Progress in the diagnosis and treatment of ocular histiocytosis / 国际眼科杂志(Guoji Yanke Zazhi)

Ocular histiocytosis is a rare and heterogeneous group of disorders which can occur in children and adults. There is a great challenge in the diagnosis and treatment because of the atypical clinical and imaging manifestations. With insights into molecular mechanism of histiocytosis, the discovery of BRAFV600E mutations has changed the understanding of this disease and enabled targeted therapies in most patients. The gold standard of diagnosis has developed into histopathological biopsy combined with the testing for mutations. Surgery is not the only treatment for ocular histiocytosis and targeted therapy has become an effective treatment for patients with mutations in MAPK-ERK signal-regulated kinase pathway. However, the greatest challenge for ocular histiocytosis is establishing the early and correct diagnosis due to the diverse types and clinical manifestations. Therefore, this article reviews recent progress in diagnosing and treating ocular histiocytosis, summarizes their clinical and pathological features, and aims to improve the level of diagnosis and treatment among clinicians.

Research progress of autophagy in retinal and eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Maintaining the homeostasis of intracellular components degradation and recycling, autophagy is a critical control mechanism of cellular quality. It promotes the degradation of cell components to provide nutrients and energy for cellular metabolism in stress response. The retina is a light-sensitive tissue that transduces and processes visual images in the eye, and it has a high demand for substances and energy. Basal autophagy is essential for holding retinal homeostasis and the normal function of the visual system. Therefore, the latest studies that investigating the participation of autophagy in eye diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy, retinal dystrophies, and retinal detachment were summarized, providing a theoretical basis for the future treatment of eye diseases by regulating autophagy.

Hollow copper sulfide nanoparticles loading deferoxamine for photothermal antibacterial therapy and promoting angiogenesis / 药学学报

Diabetic ulcer is recognized as a chronic nonhealing wound, often associated with bacterial infection and tissue necrosis, which seriously affect patients' health and quality of life. The traditional treatment methods exist some problems, such as bacterial resistance and secondary trauma, so it is urgent to find new methods to meet the requirements of diabetic ulcer treatment. In this study, we prepared a drug delivery system (DFO@CuS nanoparticles) based on hollow copper sulfide (CuS) nanoparticles loaded with deferoxamine (DFO), which realized the synergistic therapy of promoting angiogenesis and photothermal antibacterial. The morphological structure and particle size distribution of DFO@CuS nanoparticles were characterized by transmission electron microscopy and particle size analyzer, respectively. The antibacterial effect of DFO@CuS nanoparticles was evaluated by the plate coating method. The effects of DFO@CuS nanoparticles on the proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs) were evaluated by CCK-8 (cell counting kit-8) assay, cell scratch assay, and tube formation assay. The results showed that DFO@CuS nanoparticles were hollow and spherical in shape with an average particle size of (200.9 ± 8.6) nm. DFO@CuS nanoparticles could effectively inhibit the growth of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) under near-infrared (NIR) light irradiation. DFO@CuS nanoparticles showed negligible cytotoxicity and effective acceleration of cell migration and tube formation in a certain concentration range. In conclusion, the prepared DFO@CuS nanoparticles exhibit good photothermal antibacterial properties and pro-angiogenic effects, providing a basis for their application in the treatment of diabetic ulcer.

Research progress of TGF-β in the formation of epiretinal membrane / 国际眼科杂志(Guoji Yanke Zazhi)

Epiretinal membrane(ERM)is a retinal disease characterized by a fibrocell membranes that can develop on the inner surface of the retina. The existing clinical guidelines and literature have reached a consensus on the diagnosis and treatment of ERM, but the explanation of their mechanism is still controversial. Transforming growth factor-β(TGF-β)is a highly pleiotropic cytokine that plays an important role in wound healing, angiogenesis, immune regulation, cancer, inflammation and fibrosis diseases. Studies have increasingly shown that ERM is a kind of pathological changes in fibrosis that caused by the posterior vitreous detachment(PVD)and lead to the retinal inflammatory damage and epithelial to mesenchymal transition(EMT)of retinal pigment epithelial cells. A variety of cytokines regulate TGF-β-mediated EMT process by participating in the non-classical TGF-β-Snail pathway and the classical TGF-β-Smad pathway. At present, some drugs targeting cytokines related to the above pathway have entered the development stage, which is of great significance to provide new ideas for clinical treatment and prevention of ERM. This review reviews the progress of TGF-β related cytokines in ERM formation.

Ample dietary fat reduced the risk of primary vesical calculi by inducing macrophages to engulf budding crystals in mice

Although primary vesical calculi is an ancient disease, the mechanism of calculi formation remains unclear. In this study, we established a novel primary vesical calculi model with d,l-choline tartrate in mice. Compared with commonly used melamine and ethylene glycol models, our model was the only approach that induced vesical calculi without causing kidney injury. Previous studies suggest that proteins in the daily diet are the main contributors to the prevention of vesical calculi, yet the effect of fat is overlooked. To assay the relationship of dietary fat with the formation of primary vesical calculi, d,l-choline tartrate-treated mice were fed a high-fat, low-fat, or normal-fat diet. Genetic changes in the mouse bladder were detected with transcriptome analysis. A high-fat diet remarkably reduced the morbidity of primary vesical calculi. Higher fatty acid levels in serum and urine were observed in the high-fat diet group, and more intact epithelia in bladder were observed in the same group compared with the normal- and low-fat diet groups, suggesting the protective effect of fatty acids on bladder epithelia to maintain its normal histological structure. Transcriptome analysis revealed that the macrophage differentiation-related gene C-X-C motif chemokine ligand 14 (Cxcl14) was upregulated in the bladders of high-fat diet-fed mice compared with those of normal- or low-fat diet-fed mice, which was consistent with histological observations. The expression of CXCL14 significantly increased in the bladder in the high-fat diet group. CXCL14 enhanced the recruitment of macrophages to the crystal nucleus and induced the transformation of M2 macrophages, which led to phagocytosis of budding crystals and prevented accumulation of calculi. In human bladder epithelia (HCV-29) cells, high fatty acid supplementation significantly increased the expression of CXCL14. Dietary fat is essential for the maintenance of physiological functions of the bladder and for the prevention of primary vesical calculi, which provides new ideas for the reduction of morbidity of primary vesical calculi.

Clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version) / 中华创伤杂志

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

Research progress in rodent modeling of major depressive disorder / 中国药理学通报

Major depressive disorder (MDD) has a high disability rate and a high risk of suicide. Due to the limited efficacy of traditional antidepressants, researchers have actively developed animal models with different mechanisms to meet the clinical needs. The principle and preparation methods, phenotypic characteristics, model validity (simulating clinical MDD) and their advantages and disadvantages of different models have been reviewed in this article. It is helpful for researchers to explore the pathogenesis of MDD and to select appropriate animal models in the development of new anti-MDD drugs.

Analysis of 4 Cases of Fungal Infections in Children and Literature Review / 中国药房

OBJECTIVE：To prov ide a reference for the diagnosis and treatment of invasive fungal infection in children. METHODS：Four male children with invasive fungal infection in critical condition ，aged from 3 months to 17 years，were treated in our hospital. The types of diseases included pneumonia ，endocarditis，meningitis and pulmonary infection. The pathogens involved Trichosporon asahii ，Candida portugal ，Malassezia globosa ，Pichia guilliermondii ，Alternaria alternate and Candida krusei. Clinical pharmacists comprehensively followed up the treatment and reviewed the literature to assist doctors in formulating treatment plans. They provided Fluconazole sodium chloride injection （6 mg/kg，ivgtt，qd），Caspofungin acetate for injection （loading dose 32 mg，maintenance dose 25 mg，ivgtt，qd），Fluconazole capsules （400 mg，p.o.，qd）and Voriconazole for injection（200 mg，i.v.，q12 h）+Capofungin acetate for injection （loading dose 70 mg，maintenance dose 50 mg，i.v.，qd）and other symptomatic treatment ，and closely monitored the changes of relevant indicators and the occurrence of ADR during the treatment of children. RESULTS ：The doctor adopted the clinical pharmacist ’s suggestion ，three cases were relieved and one was not cured. No serious ADR was found. CONCLUSIONS ：Once similar infections are found in clinic ，timely targeted treatment should be given in combination with the types of pathogens and drug resistance characteristics ，so as to effectively control the disease. The real cases provided in this article can provide evidence for the treatment of children with fungal infection.

Clinical Features and Prognosis of Acute Lymphoblastic Leukemia Children with P2RY8-CRLF2 Gene Rearrangement / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical features and prognostic factors of acute lymphoblastic leukemia (ALL) children with P2RY8-CRLF2 gene rearrangement.@*METHODS@#A total of 108 children with B-cell ALL (B-ALL) were diagnosed and systematically treated according to Chinese Children's Leukemia Group (CCLG) -ALL 2008 in our hospital from January 2016 to December 2016. The 108 patients were divided into two groups according to the result of mutiplex polymerase chain reaction: group with P2RY8-CRLF2 gene rearrangement and group without P2RY8-CRLF2 gene rearrangement. The ALL children with P2RY8-CRLF2 gene rearrangement were all treated by CCLG-ALL 2008 high-risk group (HR) regimens, and the ALL children in group without P2RY8-CRLF2 gene rearrangement received different intensity chemotherapy according to clinical risk classification.@*RESULTS@#Five (4 male and 1 female) out of 108 patients with B-ALL had P2RY8-CRLF2 gene rearrangement. In the 5 B-ALL patients with P2RY8-CRLF2 gene rearrangement, the median age of the was 4 (2-6) years old and the median WBC count was 26.2 (2.46-525.1)×10@*CONCLUSION@#The early treatment response and prognosis of ALL children with P2RY8-CRLF2 gene rearrangement are worse, and more effective protocol is needed for this subtype patients.

Clinical Effect and Safety of CCLG-ALL 2008 (high risk group) Protocol in the Treatment of Childhood Mixed Phenotype Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical effect and safety of Chinese Children's Leukemia Group (CCLG)-ALL 2008 (high risk group) protocol in the treatment with childhood Mixed phenotype acute leukemia (MPAL).@*METHODS@#The clinical data of 15 new diagnosed patients with MPAL treated in our hospital from January 2013 to December 2017 were retrospectively analyzed, and received CCLG-ALL 2008 (high risk group) protocol chemotherapy.@*RESULTS@#One patient gave up treatment after diagnosed, and 14 children with MPAL after induction remission chemotherapy, 3 patients gave up, and 5 patients received consolidation chemotherapy, and 6 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT). The complete remission (CR) rate was 85.7% at d33 of induction remission chemotherapy. The serious adverse event and treatment-related mortality (TRM) rate was 71.4% and 14.3%, respectively. The recurrence rate was 21.4% and the median time of relapse was 12(9.7-18.4) months. Except for 4 patients who gave up treatment, the 5-year event-free survival (EFS) rate in the other 11 patients was (54.5±15.0)%. The 5 years EFS of 4 patients who received consolidation chemotherapy was significantly lower than the 6 patients who received allo-HSCT after CR (25.0%±21.7% vs 83.3%±15.2%, P=0.033).@*CONCLUSION@#The CCLG-ALL2008 (for high-risk group) protocol in treatment of children with MPAL can get a high CR rate, but also with a high incidence of SAE. The patients received allo-HSCT after CR may have a good prognosis.

Study on Methodology Re-evaluation for Systematic Review/Meta-analysis of Antidepressants in the Treatment of Post-stroke Depression / 中国药房

OBJECTIVE： To re-evaluate t he methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase， SinoMed，CNKI，Wanfang database ，VIP，CBM and other databases ，systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec. 2019. After literature screening and data extraction ， methodology quality of included literatures were evaluated by using the AMSTAR scale. RESULTS ：A total of 33 systematic reviews/Meta-analysis were included ，involving 523 RCTs and 41 020 patients. Average score of AMSTAR methodological quality evaluation was 6.76. Citalopram ，duloxetine and paroxetine were effective for the therapy of post-stroke depression ，but the conclusions about the effectiveness among antide-pressants were not consistents. The ADR incidence of Paroxetine was low. It was not clear that sertraline and citalopram may improve the neurological function of patients. CONCLUSIONS ：The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium ，and the conclusions about the effectiveness of antidepressants ，improvement of daily life ability and the recovery of neurological function are still controversial.

Study on function evaluation of health food containing Chinese materia medica based on data mining / 中国中药杂志

Homology of medicine and food is an important content in Chinese medicine and also works as the basis for guiding the development of compound health food containing Chinese materia medica. The top products,supplements,health care prescriptions,and medicinal meals in traditional herbal texts are the theoretical treasures of Chinese medicine compound health foods. With the implementation of the National Healthy China 2030,China's major health industry faces with tremendous opportunities. It is necessary to develop a batch of compound health food containing Chinese materia medica with Chinese medicine characteristics,in line with the needs of the country and society. Domestic research on compound health food containing Chinese materia medica mainly focuses on the extraction of functional components,preparation molding processes,quality standards,and efficacy evaluation. However,there are still some deficiencies in the related characteristics of traditional Chinese medicine(TCM) theory and function,evaluation criteria of efficacy and safety,new product R&D evaluation system and R&D platform. Based on a large number of previous studies by this laboratory,the views in nature,flavor and efficacy relationship were put forward in this paper. Based on the establishment of the Chinese medicine function-pharmacology-clinical application database system,the Chinese medicine compatibility database system,the Chinese medicine nature and flavor modern research database system,and the evaluation platform for animal models of Chinese medicine; the efficacy study,safety evaluation system,new product research and development evaluation system as well as research and development platform were established,providing a basis for the development and evaluation of compound health food containing Chinese materia medica. The modern scientific connotation of the core efficacy of compound health food containing Chinese materia medica was explained as well,helpful to promote the research and development of compound health food containing Chinese materia medica and play an important role in general health.

Clinical Features and Prognostic Factors of 18 Children with Anaplastic Large Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical features and to explore the therapeutic efficacy and prognostic factors of children with anaplastic large cell lymphoma (ALCL).@*METHODS@#The clinical data of 18 children with ALCL admitted in Department of Pediatric Hematology, Union Hospital of Fujian Medical University from April 2011 to November 2017 was collected and analyzed.@*RESULTS@#The male to female ratio was 2∶1, the median age of onset was 6 (0.9-11.3) years old, and the B symptom was positive in 13 cases. The most common initial symptom was lymphadenopathy (in 17 cases). All patients were manifested with multiple organ involvements. 4 cases were classified as clinical stage Ⅱ, 11 cases as stage Ⅲ, and 3 cases as stage Ⅳ. Laboratory tests revealed 9 cases with leukocytosis and 8 cases with CRP＞20 mg/L. The pathological results showed all ALK-positive anaplastic large cell lymphoma with Ki-67 rate between 40%-90%. The median follow-up time was 41 months. 2 patients died before treatment, 1 patient was lost to follow-up. 15 patients accepted chemotherapy protocol of CCCG-BNHL-2011. 2 patients relapsed early, the 3 year event-free survival rate was (76.7±10.2)%. Kaplan-Meier survival analysis showed leukocytosis, increased CRP level, bone involvement and clinical stage were factors affecting prognosis.@*CONCLUSION@#ALCL is a relatively rare subtype of childhood non-Hodgkin's lymphoma with high invasiveness. Leukocytosis, increased CRP level, bone involvement and clinical stage are poor factors affecting the prognosis of patients.

Clinical Features and Prognosis of 35 Children with Burkitt Lymphoma/Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical features and prognostic factors of childhood Burkitt Lymphoma/leukemia.@*METHODS@#The clinical data of 35 patients with newly-diagnosed childhood Burkitt lymphoma/leukemia from March 2011 to September 2017 in Fujian Medical University Union Hospital were retrospectively analyzed and summarized. Among 35 patients, 5 gave up treatment and one patient died of multiple organ failure before treatment, and 29 patients received CCCG-BNHL-2010 protocol chemotherapy.@*RESULTS@#The 35 cases of BL/L includsd 31 males and 4 females (M∶F=7.75∶1) with the median age of 5(2.0-11) years. Clinically, the common infiltration sites were as follows: abdominal organs (especially ileocecus, 21/35, 60%), bone marrow (21/35, 60%), faciomaxillary (10/35, 28.57%), and central nervous system (8/35, 22.85%). According to St. Jude staging system, 6 patients were grouped into stage Ⅱ, and 8 into stage Ⅲ and 21 into stage Ⅳ, among which the bone marrow blasts of 17 patients were more than 25%. The analysis of therapeutic efficacy and prognosis showed that in median follow up of 23.4 (5.3-86.4) months, 5 patients relapsed (5/29, 17.24%), the median relapsed time was 5.7 (3.9-7.2) months; tow-year overall survival (OS) rate and progression-free survival (PFS) rate was 79.2%±7.6% and 78.3%±7.9%, respectively. Univariate analysis showed that the 2-year OS and PFS in patients with LDH＞2N, stage Ⅳ (bone marrow infiltration), central nervous system infiltration and no-CR after 2 courses of treatnent all were significantly lower than those in patients with LDH≤2N, stageⅡ-Ⅲ, without central nervous system infiltration as well as CR after 2 course of treatment (P values were 0.015, 0.015, 0.019 and 0.000, respectively). Cox regression analysis showed that no-CR after 2 course was an independent unfavorable prognostic factor (HR 0.34, 95%CI: 0.03-0.407).@*CONCLUSION@#The childhood Buruitts lymphoma/leukemia is more freguently seen in males and school-age children, Advanced stage, bone marrow and contral nervous system infitration are common at the first visit to doctor, moreover the Burkitt's lymphoma/leykemia present repid progression and dangerous feature. The current intensive chemotherapy (high dose of drugs and short course) possess the significant therapeutic efficacy for this disease, but the patients should have very poor prognosis if they can not achieve CR after 2 course of chemotherapy.

High-resolution Peripheral Quantitative Computed Tomography for the Assessment of Bone Strength and Structure in Obstructive Sleep Apnea Patients / 中国医学科学院学报

To evaluate the bone strength and structure of patients with obstructive sleep apnea(OSA)by the high-resolution peripheral quantitative computed tomography(HR-pQCT)and to explore the relationship between OSA and osteoporosis. Male patients who visited the Sleep Respiratory Center of our hospital from August 2017 to January 2019 were consecutively recruited.Clinical data including the results of Epworth sleep scale(ESS)scoring and overnight polysomnography were collected.HR-pQCT was used to compare the differences in bone geometry,density,and microstructure between OSA patients and non-OSA people;also,the radius and tibia on the non-dominant side were measured to explore the relationship between OSA and osteoporosis. A total of 83 subjects were enrolled in the study.The number of patients in the mild,moderate,and severe OSA groups and non-OSA group were 21,18,34,and 10,respectively.There was no significant difference in age,blood pressure,ESS score,sleep stage,and sleep efficiency among these four groups(>0.05).Body mass index(BMI)and neck circumference were significantly different among these groups(=4.234,=0.008;=3.100,=0.031).There was no significant difference in the radius indicators(>0.05).For tibia,there were significant differences among the four groups in the cortical area(Ct.Ar)(=3.937,=0.011).There were also significant differences in the bone microstructural indicators including trabecular thickness(Tb.Th)and cortical thickness(Ct.Th)(=6.247,=0.001;=3.746,=0.014),which were significantly lower in the three OSA groups than in the control group.Pairwise comparisons showed that the Ct.Ar in the severe OSA group was significantly higher than that in the mild OSA group(=0.019)and Tb.Th in the control group was significantly higher than those in the mild and moderate OSA groups(=0.006,=0.001).Correlation analysis showed that,within a certain range,total volumetric bone mineral density(Tt.vBMD)and Tb.Th of radius and tibia were negatively correlated with age(=-0.312,=0.004;=-0.328,=0.002;=-0.265,=0.015;=-0.280,=0.010)and positively correlated with BMI(=0.240,=0.029;=0.369,=0.004;=0.299,=0.006;=0.416,=0.010).Stepwise multiple regression analysis showed that Tb.Th of radius and tibia were mostly correlated with BMI(=0.262,=0.008,=0.243,=6.270,=0.000;=0.494,=0.000,=0.186,=7.243,=0.000)and age(=-0.216,=0.030,=0.243,=6.270,=0.000;=-0.306,=0.003,=0.186,=7.243,=0.000).Tt.vBMD of radius had a certain correlation with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA(=0.312,=0.002, =-0.249,=0.012,=0.327,=7.482,=0.000). In non-elderly male populations,OSA mainly causes a decrease in Tb.Th and Ct.Th of the tibia.The changes in bone strength and structure are mainly related with age and body size and also have certain correlations with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA.

Effect of Ershiwuwei Zhenzhu Tablets on Microvascular Function in Zebrafish / 中国实验方剂学杂志

Objective:To explore the effect of Ershiwuwei Zhenzhu tablets (EZT) on microvascular function. Method:The zebrafish models of thrombosis, microvascular defect and vascular endothelial injury were induced by using arachidonic acid, simvastatin and ponatinib respectively, and treated with EZT, astragaloside or asprin. To evaluate the protective effect of EZT on vascular endothelium and its effect on thrombus formation, zebrafish heart output and blood flow velocity were counted, and the vascular area of the zebrafish intestine and the intervascular diameter were calculated. The thrombus in the tail vein was observed under microscope. Result:Compared with model group,EZT improved the cardiac output (PP-1, and promoted angiogenesis in zebrafish at concentrations of 0.11, 0.33, 1 mg·L-1. Compared with the model group, the vascular diameter of the zebrafish internode was significantly increased at the concentrations of 33 mg·L-1 (P-1 (P-1(PConclusion:EZT could improve microvascular dysfunction, and its mechanism may be related to the reduction of vascular endothelial damage to promote its angiogenesis and the improvement of microvascular hemodynamics to reduce thrombus formation.

Research advance in clinical application of multimode imaging in Serpiginous choroiditis / 国际眼科杂志(Guoji Yanke Zazhi)

@#Serpiginous choroiditis(SC)is a rare, chronic-idiopathic inflammatory disease mainly involving choriocapillaris and the retinal pigment epithelium(RPE), characterized by grayish yellow geographic lesions. Pathogenesis is unclear, the choriocapillaris is a main pathology of SC. Based on clinical presentation, it can be classified into peripapillary, macular, and ampiginoustype. The clinical appearance of SC is varied and similar to those of acute posterior multifocal placoid pigment epitheliopathy(APMPPE), tuberculosis, toxoplasmosis and choroidal ischemia. So, it is still difficult to diagnose SC without typical fundus symptoms.With the development of science and technology, multimode imaging such asfundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence and optical coherence tomography are helpful for the diagnosis of SC, assessment of lesion extent, activity, and complications. Besides, it's very important to avoid unnecessary drug use.

Effectiveness of inverted internal limiting membrane flap technique combined with sterile air tamponade surgery on managing idiopathic macular hole / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To compare the effectiveness of inverted internal limiting membrane flap ( ILMF) coverage combined with sterile air tamponade or C3F8-filled surgery for idiopathic macular hole (IMH). ·METHODS: In this retrospective study, 165 patients (175 eyes) who underwent pars plana vitrectomy ( PPV) combined with inverted ILMF coverage were evaluated. The surgeries were performed by one surgeon at the Renmin Hospital, Wuhan University between January 2014 and June 2017. The patients were divided into sterile air (Group A) and C3F8-filled (Group B) groups, based on the technique used for intraocular tamponade. With a minimum 3-month follow-up, pre- and post-operative best corrected visual acuity ( BCVA ), macular hole closure rate, and major postoperative complications were analyzed. · RESULTS: Both groups showed significant improvement in visual acuity at 1 and 3mo postoperatively ( P< 0. 05 ). There was no significant difference between the two groups 1mo postoperatively, but the average BCVA in Group A was better than that in Group B at 3mo, to a level of statistical significance ( P<0. 05). The closure rate of macular hole was 97. 5% in Group A and 96. 8% in Group B, a statistically non-significant difference. There were no statistically significant differences in defect diameters of the inner and outer junctions between the two groups at 1 and 3mo postoperatively(P<0. 05), but significant differences compared to before surgery in both groups (P<0. 05). The rate of IOP elevation was 9. 5% in Group B, and zero ( 0 ) in Group A; this difference was statistically significant (P<0. 05). ·CONCLUSION: We postulate that PPV combined with inverted ILM flap is a safe and effective method for surgical management of IMH. Compared to C3F8-filling, sterile air tamponade can avoid IOP elevation; it may replace C3F8-filling in PPV for IMH.

Effects of 17-beta estradiol and tamoxifen in chronic ocular hypertension mouse model / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To explore the modulation effects of 17-β estradiol (E2) and tamoxifen (TAM) in chronic intraocular hypertension mouse model.· METHODS:We performed anterior chamber injection of magnetic beads to induced chronic ocular hypertension models.Adult C57BL/6 male mice were used in the experiments and randomly divided into four groups:control,Beads group,E2 group and E2+TAM group.The intraocular pressure (lOP) were measured by Tonolab tonometer.Central retinal thickness was evaluated by HE staining.Brn3a as a specific marker of retinal ganglion cells (RGCs),were stained and counted by immunohistochemistry (IHC) staining.Glial fibrillary acidic protein (GFAP) as a marker of proliferation of astrocytes,was quantified using western blotting.· RESULTS:The IOP level was significantly elevated after anterior chamber injection of magnetic beads compared to control group (P＜0.05),while in E2 and E2+TAM group,the IOP levels were reduced (P＜ 0.05 vs Beads group),especially in E2+TAM group in 2wk.The RGCs happened to degenerated in Beads group after 2wk,while the effects were reversed by E2+TAM (P＜0.05).The central retinal thickness showed no significant statistical difference among the four groups after 2wk (P ＞ 0.05).The expression level of GFAP increased caused via beads injection,however,decreased in E2 and E2+TAM group (P＜0.05).· CONCLUSION:E2 and E2+TAM could both effectively decrease the IOP level in chronic intraocular hypertension mouse model,increase the survival of RGCs from high intraocular pressure,suppress expression of GFAP,which indicated neuroprotective effects of E2 and TAM in glaucoma through an anti-inflammatory effects.

Expression and its clinical significance of RBP4 in vitreous in patients with proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the concentration of RBP4 and IL-6 in vitreous of proliferative diabetic retinopathy (PDR). METHODS: A total of 65 patients (66 eyes) were enrolled in Department of Ophthalmology, Renmin Hospital of Wuhan University from February 2017 to July 2017 with the informed consent. The patients were divided into PDR group (23 cases) and NPDR group (16 cases). Twenty- six patients without diabetic mellitus (DM) served as control group. The demography was matched among the groups, but the course of DM, the blood glucose level and the HbA1c level were elevated in the PDR group and the NPDR group (all P<0.05). Vitreous samples were collected during the procedure of vitrectomy. RBP4,IL-6,TNF-α concentrations in vitreous specimens were detected by ELISA. The differences of vitreous RBP4, IL-6 and TNF-α in various groups were statistically analyzed by ANOVA, respectively. The correlations between RBP4 and IL - 6, TNF - α were calculated by Pearson correlation analysis. RESULTS:The concentration of RBP4 in PDR group,the NPDR group and control group were 13.68士2.66, 11 03士1 12,10.45士1.17μ g/Ml, and the concentration of IL-6 were 56.0士10.27, 20.92士5.77, 10.26士1.91pg/Ml. RBP4 and IL- 6 concentrations were elevated in PDR group compared with NPDR group and control group, with significant difference among three groups (F = 12. 135, 161.167; P < 0. 01). IL - 6 concentrations in vitreous increased in the NPDR group in comparison with control group(P<0.05). RBP4 concentrations had no significant difference between the NPDR group and the group(P>0 05). Pearson correlation coefficient was significant positive between RBP4 concentration and IL - 6 concentration(r=0.606,P=0.001). CONCLUSION: RBP4 is probability involved in the inflammation pathogenesis of PDR. These results indicate that RBP4 could be a new target for the diagnosis and treatment of PDR.