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AIM: To explore a more convenient and accurate method for evaluating the anterior chamber angle width based on the Van Herick method.METHODS:A total of 58 patients(69 eyes)with age-related cataract who visited our hospital between January and December 2021 were included. They were divided into the chamber angle width ≥1/2 corneal thickness(CT)group(44 eyes of 37 cases)and <1/2CT group(25 eyes of 21 cases)according to the Van Herick method. The central anterior chamber depths and the peripheral anterior chamber angle degrees were measured by ultrasound biomicroscopy.RESULTS: There were statistically significant differences in central anterior chamber depth between the two groups(2.64±0.27 mm vs. 2.23±0.29 mm, P<0.01), and the differences of chamber angle degrees of quadrants of superior, temporal, inferior and nasal compared between two groups were all statistically significant(P<0.01). The difference of chamber angle degrees of quadrants of superior and inferior in chamber angle width ≥1/2CT group was not statistically significant(P>0.05), while the differences of chamber angle degrees of other quadrants were all statistically significant(P<0.05). The differences of chamber angle degrees of quadrants of superior and nasal, temporal and the chamber angle degrees of quadrants of inferior and temporal were all statistically significant in chamber angle width <1/2CT group(P<0.05).CONCLUSION: In the overall evaluation of the anterior chamber angle, it would be more simple, fast and accurate when evaluating the temporal chamber angle width and inferior quadrant of chamber angle width by using the Van Herick method under silt lamp.
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OBJECTIVE To investigate the effect of erianin on the angiogenesis of glomerular endothelial cells in diabetic nephropathy(DN)rats and the role of slit homolog 2 protein(Slit2)/roundabout homolog 1(Robo1)consecutive signaling pathway.METHODS Rats were fed with high sugar and high fat feed for 8 weeks,before being intraperitoneally injected with streptozotocin solution(35 mg·kg-1)to prepare a DN rat model.DN rats were divided into the model group and model+erianin 10,20 and 40 mg·kg-1 groups,with 10 rats in each,while another 10 rats served as normal control group.The urine protein quantification kit was used to measure the 24 h urine protein level of rats in each group while the automatic biochemical analyzer was used to detect the fasting plasma glucose(FPG)and serum creatinine(Scr)levels of rats in each group.PAS staining was applied to observe the pathological changes in the renal tissue of rats in each group.Immunofluorescence was used to detect the expressions of platelet endo-thelial cell adhesion molecule-31(CD31)and podocalyxin(PCX)in kidney tissue of rats in each group.Western blot was adopted to detect the expressions of Slit2 and Robo1 proteins in the renal tissues of rats in each group.RESULTS Compared with normal control group,the CD31 protein expressions,FPG,Scr,24 h urine protein levels,and renal tissue Slit2 and Robo1 protein expressions were significantly increased in the model group(P<0.05).Pathological and immunofluorescence results suggested that rats in the model group developed many neoplastic glomerular capillaries,glomerular hypertrophy,and dilated mesangial areas,with non-tubular CD31 staining lacking adjacent PCX staining,and partial staining of tubular areas of CD31 lacking adjacent PCX staining.Compared with the model group,the CD31 glomerular endothelial area,FPG,Scr,24 h urine protein levels,and protein expressions of Slit2 and Robo1 in renal tissues were significantly reduced in the model+erianin 10,20 and 40 mg·kg-1 groups(P<0.05).Pathological and immunofluorescence results showed new glomerular capillaries,glomerular hypertrophy and dilatation of the thylakoid area were attenuated in rats,and CD31 tubular region staining was essentially adjacent to the PCX foot cell region staining in the model+erianin 10,20 and 40 mg·kg-1 groups.CONCLUSION Erianin may inhibit angiogenesis in glomerular endothelial cells of DN model rats by inhibiting the Slit2/Robo1 signaling pathway.
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The incidence of diabetes is rising globally with Qatar being ranked as the 3rd highest country for the prevalence of diabetes in the Middle East and North African (MENA) region. Diabetic retinopathy (DR) is the main cause of sight-threatening complications of diabetes. Significant advances in screening and treatment for DR have emerged in the last few decades with a strong impact on the accuracy and effectiveness of screening. DR being a preventable cause of blindness with early detection and interventions like laser photocoagulation and anti-vascular endothelial growth factor (anti-VEGF) treatments makes it imperative to invest in early recognition and treatment for DR. Globally screening is done by direct/indirect ophthalmoscopy or retinal photography with huge variations in early diagnosis. Studies have revealed the superiority of three-field retinal photography when compared to direct ophthalmoscopy, for DR screening, even if performed by an experienced ophthalmologist. The two most sensitive means of detection at present are digital retinal imaging and slit lamp examination post mydriasis. Both modalities require assessment by trained personnel. Digital retinal photography is extremely quick, allows the creation of permanent records and with the advent of semiautomatic nonmydriatic cameras, requires less skill as compared to the use of a slit lamp. Hence, should digital retinal photography be a preferred standardised method for retinal screening in Qatar?
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Purpose: To compare the slit?lamp method and wavefront aberrometry method based on outcomes of toric realignment surgeries. Settings: Tertiary care ophthalmic hospital. Design: Retrospective study. Methods: This study included all eyes undergoing toric intraocular lens (TIOL) realignment surgery between January 2019 and December 2021 for which TIOL axis assessment by slit?lamp method and wavefront aberrometry method was available. Data were retrieved from electronic medical records, and we documented demographics, uncorrected visual acuity (UCVA), subjective refraction, and TIOL axis by slit?lamp and wavefront aberrometry methods on postoperative day 1 and day 14. In patients with misalignment, TIOL was realigned to the original position in group 1 (27 patients) and to an axis based on calculations provided by wavefront aberrometer in group 2 (25 patients). Post?realignment surgery, UCVA, subjective refraction, and TIOL axis by slit?lamp and wavefront aberrometry methods were assessed and analyzed. Results: We analyzed 52 eyes and found that the mean preoperative misalignment with the slit?lamp method (44.9° ±20.0°) and wavefront aberrometry (47.1° ±19.5°) was similar. The corresponding degrees of misalignment post?TIOL repositioning surgeries were 5.2° ±5.2° (slit?lamp method) and 4.7° ±5.1° (wavefront aberrometry) (P = 0.615). Both groups showed significant improvement in median log of minimum angle of resolution (logMAR) UCVA and reduction in median refractive cylinder. Conclusions: Slit?lamp method is as good as wavefront aberrometer method to assess TIOL axis. Toric realignment surgery is found to be safe, and realigning TIOL based on either slit?lamp method or wavefront aberrometer method equally improved UCVA and decreased residual refractive cylinder.
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ABSTRACT Purpose: This study aimed to use computational models for simulating the movement of respiratory droplets when assessing the efficacy of standard slit-lamp shield versus a new shield designed for increased clinician comfort as well as adequate protection. Methods: Simulations were performed using the commercial software Star-CCM+. Respiratory droplets were assumed to be 100% water in volume fraction with particle diameter distribution represented by a geometric mean of 74.4 (±1.5 standard deviation) μm over a 4-min duration. The total mass of respiratory droplets expelled from patients' mouths and droplet accumulation on the manikin were measured under the following three conditions: with no slit-lamp shield, using the standard slit-lamp shield, and using our new proposed shield. Results: The total accumulated water droplet mass (kilogram) and percentage of expelled mass accumulated on the shield under the three aforementioned conditions were as follows: 5.84e-10 kg (28% of the total weight of particle emitted that settled on the manikin), 9.14e-13 kg (0.045%), and 3.19e-13 (0.015%), respectively. The standard shield could shield off 99.83% of the particles that would otherwise be deposited on the manikin, which is comparable to 99.95% for the proposed design. Conclusion: Slit-lamp shields are effective infection control tools against respiratory droplets. The proposed shield showed comparable effectiveness compared with conventional slit-lamp shields, but with potentially enhanced ergonomics for ophthalmologists during slit-lamp examinations.
RESUMO Introdução: Os oftalmologistas têm alto risco de contrair a doença do Coronavírus-19 devido à proximidade com os pacientes durante os exames com lâmpada de fenda. Usamos um modelo de computação para avaliar a eficácia das proteções para lâmpadas de fenda e propusemos uma nova proteção ergonomicamente projetada. Métodos: As simulações foram realizadas no software comercial Star-CCM +. Os aerossóis de gotículas foram considerados 100% de água em fração de volume com distribuição de diâmetro de partícula representada por uma média geométrica de 74,4 ± 1,5 (desvio padrão) μm ao longo de uma duração de quatro minutos. A massa total de gotículas de água acumulada no manequim e a massa expelida pela boca do paciente foram medidas em três condições diferentes: 1) Sem protetor de lâmpada de fenda, 2) com protetor padrão, 3) Com o novo protetor proposto. Resultados: A massa total acumulada das gotas de água (kg) e a porcentagem da massa expelida acumulada no escudo para cada uma das respectivas condições foram; 1) 5,84e-10 kg (28% do peso total da partícula emitida que assentou no manequim), 2) 9,14e-13 kg (0,045%), 3,19e-13 (0,015%). O escudo padrão foi capaz de proteger 99,83% das partículas que, de outra forma, teriam se depositado no manequim, o que é semelhante a 99,95% para o projeto proposto. Conclusão: Protetores com lâmpada de fenda são ferramentas eficazes de controle de infecção contra gotículas respiratórias. O protetor proposto mostrou eficácia comparável em comparação com os protetores de lâmpada de fenda convencionais, mas potencialmente oferece uma melhor ergonomia para oftalmologistas durante o exame de lâmpada de fenda.
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Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.
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Fundus photography is an arduous task as it involves using 90 D in one hand and a smartphone attached on an eyepiece of a slit-lamp biomicroscope in the other hand. Similarly, with a 20 D lens, the filming distance is adjusted by moving the lens or mobile forward or backward, which makes it difficult to adjust and focus the image in busy ophthalmology outpatient departments (OPDs). Moreover, fundus camera costs thousands of dollars. Authors describe a novel technique of performing fundus photography with a 20 D lens and a universal slit-lamp–mounted mobile adapter made from trash. By the use of this simple, yet frugal innovation, primary care physicians or ophthalmologists without a fundus camera can easily snap a fundus photo and subject it to digital analysis by retina specialists across the world. This will help in simultaneous ocular examination and fundus photos taken via mounted 20 D on a slit lamp itself and also reduce the need for unnecessary retina referrals to tertiary eye care centers.
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Background: Toric Intraocular lenses (IOLs) are supposed to be aligned at a particular axis for spectacle?free vision for distance. The evolution of topographers and optical biometers has made it quite achievable for us to aim the target. However, the result sometimes remains unpredictable. A big aspect of this depends on the preop axis marking for toric IOL alignment. Errors in axis marking have been reduced recently with the array of different toric markers in the market, but still we see postoperative refractive surprises due to faulty marking. Purpose: In this video, we present a novel slit lamp–based toric marker innovation, STORM, which gives us a hands?free approach to a reliable and accurate axis marking on the cornea. The axis marker is a simple modification to our age?old marker, with the advantage of no touch and slit?lamp assistance, which will make it error free and easy to use. Synopsis: The present innovation answers the problem statement of stable, economical, and accurate marking solution. Many a times, hand?holding devices create inaccurate and stressed condition while marking the cornea before corneal surgery. Highlights: The invention can be used for marking of accurate and easy astigmatic axis of a toric IOL preoperatively, that is, before the surgery. If the appropriate device is used to mark the cornea, it would impact the outcome of surgery. This device also makes the patient and the surgeon comfortable to mark the cornea with accuracy and without hesitation
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Introduction: Kite flying is a colourful festival; it is unfortunately associated with a significant number of in-cising injuries of neck and face caused by the kite string (Manja). The emergency departments report a large number of patients with such injuries during this festival. Materials And Methods: Patients presented to the Emergency Department at Civil Hospital, Gandhinagar on 14th and 15th January with neck and face injury caused by contact with kite string were included in study. Af-ter careful assessment (primary and secondary survey) patients were classified as Superficial (Laceration lim-ited to the skin and subcutaneous tissue) or Deep injury (breach of the platysma, and damage to muscles, thy-roid gland, neurovascular or airway involvement). Results: 20 patients were included in study. Out of which 18 were males and 2 were females. Amongst 18 males 2 were children. Two patients wearing a helmet suffered an injury to the nose. The neck zones involved in the injury, 5 cases involved zone I injury, 9 cases in zone II, 4 cases were in zone III and the remaining 2 had the nasal injury. Conclusion: From this study we conclude that kite string injury lead to serious damage to local tissues. Using protective measures can reduce the incidence and severity of injuries
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Purpose: The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit?lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open?angle glaucoma (POAG) patients. Methods: This was a cross?sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit?lamp fundoscopy with a +78 D lens and high?definition (HD)?OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit?lamp biomicroscopy with best?corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD?OCT. Results: The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit?lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1–0.77), whereas on HD?OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07–0.81). The mean deviation on visual field testing in decibels was ?14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit?lamp biomicroscopy and DDLS staging by HD?OCT parameters was r = 0.96. Conclusion: There is a positive correlation between the DDLS system of optic disk evaluation on slit?lamp biomicroscopy and most of the HD?OCT evaluation parameters
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Allergic rhinitis addresses a hyperactivity of the resistant framework in any case harmless particles making a fiery reaction where none is required. Allergic Rhinitis is clinically represented by a mixture of two or additional nasal symptoms: running, blocking, itching and sneezing. Allergic rhinitis is regularly partitioned by age, seriousness, and duration of symptoms. Investigation represents how epidemiologic evaluations on the commonness of hypersensitive or allergic rhinitis shift considerably with whether both clinical appraisal and testing were utilized to make the determination. The treatment of allergic rhinitis should combine allergen avoidance, pharmacotherapy and allergen immunotherapy. Treatments of allergic rhinitis include intranasal corticosteroids, oral and topical antihistamines, decongestants, intranasal cromolyn, intranasal anticholinergics. First-generation and Second-generation oral antihistamines and intranasal corticosteroids are the most effective modality for treating allergic rhinitis. Immunotherapy is an efficient immune-modulating treatment that ought to be counseled if pharmacologic medical care for allergic rhinitis isn't effective or not tolerated. This article provides an overview of the prevalence, pathophysiology, diagnosis, and appropriate management of the allergic rhinitis.
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Aims: Image-guided systems are the gold standard for determining toric intraocular lens (IOL) axis alignment. However, their high cost prevents widespread use of these systems. As an alternative, a simpler and affordable method could be performed manually using a slit-lamp biomicroscope. This study aims to compare the accuracy of manual toric IOL axis marking using a slit-lamp compared to the CALLISTO eye image-guided system.Study Design: Prospective comparativeMethods: In this prospective study, toric IOL axis alignment of 42 eyes with cataract and coexisting corneal astigmatism were evaluated using manual slitlamp method and CALLISTO eye image-guided method. Preoperative and postoperative uncorrected visual acuity, best corrected visual acuity, amount of spherical and astigmatic refractive errors, and postoperative IOL axis alignment were evaluated. Intraclass correlation of the manual method was calculated and the difference of IOL axis alignment to the image-guided method was compared.Results: Toric IOL implantation reduced the amount of astigmatic refractive error from -1.63 � 0.65 D to -0.50 � 0.19 D in the image-guided group and from -1.93 � -0.90 D to -0.87 � 0.26 D in the manual slitlamp group. As many as 90.5% of eyes in the image-guided group and 81.0% of eyes in the manual slitlamp group reached the target induced astigmatism (p=0.38). Manual axis marking showed intraclass correlation of 99.3%. However, when the manual method was compared to the image-guided method a mean difference in axis alignment of 10.98o (95% confidence interval: 9.32o - 12.63o) was observed.Conclusions: Alignment of toric IOL axis using the manual method demonstrated a consistent result; yet producing a considerable difference to the result of the image-guided method.
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Objective:To identify clinical characteristics of slit ventricle syndrome (SVS) in children, thus improving pediatricians′ understanding of pediatric SVS.Methods:Clinical data of children diagnosed as SVS in the Emergency Department of Beijing Children′s Hospital, Capital Medical University from June 2015 to May 2019 were collected and retrospectively analyzed.Results:A total of 10 children with SVS were included, including 3 cases of arachnoid cyst, 3 cases of congenital hydrocephalus, 2 cases of Dandy-Walker syndrome, 1 case of idiopathic intracranial hypertension syndrome, and 1 case of hydrocephalus secondary to intracranial hemorrhage as the primary disease.The age of first shunting, and that at diagnosis of SVS were 1.3 (0.3-12.8) years, and 9.9 (3.8-13.3) years, respectively.SVS-associated symptoms appeared in 4.4 (0.5-12.0) years after shunting, including intermittent headache (10/10 cases), vomiting (10/10 cases), irritability (4/10 cases), seizures (5/10 cases), diminution of vision (2/10 cases), and intracranial hypertension (10/10 cases) at varying severities.When SVS occurred, the cerebral ventricle presented slit-like morphology.Three cases were relieved with mannitol treatment and 7 cases were treated with emergency lumbar-peritoneal shunt after mannitol failure.During 1-5 years of follow-up, 9 patients did not have SVS-associated symptoms and 1 case with medical therapy had recurrences.Conclusions:SVS is a rare complication after shunt surgery, with the clinical manifestations of intermittent headache and slow valve refilling conforming; imaging showed that the cerebral ventricle was slit-like morphology.When there are signs of intracranial hypertension after shunting and there is no cerebral ventricle dilatation in imaging, SVS should be highly vigilant.Once SVS is confirmed, surgical intervention should be introduced as early as possible after treatment failure of medication, so as to improve the prognosis.
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ABSTRACT Here, we describe the result of a Descemet's membrane endothelial keratoplasty for acute corneal hydrops in a 45-year-old female with keratoconus, who presented with severe visual loss in her OS. The patient's best-corrected visual acuity was 20/80 in the right eye and hand motion in the OS. Slit-lamp examination revealed an extensive tear of the Descemet's membrane and stromal corneal edema in the OS. We opted for Descemet membrane endothelial keratoplasty. Twelve months postoperatively, the patient had a best-corrected visual acuity of 20/50 in the OS.
RESUMO Trata-se de uma paciente do sexo feminino, de 45 anos, portadora de ceratocone, submetida a uma ceratoplastia endotelial com membrana Descemet após apresentar um quadro de perda de visão severa devido a uma hidrópsia corneana aguda no olho esquerdo. Inicialmente, a acuidade visual corrigida da paciente era de 20/80 no olho direito e de movimento de mãos no olho esquerdo. Após exame de biomicroscopia que detectou uma extensa rotura da membrana de Descemet e edema estromal, optamos por tratar esse caso com o ceratoplastia endotelial com membrana Descemet. Doze meses após o procedimento cirúrgico, percebeu-se uma melhora do edema corneano, não havia sinais de rejeição do botão óptico e a acuidade visual corrigida da paciente era de 20/50 no olho afetado.
Subject(s)
Humans , Female , Middle Aged , Corneal Edema , Corneal Transplantation , Descemet Membrane , Descemet Stripping Endothelial Keratoplasty , Endothelium, Corneal , Visual Acuity , Corneal Edema/surgery , Corneal Edema/etiology , Descemet Membrane/surgery , EdemaABSTRACT
Purpose: To assess the role of Scheimpflug imaging in improving the accuracy of reference marking for toric IOL implantation. Methods: In this prospective, randomized, clinical trial all patients with cataract and pre-existing significant regular corneal astigmatism, who required implantation of a toric IOL were included in the study, and patients with any ocular pathology or abnormality were excluded. Patients were divided into two groups: For one group of patients, Group I (GI), reference marking was finalized using slit lamp only, and for the second group, Group II (GII), after slit lamp marking, the reference marks were checked using Goniometer of Scheimpflug imaging. The primary outcome was to determine the axis of toric intraocular lens (IOL) postoperatively (within 1 hour) and compare it with the desired axis of placement. Results: We found a statistically significant difference in the two groups (P < 0.001) suggesting Group II (4 step technique) is better than Group I (3 step technique). Conclusion: Scheimpflug imaging, an extra step preoperatively, is an effective measure to reduce errors in reference marking and thereby improving the refractive outcome of toric intraocular lens.
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@#AIM: To verify the accuracy of Van Herick method and slit-lamp anterior chamber depth examination in estimating angle closure. <p>METHODS: Totally 52 patients(100 eyes)over 40 years old were randomly selected from our outpatient department from June 2018 to January 2019.Their anterior chamber depth were examined by the methods of Van Herick method and the improved method to sort out peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT and peripheral anterior chamber depth are less than or equal to 1/4 CT. Van Herick's anterior chamber depth inspection method and improved anterior chamber depth inspection method were checked for consistency, and then gonioscopic inspection and UBM inspection under darkroom were performed to check whether the peripheral angle was closed. In order to know whether there was any difference between gonioscopic and UBM inspection for angle closure, the consistency of the two verification results was checked. <p>RESULTS: Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the methods of Van Herick, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopy are 39% and 43% respectively, Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the improved methods, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopyare 46% and 42% respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by Van Herick method, the positive rate of angle closure was 67% and 89%, respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by the improved method, the positive rate of angle closure was 67% and 89%, respectively. The consistency test of the Van Herick method and the improved method showed good consistency(Kappa value: 0.85), when peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT. peripheral anterior chamber depth(>1/4 CT), and good consistency(Kappa value: 0.83)when estimating peripheral anterior chamber depth ≤1/4 CT. According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the Van Herick method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was general(Kappa value: 0.73). When the Van Herick method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was general(Kappa value: 0.40). According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the improved method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was good(Kappa value: 0.75). When the improved method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was poor(Kappa value: 0). <p>CONCLUSION: The slit lamp anterior chamber depth examination has a certain false negative rate in estimating the angle closure in the population, but its accuracy is high, and it is still suitable for the preliminary examination of estimating the angle closure.
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AIM: To study the establishment of adriamycin nephropathy rat model and the protective effects and mechanisms of dexamethasone implants (DEXI) through renal capsule implantation. METHODS: The adriamycin-induced nephropathy model was built by injecting Adriamycin (4 mg/kg) and Adriamycin (3.5 mg/kg) was injected again after week into tail-vein in SD rats. Renal capsule puncture was performed in model group. The excipient control group injected intra-renal capsule with drug-free excipient (1.4 mg/kg). The experimental group (2.8, 1.4, 0.7 mg/kg) was given by intrarenal capsule injection and positive drug group (0.1 mg/kg, qd × 8 w) was made by intragastric administration. The rat weight, kidney function and blood biochemical were observed and detected during the experiment. After the experiment, rat kidneys were stained with periodic acid-schiff to observe the morphological changes of mesangial and basement and sirius red to observe the renal tissue collagen fibers, expression of podocin and CD2AP were detected by immunohistochemistry. RESULTS: The blood protein content of adriamycin rats decreased, total blood cholesterol, uric acid, blood creatinine and urea nitrogen increased (P<0.05 or P<0.01), mesangium and fibers increased. The expression of Podocin protein in kidney tissue decreased and the expression of CD2AP protein increased (P<0.05 or P<0.01). DEXI increased the weight and blood protein levels of adriamycin rats, reduced blood lipids and blood uric acid levels (P<0.05 or P<0.01), improved renal function and tissue damage, and regulated the abnormal expression and distribution of Podocin and CD2AP proteins (P<0.05 or P<0.01). CONCLUSION: These results suggest that injecting adriamycin into the tail vein can establish a stable kidney disease model. DEXI renal capsule implantation can improve adriamycin nephropathy injury, and its mechanism may be related to restoration the expression and distribution of Podocin and CD2AP proteins on podocyte slit diaphragm.
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Quality assurance (QA) is the maintenance of a desired level of quality in a service, by means of attention to every stage of process of delivery. Correct image acquisition along with accurate and reproducible quantification of ophthalmic imaging is crucial for evaluating disease progression/stabilization, response to therapy, and planning proper management of these cases. QA includes development of standard operating procedures for the collection of data for ophthalmic imaging, proper functioning of the ophthalmic imaging equipment, and intensive training of technicians/doctors for the same. QA can be obtained during ophthalmic imaging by not only calibration and setting up of the instrument as per the manufacturer's specifications but also giving proper instructions to the patients in a language which they understand and by acquisition of good quality images. This review article will highlight on how to achieve QA in imaging which is commonly being used in ophthalmic practice.
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OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Huantiao"(GB30) and" Zusanli"(ST36)on muscular atrophy and expression of Slit-Robo GTPase-activating protein(srGAP)1, 2 and 3 in the injured sciatic nerve and lumbar spinal cord tissues in sciatic nerve injury (SNI) rats, so as to reveal its mechanisms underlying improvement of peripheral nerve injury (PNI).. METHODS: A total of 120 healthy male SD rats were randomly divided into control, sham-operation, model and EA groups (n=30 rats in each) which were further divided into 7, 15 and 23 d subgroups (n=10 rats in each subgroup). The SNI model was established by transecting the right sciatic nerve beneath the piriformis and immediately subsequent end-to-end suture. Rats of the sham operation group received an incision of the corresponding skin and suture. EA (5 Hz/20 Hz, 2-3 mA) was applied to the right GB30 and ST36 for 15 min, once daily, 6 days a week separately for 1,2 and 3 weeks. Rats in the sham-operation and model groups were grasped in the similar procedure as the EA group. The wet weight of gastrocnemius muscles (WWG) on both sides was measured to calculate the recovery rate (weight of the right WWG/weight of the left WWG×100%), and the expression levels of srGAP1, srGAP2 and srGAP3 proteins in the sciatic nerve and the spinal cord (L4-L6) tissues were detected by Western blot. RESULTS: After modeling and compared with the control and sham-operation groups, the recovery rate of WWG was significantly reduced, and the expression levels of srGAP1, srGAP2 and srGAP3 proteins of the sciatic nerve and lumbar spinal cord on day 7, 15 and 23 were considerably increased in the model group (P<0.01). Following the EA treatment, the reco-very rate of WWG was obviously increased and the expression levels of srGAP1, srGAP2 and srGAP3 proteins of both sciatic nerve and spinal cord on day 7, 15 and 23 were further significantly up-regulated in the EA group relevant to the model group (P<0.05,P<0.01). In addition, the expression levels of the 3 proteins in both sciatic nerve and lumbar spinal cord peaked on day 15 and attenuated on day 23. CONCLUSION: EA of GB30 and ST36 may relieve gastrocnemius atrophy in SNI rats, which is related to its function in up-regulating the Slit/Robo signaling in the sciatic nerve and lumbar spinal cord to promote the axonal targeting regeneration and repair of axonal plasma nutrition transportation.
ABSTRACT
Objective: To explore the effect of Slit2/ROBO1 protein (Slit2/ROBO1) signaling pathway in high glucose-induced epithelial-mesenchymal transdifferentiation (EMT) and its mechanism. Methods: Human renal tubular epithelial cells (HK-2) were cultured in vitro and subjected to high glucose concentration and time gradient experiments. First, for concentration gradient experiment, the sample was randomly divided into normal group, control group 1, control group 2, high glucose group 1, high glucose group 2. While for high glucose time gradient experiment, the sample was randomly divided into normal group, control group, high glucose 24 h group, high glucose 36 h group and high glucose 48 h group. Western blotting was used to detect the expression changes of Slit2, ROBO1, α-smooth muscle actin (α-SMA) and fibronectin in HK-2 cells, and then the optimal high glucose stimulation concentration and time were screened out. Slit2 over-expressed plasmid and negative control plasmid were transfected into HK-2 cells to verify the successful transfection, the cells were then randomly divided into normal group, control group, high glucose group, high glucose empty group and high glucose Slit2 group. The total protein was extracted after stimulation with optimal high glucose concentration and time, and Western blotting was then performed to detect the change in expression of fibronectin and α-SMA. Results: In the high glucose concentration gradient experiment, the expression of Slit2 declined significantly in high glucose group 1(0.647±0.048) and high glucose group 2(0.210±0.023) than in the normal group (1.000±0.050); the expression of ROBO1 declined significantly in high glucose group 1(0.703±0.041) and high glucose group 2(0.303±0.022) than in the normal group (1.000±0.057); while the expression of fibronectin increased significantly in high glucose group 1(1.953±0.042) and high glucose group 2(2.997±0.078) than in the normal group (0.990±0.059), and the expression of α-SMA increased significantly in high glucose group 1(1.767±0.012) and high glucose group 2(2.427±0.059) than in the normal group (1.033±0.067), all the differences were of statistical significance(P<0.05). Compared with the high glucose group 1, the expressions of Slit2 and ROBO1 decreased, and of fibronectin and α-SMA increased significantly in the high glucose group 2(P<0.05). In the high glucose time gradient experiment, compared with the normal group, the expressions of Slit2 in high glucose 36 h group and high glucose 48 h group decreased (0.943±0.032 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 decreased (1.000±0.058 vs. 0.600±0.023, 0.227±0.028, respectively). Compared with the normal group, the expression of fibronectin increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (0.970±0.040 vs. 1.247±0.052, 1.733±0.084, 2.780±0.090, respectively), and the expression of α-SMA increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (1.033±0.067 vs. 1.277±0.041, 1.767±0.120, 2.537±0.078, respectively), and the difference was statistically significant (P<0.05). Compared with high glucose 24 h group, the expression of Slit2 declined significantly in high glucose 36 h group and high glucose 48 h group(0.893±0.034 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 declined significantly (0.930±0.025 vs. 0.600±0.023, 0.227±0.028, respectively), the expressions of fibronectin and α-SMA increased significantly with statistical significance (P<0.05). Compared with high glucose 36 h group, the expression of Slit2 and ROBO1 declined significantly, and the expression of fibronectin and α-SMA increased significantly in high glucose 48 h group (P<0.05). In the high glucose environment, and achieving Slit2 overexpression and negative control plasmid transfection, the expression of fibronectin increased significantly in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.760±0.012, 2.667±0.027, 1.460±0.034, respectively) than in normal group (1.000±0.058); the expression of α-SMA increased also in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.487±0.048, 2.557±0.037, 1.270±0.017, respectively) than in normal group (1.000±0.050) with statistical significance (P<0.05). Compared with the high glucose+empty group, the expression of fibronectin and α-SMA declined significantly in the high glucose+Slit2 group(P<0.05). Conclusion: The decreased expression of Slit2 and ROBO1 is involved in the high glucose-induced renal tubular EMT. Overexpression of Slit2 may significantly inhibit the high glucose-induced EMT.