Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China / 中华预防医学杂志

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Correlation analysis between prenatal exposure of per-/polyfluoroalkyl compounds and neonatal outcome / 中华预防医学杂志

Objective: To investigate the correlation between the prenatal exposure of per-/polyfluoroalkyl substances (PFASs) and the neonatal outcome. Methods: A total of 506 maternal infant cohort samples were collected in Hangzhou, Zhejiang province from 2020 to 2021. The exposure levels of seven PFASs in maternal serum before delivery were detected by solid-phase extraction-ultra performance liquid chromatography tandem mass spectrometry. Multivariable linear regression model was used to analyze the influence of prenatal exposure of PFASs on birth weight, birth length and Apgar score. Results: The maternal age, prenatal body mass index and gestation age were (31.3±4.3) years old, (26.7±3.2) kg/m2 and (265.0±28.3) days, respectively. The birth weight, birth length and scores of Apgar-1 and Apgar-5 were (3.1±0.8) kg, (49.3±2.9) cm, (9.88±0.47) points and (9.99±0.13) points, respectively. PFASs were widely distributed in maternal serum, with the highest concentration of (18.453±19.557) ng/ml, (6.756±9.379) ng/ml and (5.057±8.555) ng/ml for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and 6∶2 chlorinated polyfluorinated ether sulfonate (Cl-PFESA), respectively. Maternal age, parity and delivery mode were associated with the exposure level of PFASs (P<0.05). Subgroup analysis showed that PFOS had negative effects on birth weight (β=-0.958), birth length (β=-0.073) and Apgar-5 score (β=-0.288) for neonates in the low birth weight (LBW) group. 6∶2 Cl-PFESA and 8∶2 Cl-PFESA inhibited the birth weight (β=-0.926; β=-0.552) and length (β=-0.074; β=-0.045) of newborn in the LBW group. In addition, 4∶2 fluorotelomer sulfonate (FTS) was associated with increased birth weight (β=0.111) and decreased Apgar-5 score (β=-0.030) in the normal weight group. Conclusion: Prenatal exposure to PFASs is associated with birth weight, birth length and Apgar-5 score. It is necessary to continue to pay attention to the impact of PFASs on fetal growth and development through maternal-fetal transmission.

Exposure to endocrine disruptors and alterations in mineralized tissues: a narrative review / Exposición a disruptores endocrinos y alteraciones en tejidos mineralizados: revisión narrativa

Background: Endocrine Disrupting Chemicals (EDCs) would cause alterations in organs/systems of exposed individuals or their progeny. Objetive: To identify and analyze the main published findings on the effects of exposure to EDCs on teeth, cartilage, and bone. Material and Methods: Two databases were analyzed: Medline and Web of Science. Only observational studies analyzing the effect of EDCs on mineralized tissues published since 2006 were included in the study. Results: 25 articles were selected, most of them involving EDCs pesticides, plasticizers, or personal care products, highlighting organochlorine compounds, bisphenols, phthalates, dioxins, parabens, and perfluoroalkyls. Thirty-six per cent of the studies reported an accumulation of EDCs in teeth or bones, while 64% reported alterations in their development or morphology, mainly at the bone level, primarily affecting their mineral density and size, as well as that of the bones of exposed individuals or their progeny. The type of effect observed was related to the EDCs analyzed, and it seemed to depend on variables such as age, sex, ethnicity/race, and even the metabolic status of the individuals in the different species analyzed. No evidence associated with effects on cartilage was found. Conclusion: EDCs in the environment, at work, or at home, under different exposure routes, are capable of accumulating in teeth and bone, particularly affecting the latter. It is necessary to study the effect of EDCs on mineralized tissues in agro-industrial areas, especially on teeth.

Antecedentes: Los Químicos Disruptores Endocrinos (EDCs) causarían alteraciones en órganos/sistemas de individuos expuestos, o su progenie. Objetivo: Identificar y analizar los principales hallazgos publicados sobre el efecto de la exposición a EDCs en dientes, cartílago y hueso. Material y Métodos: Se analizaron dos bases de datos: Medline y Web of Science, incluyendo solo estudios observacionales publicados desde el 2006, analizando el efecto de los EDCs sobre tejidos mineralizados. Resultados:25 artículos fueron seleccionados, siendo la mayoría de los EDCs pesticidas, plastificantes o productos de cuidado personal, destacando los compuestos Organo-clorados, Bisfenoles, Ftalatos, Dioxinas, Parabenos y los Perfluoroalquilos. Un 36% de los estudios reportaron un acúmulo de EDCs en dientes o huesos, mientras que un 64% informaron de alteraciones en su desarrollo o morfología, particularmente a nivel de huesos, afectando principalmente su densidad mineral y su tamaño, así como el de los individuos expuestos o su progenie. El tipo de efecto observado tuvo relación con el EDCs analizado, pareciendo depender de variables tales como edad, sexo, etnia/raza e incluso el estado metabólico de los individuos, en las diferentes especies analizadas. No se encontraron evidencias asociadas a efectos en el cartílago. Conclusión: Los EDCs en el medio ambiente, ámbito laboral o doméstico, bajo distintas rutas de exposición, son capaces de acumularse en diente y hueso, afectando particularmente a este último. Es necesario estudiar el efecto de los EDCs en los tejidos mineralizados en zonas agroindustriales, particularmente a nivel de dientes.

Perfluorooctanoic acid-induced lipid metabolism disorder in SD rat liver and its effect on the expression of fatty acid metabolism-related proteins / 中南大学学报(医学版)

OBJECTIVES@#Perfluorooctanoic acid (PFOA) can cause lipid metabolism disorders in animal body and affect the lipolysis and synthesis of fatty acids. Peroxisome proliferators-activated receptor (PPAR) plays an extremely important role in this process. This study aims to explore the effects of PFOA on liver lipid metabolism disorders in Sprague Dewley (SD) rats and the expression of PPAR.@*METHODS@#A total of 40 male SD rats were randomly divided into 4 groups (n=10 in each group): a control group (ddH2O), a low-dose PFOA group [PFOA 1.25 mg/(kg·d)], a middle-dose PFOA group [PFOA 5.00 mg/(kg·d)], and a high-dose PFOA group [PFOA 20.00 mg/(kg·d)]. The rats were fed with normal diet, and PFOA exposure were performed by oral gavage for 14 days, and the rats were observed, weighted and recorded every day during the exposure. After the exposure, the blood was collected, and the livers were quickly stripped after the rats were killed. Part of the liver tissues were fixed in 4% paraformaldehyde for periodic acid-schiff (PAS) staining; the contents of HDLC, LDLC, TG, TC in serum and liver tissues, as well as the activities of their related enzymes were assayed; The expression levels of cyclic adenosine monophosphate-response element binding protein (Cbp), general control of amino acid synthesis 5-like 2 (Gcn5L2), peroxidation peroxisome proliferation factor activated receptor γ (PPAR), silent information regulator 1 (Sirt1) and human retinoid X receptor alpha 2 (Rxrα2) ) were detected by Western blotting.@*RESULTS@#After 14 days of PFOA exposure, the PAS staining positive particles in the cytoplasm and nucleus of SD rats in the medium and high dose groups were significantly reduced compared with the control group. The serum levels of LDLC and TC in the low-dose and middle-dose groups were significantly reduced compared with the control group (all P<0.05), while the high-dose group showed an increasing tendency, without siginificant difference (P>0.05), there was no significant difference in HDLC and TG (both P>0.05). The activities of alkaline phosphatase (AKP) and alanine aminotransferase (ALT) were increased significantly (both P<0.05) compared with control group; the ratio of ALT/aspartate aminotransferase (AST) in the high-dose group was increased significantly (P<0.05), there was no significant difference in LDH and TG (both P>0.05); the HDLC content in the liver tissues in the high-dose group was significantly reduced, compared with the control group (P<0.05); the TC contents in the liver tissues in the low, medium and high-dose groups were significantly increased (all P<0.05), there was no significant difference in LDLC and TG (both P>0.05); the AKP activity in the livers in the medium and high-dose groups was significantly increased (both P<0.05), there was no siginificant difference in LDH, ALT, and the ratio of ALT/AST (all P>0.05); the protein expression levels of Ppar γ, Cbp and Rxrα2 in the liver in the high dose groups were significantly down-regulated compared with the control group (all P<0.05), while the protein expression levels of Sirt1 were significantly up-regulated (all P<0.05).@*CONCLUSIONS@#PFOA exposure can cause lipid metabolism disorder and glycogen reduction in SD rat livers, which may be related to the activation of Sirt1 and inhibition of Ppar γ expression, leading to affecting the normal metabolism of fatty acids and promoting glycolysis.

Maternal consumption of ultra-processed foods and newborn exposure to perfluoroalkyl substances (PFAS) / O consumo materno de alimentos ultraprocessados e exposição intrauterina a compostos perfluoroalquil (PFAS) / Consumo materno de comidas ultraprocesadas y exposición de recién nacidos a sustancias perfluoroalquílicas (PFAS)

Abstract: Evolving evidence shows that ultra-processed food consumption may increase exposure to chemicals used in food packaging and production, such as per- and poly-fluoroalkyl substances, phthalates, and bisphenols. Studies suggested that these contaminants may be transferred from mother to child through placenta, increasing concerns for both maternal and child health. This study aimed to investigate the association of maternal consumption of ultra-processed foods with newborn exposure to perfluoroalkyl substances (PFAS) in the PIPA Project (The Rio Birth Cohort Study on Environmental Exposure and Childhood Development). The pilot cohort study conducted with 131 pregnant women-child pairs in a public maternity school in Rio de Janeiro, Brazil, was assessed. Maternal dietary intake in the third trimester of pregnancy was evaluated using a qualitative food frequency questionnaire. Food items were classified as non-ultra-processed food and ultra-processed food using the NOVA system and regular consumption of ultra-processed foods was estimated. Newborns of pregnant women who weekly consumed three or more subgroups of ultra-processed food presented the highest level of PFAS (2.47ng/mL; 95%CI: 1.22; 3.72), compared to non-consumption of ultra-processed food investigated (0 ultra-processed food = 1.86ng/mL; 95%CI: 1.38; 2.50). Additionally, cluster analysis grouped ultra-processed food, fish, and PFAS levels. In conclusion, we found increased levels of PFAS in newborns whose mothers were higher consumers of ultra-processed foods.

Resumo: Evidências crescentes demonstram que o consumo de alimentos ultraprocessados pode aumentar a exposição a substâncias químicas utilizadas na produção e embalagem desses alimentos, como os compostos per- e polifluoroalquil, ftalatos e bisfenóis. Os estudos sugerem que esses contaminantes podem ser transferidos da mãe para o feto pela via transplacentária, o que aumenta as preocupações em relação à saúde tanto materna quanto infantil. O estudo buscou investigar a associação entre o consumo materno de alimentos ultraprocessados e a exposição intrauterina aos compostos perfluoroalquil (PFAS) no Projeto PIPA Rio - Projeto Infância e Poluentes Ambientais. Foi avaliada a coorte-piloto com 131 pares gestante-feto em uma maternidade-escola pública no Rio de Janeiro. A ingestão materna no terceiro trimestre da gestação foi avaliada com um questionário qualitativo de frequência alimentar. Os itens alimentares foram classificados entre não ultraprocessados e ultraprocessados, usando o sistema NOVA, e foi estimado o consumo regular de ultraprocessados. Os PFAS foram medidos no sangue do cordão umbilical. Os recém-nascidos de mães que haviam consumido três ou mais subgrupos de ultraprocessados por semana apresentaram os níveis séricos mais elevados de PFAS (2,47ng/mL; IC95%: 1,22; 3,72), comparado com nenhum consumo dos subgrupos de alimentos ultraprocessados (0 alimento ultraprocessado = 1,86ng/mL; IC95%: 1,38; 2,50). Além disso, a análise de clusters agrupou ultraprocessados, peixe e níveis de PFAS. Em conclusão, o estudo mostrou níveis elevados de PFAS em neonatos de gestantes com maior consumo de alimentos ultraprocessados.

Resumen: Evidencias recientes han mostrado que el consumo de comida ultraprocesada puede incrementar la exposición a sustancias químicas usadas en el empaquetado de comida y producción, tales como las sustancias per- y poli- fluoroalquílicas, ftalatos, y bisfenoles. Los estudios han sugerido que estos contaminantes pueden transmitirse de la madre al niño, a través de la placenta, incrementando los problemas de salud de la madre y el niño. El objetivo de este estudio fue investigar la asociación del consumo materno de comidas ultraprocesadas con la exposición de los recién nacidos a las sustancias perfluoroalquílicas (PFAS) en el Proyecto PIPA (Estudio de Cohorte de Nacimiento en Río sobre la Exposición Ambiental y Desarrollo en la Infancia). El estudio de la cohorte piloto evaluó a parejas constituidas por 131 mujeres embarazadas y sus hijo/as en una escuela de maternidad pública en Río de Janeiro, Brasil. Se evaluó la ingesta alimentaria materna en el tercer trimestre de embarazo, usando un cuestionario de calidad de frecuencia de la comida. Los ítems alimentarios fueron clasificados como no-comida ultraprocesada y comida ultraprocesada usando el sistema NOVA y se estimó el consumo regular de comidas ultraprocesadas. Las PFAS se determinaron en la sangre del cordón umbilical. Los recién nacidos de mujeres embarazadas que consumieron tres o más subgrupos de comidas ultraprocesada semanalmente presentaron el nivel más alto de PFAS (2,47ng/mL; IC95%: 1,22; 3,72), comparado con ninguno consumo de comida ultraprocesada (0 comida ultraprocesada = 1,86ng/mL; IC95%: 1,38; 2,50). Asimismo, el análisis de conglomerados agrupó comida ultraprocesada, pescado y niveles de PFAS. En conclusión, se encontraron niveles elevados de PFAS en recién nacidos, cuyas madres eran grandes consumidoras de comidas ultraprocesadas.

Inyección de gas intravítreo combinada con fotocoagulación con láser de argón para el tratamento de la maculopatía de la foseta del disco óptico sin vitrectomía / Intravitreal gas injection combined with argon laser photocoagulation for treatment of optic disc pit maculopathy without vitrectomy

RESUMEN Presentamos el caso de un paciente con foseta del disco óptico, quien presentó una disminución de la agudeza visual secundaria a desprendimiento seroso de retina. Se decidió realizar una inyección intravítrea de 0.3ml de gas C3F8 (100%), seguida de fotocoagulación con láser de argón en el borde temporal de la foseta, logrando reaplicación total de la retina, con reabsorción de todo el líquido subretiniano visible en la tomografía de coherencia optica (OCT) luego de 400 días. Además hubo una mejoría significativa en la agudeza visual.

ABSTRACT We present the case of a patient with an optic disk pit, presenting with great loss of visual acuity secondary to serous retinal detachment. The management chosen was an intravitreal injection of 0.3 mL of C3F8 (100%), followed by argon laser photocoagulation on the temporal edge of the pit, ), achieving total retinal reattachment , and reabsorption of all subretinal fluid visible at optical coherence tomography after 400 days, in addition to great improvement in visual acuity.

Surgical results regarding the correction of macular hole with and without face-down posturing using 25% SF6 gas: a retrospective case series / Resultados cirúrgicos para correção de buraco macular com gás SF6 a 25% com e sem orientação postural: Série retrospectiva de casos

ABSTRACT Purpose: This study aims to compare the anatomical success rates of vitrectomy and SF6 gas tamponade for macular hole surgery with and without postoperative face-down posturing. Methods: This was an observational, longitudinal, and retrospective case series analysis. The study included 52 eyes from 52 patients who underwent pars plana vitrectomy with trypan blue-assisted internal limiting membrane peeling and 25% SF6 tamponade for stages 2, 3, and 4 macular holes. After surgery, all patients were provided with a postoperative postural regimen: 31 patients were instructed not to maintain face-down posturing, whereas 21 were instructed to maintain face-down posturing for 7 days. The primary outcome measure was the macular hole closure rate. Statistical analysis was performed using Epi Info 7.1. Results: A total of 47 (90.3%) patients achieved hole closure. The nonface-down posturing group and face-down posturing group obtained closure rates of 90.3% and 90.4%, respectively; these rates were not significantly different. Statistical analysis revealed that no significant differences existed in sex, age, hole duration, hole stage, preoperative visual acuity, or postoperative visual acuity between the two groups. Conclusion: Our results suggest that macular hole surgery with the use of short duration gas (SF6) is safe and effective and that maintaining a postural orientation of nonface-down posturing is also safe. However, these recommendations should be assessed further in a prospective and randomized study to comprehensively delineate the associated benefits and risks.

RESUMO Objetivos: Comparar as taxas de sucesso anatômico da vitrectomia e tamponamento de gás SF6 na cirurgia de buraco macular com e sem a postura pronada pós-operatória. Métodos: Foi realizado um estudo observacional, longitudinal e retrospectivo de séries de casos. O estudo incluiu 52 olhos de 52 pacientes submetidos à vitrectomia posterior via pars-plana com peeling de membrana limitante interna auxiliada por azul trypan e tamponamento com gás SF6 a 25% para os estágios 2, 3 e 4 dos buracos maculares. Após a cirurgia, todos os pacientes foram orientados a manter um regime postural pós-operatório: 31 pacientes foram orientados a não realizar posição pronada de cabeça, enquanto 21 foram orientados a manter uma pronada pós-operatória por 7 dias. O objetivo principal foi a análise da taxa de fechamento do buraco macular. A análise estatística foi realizada usando Epi-Info 7.1. Resultados: Um total de 47 (90,3%) pacientes obtiveram fechamento do buraco macular. O grupo de postura não pronada e o grupo de postura pronada obtiveram taxas de fechamento de 90,3%, e 90,4%, respectivamente; essas taxas não foram significativamente diferentes. A análise estatística revelou que não houve diferenças significativas relacionadas ao gênero, idade, duração do buraco macular, estágio do buraco macular, acuidade visual corrigida pré e pós-operatória entre os dois grupos. Conclusão: Nossos resultados sugerem que a cirurgia para buraco macular com o uso de gás de curta duração (SF6) é segura e eficaz e que a manutenção de uma orientação pós-operatória de não-pronada também é segura. No entanto, essas recomendações devem ser avaliadas em um estudo prospectivo e randomizado para delinear de forma abrangente os riscos e benefícios associados.

Subfoveal perfluorocarbon liquid removal by peeling of internal limiting membrane, without retinotomy / Remoção de perfluorocarbono líquido subfoveal, sem retinotomia, através do peeling da membrana limitante interna

ABSTRACT Perfluorocarbon liquid has been widely used during vitreoretinal operations. Subretinal retention is a rare intraoperative complication, but even small quantities can damage the macular structure and function, and no standard treatment has been established. We encountered a 43-year-old woman who presented a retained subfoveal bubble after a vitreoretinal operation due to primary rhegmatogenous retinal detachment. Herein, we describe the procedure we used to remove the perfluorocarbon liquid without retinotomy using internal limiting membrane peeling.

RESUMO O perfluorocarbono líquido tem sido amplamente durante cirurgias vitreorretinianas. A retenção subretiniana, é uma complicação intraoperatória rara, mas mesmo pequenas quantidades podem danificar a estrutura e função macular, e nenhum tratamento padrão foi estabelecido. Encontramos uma mulher de 43 anos que apresentou bolha subfoveal retida após uma cirurgia vitreorretiniana devido a descolamento de retina regmatogênico. Aqui, descrevemos o procedimento que usamos para remover o líquido perfluorocarbono sem retinotomia usando peeling da membrana limitante interna.

Patrón crazy paving en una mujer joven: hallazgo inesperado y tratamiento no tradicional en un caso de proteinosis alveolar pulmonar / Crazy paving computed tomography pattern in a young woman: unexpected findings and non-traditional treatment in a pulmonary alveolar proteinosis case

El patrón llamado 'crazy paving' en tomografia computada de tórax (TAC) puede deberse a diferentes condiciones siendo una de ellas la Proteinosis Alveolar Pulmonar (PAP), rara condición que puede llevar a insuficiencia respiratoria y a menudo, a la muerte. Presentamos el caso de una mujer joven con una historia de un año de evolución de disnea progresiva y tos seca que consultó por un cuadro de aparición brusca de fiebre, calofríos, malestar general y falla respiratoria hipoxémica severa (PaO2 = 51,9 mmHg con FiO2 = 0,50) en la cual la TAC de tórax mostraba un patrón de empedrado o 'crazy paving' que significó un desafío diagnóstico resuelto finalmente con una biopsia pulmonar quirúrgica que mostró una PAP. Ante el fracaso del tratamiento tradicional de Lavado Pulmonar Total (LPT) se usó una aproximación terapéutica novedosa consistente en una serie de 4 lavados lobares con un perfluorocarbono, Perflubron (PFC) bajo anestesia local seguido por 5 sesiones de Plasmaféresis. Casi inmediatamente después de este tratamiento la paciente evidenció mejoría radiológica y funcional. La PaO2 fue de 89,9 mmHg respirando aire ambiental y la CVF y el VEF1 aumentaron alcanzado respectivamente el 77 y el 75% de sus valores normales de referencia. Dadas las características químicas y físicas del PFC, pensamos que es una alternativa válida al LPT en estos casos.

Crazy paving computed tomography pattern may be due to a number of causes, one of them being Pulmonary Alveolar Proteinosis, a rare condition leading to respiratory failure and often to death. We present the case of a young woman with a one-year history of progressive dyspnea and dry cough, who consulted for an acute onset of fever, chills, malaise and severe hypoxemic respiratory failure (PaO2 = 51.9 mmHg; FiO2 = 0.50) with a 'crazy paving' pattern on chest CT. This diagnostic challenge was resolved by a surgical lung biopsy that showed a pulmonary alveolar proteinosis. Taking into account that the traditional treatment using whole lung lavage had already failed in this patient, a novel therapeutic approach was settled. A series of 4 lobar lavages with a perfluorocarbon (Perflubron) under local anesthesia followed by 5 plasmapheresis sessions were carried out. The patient showed radiographic and functional improvement almost immediately after this treatment. PaO2 was 89.9 mmHg breathing room air and FVC and FEV1 increased to reach 77 and 75% respectively of their normal reference values. Because of its chemical and physical properties we think this novel therapeutic approach should be a valuable alternative to saline solution for whole lung lavage in these cases.

Effect of vaporized perfluorocarbon on oxidative stress during the cold ischemia phase of lung graft preservation / Efeito do perfluorocarbono vaporizado sobre o estresse oxidativo no período de isquemia fria durante a preservação pulmonar

ABSTRACT Liquid perfluorocarbon (PFC) instillation has been studied experimentally as an adjuvant therapy in the preservation of lung grafts during cold ischemia. The objective of this study was to evaluate whether vaporized PFC is also protective of lung grafts at different cold ischemia times. We performed histological analysis of and measured oxidative stress in the lungs of animals that received only preservation solution with low-potassium dextran (LPD) or vaporized PFC together with LPD. We conclude that vaporized PFC reduces the production of free radicals and the number of pulmonary structural changes resulting from cold ischemia.

RESUMO O perfluorocarbono (PFC) líquido tem sido estudado experimentalmente como uma substância adjuvante na preservação de enxertos pulmonares durante o período de isquemia fria. O objetivo deste estudo foi avaliar se o PFC vaporizado (e não instilado) também atuaria como protetor de enxertos pulmonares em diferentes tempos de isquemia fria. Realizamos análise histológica e dosamos o estresse oxidativo em pulmões de animais que receberam somente uma solução de preservação com low-potassium dextran (LPD, dextrana com baixa concentração de potássio) ou PFC vaporizado associado a LPD. Concluímos que o PFC vaporizado reduziu a produção de radicais livres e provocou menor número de alterações estruturais pulmonares decorrentes do período de isquemia fria que o uso de LPD isoladamente.

Development and evaluation of ultrasound contrast agents with AS1411-conjugated nanoparticles with liquid core / 中南大学学报(医学版)

To prepare AS1411 targeted nano-ultrasonic contrast agent with liquid core, and to evaluate its ability for ultrasonic contrast enhancement and targeting MCF-7 cell in vitro.
 Methods: The modified solvent evaporation, self-synthesized membrane material and perfluorobrominane (PFOB) was used to form nano-ultrasonic contrast agent with PFOB core (nanoparticles, NP); then N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride and N-hydroxysuccinimide (EDC/NHS) catalysis was used to connect AS1411 to the surface of NP to prepare NP-AS1411. The transmission electron microscopy was chosen to check the morphology of NP-AS1411. The size, surface charge, encapsulation efficiency, biocompatibility, the contrast grey value and the stability of NP-AS1411 and NP were compared. Whether AS411 was attached to the surface of NP was checked by gel electrophoresis. Fluorescence microscopy and flow cytometry were performed to examine the targeting ability of AS1411.
 Results: NP-AS1411 was a shell-nuclear structure under the electron microscope. Its size was at (245.4±16.5) nm, which was larger than that of NP (P=0.05). There was no significant difference in surface charge and encapsulation efficiency between NP-AS1411 and NP (P>0.05). In the MTT experiment, the cell viability decreased significantly at high concentration of NP-AS411 (25 mg/mL) after incubation for 24 h compared with the control group (0 mg/mL ) (P0.05). The contrast grey value of AS1411-NP was 80.1±9.2 after keeping at room temperature for 24 h, which showed no obviously change comparing with that before the treatment (P>0.05). The size of NP-AS1411didn't change too (P>0.05). The results of gel electrophoresis demonstrated that the AS1411 connecting to the surface of NP was the most when the molar ratio of NP:AS1411 was at 40:1. Flow cytometry analysis confirmed that NP and NP-AS1411 were combined with MCF-7 cells separately but the fluorescence produced by the combination of NP-AS1411 and MCF-7 was more intense.
 Conclusion: The modified solvent evaporation and EDC/NHS catalysis could successfully prepare ultrasound contrast agents with aptamer-conjugated nanoparticles with liquid core. The targeted ultrasonic contrast agents with liquid core possess good ultrasonic contrast enhancement ability in vitro, stability and specificity as well.

Microscopic analysis of an opacified OFT CRYL® hydrophilic acrylic intraocular lens / Análise microscópica de uma lente intraocular acrílica hidrofílica OFT CRYL® opacificada

ABSTRACT A 51-year-old patient underwent posterior vitrectomy with perfluoropropane gas injection, phacoemulsification, and implantation of an Oft Cryl® hydrophilic acrylic intraocular lens (IOL) because of traumatic retinal detachment and cataract in the right eye. On the first postoperative day, gas was filling the anterior chamber because of patient's non-compliance in terms of head positioning, and was reabsorbed within one week. Eight months later, the patient returned complaining of a significant decrease in vision. IOL opacification was noticed by slit-lamp examination. The lens was explanted to undergo gross and light microscopic analysis. The lens was also stained with the alizarin red method for calcium identification. Light microscopic analysis confirmed the presence of granular deposits, densely distributed in an overall circular pattern in the central part of the lens optic. The granules stained positive for calcium. This is the first case of the opacification of this type of hydrophilic lens. Surgeons should be aware of this potential postoperative complication, and the use of hydrophilic IOLs should be avoided in procedures involving intracameral gas because of the risk of IOL opacification.

RESUMO Uma paciente de 51 anos foi submetida à vitrectomia posterior com injeção de gás perfluoropropano, facoemulsificação e implante de lente intraocular (LIO) acrílica hidrofílica Oft cryl® devido a descolamento traumático da retina e catarata. No primeiro dia pós-operatório, o gás estava ocupando a câmara anterior pois a paciente não manteve o decúbito ventral restrito, tendo sido absorvido ao longo de uma semana. Oito meses depois, a paciente retornou com baixa da acuidade visual. Ao exame foi evidenciado opacificação da lente intraocular. A lente foi explantada e submetida à análise macroscópica e sob microscopia óptica. Também, foi corada pelo método de vermelho de alizarina, que identifica cálcio. A análise sob microscopia óptica evidenciou depósitos granulares, densamente distribuídos em padrão circular na parte central da óptica da lente intraocular, que coraram positivo para cálcio. Esse é o primeiro relato de opacificação dessa lente hidrofílica. Os cirurgiões devem estar atentos para esta potencial complicação pós-operatória.

Protective effects of perfluorocarbon combined with ligustrazine against lung ischemia-reperfusion injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of perfluorocarbon and ligustrazine in protecting the lungs against ischemia-reperfusion injury in rats.</p><p><b>METHDS</b>Forty SD rats with ischemia-reperfusion lung injury were randomized equally into control, ligustrazine, perfluorocarbon, and perfluorocarbon plus ligustrazine groups and received the corresponding treatment via the tail vein 5 min before reperfusion. The lung tissues were harvested and the levels of malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and tumor necrosis factor-α (TNF-α) were detected 3 h after reperfusion. The pathological changes and pathological scores of the lung tissues were analyzed.</p><p><b>RESULTS</b>MDA and MPO levels were significantly lower and SOD activities significantly higher in the lung tissues in the 3 treatment groups than in the control group (P<0.05). The rats in the combined treatment group showed a significantly lower MPO level and a significantly higher SOD activity than those treated with ligustrazine or perfluorocarbon alone (P<0.05). No significant difference was found in TNF-α levels in the lung tissues among the 4 groups (P>0.05). The lung tissues in the control group showed obvious edema and exudation, and the tissues in ligustrazine and perfluorocarbon groups showed no edema but with a few red blood cells and exudation; no edema was found in the combined treatment group with only a small amount of exudation. The pathological scores differed significantly among the 4 groups.</p><p><b>CONCLUSION</b>Perfluorocarbon and ligustrazine, especially in combined use, can promote endogenous oxygen free radical scavenging, decrease peripheral blood proinflammatory cytokines, and inhibit neutrophils filtration in the lungs of rats with ischemia/reperfusion lung injury.</p>

Management of Acute Submacular Hemorrhage with Intravitreal Injection of Tenecteplase, Anti-vascular Endothelial Growth Factor and Gas

PURPOSE: To evaluate the visual and anatomical outcomes for neovascular age-related macular degeneration with submacular hemorrhage after intravitreal injections of tenecteplase (TNK), anti-vascular endothelial growth factor (VEGF) and expansile gas. METHODS: This study was a retrospective clinical case series following 25 eyes of 25 patients. All patients received a triple injection using 0.05 mL TNK (50 µg), 0.05 mL anti-VEGF and 0.3 mL of perfluoropropane gas. Retreatment with anti-VEGF was performed as needed. Preoperative and postoperative best-corrected visual acuity and central retinal thickness were analyzed. RESULTS: The mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved significantly from 1.09 ± 0.77 at baseline to 0.52 ± 0.60 at 12 months (p < 0.001). The mean central retinal thickness also improved significantly from 545 ± 156 at baseline to 266 ± 107 at 12 months (p < 0.001). A visual improvement of 0.3 logarithm of the minimum angle of resolution unit or more was achieved in 15 eyes (60%). During the 12 postoperative months, an average of 4.04 intravitreal anti-VEGF injections was applied. CONCLUSIONS: A triple injection of TNK, anti-VEGF, and a gas appears to be safe and effective for the treatment of submacular hemorrhage secondary to neovascular age-related macular degeneration.

Case report: pneumatic retinopexy for the treatment of progressive retinal detachment in senile retinoschisis / Relato de caso: retinopexia pneumática no tratamento do descolamento de retina associado à retinosquise senil

Retinoschisis is an abnormal separation of the retinal layers and is asymptomatic in most cases. Enlargement of the area of retinoschisis and retinal tear and detachment are possible complications of the disease, and the treatment of retinoschisis is controversial. In this case report, we present a case of retinal detachment associated with senile retinoschisis in which pneumatic retinopexy was chosen as the treatment of choice and was performed successfully in one of the eyes. After a literature review on retinoschisis and pneumatic retinopexy for the treatment of associated retinal detachment, we found only one case that was successfully treated without drainage of subretinal fluid, using air as the filler. However, no previous reports have been found in the literature on the effectiveness of pneumatic retinopexy using C3F8 as the sole treatment for progressive retinal detachment in senile retinoschisis.

Retinosquise significa uma separação anormal das camadas da retina e, na maioria dos casos, é assintomática. Aumento da área de retinosquise, roturas e descolamento de retina são possíveis complicações da doença, sendo seus tratamentos controversos. Nesse relato, apresentamos um caso de descolamento de retina associado à retinosquise senil em que foi optado pela retinopexia pneumática como primeiro tratamento, com sucesso em um dos olhos tratados. Revisada literatura sobre retinosquises e retinopexia pneumática para tratamento de descolamento de retina associado, foi encontrado apenas um caso tratado com sucesso, sem drenagem de líquido sub-retiniano, utilizando-se ar como agente tamponante. Não existem relatos na literatura de retinopexia pneumática efetiva utilizando C3F8 como tratamento único para descolamento de retina progressivo na retinosquise senil.

Preparation and characterization of microbubbles loaded with hydrogen sulfide / 南方医科大学学报

<p><b>OBJECTIVE</b>To prepare a phospholipid-coated microbubble loaded with hydrogen sulfide (HSMB) and evaluate its physicochemical and acoustic properties.</p><p><b>METHODS</b>Hydrogen sulfide and perfluoropropane were mixed at the ratios of 4:0, 3:1, 2:2, 1:3, and 0:4 to prepare hydrogen sulfide-loaded microbubbles (termed HSMB4:0, HSMB3:1, HSMB2:2, HSMB1:3, and HSMB0:4, respectively). The microbubble concentration and diameter were investigated and their stability were evaluated. The optimal ratio of hydrogen sulfide and perfluoropropane was determined according to the changes of microbubble concentration. The changes of dissolved hydrogen sulfide and concentration of the microbubbles were investigated after exposure to ultrasound, and their acoustic enhancement effects in the myocardium and kidney were observed after intravenous injection in rats.</p><p><b>RESULTS</b>HSMBs were milky in color and spherical in shape without aggregations. The concentrations of HSMB4:0 and HSMB3:1 were lower than that of HSMB2:2 and decreased with time. HSMB2:2, HSMB1:3 and HSMB0:4 showed comparable concentrations and were stable within 72 h. After exposure to ultrasound, the concentration of HSMB2:2 decreased while the dissolved hydrogen sulfide increased significantly. Intravenous injection of HSMB2:2 produced a satisfactory contrast-enhancing effect in the myocardium and kidney of rats.</p><p><b>CONCLUSION</b>HSMB prepared with the hydrogen sulfide to perfluoropropane ratio of 2:2 has excellent contrast-enhancing effect and is capable of carrying and releasing hydrogen sulfide upon ultrasound exposure to potentially allow visual site-specific delivery of hydrogen sulfide.</p>

Perfluoroalkyl substances: emerging environmental contaminants involving potential health risk / 中华预防医学杂志

Perfluoroalkyl substances (PFASs) have been distributed in environment and human body worldwide. Due to their bioaccumulative and multiple organ toxic, these compounds have raised more and more attention in recent years. The precursors of PFASs can be metabolized to PFASs both in environment and human body, which makes an important contribution to human body burdens. Apart from transformation into PFASs, some of these precursors themselves or their metabolic intermediates also have toxicity effects, such as estrogen-like properties, protein binding, cytotoxicity and so on, and there might be a potential harmful impact on human health. In this paper, the toxicity and biotransformation of PFASs and their precursors were introduced briefly.

Analysis of perfluoroalkyl substances and their precursors in eighteen market milk / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the level of perfluoroalkyl substances (PFASs) and their precursors in 18 market milk samples of China.</p><p><b>METHOD</b>The 18 milk samples were selected in 8 provinces of China, including Ningxia, Neimeng, Beijing, Tianjin, Hebei, Shanxi, Chongqing, and Guangdong. 8 PFASs and 11 PFAS precursors were measured by ultra-high performance liquid chromatography-tandem quadruple mass spectrometry (UPLC-MS/MS). The dietary exposure assessment was made.</p><p><b>RESULTS</b>Three PFASs were detected in milk samples which were PFOA, PFUdA, and PFOS. The numbers of detected samples were 5, 12, and 14, respectively. Their concentration ranges were < Limit of determination (LOD)-431.94 pg/ml, < LOD -15.95 pg/ml and < LOD -126.98 pg/ml, respectively. Three PFAS precursors were also found above the detection limits, namely, 4:2 FTS, 6:2 FTS, and 6:2 diPAP. Only one sample was detected 4:2 FTS at the concentration of 3.75 pg/ml. The detected samples of 6:2 FTS and 6:2 diPAP were 12 and 3. Their concentration ranges were < LOD -2.49 pg/ml and < LOD -24.56 pg/ml, respectively. The ranges estimated daily intake of PFOA and PFOS of the detected samples were 2.49 × 10⁻³-405.89 × 10⁻³ ng · kg⁻¹ · d⁻¹ and 36.10 × 10⁻³-119.32 × 10⁻³ ng · kg⁻¹ · d⁻¹.</p><p><b>CONCLUSION</b>Our results suggested that there were different contamination levels of PFASs and their precursors in the 18 market milk produced from different regions in china. The estimated daily intake of PFASs from the milk in our study were far below the tolerable daily intake set by European Union (PFOS: 150 ng · kg⁻¹ · d⁻¹, PFOA: 1 500 ng · kg⁻¹ · d⁻¹).</p>

Analysis of perfluoroalkyl substances precursors in human milk from 12 provinces of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the level of perfluoroalkyl substances (PFASs) precursors in Chinese human milk samples.</p><p><b>METHODS</b>The human milk samples were collected during the performance of Stockholm convention on survey of human milk in China in 2007. Based on the geographical location and dietary habits, China was divided into the south area and north area which 6 provinces were chosen from each area and there were 12 provinces in all. In each province, one urban site and two rural sites were selected to collect 80-110 samples. Mothers were randomly selected in each site to collect their breast milk. There were 1 237 individual human milk samples in all. For each province, the individual samples from the urban areas and the rural areas were pooled separately resulting in 24 pooled human milk samples. 11 PFAS precursors were measured in pooled samples by ultra-high performance liquid chromatography-tandem quadruple mass spectrometry (UPLC-MS/MS). The dietary exposure assessment of newborns was made.</p><p><b>RESULTS</b>Three PFAS precursors were found above the detection limits, namely, 6:2 FTS, FHUEA, and 6:2 diPAP. Their concentration ranges were < Limit of determination (LOD) -47.46 pg/ml, < LOD -70.68 pg/ml and < LOD -35.08 pg/ml, respectively. The highest total PFAS precursor concentration 77.70 pg/ml was found in urban area samples from Shannxi Province. Rural area samples from Hubei had the lowest total PFAS precursor concentration, which was below the LOD. There were significant differences between rural and urban areas in many provinces, such as Shannxi (rural: 1.51 pg/ml; urban: 77.70 pg/ml), Shanghai (rural: 1.13 pg/ml; urban: 71.88 pg/ml), Jiangxi (rural: 65.39 pg/ml; urban: 0.55 pg/ml) and so on. The ranges estimated daily intake of 6:2 FTS, FHUEA and 6:2 diPAP of the samples from 12 provinces were 0.05-4.51, 1.13-6.72 and 1.15-3.34 ng · kg⁻¹ · d⁻¹.</p><p><b>CONCLUSION</b>The results suggested the human exposure of PFAS precursors in China and the potential health impact of postnatal exposure through breastfeeding to infants. The level of PFAS precursors showed differences in regions, rural and urban places.</p>

Simultaneous determination of three organic fluorides in workplace air by portable gas chromatography-mass spectrometer / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method for rapid determination of organic fluorides in the air of a fluorine chemical plant using portable gas chromatography-mass spectrometer (GC-MS).</p><p><b>METHODS</b>Standard samples of monochlorodifluoromethane, tetrafluoroethylene, and hexafluoropropylene of different concentrations were prepared by static volumetric method with high-purity nitrogen as the diluent gas. The samples were injected into the GC-MS by a hand-held probe. Retention time and characteristic ion were used for qualitative analysis, and the area of selected ion peak was used for quantitative analysis. The standard curves were then created for quantitative determination of the three organic fluorides.</p><p><b>RESULTS</b>The linear ranges for monochlorodifluoromethane, tetrafluoroethylene, and hexafluoropropylene by the method were 0.39-7.72, 0.45-8.84, and 0.61-12.20 mg/m3, respectively, the average recovery rates for the three concentrations were 102.8%, 96.0%, and 106.5%, respectively, and the average deviations were 2.1%, 5.1%, and 2.4%, respectively.</p><p><b>CONCLUSION</b>The portable GC-MS can be used for the simultaneous qualitative and quantitative analysis of monochlorodifluoromethane, tetrafluoroethylene, and hexafluoropropylene in the workplace air, and the method is simple, fast, and accurate.</p>