Treatment of intrauterine adhesions in rats with hypoxia-cultured BMSC-derived exosomes / 中华妇产科杂志

Objective: To perform intrauterine adhesion modeling, and to investigate the repair effect of hypoxic treated bone marrow mesenchymal stem cells (BMSC) and their derived exosomes (BMSC-exo) on endometrial injury. Methods: BMSC and their exosomes BMSC-exo extracted from rats' femur were cultured under conventional oxygen condition (21%O2) or hypoxia condition (1%O2). Intrauterine adhesion modeling was performed on 40 healthy female SD rats by intrauterine injection of bacterial lipopolysaccharide after curettage. On the 28th day of modeling, 40 rat models were randomly divided into five groups, and interventions were performed: (1) NC group: 0.2 ml phosphate buffered solution was injected into each uterine cavity; (2) BMSC group: 0.2 ml BMSC (1×106/ml) with conventional oxygen culture was injected intrauterine; (3) L-BMSC group: 0.2 ml of hypoxic cultured BMSC (1×106/ml) was injected intrauterine; (4) BMSC-exo group: 0.2 ml of BMSC-exo cultured with conventional oxygen at a concentration of 500 μg/ml was injected into the uterine cavity; (5) L-BMSC-exo group: 0.2 ml hypoxic cultured BMSC-exo (500 μg/ml) was injected intrauterine. On the 14th and 28th day of treatment, four rats in each group were sacrificed by cervical dislocation after anesthesia, and endometrial tissues were collected. Then HE and Masson staining were used to observe and calculate the number of glands and fibrosis area in the endometrium. The expressions of angiogenesis related cytokines [vascular endothelial growth factor A (VEGFA) and CD31], and fibrosis-related proteins [collagen-Ⅰ, collagen-Ⅲ, smooth muscle actin α (α-SMA), and transforming growth factor β1 (TGF-β1)] in endometrial tissues were detected by western blot. Results: (1) HE and Masson staining showed that the number of endometrial glands in L-BMSC group, BMSC-exo group and L-BMSC-exo group increased and the fibrosis area decreased compared with NC group on the 14th and 28th day of treatment (all P<0.05). Noteworthily, the changes of L-BMSC-exo group were more significant than those of BMSC-exo group (all P<0.05), and the changes of BMSC-exo group were greater than those of BMSC group (all P<0.05). (2) Western blot analysis showed that, compared with NC group, the expressions of collagen-Ⅲ and TGF-β1 in BMSC group, L-BMSC group, BMSC-exo group and L-BMSC-exo group decreased on the 14th and 28th day of treatment (all P<0.05). As the treatment time went on, the expressions of fibrosis-related proteins were different. Compared with BMSC group, the expressions of collagen-Ⅲ, α-SMA and TGF-β1 in the BMSC-exo group and L-BMSC group decreased on the 28th day (all P<0.05). Moreover, the expressions of collagen-Ⅲ and TGF-β1 in L-BMSC-exo group were lower than those in BMSC-exo group on the 28th day (all P<0.05). And the expressions of collagen-Ⅰ, α-SMA and TGF-β1 in L-BMSC-exo group were lower than those in L-BMSC group on the 28th day (all P<0.05). (3) The results of western blot analysis of VEGFA and CD31 showed that, the expressions of VEGFA and CD31 in BMSC group, L-BMSC group, BMSC-exo group and L-BMSC-exo group increased on the 14th and 28th day of treatment compared with NC group (all P<0.05). Treatment for 28 days, the expressions of VEGFA and CD31 in BMSC-exo group and CD31 in L-BMSC group were higher than those in BMSC group (all P<0.05). Moreover, the expressions of VEGFA and CD31 in L-BMSC-exo group were higher than those in BMSC-exo group and L-BMSC group on the 28th day (all P<0.05). Conclusions: Treatment of BMSC and their exosomes BMSC-exo with hypoxia could promote endometrial gland hyperplasia, inhibit tissue fibrosis, and further repair the damaged endometrium in rats with intrauterine adhesion. Importantly, hypoxic treatment of BMSC-exo is the most effective in intrauterine adhesion rats.

Analysis of visual quality of myopia and myopia combined with astigmatism after SMILE surgery for 1a / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To present the visual quality and refractive outcomes obtained in small incision lenticule extraction(SMILE)refractive surgeries, and observe the follow-up of patients over 1a period.<p>METHODS: Retrospective comparative analysis of 85 patients(85 eyes)were treated with SMILE between July and December 2019. Pre- and postoperative uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), spherical equivalent refraction(SE)were all observed, to evaluate the efficacy, safety and predictability after SMILE refractive surgery. Total corneal higher-order aberrations(HOAs), modulation transfer function cut-off(MTF_cutoff), strehl ratio(SR), and objective scattering index(OSI)were evaluated. <p>RESULTS: One year after SMILE refractive surgery, the efficacy index was 1.08, 84 eyes(99%)reached an UDVA as or over CDVA preoperatively, 22 eyes(26%)gained one line of CDVA than preoperatively. The safety index was 1.04, 59 eyes(69%)of the treated eyes had an unchanged CDVA postoperatively, 24 eyes(28%)gained one line of CDVA, 2 eyes(2%)gained two lines of CDVA. 85 eyes(100%)were all within ±0.50D. The pre-correction is highly related with the actual correction of SE(<i>Y</i>=0.9949<i>X</i>-0.0033; <i>R</i>²=0.9977). HOA, spherical aberration and coma were increased under pupil diameters of 6mm(all <i>P</i><0.001). Both MTF_cutoff and SR were higher than that of SMILE preoperatively(<i>P</i><0.05).<p>CONCLUSION: SMILE demonstrated to be safe, effective, and predictable in the treatment of myopia and myopic astigmatism, and good accuracy in correcting medium and low astigmatism. The post-quality of retinal image is better than that of SMILE preoperatively.

Effect of orthokeratology on myopia control in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the related factors influencing the myopia control effect in adolescents with orthokeratology.<p>METHODS: This study selected 102 adolescents who wearing ortho-k lens in the First Affiliation Hospital of Xi'an Jiaotong University during July 2014-October 2017.Their axial elongation, refraction, wearing time were observed.<p>RESULTS: After 3a treatment, the axial elongation of 102 adolescents increased 0.42±0.37mm. Among the low myopia, the middle and high myopia groups, the axial elongation increased 0.65±0.35mm, 0.32±0.37mm and 0.30±0.29mm, respectively. The axial elongation in the high myopia groups was the most slowest(the combination of orthokeratology and spectacles); There was an interaction between the wearing time and the initial refraction, the wearing time and the initial age(all <i>P</i><0.001). It is suggested that the axial elongation is slower in middle-high myopia than that in the low myopia. The axial elongation was slower in the older adolescents than that in the younger adolescents; There was no interaction between wearing time and gender(<i>F</i>=0.292, <i>P</i>=0.695). The axial elongation has no difference between male and female.<p>CONCLUSION: The initial refraction and the initial age of myopic adolescents were important factors influencing axial elongation. The combination of orthokeratology and spectacles has effection in controlling axial elongation.

Evaluation of cycloplegic effectiveness of atropine, cyclopentolate and tropicamide / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effectiveness of three cycloplegia drugs: atropine, cyclopentolate and tropicamide on school-age children, and provid theoretical basis in choosing cycloplegic drugs for school-age children. <p>METHODS: Totally 420 myopic school-age students(818 eyes)in out-patients department were selected during July to August 2017. Candidates were divided into three medicine groups according to their age: Group A: <8 years old, utilizing 1% atropine; Group B: 8-12 years old, utilizing the cyclopentolate; Group C: >12 years old, utilizing the tropicamide. The difference of refraction degree before and after medicine application were calculated. <p>RESULTS: The coincidence rate of spherical equivalent refraction with cycloplegia and without cycloplegia was 81.0% in atropine group, 81.3% in cyclopentolate group and 79.4% in tropicamide group respectively. There was statistical difference of refraction results of the Group A between with atropine cycloplegia and without cycloplegia. The mean difference was -0.113±0.226D(<i>t</i>=-4.663, <i>P</i><0.001). There was no statistical refraction difference of the Group B between with cyclopentolate cycloplegia and without cycloplegia, the mean difference was -0.025±0.192D(<i>t</i>=-1.665, <i>P</i>=0.099). So does the difference of Group C between with tropicamide cycloplegia and without cycloplegia, which was -0.026±0.193D(<i>t</i>=1.760, <i>P</i>=0.080). <p>CONCLUSION: For children older than 8-years old and without strabismus and amblyopia, cyclopentolate or tropicamide can be used to give cycloplegia refraction for the first time, which is convenient for their daily activities. The cycloplegia refraction results should been re-checked after used atropine, and giving prescription by using the principle of maximum plus to maximum visual acuity(MPMVA).