A preliminary study of fecal microbiota transplantation alleviating inhibition of radiation-induced hippocampal neurogenesis in mice / 中华放射肿瘤学杂志

Objective:To evaluate the effects of whole brain irradiation (WBI) and fecal microbiota transplantation (FMT) on hippocampal neurogenesis and the composition of gut microbiota in mice.Methods:Forty specific pathogen free ICR male mice (8-week-old, weighed 30 g) were divided into four groups by simple random sample method: control group (group C), radiation group (group R), group C+FMT and group R+FMT, 10 in each group. Animal models were established by WBI at a dose of 10 Gy by 4 MeV electron beam. In group C+FMT and group R+FMT, mice were gavaged with normal fecal bacteria suspension on day 2 post-irradiation, while those in group C and group R were gavaged with phosphate buffered saline as alternative. Hippocampal tissues and feces in four groups were collected on day 15 post-irradiation. 16S rRNA sequencing was used to detect the species and abundance of fecal flora. BrdU +/NeuN + immunofluorescence staining was performed to observe the neurogenesis in hippocampus of mice. Results:WBI and FMT had no effect on survival rate and body weight of mice. WBI induced the inhibition of hippocampal neurogenesis and flora disorder. The quantity of Bacteroideae and Rumen bacteria was increased by 28.6% and 102.9%, whereas that of Lactobacillus was significantly decreased by 70.6% ( P<0.05). FMT regulated the abundance of bacteria. The abundance of Enterobacteriaceae was significantly declined by 65.1% ( P=0.028), while that of Lactobacillus was increased by 58.2% ( P=0.015). FMT also promoted hippocampal neurogenesis to some extent after WBI. Conclusions:This preliminary study demonstrates that FMT alleviates the inhibition of hippocampal neurogenesis and flora disorder induced by WBI in mice. Ionizing radiation directly acting on the whole brain of mice indirectly disturbs the composition of gut microbiota, which in turn affects the degree of hippocampal neurogenesis in the brain of mice. There is a bidirectional interaction between gut microbiota and brain.

Clinical study of lupus nephritis complicated with renal thrombotic microangiopathy / 中华肾脏病杂志

Objective:To study the clinicopathological characteristics, treatment and prognosis in lupus nephritis (LN) patients with renal thrombotic microangiopathy (TMA), so as to provide more theoretical basis for clinicians to recognize and treat this disease.Methods:The clinical data of LN patients who underwent renal biopsy in the First Affiliated Hospital of Zhengzhou University from January 1, 2012 to May 31, 2019 were retrospectively collected and analyzed. According to renal clinicopathological examination, the patients were divided into renal TMA group and non-renal TMA group. The clinical data, laboratory examination, renal pathological examination, therapeutic measures and prognostic between the two groups were compared. Follow-up end points were defined as composite ends, including all-cause death, entry into end-stage renal disease, and estimated glomerular filtration rate decrease>50% of baseline. Kaplan-Meier survival curve and log-rank test were used to compare the difference of survival rate between the two groups, and multivariate Cox regression equation was used to analyze the risk factors of endpoint events in LN patients.Results:A total of 1 133 patients with LN were enrolled in this study. Patients with renal TMA were more likely to have hypertension ( χ2=16.310, P<0.001), higher baseline serum creatinine ( Z=-6.918, P<0.001) and 24-hour urine protein ( Z=-2.232, P=0.026), and higher renal pathology activity index (AI) score ( Z=1.957, P=0.001)and chronic index (CI) score ( Z=1.836, P=0.002). The proportions of hormone shock ( P<0.001) and plasma exchange ( P<0.001) in the renal TMA group were higher than those in non-renal TMA group. After treatment of (12±2) months, patients in the renal TMA group had a lower complete response rate ( χ2=10.455, P=0.001) and a higher non-response rate ( χ2=6.047, P=0.014) than those in non-renal TMA group, and were associated with worse prognosis (Log-rank test χ2=26.490, P<0.001). Renal TMA was an independent risk factor for poor prognosis ( HR=2.347, 95% CI 1.210-4.553, P=0.012). Conclusions:Compared with LN patients without renal TMA, LN patients with renal TMA are more likely to have hypertension, with higher serum creatinine, 24-hour urinary protein, AI and CI, suggesting poorer treatment response and renal prognosis. Moreover, renal TMA is an independent risk factor for poor prognosis in patients with LN.

Grouping rules and implications of MS-DRG in the United States / 中华医院管理杂志

The United States is the first country to implement DRG payment in the world, and its MS-DRG(medical severity DRG)version has been used for reference by many countries and regions. In order to ensure the universal applicability of DRG grouping scheme and adapt to the clinical reality, the MS-DRG grouping scheme should follow such grouping rules as similarity of resource consumption, clinical similarity and easy management of DRG groups. This paper presented the evolution of MS-DRG and expounded on its grouping rules in detail, for reference in the amendment and improvement of grouping rules in CHS-DRG.

Clinical study on Buyang-Huanwu Decoction combined with Tingli-Dazao-Xiefei Decoction combined with conventional therapy of western medicine in the treatment of chronic heart failure with qi deficiency and blood stasis / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of Buyang-Huanwu Decoction combined with modified Tingli-Dazao-Xiefei Decoction on the basis of conventional western medicine therapy in the treatment of chronic heart failure (CHF) with syndrome of qi deficiency and blood stasis. Methods:Seventy patients who met the inclusion criteria from November 2017 to November 2019 in Shijingshan District Hospital of Traditional Chinese Medicine were randomly divided into two groups, 35 in each group. The control group was treated with western medicine for chronic heart failure, and the treatment group was treated with Buyang-Huanwu Decoction combined with Tingli-Dazao-Xiefei Decoction on the basis of the control group. Both groups were treated for 2 weeks. The TCM syndrome scores were observed and compared before and after treatment. Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate the quality of life of patients. Lee’s Heart Failure Score was used to evaluate the severity of symptoms. The N-terminal pro-B type natriuretic peptide(NT-proBNP) was detected by ELISA. The adverse reactions during treatment were observed and the clinical efficacy was evaluated. Results:The total effective rate was 91.4% (32/35) in the treatment group and 77.1 % (27/35) in the control group, and the difference was statistically significant ( χ2=7.050, P=0.014). After treatment, the serum NT-proBNP in the treatment group [(1 725.3 ± 1 473.8) ng/L vs. (2 485.7 ± 2 164.4) ng/L; U=341.200, P=0.031] was significantly lower than that of the control group. The NT-proBNP [(54.3 ± 26.7) % vs. (35.5 ± 19.8)%; U=4.310, P=0.003] was significantly higher than that of the control group. After treatment, the TCM syndrome scores and MLHFQ scores in the treatment group were significantly lower than those in the control group ( t=3.785, 9.925, P=0.031, 0.001). During the treatment, no obvious adverse reactions were observed in both groups. Conclusion:On the basis of standardized treatment of Western medicine, Buyang-Huanwu Decoction and Tingli-Dazao-Xiefei Decoction can improve the clinical efficacy of CHF patients with qi deficiency and blood stasis syndrome, promote the repair of damaged myocardium (reduce NT-proBNP), and improve the quality of life of patients.

Dosimetric verification of stereotactic body radiotherapy treatment plan via ArcCHECK-3DVH system / 中南大学学报(医学版)

OBJECTIVES@#To study the feasibility of ArcCHECK-3DVH system in dosimetric verification for stereotactic body radiaotherapy (SBRT) with flattening filter free (FFF) model.@*METHODS@#SBRT treatment plans for 57 patients were introduced into ArcCHECK phantom and recalculated. The calculated dose distribution of treatment planning system and the measured dose distribution of ArcCHECK phantom were compared by γ analysis. Then the 3 dimensional dose distribution of target and organs at risk was reconstructed by 3DVH software. The reconstructed dose and calculated dose with treatment planning system (TPS) were compared, and the dose volume γ pass rate and deviation of dose volume parameters to the target and organs at risk were quantitatively valuated.@*RESULTS@#Based on the threshold criteria (3%, 3 mm, 10%), namely the deviation of measuring points between the planned value and the measured value was less than 3%, and the proportion of points with similar values in the plane or sphere with the center of the point and the radius of 3 mm was 10%, the relative and absolute dose pass rates of SBRT treatment plans in ArcCHECK system via γ analysis were greater than 95%. Based on the stricter threshold criteria (2%, 2 mm, 10%), the relative and absolute dose pass rates of SBRT treatment plan in ArcCHECK system via γ analysis were about 93%. In 3DVH dose verification, the γ pass rate of target and organs at risk was exceed 97%, and the deviations in 3DVH of the target and organs at risk were less than ±5%.@*CONCLUSIONS@#The ArcCHECK-3DVH system in dose verification can provide more comprehensive dose distribution information to reasonably evaluate the SBRT plan, with more significance for guiding clinical treatment.

Research progress on biomarkers for radiation-induced intestinal injury based on intestinal flora / 中华放射肿瘤学杂志

Recently,the relationship between intestinal flora and its metabolites and tumorigenesis,inflammatory bowel diseasesas well as radiation-induced intestinal injury has captivated widespread attention from researchers.Accumulated evidence derived from nuclear accident investigation,animal model experiment and clinical research has proven the role of intestinal flora and its metabolites as the biomarkers to evaluate the radiation dose and severity of radiation-induced intestinal injury.This article reviews the relationship between intestinal flora and its metabolites and radiation-induced intestinal injury,aiming to provide theoretical reference for assessing the risk of radiation-induced intestinal injury.

Carbamazepine-induced toxic epidermal necrolysis in a patient with HLA-A*31:01 allele / 中华皮肤科杂志

Objective:To detect susceptibility genes for toxic epidermal necrolysis (TEN) caused by carbamazepine in a patient.Methods:Clinical data and peripheral blood samples were collected from a patient with carbamazepine-induced TEN. DNA was extracted from the peripheral blood samples, fluorescence in situ hybridization was performed to detect susceptibility gene loci for carbamazepine-induced TEN, including HLA-A*31:01 (rs1633021), HLA-B*58:01 (rs3095318), HLA-B*15:02 (rs3909184) and HLA-B*15:02 (rs2844682) . Results:The 40-year-old female patient of Han nationality presented with perioral erythema and blisters for 7 days, which had spread all over the body for 4 days. The patient had been treated with carbamazepine for 1 month before the occurrence of skin lesions. Genetic testing showed that the patient was negative for HLA-B*15:02 allele, but positive for HLA-A*31:01 allele.Conclusion:The Chinese patient of Han nationality with carbamazepine-induced TEN was positive for HLA-A*31:01 allele.

Analysis of the pathogen spectrum of severe hand, foot and mouth disease and genetic characteristics of enterovirus A71 in Xianyang, 2018 / 中华实验和临床病毒学杂志

Objective@#To understand the pathogen spectrum of severe hand, foot and mouth disease (HFMD), and analyze the genetic characteristics of enterovirus A71(EV-A71) in Xianyang in 2018.@*Methods@#Totally 67 specimens of severe cases of HFMD were collected. Enteroviruses associated with HFMD were detected by real-time PCR and the genotypes of enteroviruses were identified by VP4 region of enteroviruses. The nucleotide and amino acid sequences of VP1 region of EV-A71 were analyzed.@*Results@#A total of 30 samples were positive for enterovirus among samples from 67 severe cases with HFMD, including 9 cases of EV-A71, 11 cases of coxsackievirus A6 (CV-A6), 5 cases of coxsackievirus A16 (CV-A16), 2 cases of coxsackievirus A10 (CV-A10) and 2 cases of coxsackievirus A4 (CV-A4). The nucleotide and amino acid homologies of EV-A71 among 4 strains reached 96.7%-99.9% and 99.3%-100% respectively. The 4 strains of EV-A71 belonged to C4a subtypes by phylogenetic analysis. The six amino acid composite model was KADSTV in 4 strains of EV-A71. The EF region and GH region in antigenic determinants of 4 strains of EV-A71 kept consistent with representative reference strains, however, the EV-A71 SZK222 and SZK497 strains developed mutation at site 93 (I93V) of BC loop region.@*Conclusions@#EV-A71 and CV-A6 are major agents of severe HFMD in Xianyang in 2018. The genotype of EV-A71 belonged to C4a subtype and the VP1 gene did not show more mutations.

Intravitreal aflibercept versus photodynamic therapy in Chinese patients with neovascular age-related macular degeneration: outcomes of the SIGHT study / 中华眼底病杂志

Objective To assess the efficacy and safety ofintravitreal aflibercept injection (IAI) compared with photodynamic therapy (PDT) in the treatment of Chinese patients with predominantly classic subfoveal choroidal neovascularization (CNV) lesions secondary to neovascular age-related macular degeneration (nAMD).Methods A randomized,double-blind,multi-center phase-3 clinical trial lasting for 52weeks (from December 2011 to August 2014).Subjects were randomized in a 3:1 ratio to either IAI group or PDT-to-IAI group.Subjects in the IAI group received 2 mg IAI at baseline and at week 4,8,16,24,32,40,48,with sham injection at week 28,36.Subjects in the PDT-to-IAI group were forced to receive PDT once at baseline and more time at week 12,24 if PDT retreatment conditions were met.Sham injections were given in PDT-to-IAI group at baseline and at week 4,8,16 and 24,followed by 2 mg IAI at week 28,32,36,40,48.The primary outcome of efficacy were the change in mean Best Corrected Visual Acuity (BCVA) from baseline to week 28,and that of week 52.Safety evaluation included the percentage of subjects who suffered treatment emergent adverse events (TEAEs).Results Among the 304 subjects enrolled,there were 228 and 76 cases in IAI group and PDT-to-IAI group respectively.At week 28,the changes of mean BCVA in IAI group,PDT-to-IAI group compared to baseline were +14.0,+3.9 letters,respectively.At week 52,the changes of mean BCVA in two groups were + 15.2,+8.9 letters respectively with the difference of +6.2 letters (95％CI 2.6-9.9,P=0.000 9).At week 52,the mean foveal retinal thickness in the two groups decreased by-189.6,-170.0 μm,respectively.Subjects with the most BCVA increase in IAI group were those aged ＜65,and those with active CNV lesion area ＜50％ of total lesion area.The most common TEAEs in IAI group and PDT-to-IAI group are macular fibrosis [11.8％ (27/228),6.6％ (5/76)] and BCVA decline [6.6％ (15/228),21.1％ (16/76)].There were 3 cases of arterial thromboembolic events defined in the antiplatelet experimental collaboration group,but all were considered unrelated to interventions.Conclusions The efficacy of aflibercept is superior to that of PDT in nAMD patients in China.The therapeutic effect of aflibercept persisted to week 52 in all subjects.The rate of adverse events was consistent with the safety data of aflibercept known before.

Analysis of the prevalence of hand, foot and mouth disease in Xianyang from 2013 to 2016 / 中华实验和临床病毒学杂志

Objective@#To understand the morbidity and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Xianyang in order to provide evidence for making prevention strategies.@*Methods@#The incidence data of HFMD from 2013 to 2016 were collected from the National Disease Information Management System. The HFMD specimens were tested by polymerase chain reaction (PCR) and the results were analyzed by the Statistical Product and Service Solutions (SPSS19.0).@*Results@#A total of 29 662 HFMD cases were reported in Xianyang from 2013 to 2016, and the average annual incidence rate was 143.62/100 000, including 406 severe cases and 4 deaths. There were statistically significant differences in incidence rate among the four years (P<0.01). The peak of the incidence occurred in April to July, and the second peak occurred in October to November. The top three counties which had high incidence were Wugong, Xunyi and Jingyang. There were statistically significant differences in different counties (P<0.01). The age group of 0-3 year scattered children has the most reported cases, a total of 26 399 cases, accounting for 89.00%. The number of male cases was higher than that of female cases and there were statistically significant differences between male and female (P<0.01). A total of 2 439 samples of HFMD were detected in the laboratory, the positive rate was 47.23%, among which coxsackievirus type 6 (CV-A6), coxsackievirus type 16 (CV-A16) and enterovirus A71 (EV-A71) were 38.02%, 29.91% and 21.01%.@*Conclusions@#The HFMD morbidity had obvious seasonal trend. Regional and demographic characteristics of morbidity were significant in Xianyang. The dominant pathogen was different from 2013 to 2016. The EV-A71 is easy to induce the epidemic of the HFMD.

The role of p75 neurotrophin receptor in hippocampal neurogenesis impairment after cranial irradiation / 中华放射肿瘤学杂志

Objective@#To investigate the role of p75 neurotrophin receptor (p75NTR) in the irradiation-induced hippocampal neurogenesis impairment.@*Methods@#Thirty Sprague-Dawley rats were subject to whole brain irradiation with a single dose of 10 Gy 4 MeV electron beam. At 1 month after irradiation, the hippocampal tissues of the rats were collected. Western blot was used to detect the changes in the expression level of p75NTR protein. Immunofluorescence confocal laser microscopy was performed to observe the variations in the hippocampal neurogenesis. The stereotatic method was adopted for intra-hippocampal injection of AAV-shp75NTR to specifically knock out p75NTR.The relationship between p75NTR and hippocampal neurogenesis was analyzed.@*Results@#Western blot demonstrated that the expression of p75NTR protein was significantly up-regulated by 43.8% after irradiation (P<0.05). Immunofluorescent staining showed that the quantity of BrdU+ NeuN+ cells in rats was significantly decreased by 81.5% at 1 month after irradiation compared with that in the control group (P<0.01). After the specific knockout of p75NTR, hippocampal neurogenesis was obviously protected.@*Conclusion@#p75NTR plays a pivotal role in the irradiation-induced hippocampal neurogenesis impairment.

Dosimetric verification of flattening filter free model based on TrueBeam accelerator using ArcCheck system / 中南大学学报(医学版)

To study the feasibility of ArcCheck verification system in dosimetric verification for stereotactic radiotherapy (SRT) the stereotactic radiotherapy (SRT) with flattening filter free (FFF) model.
 Methods: A total of 76 cases under SRT treatment plans were introduced into ArcCheck phantom and recalculated. Threshold criteria was set as (3%, 3 mm, 10%) or (2%, 2 mm, 10%). The calculated dose distribution and the measured dose distribution of ArcCheck phantom were compared by means of distance to agree (DTA) and Gamma analysis method respectively.
 Results: Based on the threshold criteria (3%, 3 mm, 10%), the relative and absolute mean pass rates of SRT treatment plans by DTA and Gamma analysis were greater than 95%. Based on the threshold criteria (2%, 2 mm, 10%), the relative and absolute mean pass rates of SRT treatment plan by DTA and Gamma analysis were about 90%. The dose pass rate of Gamma analysis method was slightly higher than that of DTA analysis method (P<0.001).
 Conclusion: The ArcCheck verification system is a rapid and accurate method for SRT dose verification, and discrepancies are found in different analysis methods.

Advances of optogenetics in the treatment of retinitis pigmentosa / 中华眼底病杂志

Retinitis pigmentosa (RP) is a disease that seriously affects vision.It mainly affects rod cells and causes night blindness.At the end of the disease,due to the simultaneous involvement of cone cells,the patient's central vision and peripheral vision loss are not effective.There is no effective treatment method.However,some studies have found that although the function of photoreceptors is lost in the pathological process of RP,the function of bipolar cells and ganglion cells and the neural connection with the visual center are preserved,which provides a condition of therapeutic application in optogenetics for optogenetics.Optogenetics controls the excitability of neurons by expressing the light-sensitive protein represented by rhodopsin ion channel protein-2 on neurons,and has shown great application prospects in reshaping the photoreceptor function of the retina.The treatment of a type of retinal degenerative disease provides an effective treatment option.

The role of TrkA/TrkB in radiation-induced hippocampal neurogenesis impairment / 中华放射医学与防护杂志

Objective To investigate the roles of TrkA and TrkB in radiation-induced hippocampal neurogenesis impairment.Methods Fifty-six rats were randomized into radiation group and sham control group.Radiation group received whole brain irradiation at a single dose of 10 Gy.The hippocampus were separated from rats in day 1,day 3,day 14 and 1 month after irradiation.Western blot and RT-PCR were applied to detect the protein levels and mRNA levels.Golgi staining was used to observe the dendritic spine of hippocampus.Immunofluorescence was performed to detect neural precursor's proliferation.Results Compared with control group,the numbers of dendritic spine significantly decreased after irradiation and its shape change obviously.Immunofluorescence showed a significant decrease in neural precursor's proliferation comparing with control group (t =6.49,P ＜ 0.05).Protein level of TrkA expression increased (t =2.64,3.06,4.80,2.64,P ＜ 0.05),while the levels of TrkB protein expression decreased significantly (t =4.59,3.06,2.81,2.57,P ＜ 0.05).The mRNA level of TrkA expressions increased (t =4.57,3.06,5.39,5.86,P ＜ 0.05),while the mRNA level of TrkB decreased (t =14.87,11.69,4.98,P ＜ 0.05).Conclusions As a signaling pathways downstream of NGF and BDNF,TrkA and TrkB may play an important role in radiation-induced neurogenesis impairment.

Effect of brain-derived neurotrophic factor on the NFAT3/c4 signaling pathway after whole brain radiotherapy / 中华放射肿瘤学杂志

Objective To explore the effects of various radiation doses on the NFAT3/c4 signaling pathway and the improvement effect of exogenous brain-derived neurotrophic factor(BDNF)on this pathway. Methods Four groups of one-month-old Sprague-Dawley rats received radiation doses of 0,2,10,and 20 Gy, respectively, in a single radiation. At three days after radiation, exogenous BDNF was injected stereotaxically into the bilateral hippocampus. Western blotting and RT-PCR were used to assess the levels of NFAT3/c4-related proteins in the hippocampus. Results The results of Western blotting and RT-PCR showed that the level of NFAT3/c4 was reduced in a dose-and time-dependent manner after ionizing radiation. Compared with the radiation alone group,the ionizing radiation plus BDNF group had significantly increased levels of NFAT3/c4 and CaN with increases in radiation dose and time. Conclusions Whole brain radiotherapy inhibits the CaN/NFAT3/c4 signaling pathway. Exogenous BDNF can promote the NFAT-dependent transcription and then improve the cognitive function.

The status of the oral drugs for chronic central serous chorioretinopathy / 中华眼底病杂志

Chronic central serous chorioretinopathy (CSC) usually demonstrates frequent recurrence,diffuse leakage and persistent subretinal fluid,which cannot be absorbed,thus lead to photoreceptor damage and poor visual acuity.As glucocorticoids have been implicated in the pathogenesis of chronic CSC,various anti-glucocorticoids oral drugs were used in the clinic to promote retinal fluid absorption and reduce the central retinal thickness of the macula and improve the vision outcomes.In addition,the 5α-reductase-specific inhibitor finasteride,the P450-3A4 inducer rifampicin,circadian rhythmic regulator melatonin,and systemic anti-inflammatory drug methotrexate have also been put into clinical trials for chronic CSC,and achieved certain effects.However,most of the clinical studies on these oral drugs were case reports,but not multi-center randomized clinical trials.The long-term effects of these oral drugs need to be observed and studied further.

Effects of Perioperative Rehabilitation on Anterior Spinal Cord Syndrome after Cervical Hyperflexion Injury / 中国康复理论与实践

Objective To observe the effect of perioperative rehabilitation on anterior spinal cord syndrome caused by cervical hyper-flexion injury. Methods Sixty-nine inpatients with anterior spinal cord syndrome after cervical hyperflexion injury from January, 2012 to De-cember, 2014 were reviewed. 32 cases (group A) accepted systematic rehabilitations and other 37 cases (group B) did not. They were as-sessed with Japanese Orthopaedic Association (JOA) scores preoperatively and 1-year follow-up. Results All the patients succeeded in the operation. The JOA score improved more 1 year follow-up in group A than group B (t=2.538, P=0.044). Conclusion Systematic rehabilita-tion may work in the management of anterior spinal cord syndrome after cervical hyperflexion injury.

Characteristics of multiple evanescent white dot syndrome with multimodal imaging / 中华眼底病杂志

Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities.Methods This was a retrospective case study.Eleven patients (11 eyes) diagnosed with MEWDS were enrolled.There were 10 females and 1 male,mean age was 27.6 years (range 15-41 years).The period between disease onset and visiting to the hospital was between 2 to 13 days,the average time was 4.7 days.All the patients underwent examinations of best corrected visual acuity,slit-lamp biomicroscope,indirect ophthalmoscope,fundus color photography,fundus autofluorescence (FAF),fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT).The mean follow up duration was 3.2 months.The imaging characteristics were compared.Results Fundus color photography showed foveal orange-red granularity in all eyes.FAF showed strong autofluorescence with a vague boundary.FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage,and fluorescence remained in the late stage.ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence.SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone,ellipsoid layer,and toward the external limiting membrane.At the site of extrafoveal lesions,SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation.Conclusions In MEWDS patients,fundus photography showed foveal orange-red granularity;FFA showed early fluorescent dots distributed in a ring pattern;ICGA showed hypofluorescent lesions in the later stage;SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape;FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.

Applying internal limiting membrane peeling for vitreoretinal disorders to improve the surgical outcomes / 中华眼底病杂志

The internal limiting membrane (ILM),composed of collagen fibers,glycosaminoglycans,laminin and fibronectin,is the basement membrane of the retinal Müller glia cells and serves as an interface between the vitreous and retina.The ILM is the structural interface between the vitreous and retina.ILM removal ensures separation of the posterior hyaloid from the macular surface,which can relieve macular traction and prevent postoperative epiretinal membrane formation.Thus,vitrectomy with ILM peeling has become an increasingly utilized and vital component in surgical intervention for various vitreoretinal disorders.However,many recent studies showed that ILM peeling is a procedure that can cause immediate traumatic effects and progressive modification on the underlying inner retinal layers.There were some surgical strategy (fovea-sparing ILM peeling or inverted internal limiting membrane flap technique,or Abrasion Technique).But some controversies exist,such as when ILM peeling is necessary,which adjuvant to use to perform the procedure,and what is the best technique to peel the ILM.A full assessment ILM structure and function and related factors of surgery is helpful to predict the anatomical and functional prognosis.

Apolipoproteins as Differentiating and Predictive Markers for Assessing Clinical Outcomes in Patients with Small Cell Lung Cancer

PURPOSE: The present study aimed to investigate the value of apolipoproteins, including ApoA-1, ApoC-III, and ApoE, in patients with small cell lung cancer (SCLC) as potential biomarkers for diagnosis, prognosis, and cancer progression. MATERIALS AND METHODS: Lung samples were collected from 89 patients with SCLC. Nineteen lung samples from non-small cell lung cancer (NSCLC) patients and 12 normal lung tissues were used as controls. Expression profiles of ApoA-1, ApoC-III, and ApoE in different samples were examined using immunohistochemical methods, and the expression levels were correlated with cancer types, treatment, and outcomes using chi-square and Mann-Whitney tests. RESULTS: Expression of ApoA-1 and ApoC-III in SCLC was significantly different, compared with that in NSCLC and normal lung tissues, and was correlated with recurrence of SCLC. Patients undergoing neoadjuvant chemotherapy before surgery showed significantly reduced expression of ApoA-1 and increased expression of ApoC-III and ApoE. Nevertheless, the expression levels of ApoA-1, ApoC-III, and ApoE were not correlated with SCLC staging. CONCLUSION: ApoA-1 and ApoC-III may be used as differentiating and predictive markers for SCLC. ApoA-1, ApoC-III, and ApoE may be used to monitor the efficacy of chemotherapy.