate full-thickness tear of the supraspinatus tendon,arthroscopic shoulder surgery performed within 1 month after persistent shoulder pain and motion limitation can achieve better pain relief and faster functional rehabilitation in the short term compared with surgery performed 1-3 months later.
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The rotator cuff injury is a kind of chronic tendon disease related to overuse injury. The main clinical manifestations of this disease include shoulder pain and dysfunction,which seriously affects people 's life quality and work capability. Although previous studies have shown that inflammation and de- generation of collagen matrix are closely related to the occurrence and development of this disease,the pathogenesis of the disease is still unclear. In this study,the authors review the pathologic mechanisms of rotator cuff injuries from aspects of oxidative stress,inflammation,macrophage and non-coding RNA so as to provide a reference for subsequent research and treatment.
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Objective To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus ( HCV) genotype 1 infection who were treatment-na?ve or had a virologic failure to prior interferon-based treatment.Methods A multicenter, randomized, open-label, phase 2 clinical trial was conducted.The patients were randomly assigned to yimitasvir phosphate 100 mg+sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+sofosbuvir 400 mg group ( Group 200 mg) in a 1∶1 ratio with the stratified factors of " treatment-naive" or"treatment-experienced" for 12 weeks and followed up for 24 weeks after the end of treatment.During the clinical trial, HCV RNA was tested in all patients.Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored.Safety and tolerability were assessed by monitoring adverse events , physical examination , laboratory examination, electrocardiogram, and vital signs during the study.The primary end point was SVR12 after the end of therapy.Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables.Descriptive statistics were used and summarized according to HCV genotypes and treatment groups.Safety data were presented using descriptive statistics and summarized according to treatment groups.Results A total of 174 subjects were screened from July 31, 2017 to September 26, 2018.One hundred and twenty-nine patients were successfully enrolled and received treatment , and 127 completed the study.There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively.Among the 129 patients who underwent randomization and were treated , 18.6% were treatment-experienced and: 100%were HCV genotype 1b infection.The total SVR rate was 98.4%(127/129), with 98.4%(63/64, 95%confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50%(64/65, 95%CI: 91.72%-99.96%) in the Group 200 mg.There was no significant difference between the two groups (χ2 =0.000 2, P=0.989 2).The SVR rates in treatment-naive group and treatment-experienced group were 98.10%(95%CI: 93.29%-99.77%) and 100.00%(24/24, 95%CI: 85.75%-100.00%), respectively.Virological failure during treatment ( including breakthrough , rebound and poor efficacy) and relapse after treatment did not occur during the trial.By Sanger sequencing , 11.6%(15/129) patients had baseline NS5A Y93H/Y or Y93H resistance-associated substitutions ( RAS), 1.6%( 2/129) patients had baseline NS5A L31M RAS.No mutation was observed in NS5B S282 at baseline.There was no S282 mutation in HCV NS5B.A total of 100 (77.5%) subjects had adverse events.No adverse events ≥Grade 3 or severe adverse events related to the study treatment.No patient prematurely discontinued study treatment owing to an adverse event.No life-threatening adverse event was reported.Conclusion Twelve weeks of yimitasvir phosphate 100 mg or 200 mg combined with sofosbuvir 400 mg daily is a highly effective and safe regimen for patients without cirrhosis with HCV genotype 1b infection who had not been treated previously or had a virologic failure to prior interferon-based treatment.
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Objective@#To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks.@*Methods@#Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations.@*Results@#Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29).@*Conclusion@#Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.
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Objective@#To investigate the prognostic relationship between the expression levels of periostin (POSTN) in hepatocellular carcinoma (HCC) tissues as well as its effect in invasion and metastasis.@*Methods@#The expression levels of POSTN in liver cancer tissues were detected with real-time quantitative PCR (QPCR) and immunohistochemistry (IHC). Kaplan-Meier method and Log-rank test were used to analyze the relationship between POSTN expression level and postoperative prognosis in patients with liver cancer. The expression of POSTN in hepatocellular carcinoma cells with different metastasis characteristics were detected in vitro and the overexpression of POSTN in low metastatic hepatocellular carcinoma cells was mediated through plasmid transfection techniques. The effects of POSTN on invasion and metastasis of hepatocellular carcinoma cells were determined by transwell migration and matrigel invasion assay. The comparative expression level of POSTN was analyzed by t-test.@*Results@#The expression levels of POSTN in tissues from high to low was in the order of metastatic liver cancer tissues, non-metastatic liver cancer tissues and normal liver tissues (P = 0.006). The median survival time and 3-year survival rate in postoperative patients with hepatocellular carcinoma of high POSTN expression level were significantly lower than the low expression group (10.00 months, 44.44%; 59.00 months, 53.13%, P = 0.031 2). In in vitro testing, the expression of POSTN was highest in MHCC97H cells with high metastatic characteristics as compared with Huh7 and MHCC97L cells with low and medium metastatic characteristics. After overexpression of POSTN in MHCC97L cells, the migration and invasion capacity of MHCC97L cells was increased.@*Conclusion@#POSTN is associated with pathological processes such as metastasis and invasion of liver cancer, which may promote the migration and invasion of liver cancer cells. It is expected to be an important prognostic biomarker of tumor recurrence and a therapeutic target for inhibiting the occurrence of metastasis in postoperative patients with hepatocellular carcinoma.
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Objective To study the application effects of timely regional vascular occlusion in primary liver cancer(PLC) surgery. Methods Eighty-eight patients with PLC who underwent surgery in the Department of General Surgery of Yan'an University Affiliated Hospital from January 2014 to December 2016 were selected for prospective study, and they were divided into the experimental group and the control group by the random number table method, 44 cases of each group. In the experimental group, the blood supply was blocked with timely regional vascular occlusion while in the control group, the blood supply was blocked with half hepatic vascular occlusion. The occurrence of postoperative complications, and surgical indexes(surgical time, intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume, abdominal drainage volume and hospital stay), levels of alanine aminotransferase, albumin and total bilirubin, levels of CD3+, CD4+, CD8+ and CD4 + /CD8 +, effective rate, control rate, and clinical efficacy were compared between the two groups. Measurement data with normal distribution were represented as (x) ± s and analyzed using the independent-sample t test between the two groups; within the groups, paired t-tests were used. Comparison of count data were represented as n(% ), and analyzed using the chi-square test. Results The intraoperative blood loss, time of hepatic portal occlusion, blood transfusion volume and hospital stay of the experimental group were(331. 48 ±30.65) ml, (14.78土2.27) min, (132.61 ±13.87) ml, (9.29土1.19) d, and the control group were (500.61 ±50.62) ml, (23.96±2.89) min, (305.76 ± 30.64) ml, (12.10 ± 1.22) d, with statistically significant differences in above indexes between the two groups(all P< 0.05). The operation time and abdominal drainage volume in the experimental group were(146.86 ± 15.87) min and(321.77 ±33.65) ml respectively, while those in the control group were (143.07土15.35) min and(335.18 ±33.82) ml respectively, there was no significant difference between the two groups(P> 0.05 ). After surgery, the levels of alanine aminotransferase, total bilirubin and albumin of the experimental group were(54.86 ±5.61) U/L, (20.65 ± 2.32) U/L, (41.95土4.32) ng/ml, and the control group were(120.75 ± 13.03) U/L, (35.42+3.21) U/L, (70.25 ±7.45) ng/ml, with statistically significant differences in above indexes between the two groups(all P <0.05). After surg;ery, the levels of CD3 +, CD4+, CD8 + and CD4 + /CD8 + of the experimental group were 0.63 ±0.16, 0.52 ± 0.11, 0.20 ±0.04, 1.70 ±0.17 and the control group were 0.56 ±0.14, 0.45±0.12, 0.26 ± 0.05, 1.46土0.22, with statistically significant differences in above indexes between the two groups (all P< 0.05 ). There were no differences between the experimental group and the controlg roup in the response rate and the control rate(75.00% vs.79.55%; 88. 64% vs.90.91% ) (P>0.05). Conclusions The application of timely regional vascular occlusion in PLC surgery can reduce the intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume and hospital stay, improve the immune level and liver function. And there is no difference in response rate and control rate compared with half hepatic vascular occlusion, therefore it is worthy of clinical application.
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Objective To establish a three-dimensional finite element model of pelvic anteroposterior compression (APC) for analysis of mechanisms for related liganentous damages.Methods A finite element model and a laboratory mechanical model of APC were established using the same pelvic specimens.In a finite element model of normal pelvic bones and ligaments,after the right pelvis was fixated the pubic symphysis (PS) was sectioned.Next,a manual external mobile force was gradually applied to the left hemipelvis to make the PS diastasis 10,20,30,40,60,80 and 100 mm apart.The mechanical experiment revealed the anterior sacroiliac ligament (ASIL) was ruptured when the PS diastasis reached 28 mm.After the strain value of ASIL was calculated through the finite element model,it was applied to the other pelvic ligaments.The displacement in front of the sacroiliac joint (SIJ),stress,strain and extent of injury and disruption of sacrotuberous/sacrospinous ligaments (STL/SSL) with a corresponding PS diastasis were observed and recorded.Results ASIL failed at the point when the PS diastasis was 28 mm and the displacement in front of SIJ was 7.41 ± 1.14 mm.The strain and maximum principal stress of ASIL calculated in the finite element model were 259.5% and 543.24 MPa respectively.The maximum principal stress value of SSL was 35.00 MPa at the point of failure when the PS diastasis and the displacement in front of SIJ were 51 mm and 15.23 ±2.88 mm,respectively.When the PS diastasis and the displacement in front of SIJ were 100 mm and 7.5 mm respectively,the maximum principal stress value of STL was 16.17 MPa but the strained ligament was not ruptured.When the pelvis was rotated externally step by step,the ASIL failure was followed by the rupture of SSL but not necessarily by the STL failure.Conclusion As the finite element pelvic bone-ligament model established in this study can effectively simulate the mechanisms for APC injury,it can be used to evaluate different extents of pelvic ligamentous injury,providing a basis for the biomechanical study of pelvic bones and ligaments.
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Objective To compare the effects of fixations with dynamic hip screw (DHS),percutaneous compression plate (PCCP) and proximal femoral nail anti-rotation (PFNA) for treatment of intertrochanteric femoral fractures with paries medialis defect.Methods We reviewed the 82 patients with femoral intertrochanteric fracture and paries medialis defect who had been treated at our department from January 2011 to July 2016.They were 42 men and 40 women,aged from 27 to 91 years (average,73.0 years).According to the AO classification,72 cases belonged to type 31-A2.2,10 to type 31-A2.3.Of them,9 cases were treated with DHS,17 cases with PCCP and 56 cases with PFNA-1].The 3 groups were compared in terms of intraoperative blood loss,blood infusion,fluid infusion,operation duration,time for fracture union,postoperative complications and Functional Recovery Score (FRS) of the hip 12 months after operation.Results The fluid infusion [1,100 (850,1,100) mL] and intraoperative blood loss [60 (5,100) mL] in the PCCP group were significantly less than in the PFNA group [1,100 (1,000,1,700) mL and 150 (50,300) mL] and the operation duration (91.4 ± 29.2 min) in the former was significantly shorter than in the latter [121 (85,185) min] (P < 0.05).No significant difference was found between the 3 groups in blood infusion (P > 0.05).Of the patients,57 (8 DHS,12 PCCP and 37 PFNA ones) were followed up for an average of 47 months (from 15 to 85 months).There were no statistically significant differences between the 3 groups in time for fracture union,complications,or average FRS score of the hip 12 months after operation (P > 0.05).Conclusions For unstable intertrochanteric fractures with paries medialis defect,it is not clear that intramedullary nails are superior to extramedullary fixation.Intramedullary nails like PFNA may be suggested for patients with better preoperative conditions while extramedullary fixation like PCCP suggested for those with poor general conditions.
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Liver pathological examination plays an important role in guiding clinical treatment and evaluating disease prognosis, especially in the diagnosis of difficult liver diseases. The application of liver biopsy and proper pathological techniques helps pathologists to observe the morphological changes of the liver and thus provides a reference for disease diagnosis, differential diagnosis, and clarification of etiology. This article introduces the commonly used techniques for liver biopsy, in order to improve the understanding of liver pathological changes among clinicians, strengthen the association between clinical practice and pathology, and provide help to the diagnosis of liver diseases, especially difficult liver diseases.
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Objective To investigate the effects of peptidoglycan (PGN) with different concentrations on Toll-like receptor 2 (TLR2),Toll-like receptor 4 (TLR4) expression in corneal epithelial cells of mice.Methods Corneal epithelial cells of c57 mice were cultured in vitro.Cells were divided into blank control group and 10 mg · L-1 group,30 mg · L-1 gruop and 80 mg · L-1 group (treated by different concentration of PGN for 12 hours).In the meantime,the cells in 30 mg · L-1 group were cultured for different times(named 12 hours group,24 hours group,36 hours group).Expressions of TLR2 and TLR4 mRNA and protein in different group were measured by RT-PCR and flow cytometry.Results Compared with control group (1.00 ± 0.14,1.00 ± 0.01),the expression of TLR2,LR4 mRNA in 10 mg · L-1 group (4.35 ± 0.46,3.53 ± 0.50),30 mg · L-1 group (8.06 ±0.72,5.31 ±0.34),80 mg · L-1 group (2.93 ±0.46,2.23 ±0.04) were increased,the differences were statistically significant (all P < 0.05).Compared with control group,the expression of TLR2,TLR4 protein in different concentration group and 12 hour group were increased,the differences were statistically significant (all P < 0.05).Conclusion PGN can up-regulate both mRNA and protein expression of TLR2 and TLR4 in corneal epithelial cells of mice,suggest that TLR2 and TLR4 in the corneal epithelial cell can recognize some exogenous pathogen and regulate the inflammatory reaction,which are closely related to the occurrence and development of infectious keratitis.
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Introduction: Le glaucome chronique à angle ouvert ou glaucome primitif à angle ouvert (GPAO) est une neuropathie optique antérieure, d'évolution chronique et progressive, caractérisée par des altérations périmétriques et une excavation papillaire pathologique, avec généralement, une élévation de la pression intraoculaire (PIO). Notre étude a pour objet de décrire l'aspect épidémiologique et clinique du GPAO chez les patients de 40 ans et plus au CHU-IOTA. Matériels et méthodes: Il s'agissait d'une étude prospective de type descriptif de 2 mois, portant sur des patients ayant un GPAO et ayant au moins un des trois signes suivants l'hypertonie oculaire >21mmHg, l'excavation papillaire cup/disc vertical â¥0,5 et le champ visuel altéré. Tous les patients glaucomateux ayant consulté pendant la période d'étude ont bénéficié d'un examen ophtalmologique complet. Les variables étudiées étaient : l'âge, les antécédents familiauxde glaucome, d'hypertension artérielle, de diabète, la PIO et la pachymétrie. Résultats:L'étude a porté sur 200 patients âgés de 40 ans et plus avec un âge moyen de 57.6 ans, le sexe ration M/F était de 1,74en faveur du sexe masculin qui était représenté par 63,5%. La baisse d'acuité visuelle était le principal motif de consultation ophtalmologique avec (55,9 %) suivi des céphalées (23,1 %). Plus d'un quart des patients (29,5 %) avaient des antécédents familiaux de glaucome, environ 2/3 des patients (63%) avaient une pachymétrie inférieure à la normale et. l'Hypertension artérielle (HBP) représentait 66,5 % des antécédents médicaux, suivi de diabète (15 %). Conclusion:Le GPAO est caractérisé principalement par des antécédents médicaux surtout l'hypertension et des antécédents familiaux de glaucome pouvant entraîner la cécité si le dépistage n'est pas précoce ou si un traitement est mal conduit. D'où l'intérêt d'une prévention par le dépistage et l'information de la population sur cette pathologie
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Case Reports , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/epidemiology , MaliABSTRACT
AIM: To evaluate the relationship between central corneal thickness and intraocular pressure in healthy and glaucomatous eyes of adults. To make up to date summary of the results of studies done on the association of central corneal thickness measurements and intraocular pressure measurements in Glaucoma patients and in healthy subject. ●METHODS: To identify relevant studies a search of MEDLINE and Science Direct databases for studies investigating the relationship between central corneal thickness ( CCT ) and intraocular pressure ( lOP ) was conducted. The Search period was from Sep. 10th to Oct. 28th of 2015. Search key words included: central corneal thickness, intraocular pressure, glaucoma, ocular hypertension, exfoliative glaucoma, applanation tonometry, pachymetry, primary open angle glaucoma, Goldmann applanation tonometry. Ln addition, a manual search of “The Year Book of Ophthalmology” Journals 2004 to 2006 lssues in the Southern Medical University Library English language section was done. The following exclusion criteria applied:1) non-English media studies;2 ) studies done before 2005; 3 ) case series and case reviews; 4 ) studies involving treatment protocols or surgical techniques; 5 ) studies comparing glaucomatous eyes with other conditions such as diabetes, hypertension or cardiovascular disease as secondary variables; 6 ) studies with children as study subjects; 7 ) studies with animal subjects. ●RESULTS: There were 12 observational studies and 1 case control study included. Compared to control subjects, patients had significantly increased lOP ( SMD:0. 50, 95% Cl:0. 30~0. 70, Z=4. 88, P ● CONCLUSION: It has been established that glaucomatous eyes tend to have thinner CCT and higher lOP compared to normal eyes.
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Background The effects of Toll-like receptor 2 (TLR2) in grafting-related immune diseases have attracted more and more attention.Blocking TLR2 signal pathway can extend the survival time of heart and kidney grafts.However, the effects of anti-TLR2 monoclonal antibody on corneal graft have not been confirmed.Objective This study was to investigate the influence of anti-TLR2 monoclonal antibody on corneal graft survival in the rats received penetrating keratoplasty (PKP).Methods Allograft corneal transplantation was performed on the right eyes of 24 SPF female Wistar rats to establish PKP models,with 12 SD rats as donors.The model eyes were randomized into the TLR2 monoclonal antibody group and the model group.Anti-TLR2 monoclonal antibody of 15 μg/30 μl was subconjunctivally injected on day 0,2,4,6 and 8 following the modeling in the TLR2 monoclonal antibody group,and equal amount of normal saline was injected in the same way in the model group.The edema,transparency and neovascularization were observed under the slit lamp microscope after surgery, and rejection index (RI) was scored based on the criteria of Holland.Corneal tissue sections of the rats were prepared for the histopathological examination on day 9 and 15 after operation.The research protocol was approved by the Southern Medical University Ethics Committee.Results Mild corneal edema was found in the two groups 1-4 days after operation.A lot of new blood vessels, edema and opacification of corneas were seen in the model group 9-14 days after operation,but in the TLR2 monoclonal antibody group,corneal opacification was found 15 days after operation.The RI scores were significantly higher in the model group than those in the TLR2 monoclonal antibody group 5,9,15 days after operation (t=4.183,4.954,13.506;all at P<0.05).The survival time in the TLR2 monoclonal antibody group was 15.5 days,with the 95% confidence interval (CI) 14.9-16.1;while that in the model group was 9.5 days,with the 95% CI 8.7-10.3, showing a significant difference between the two groups (Z =12.728,P =0.001).The corneal histopathological examination revealed that corneal stromal edema,infiltration of inflammatory cells and vascular lumen were more prominent 9 and 15 days after operation in the model group than those in the TLR2 monoclonal antibody group.Conclusions Anti-TLR2 monoclonal antibody can inhibit inflammatory response after allograft corneal transplantation and therefore extend the survival time of graft in rats.
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Tenascin-C (TNC) is an extracellular matrix glycoprotein, which is usually highly expressed in embryonic tissues and tumor tissues, but is not expressed or just lowly expressed in mature tissues. TNC is involved in various complex signaling pathways during tumor metastasis, especially through modulating FAK, RhoA, Wnt and Notch pathways by interacting with syndecan-4, integrin α5β1, matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF). As a result, TNC affects epithelial mesenchymal transition, tumor cell adhesion, proliferation and angiogenesis, which eventually enhances the invasion and metastasis ability of many tumors. Further studies have demonstrated that TNC could be used as prognosis or metastasis marker of patients with malignant tumor.
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Humans , Cell Adhesion , Integrins , Matrix Metalloproteinases , Neoplasm Metastasis , Neoplasms , Neovascularization, Pathologic , Signal Transduction , Tenascin , Physiology , Vascular Endothelial Growth Factor AABSTRACT
BACKGROUND:Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period. OBJECTIVE:To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states. METHODS:Thirty patients undergoing total knee arthroplasty were randomly al ocated to control group and LIA group, receiving oral non-steroidal anti nflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9%saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded. RESULTS AND CONCLUSION:Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. Al the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions.