Advances in Retinopathy of Prematurity / 中国医学科学院学报

Retinopathy of prematurity(ROP)is a pathological neovascularization with fibrotic changes in the fundus of premature infants.It is a major cause of preventable blindness in children in both developing and developed countries.Treatment of ROP has long been a hot research topic in ophthalmology and pediatrics.With a clearer knowledge of the pathogenesis of ROP,more basic and clinical studies have been carried out.The anti-vascular endothelial growth factor therapy and surgical treatment have become mature strategies,and a variety of therapeutic drugs including insulin-like growth factor-1,transforming growth factor-β,polyunsaturated fatty acids,and β-adrenergic receptor blockers have been developed.This article reviews the recent advances in ROP.

Research Advances in Ocular Myasthenia Gravis / 中国医学科学院学报

Ocular myasthenia gravis(OMG)is an autoimmune disease caused by neuromuscular junction transmission disorders and manifested mainly as fluctuating blepharoptosis and diplopia,with the extraocular muscles as the main involveed sites.While the pathogenesis of OMG remains unclear,some antibodies,complements,and cytokines may be the contributing factors.The diagnosis and treatment of OMG have been defined in recent years.This article reviews the pathogenesis,diagnosis,and treatment of OMG.

Mechanism of Th1/Th2 Cytokines in HLA-DQ8 Transgenic Mice Model of Ocular Experimental Autoimmune Myasthenia Gravis / 中国医学科学院学报

Objective To analyze the levels of cytokines (IL-2,IFN-γ,IL-6,IL-10) associated with Th1 and Th2 cells in HLA-DQ8 transgenic mice model of ocular experimental autoimmune myasthenia gravis (oEAMG) induced by recombinant H-AChR γ subunit immunization.Methods DQ8 mice were immunized with 20 μg of AChR γ subunit,20 μg of crude E. coli extract (E. coli group),or complete Freund's adjuvant (CFA) only (CFA group). All mice were immunized on days 0,30,and 60. Mice were euthanized 28 days after the third immunization,and draining lymph node cells (LNC) and spleen lymphocytes were cultured in vitro. The supernatant was collected to observe the interleukin(IL)-2,interferon(IFN)-γ,IL-6,IL-10 production by ELISA.Results LNCs and spleen lymphocytes of H-AChR γ subunit-immunized mice exhibited significantly enhanced IFN-γ (F=76.332,P<0.001;F=34.865,P<0.001) and IL-2 (F=42.835,P<0.001;F=38.030,P<0.001),which associated with Th1 cells,as compared to E. coli group and CFA group. There were no significant differences in IL-6 (F=1.325,P=0.284;F=1.935,P=0.166) and IL-10 (F=0.908,P=0.417;F=1.189,P=0.322) levels,which secreted by Th2 cells,among these three groups.Conclusion Th1 cytokines play key roles in the pathogenesis of oEAMG,while the mechanism of Th2 cytokines for oEAMG remains unclear.

Identification of Circular RNAs as a Novel Biomarker for Ovarian Endometriosis / 中华医学杂志(英文版)

<p><b>Background</b>Endometriosis is a challenging disease with symptoms such as dysmenorrhea and infertility. However, its etiology is still vague and there is still no effective markers or treatment. This study aimed to profile the circular RNAs (circRNAs) expressed in eutopic endometrium from patients with ovarian endometriosis and explore potential clues to the pathogenesis of endometriosis, providing an evidence for clinical diagnosis and treatment.</p><p><b>Methods</b>A total of 63 clinical samples, including control endometrium (n = 22) and eutopic endometrium (n = 41), were collected from Peking Union Medical College Hospital between May 1, 2016, and December 31, 2016. Of them, four samples in each group were used for circRNA microarray. Then, four upregulated circRNAs were screened out for quantitative real-time polymerase chain reaction (qRT-PCR) validation. After that, bioinformatics analysis was performed to predict miRNAs targeted by validated circRNAs and investigate the circRNA-miRNA-mRNA interactions.</p><p><b>Results</b>Among 88 differentially expressed circRNAs, 11 were upregulated and 77 were downregulated in eutopic endometrium of patients with endometriosis. qRT-PCR validation results for two upregulated circRNAs (circ_0004712 and circ_0002198) matched the microarray results. The area under the receiver operating characteristic curve of circ_0002198 for distinguishing ovarian endometriosis was 0.846 (95% confidence interval [CI]: 0.752-0.939; P < 0.001) while that of circ_0004712 was 0.704 (95% CI: 0.571-0.837; P = 0.008). On the basis of target prediction, we depicted the molecular interactions between the identified circRNAs and their dominant target miRNAs, as well as constructed a circRNA-miRNA-mRNA network.</p><p><b>Conclusions</b>This study provides evidence that circRNAs are differentially expressed between eutopic and normal endometrium, which suggests that circRNAs are candidate factors in the activation of endometriosis. circ_0002198 and circ_0004712 may be potential novel biomarkers for the diagnosis of ovarian endometriosis.</p>

Menorrhagia and Uterine Volume Associated with Lower Urinary Tract Symptoms in Patients with Adenomyosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adenomyosis is a gynecological disorder with symptoms most presenting as dysmenorrhea and heavy menstrual bleeding. However, the presence of lower urinary tract symptoms (LUTS) among women with adenomyosis remains unclear. This study was designed to determine the prevalence of LUTS and factors related to the severity of these symptoms in this population.</p><p><b>METHODS</b>From July 2016 to November 2016, a total of 298 untreated symptomatic adenomyosis patients and 280 age-matched controls were enrolled. Demographics, LUTS, pain symptoms, ultrasonographic uterine size, and serum CA125 level were recorded. LUTS were evaluated using the International Prostate Symptom Score (IPSS) questionnaire. Factors related to the severity of LUTS were detected using the logistic regression analysis presented as odds ratio (OR) and 95% confidence interval (CI).</p><p><b>RESULTS</b>Compared with the control group, patients with adenomyosis had a greater IPSS total (4 [2-8] vs. 2 [0-3], Z = -8.159, P 0.001), IPSS storage (2 [1-4] vs. 1[0-2], Z = -7.361 P 0.001), and IPSS voiding (2 [0-4] vs. 0 [0-1], Z = -7.194, P 0.001). Of the patients with adenomyosis, 30.2% had moderate-to-severe lower urinary tract symptoms (IPSS ≥8). The most prevalent LUTS were daytime frequency (40.9%), followed by nocturia (24.8%), weak stream (24.2%), and incomplete emptying (23.5%). In study group, patients with an IPSS total score ≥8 had higher proportion of menorrhagia (51.1% vs. 30.8%, χ2= 11.162 P= 0.025) and larger uterine volumes (183.3 [109.8-273.8] cm3 vs. 148.5 [96.4-262.7] cm3, Z = -1.441, P= 0.150) compared to patients with an IPSS total score <8. On multivariate logistic regression analysis, patients with menorrhagia were associated with an increased risk of an IPSS total score ≥8 (OR: 2.309, 95% CI: 1.310-4.070, P= 0.004), an IPSS storage subscore ≥4 (OR: 2.422, 95% CI: 1.395-4.206, P= 0.002), and an IPSS voiding subscore ≥5 (OR: 1.971, 95% CI: 1.176-3.302, P= 0.010). However, patients with uterine volume more than 180 cm3 had more than 2-fold risk of bearing IPSS total score ≥8 (OR: 2.437, 95% CI: 1.381-4.300, P= 0.002), IPSS storage subscore ≥4 (OR: 2.486, 95% CI: 1.433-4.314, P= 0.001), and IPSS voiding subscore ≥5 (OR: 2.700, 95% CI: 1.485-4.908, P= 0.001).</p><p><b>CONCLUSIONS</b>Lower urinary tract symptoms are prevalent in patients with symptomatic adenomyosis and greatly affect patients' quality of life. Menorrhagia and large uterine volume could be potential risk factors that increase the occurrence of moderate-to-severe LUTS.</p>