Feasibility of fundus imaging in cataractous eyes by Retinal Health Assessment System / 中华实验眼科杂志

Objective:To study the ability of the Retinal Health Assessment (RHA) system to obtain fundus images in patients with different types and degrees of cataracts.Methods:A cross-sectional study was performed.Forty-five eyes of 41 patients with cataract were enrolled in First People's Hospital, Shanghai Jiaotong University from December 2016 to January 2017.Lens opacity grading and RHA fundus imaging were performed after pupil dilation.Forty-five eyes were divided into 4 groups according to the degree of lens opacity: cortical cataract group 18 eyes, nucleus cataract group 21 eyes, posterior subcapsular cataract group 2 eyes, hybrid cataract group 4 eyes.Fundus images were obtained by FullSpectrum mode of RHA2020, and the clearness of fundus images was evaluated.Scores of fundus images clarity were compared between the cortical cataract group and nucleus cataract group.This study was approved by the Ethics Committee of First People's Hospital, Shanghai Jiaotong University.Written informed consent was obtained from each patient prior to any medical examination.Results:In all 45 eyes, the phacoscotasmus classification ranged from mildest (C0N2P0, 1 eye) to very serious (C2N5P2 and C4N2P4, 2 eyes). The grade Ⅳ nuclear opacity, grade Ⅲ cortical opacity, and grade Ⅲ posterior subcapsular opacity reduced the quality of RHA images significantly, especially for images with red and green light.In cortical cataract group, images showed peripapillary vessels and retinal vessels at 580 nm and 590 nm, while retinal and choroidal vessels, as well as choroidal pigmentation, were visible at 810 nm.The clarity scores at 580, 590 and 810 nm were 2.0 (1.0, 3.0), 2.0 (2.0, 3.0) and 2.0 (2.0, 3.0), which were lower than that with red and green light (620 nm + 550 nm) (3.0[2.0, 3.0]), with statistically significant differences (all at P<0.05). In nucleus cataract group, the quality of fundus images from the eyes with grade Ⅲ nucleus cataracts was good, the image quality decreased when the nucleus opacity was grade Ⅳ, retinal vessels were occasionally observed at 580 nm and 590 nm.Additionally, retinal and choroidal vessels and choroidal pigment were visible at 810 nm and 850 nm.The clarity scores at 580, 590, 810 and 850 nm were 1.0 (1.0, 3.0), 2.0 (1.0, 3.0) and 2.0 (1.0, 3.0), which were lower than that with red and green light (620 nm + 550 nm) (3.0[1.5, 3.0]), with statistically significant differences (all at P<0.05). In posterior subcapsular cataract group, the retinal vessels were visible at 580 nm, meanwhile retinal and choroidal vessels and choroidal pigment could be observed at 810 nm and 850 nm.In hybrid cataract group, running lines of retinal vessels could be seen at 850 nm, while the central reflection was absent.Focal choroidal vessels were observed. Conclusions:Except for severe cases, RHA system can produce good quality fundus images in cataract eyes at 580, 590, 810 and 850 nm, facilitating the evaluation of fundus disease before surgery and prediction of visual outcomes after surgery.

Research advances in TET enzyme and its intermediate product 5hmC / 中南大学学报(医学版)

DNA methylation is a significant epigenetic modification mode, which plays an important role in embryo reprogramming, stem cell differentiation and tumor occurrence. The ten-eleven translocation (TET) enzyme is a crucial demethylation enzyme, which can catalyze 5-methylcytosine(5mC) to 5-hydroxymethylcytosine(5hmC), 5-formylcytosine (5fC), and 5-carboxylcytosine(5caC). These bases represent the epigenetic modifications of DNA and regulate the process of DNA methylation. Understanding the role of TET enzyme in regulating the DNA methylation modification and gene expression can help us to gain the knowledge for the normal growth development and epigenetic regulation in human diseases.

Effect of adipose-derived mesenchymal stem cell transplantation on cyclophosphamide-induced ovarian damage in rats / 中南大学学报(医学版)

To explore the effect of adipose-derived mesenchymal stem cells (ADMSCs) on ovarian damage induced by cyclophosphamide (CTX) and its mechanism.
 Methods: ADMSCs isolated from adipose tissue of female SD rats were cultured and divided into a blank group and a CTX group (n=15 in each group). CTX (75 mg/kg) was injected intraperitoneally to establish a model of ovarian damage in rats. A total of 45 female SD rats were also divided into 3 groups: Group A (15 rats, only injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline), Group B [15 rats, injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline, after 4 estrus cycles, injected 0.6 mL ADMSCs (6×105 cells) by the tail vein], and Group C [15 rats, injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline, after 4 estrus cycles, injected 40 mL ADMSCs (20 mL per side, 2×104 cells) in situ ovarian]. After 4 estrus cycles, the changes of quality of life, ponderal growth were recorded, the sex hormone levels [estradiol (E2), follicle-stimulating hormone (FSH)] were tested by ELISA, and the morphology of ovarian tissue and follicle count were observed by HE staining. The expression of BMP-15, Bcl-2 and Bax in ovarian tissues were tested by immunohistochemistry, real-time PCR or Western blotting. The apoptosis rate of follicular cells was detected by TdT-mediated dUTP nick end labeling (TUNEL) assay.
 Results: After transplantation of ADMSCs, compared with the Group A, their quality of life of rats in the Group B and C was improved, and the ponderal growth was increased (both P0.05).
 Conclusion: ADMSCs transplantation can effectively repair ovarian damage induced by CTX in rats, which may be achieved by inhibiting mitochondrial apoptosis of granulosa cells.

Application of ATP bioluminescence assay in survey of cleanliness of hos-pital environmental object surfaces and health care workers’hands / 中国感染控制杂志

Objective To investigate cleanliness of hospital environmental object surfaces and hands of health care workers(HCWs).Methods The adenosine triphosphate (ATP)bioluminescence assay was used to detect object surfaces and hands of HCWs in a hospital,on-the-spot intervention was conducted.Results The qualified rates of hospital environmental object surfaces and ventilator-relevant object surfaces were 58.14% (200/344)and 69.88%(116/166)respectively,the qualified rate of ventilator tracheal intubation site was low (29.17%);the qualified rate of telephone surfaces was the lowest (27.27%).The qualified rates of ventilator-relevant object surfaces used con-tinuously for ≥48h and <48 h were 56.70%(55/97)and 88.41 %(61/69)respectively,there was significant differ-ence between the two(χ2 =19.26,P <0.01).The qualified rates of HCWs’hands before and after intervention were 34.18% and 85.58% respectively,relative light unit (RLU)values were (1 033.46±106.20)and (80.46±10.68) respectively,the qualified rates and RLU before and after intervention were both significantly different (both P <0.01).Conclusion Contamination of object surfaces and hands’of HCWs in hospital dynamic environment is seri-ous,ATP bioluminescence detection and on-the-spot intervention is helpful for improving cleanliness of hospital en-vironment object surfaces and HCWs’compliance to hand hygiene.

Pathogenic bacteria distrtibution and drug resistance of 259 cases of urinary system infection / 国际检验医学杂志

Objective To analyze the pathogen distribution and drug resistance in the patients with urinary system infection in our hospital so as to provide the basis for prevention and treatment of urinary system infection .Methods 259 strains of pathogenic bacteria cultured and isolated from the midstream urine were performed the bacteriologic identification and the drug susceptibility testing ,Escherichia coli and Klebsiella pneumoniae were performed the extend‐spectrum β‐lactamase (ESBLs) producing testing . Results Among 259 strains of bacteria ,187 strains 72 .2% (187/259) were Gram negative stains ,43 strains 16 .6% (43/259) were Gram positive stains and 29 strains 11 .20% (29/259) were fungi .Gram negative stains were dominated by Escherichia coli (139 strains) and Klebsiella pneumoniae (22 strains) .The detection rates of ESBLs‐producing Escherichia Coli and Klebsiella pneumoni‐ae were 55 .4% (77/139) and 45 .4% (10/22) .The drug susceptibility testing results showed that Gram negative stains were sus‐ceptible to both imipenem and meropenem (100% ) and Gram positive stains were susceptible to vancomycin ,teicoplanin and linezol‐id (100% ) .Conclusion Gram negative bacilli are the main infectious pathogens in urinary tract infection and Escherichia coli is the most common pathogen .No vancomycin‐resistant Gram positive cocci is found .Rationally selecting antibacterial drugs according to the drug susceptibility testing results has great significance in the therapy of urinary tract infection and the control of drug‐resistant bacterial strains .

Effect of letrozole on endometrosis and apoptosis of ectopic endometrial cells in rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the therapeutic mechanism of letrozole, the third-generation aromatase inhibitor, on endometriotic lesions in a rat model and its effect on the apoptosis of ectopic endometrial cells.@*METHODS@#Endometriosis was induced by autotransplanting pieces of uterus onto the peritoneum in rats. The rats with successful ectopic implants were divided into 2 groups: A letrozole group (n=15) and a control group (n=15). The volume, appearance, and histopathology of ectopic implant were determined before and after the treatment. Expression of P450arom, COX-2, bcl-2, and bax in the ectopic implant was detected by immunohistochemistry and RT-PCR in the 2 groups.@*RESULTS@#The volume of ectopic implant in the letrozole group was significantly reduced compared with the control group (P<0.05). The protein and mRNA levels of P450arom and COX-2 in the ectopic implant were significantly decreased in the letrozole group compared with the control group (P<0.05). There was a positive correlation between the expression of P450arom and the expression of COX-2 (r=0.943, P<0.001; r=0.913, P<0.001). The protein and mRNA expression of bcl-2 was significantly decreased (P<0.05), and the bax protein and mRNA expression was significantly increased (P<0.05) in the ectopic implant with an increased bax/bcl-2 ratio in the letrozole group compared with the control group (P<0.05).@*CONCLUSION@#Letrozole can obviously reduce the size of ectopic implant through decreasing P450arom and COX-2 expression, suppressing the secretion of estrogen, inhibiting the proliferation, and inducing the apoptosis of ectopic implants.

Expression of DNMT1, DNMT3a, and DNMT3b in eutopic endometrium / 中南大学学报(医学版)

OBJECTIVE@#To examine the expression of DNMT1, DNMT3a, and DNMT3b in the eutopic and ectopic endometrium in women with endometriosis.@*METHODS@#RT-PCR and real-time RT-PCR were used to examine the expression of DNMT1, DNMT3a, and DNMT3b in the eutopic and ectopic endometrium in 20 women with endometriosis and the endometrium in 20 women without endometriosis. Immunofluorescene staining was used to detect the expression of DNMT1 in these tissues.@*RESULTS@#The expression levels of DNMT1, DNMT3a, and DNMT3b were significantly lower in the ectopic endometrium and eutopic endometrium than those of the control endometium (P0.05 ). Immunofluorescence staining that DNMT1 protein level significantly decreased in the ectopic endometrium and eutopic endometrium of endometriosis patients.@*CONCLUSION@#Decreased expression levels of DNMT1, DNMT3a, and DNMT3b in the ectopic endometrium and eutopic endometrium may play a role in patients with abnormal epigenetics which may lead to endometriosis.

Clinical analysis on 28 cases of oblique vaginal septum syndrome / 中南大学学报(医学版)

OBJECTIVE@#To sum up the diagnosis and surgical treatment of oblique vaginal septum syndrome (OVSS).@*METHODS@#The clinical data of OVSS patients from January 2005 to June 2010 were retrospectively analyzed. The patients were divided into 2 groups: a re-operation group (n=11)and a first-operation group (n=17).The general clinical data, surgery Methods and outcome between 2 groups were compared.@*RESULTS@#The number of patients with pelvic mass on first attendance in the re-operation group was significantly more than those in the first-operation group(χ(2)=8.134,P=0.004). Only 1 patient was diagnosed during the first operation in the re-operation group. All the patients were diagnosed with OVSS in the first-operation group. Except for 1 case of hysterectomy in the post-cavity of the septum in each group, the basic operation was oblique vaginal septum resection. All the patients were followed up. Symptoms as the pelvic mass, irregular vaginal bleeding, and vaginal flow of purulence completely disappeared, and dysmenorrhea symptoms completely disappeared or apparently improved.@*CONCLUSION@#The diversity of clinical manifestations of OVSS increases the difficulty of diagnosis and treatment. In younger patients with pelvic mass,primary dysmenorrheal, and one side renal agenesis, OVSS should be highly suspected. The basic treatment for OVSS is septum resection and drainage, and the correct pre-operative diagnosis is critical. If necessary, combination of hysteroscopy with laparoscopy will be helpful.

Expression and significance of peritoneal fluid EPO and ENA-78 in patients with endometriosis / 中国医师杂志

Objective To investigate the.expression and significance of peritoneal fluid (PF) erythropoietin (EPO) and neutrophils activation peptide-78 (ENA-78)in patients with endometriosis.Methods The levels of EPO and ENA-78 in peritoneal fluid (PF) were measured by means of enzymelinked immunosobent assay (ELISA) in 30 women with endometriosis (9 in Ⅰ ～ Ⅱ stage,21 in Ⅲ～ Ⅳ stage)and 30 without endometriosis.And the relationship between the PF levels of EPO and ENA-78 in patients with endometriosis was analyzed.Results The PF levels of EPO and ENA-78 in women with endometriosis [ (9.272 ± 2.284 ) IU/L,( 2.068 ± 0.794 ) ng/ml ] were significantly higher than those in control group [ (5.759 ±0.502) IU/L,(0.886 ±0.145 ) ng/ml,P ＜0.05].There were no significant differences in the PF levels of EPO between stage Ⅰ ～ Ⅱ [ (9.549 ± 1.996) IU/L] and Ⅲ ～ Ⅳ [ (9.181 ± 1.897) IU/L,P ＞0.05].The ENA-78 concentrations of PF in stage Ⅲ～ Ⅳ [ (2.517 ± 0.518 )ng/ml] were significantly higher than those in stage Ⅰ ～ Ⅱ[ ( 1.137 ±0.169)ng/ml,P ＜0.05].There were no obvious correlations in PF EPO and ENA-78 in patients with endometriosis.Conclusions The excessive expression of EPO and ENA-78 in the PF of women with endometriosis suggests that EPO and ENA-78 may be an important role in the pathogenesis of endometriosis.

Optimization of the self micro-emulsifying drug delivery system of probucol by the central composite design-response surface methodology / 复旦学报（医学版）

Objective To determine the optimized self micro-emulsifying drug delivery system (SMEDDS) formulation of probucol. Methods According to the indexes of mean particle size, zeta-potential, solubility of probucol in blank SMEDDS and the dissolution percentage in 5 minutes of the preparations, the optimized formulation was determined by the central composite design-response surface methodology. Results When the correspondent percentage of olive oil in oil phase (W/W) was 0.33, the percentage of oil phase in formulation (W/W) was 0.5, and the ratio of surfactant to co-surfactant (W/W) was 2.0, respectively. The mean particle size, zeta-potential, solubility of probucol and dissolution percentage in 5 minutes of micro-emulsion was 92.7 nm, -17.38 mV, 65.17 mg/mL and 63.46%, respectively. Conclusions The optimized formulation of the probucol SMEDDS was obtained quickly and conveniently by the central composite design-response surface methodology. The method had a reliable predictability.

Transport of aripiprazole across Caco-2 monolayer model / 药学学报

This study aimed to investigate the transport characteristics of aripiprazole.A human intestinal epithelial cell model Caco-2 cell in vitro cultured had been applied to study the transport of aripiprazole.The effects of time,concentration of donor solutions,pH,temperature and P-glycoprotein inhibitor on the transport of aripiprazole were investigated.The determination of aripiprazole was performed by HPLC.It is concluded that aripiprazole is transported through the intestinal mucosa via a passive diffusion mechanism primarily,coex- isting with a carrier-mediated transport.The transport of aripiprazole is positively correlated to transport time, concentrations.The P-glycoprotein inhibitor cyclosporine A significantly enhanced the transport amount of aripiprazole.

Bioavailability and pharmacokinetics of two sustained release formulations of mizolastine in healthy volunteers / 复旦学报（医学版）

Purpose The aim of this study was to compare the pharmacokinetic(PK) profile and relative bioavailability of two sustained release tablets containing 10 mg mizolastine in healthy, young Chinese volunteers. Methods A single oral dose of mizolastine was given under fasting conditions to volunteers aged from 21 to 24 years in this open-label, randomized, crossover study. A ten-day washout period was applied between each of the two formulations. Plasma samples were obtained before dosing and at predetermined time points after dosing up to 48 hours and were analyzed for plasma concentration with a high-performance-liquid chromatography-UV method. PK parameters representing the extent and the rate of absorption of mizolastine were obtained. An analysis of variance, 90% confidence intervals, and two one-sided tests were employed for statistical analysis of relative difference between the two formulations. Results According to the pharmacokinetic and statistical analysis, parameters were not statistically different between the two formulations except the peak concentration (cmax). The point estimates of the ratios of AUC0→t, AUC0→∞ of mizolastine were (101.26 + 9.82) % and (102.52 + 8.61)% with 90% confidence intervals (CIs) of 95. 5% - 106. 5% and 97. 7% -106.9% respectively, comprised in the stipulated 80% - 125% range; for cmax values, the ratios was 82.17% - 15.32% with the 90% CIs of 71. 7% - 91.1%, fell in the recommended range of 70% -143%. Conclusions The results indicate that there is no statistically significant difference in PK parameters except cmax between the two sustained release tablets of mizolastine. The 90% CIs of AUC0→t,AUC0→∞ and cmax are within the predefined range. Thus, the two sustained release tablets of mizolastine are considered bioequivalent and generally well tolerated.

In Vitro Porcine Buccal Permeation of Propranolol Hydrochloride and Its Influencing Factors / 复旦学报（医学版）

PurposeTo investigate the permeation of model drug,propranolol hydrochloride, through the excised porcine buccal mucosa. To study the influences of various factors on the buccal absorption also studied. MethodsUsing excised porcine buccal mucosa permeation test in vitro. By means of changing the medium pH, osmotic concentration, drug concentration, the concentration of various penetration enhancers including sodium glycodeoxycholate (GDC), sodium glycocholate (GC), dimethy1-β-cyclodextrin (DMβCD), and hydropropyl-β-cyclodextrin(HPβCD). The permeation rates and permeability coefficients(P) were determined and evaluated. The solubilities and apparent partition coefficients also determined in some tests. ResultsThe result showed that the P were increased when porcine buccal mucosae were pretreated with every penetration enhancement of certain concentration, increased as the pH of test solution rose from 4.9 to 9.1. The P remained constant as the concentration of propranolol hydrochloride increased from 5 to 80 mg/ml, decreased with the increasing of osmotic concentration Conclusions The absorption of propranolol hydrochloride through porcine buccal mucosa is a typical passive process, and affected by penetration enhancers, medium pH, osmotic concentration.

In Vitro-in situ Correlation of Propafenone Transnasal Absorption / 复旦学报（医学版）

Purpose This paper was to investigate the correlation between in vitro and in situ methods for propafenone transnasal absorption.MethodsUsing excised sheep nasal mucosa permeation test in vitro and rat nasal infusion test in situ. By means of changing the medium pH, drug conoentration, and forming β-cyclodextrin inclusion compound, the permeability coeffident (Pm), mean permeation rate, and permeation fraction were determined in vitro. Under the corresponding conditions the absorption rate oostant(k ) ,mean absorption rate and absorption fraction in situ were also detrmined.ResultsThe linear regression coefficient indicated that,under the various experimental conditions,a good in vitro-in situ correlation could be confirmed.ConclusionsHaving an in vitro-in situ correlation is useful for scientific justifying the different methods for nasal absorption studies.

Ethical Reflection on Mental Problems of patients Admitted to Intensive Care Unit(ICU) / 中国医学伦理学

Patients in ICU could be complicated by some mental problems such as fear,hopeless,anxiety and depression because of the severe disease itself,invasive diagnosis and treatments,strange surroundings and equipments in the ward.As a human with rich human nature,doctors and nurses should pay attention to those mental problems in patients in order to make them recover completely both in mentality and physiology,and they should carry out a humanistic overall health idea while treating patients.

Panax notoginseng saponin liposomes:Characterization of pharmaceutics and pharmacokinetics on pulmonary instillation in rats / 中草药

Object To prepare Panax notoginseng saponin (PNS) liposomes and investigate their characterization of pharmaceutics and pulmonary pharmacokinetics in rats. Methods The film-disperion method was used to prepare PNS liposomes by investigating its form, vesicle size, entrapping efficiency and stability. The study of pulmonary pharmacokinetics in rats was carried out by pulmonary instillation. Results The entrapment of PNS liposomes was 78.50%. The mean vesicle size was 1.5 ?m with uniform externality. The drug leakage from PNS liposomes was slow. Low temperature was required for its storage. The pulmonary pharmacokinetics parameters were as follows: T 1/2 ?=7.00 h, T 1/2 ?=27.72 h, AUC= 2 218.9 ?g?h/mL, the absolute bioavailability was 70.14%. Conclusion PNS liposomes with high entrapment and stability can prolong its circulation in blood and improve the PNS bioavailability via lung approach.

Notoginseng noside liposomes: preparation and physiological compatibility study / 中成药

AIM: To study the preparation and physiological compatibility of pulmonary administration with Saponius of Panax Notoginseng (PNS) liposomes. METHODS: PNS liposomes was prepared by thin film dispersion method. The prefered formulation was determined by factorial design. Ciliary movement in situtoad palate model and the changes of pulmonary edema index and pathology of lungs in rats were investigated to evaluate the physiological compatibility of PNS liposomes. RESULTS: PNS liposomes were proved to be large unilamellar vesicle (LUV) liposomes with spherical shape .The liposomes composed of PC and Ch has a high PNS capture efficiency of 78.5% ?2.15% . The mean vesicle size of liposomes were 1546.5nm ?321.4nm which were quite homogeneous in size distribution. The lasting time of ciliary movement after the rinsing of PNS liposomes was the 92.14% of the effect of PBS buffer. The pulmonary edema index and pathological changes of lung tissue in PNS liposomes group were significantly different from those in PNS solution group and close to those in PBS buffer group. CONCLUSION: PNS liposomes has good physiological compatibility with promising market development and application.

Percutaneous absorption of Rg1 in Panax notoginseng in vitro / 中成药

AIM: To study the percutaneous absorption of Rg1 in Panax notoginseng and the effects of some commom enhancer and pH value on it. METHODS: Drug permeation tests were performed through excised rat skin in V-C diffusion cell.Rg1 concentration in samples was determined by HPLC. RESULTS: Rg1 could penetrate through excised rat skin with lower permeability coefficient;in the range of concentration 300 mg/mL～60 mg/mL permeability coefficient of Rg1 decreased as its concentration increasd;Among enhancers,10% ethanol,10%,20% and 30% propylene glycol,2% Azone,2% Eucalyptus Oil and 5% Oleic Acid had markedly promotive effect on transdermal penetration of Rg1. CONCLUSION: The research will provide experimental data for skin administration of Chinese medicine containing Panax notoginseng.

Optimization of the intranasal powders of Panax Notoginseng Saponins by the central composite design-response surface methodology / 中成药

AIM: To determine the optimized intranasal powders formulation of Panax Notoginseng Saponins(PNS). METHODS: According to the indexes of the in vitro release rate in 1h and 12h of Rb1 and Rg1, bioadhesive intensity and the ciliary toxicity in situtoad palatal mucosa of the preparations, the optimized formulation was determined by the central composite design-response surface methodology. RESULTS: When the correspondent percentage of PNS, microcrystalline cellulose (MCC) and moderate viscosity hydroxypropyl cellulose (H-HPC) was 31%, 60% and 9%, respectively, the release rate in 1h and 12h of Rb1 and Rg1 was 6.82%, 53.25% and 83.4%, 95.09%, respectively. The adhesive time was 78min, and the lasting time of ciliary movement after the rinsing of the PNS powders was 94.84% to the physiological saline group which suggested the powder was almost no toxicity. CONCLUSIONS: The optimized formulation of the PNS intranasal powder was obtained quickly and conveniently by the central composite design-response surface methodology.