Knowledge, attitudes and practices related to seeking medical eyecare services by adults with moderate-to-severe visual impairment in rural Yueqing, Wenzhou, China: a cross-sectional survey.

AIM: To evaluate the knowledge, attitudes, and practices regarding eye-care seeking practices of visually impaired adults in a rural area Yueqing, and explore factors influencing their behavior. METHODS: A stratified sampling method was used to select 48 villages in Yueqing, from which 2400 people were selected to receive vision screenings conducted by oculists during a household visit. Those presenting visual acuity ≥0.5 logMAR in either eye completed a self-designed questionnaire investigating their knowledge about medical eye-care seeking, attitudes about eye health and eye-care-seeking behavior. RESULTS: Totally 165 people with moderate-to-severe visual impairment were identified (6.9%, 165/2400), and 146 eligible participants were recruited (response rate: 88.4%, mean age: 68.6±15.0y), among which 88 (60.3%) were female. They had 82 (56.2%) and 64 (43.8%) monocular and binocular visual impairments respectively. A total of 67 (45.9%) subjects demonstrated a high knowledge level about medical eye-care seeking and 88 (60.3%) had self-rated poor vision, with 23 (15%) receiving regular vision checks. The 105 (71.9%) subjects had never been to hospital for an eye examination. "No need" and "schedule conflicts" were the main reasons for not seeking eye care. Having extensive knowledge of medical eye-care seeking was positively associated with high education levels (OR=3.73, P=0.045) and negatively correlated with older age (OR=0.97, P=0.043). Both the self-perceived vision condition (OR=2.59, P=0.03) and regular vision check behavior (OR=6.50, P<0.01) were related with seeking eye care services. CONCLUSION: In rural Yueqing, intervention is required to increase public knowledge about seeking medical eye care among people with moderate-to-severe visual impairment, especially for the elderly and poorly education. Regular vision checks may be useful to promote their medical eye-care utilization.

The impact of exogenous testosterone supplementation on spermatogenesis in a rat model of oligoasthenospermia.

Oligoasthenospermia is one of the main causes of infertility in reproductive-age men. This study aimed to explore the feasibility of exogenous testosterone supplemental therapy (TST) for adult male rats with oligoasthenospermia model. The rats (n=40) were randomized equally into 4 groups: control group, model group, low-dose and high-dose groups (n=10, respectively). After establishment of an oligoasthenospermia model that was treated with glucosides of tripterygium wilfordii (GTWs), the low-dose and high-dose groups were treated with 2 testosterone undecanoate (TU) injections at doses of 7.5 mg and 15 mg for 8-week period (4-week intervals). Body weights, serum reproductive hormone levels, sperm measurements in the epididymis, and testis histology were monitored. The TU injections increased serum testosterone levels steadily. The epididymis sperm concentration and motility increased slowly in high dose group at 4-weeks whereas sperm measurements increased significantly in the TST groups at 8 weeks. In addition, exogenous TST increased the intra-testicular testosterone concentration somewhat and alleviated the testicular oxidative stress markers of Malondialdehyde (MDA) and level of GSH-PX (Glutathione Peroxidase) after 8 weeks treatment. The improvement of sperm and testicular function acted mainly by curbing mitochondrial apoptosis in the testis by modulation of Bcl-2, Bax, Caspase-3, and Caspase-9 expression. However, the results of immunohistochemistry and western blotting in the low-dose group were still lower than control values. TST at an appropriate dose within a period of 8 weeks was effective to stimulate spermatogenesis and alleviate inflammation, oxidative stress, and apoptosis through suppression of testis damage in this rat model of oligoasthenospermia.

Antioxidant capacity of extract from Jiangtang Xiaozhi recipe in vitro.

OBJECTIVE: To evaluate the antioxidant capacity of the extract from Jiangtang Xiaozhi recipe (JXR) of in vitro. METHODS: JXR extract was prepared according to previously reported method. In vitro antioxidant assays were used in this experiment, including 1,1-Diphenyl-2-picrylhydrazyl free radical (DPPH) radical scavenging ability, 2-2'-Azinobis-(3-ethylbenzthiazoline-6-sul phonate (ABTS) radical scavenging ability, reducing power assay, fluorescence recovery after photo bleaching assay, ß-carotene bleaching assay, ferric thiocyanate assay, and thiobarbituric acid method. RESULTS: DPPH, ABTS assay showed that JXR extract had distinct effect on scavenging free radicals; reducing power and ferricreducing-antioxidant power assay showed that JXR extract possessed redox ability; ß-Carotene bleaching assay and antioxidant activity in a linoleic acid system using ferric thiocyanate method, thiobarbituric acid assay indicated that JXR extract could effectively inhibit lipid peroxidation, and the effect was better than that of Vitamin C. CONCLUSION: JXR extract has significant antioxidant capacity in vitro.

Validity and feasibility of a self-administered home vision examination in Yueqing, China: a cross-sectional study.

OBJECTIVE: To investigate the validity and feasibility of a self-administered home vision examination programme in China. DESIGN: Cross-sectional study. SETTING: Yueqing, China. PARTICIPANTS: A two-stage convenience sampling procedure was used to randomly select 600 households from 30 communities participating in the Yueqing Eye Study (YES). The aim of YES is to encourage home-based vision screening, reporting of visual acuity (VA) annually through social media and encouraging people to attend follow-up clinic appointments as a way to improve eye care access for adults with VA ≤+0.5 log of the minimum angle of resolution (logMAR). INTERVENTIONS: Household screeners (one per household) who tested other family members' VA completed a questionnaire on family structure, demographic information and knowledge about screening procedures. Other family members then underwent confirmatory VA testing by researchers. OUTCOME MEASURES: The completion rate of home-based VA screening, its sensitivity and specificity were used to evaluate validity. Factors that determined whether families participated in the self-VA screening were used to evaluate feasibility. RESULTS: 345 (66%) of the 523 (87.2%) households with valid data form their home-based vision examinations also were retested by researchers. There was no statistically significant difference in scores on the family-administerd or researcher-administerd VA test (VA≤+0.5 logMAR, p=0.607; VA >+0.5 logMAR, p=0.612). The sensitivity and specificity of home-based vision screening were 80.5% (95% CI 70.2% to 86.9%) and 95.1% (95% CI 92.6% to 96.8%), respectively. 14.7% (77/523) of tested respondents had VA ≤+0.5 logMAR. Predictors of performing home screening for VA remaining in regression models included higher economic status ('fair and above' vs 'poor': OR 1.74; 95% CI 1.08 to 2.76; p=0.022), age (<45 years vs ≥45 years: OR 0.46; 95% CI 0.25 to 0.85; p=0.014) and living in a nuclear (OR 5.17; 95% CI 2.86 to 9.36; p<0.001) or extended family (OR 8.37; 95% CI 4.93 to 14.20; p<0.001). CONCLUSION: Self-administered home vision screening is reliable and highly accepted by Chinese adults.

Qilin pills alleviate oligoasthenospermia by inhibiting Bax-caspase-9 apoptosis pathway in the testes of model rats.

At present, the treatment of oligoasthenospermia with western medicine is ineffective. Qilin pill (QLP) is a Chinese traditional medicine for treating male infertility. Recent multicenter clinical studies in China reported that QLPs markedly improved sperm quality. However, the mechanism of action of QLPs on oligoasthenospermia remains unknown. In this study, we investigated the mechanistic basis for improvement of semen parameters and reversal of testis damage by QLPs in a rat model of oligoasthenospermia induced by treatment with tripterygium glycosides (TGs) (40 mg/kg) once daily for 4 weeks. Rats were administered QLPs (1.62 g/kg or 3.24 g/kg) each day for 60 days, with untreated animals serving as controls. The concentration and motility of sperm extracted from rat epididymis were determined, whereas histopathological examination and immunohistochemical apoptosis analysis of rat testes was performed. Expression profiles of apoptosis-related genes were determined by microarray analysis; the results were validated by quantitative real-time PCR, western blotting, and immunohistochemistry. Sperm concentration and motility in the QLP treatment group were increased relative to those in control rats. Testis tissue and DNA damage were reversed by QLP treatment. The improvement function of QLPs on sperm and testis works mainly by suppressing mitochondrial apoptosis in the testis via modulation of B cell lymphoma (Bcl)-2, Bcl-2-associated X protein (Bax), cytochrome C, caspase-9 and caspase-3 expression. QLPs could improve sperm quality and testis damage in a rat model of oligoasthenospermia by inhibiting the Bax-Caspase-9 apoptosis pathway and exerting therapeutic effects.

Obesity impairs male fertility through long-term effects on spermatogenesis.

OBJECTIVE: This study aimed to investigate the effect and possible underlying mechanisms of high-fat diet-induced obesity on spermatogenesis in male rats. METHODS: A total of 45 male rats were randomly divided into control (n = 15, normal diet) and obesity groups (n = 30, high-fat diet) and were fed for 16 weeks. Body weight and organ indexes were determined after sacrifice. Indicators of reproductive function, including sperm count, sperm motility, apoptosis of spermatogenic cells, and oxidative stress levels, were measured. Serum metabolic parameters and reproductive hormones were also assayed. RESULTS: Compared with the control group, epididymal sperm motility in the obese rats was significantly decreased (P < 0.01). Morphological analysis of the obesity group showed vacuolar changes in seminiferous tubules, spermatogenic cell dysfunction, and increased apoptosis of spermatogenic cells in testicular tissue (P < 0.05). The calculated free testosterone (cFT) concentration in serum was decreased (P < 0.05), whereas the serum sex hormone-binding globulin (SHBG) level was significantly increased (P < 0.01). The superoxide dismutase (SOD) concentration decreased and the malondialdehyde (MDA) concentration increased in testis tissues; however, neither changes were statistically significant (P > 0.05). RESULTS: Nutritional obesity can damage spermatogenesis in male rats due to long-term effects on spermatogenesis.

Comprehensive metabonomic analysis of heart tissue from isoproterenol-induced myocardial infarction rat based on reversed-phase and hydrophilic interaction chromatography coupled to mass spectrometry.

We aim to describe the metabonomic characteristics of myocardial infarction rats. High-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry was utilized to develop a metabonomic method of the heart homogenates of myocardial infarction rats. Hydrophilic interaction chromatography allows the analysis of high polar metabolites, providing complementary information to reversed-phase liquid chromatography. We combined reversed phase and hydrophilic interaction chromatographic separations to analyze 18 samples, ten from myocardial infarction rat hearts and eight from normal rat hearts. A total of 16 potential biomarkers in rat heart tissue were screened out, primarily related to oxidative stress, nitric oxide damage, taurine, and hypotaurine metabolism and sphingolipid metabolism. This research showed that a comprehensive metabonomic study is a useful tool to reveal the underlying mechanism of myocardial infarction.

Jiangtang Xiaozhi Recipe () prevents diabetic retinopathy in streptozotocin-induced diabetic rats.

OBJECTIVE: To evaluate the prevention effect of diabetic retinopathy of Jiangtang Xiaozhi Recipe (, JXR) in streptozotocin (STZ)-induced diabetic rats. METHODS: Sprague-Dawley rats were randomly divided into normal control group and diabetic group. Rats in the diabetic group were induced by intraperitoneal administration of STZ (50 mg/kg), and subdivided into 5 groups. Rats in the diabetic control group were given saline; four treatment groups were given metformin (300 mg/kg), JXR (2, 4 and 8 g/kg) respectively for 8 weeks, while rats in the normal control group were injected with citrate buffer and given the same volume of vehicle. Body weight and food intake were measured every week. The hypoglycaemic effects were determined by testing fasting blood glucose (FBG) every other week, and hemoglobin A1c (HbA1c), insulin, and glucagon at the end of the treatment. The preventive effects of JXR on STZ-induced diabetic rats were determined by histopathological examination with hematoxylin and eosin staining, and periodic acid-schiff staining. The effects were further evaluated by serum superoxide dismutase (SOD) activity and malondialdehyde (MDA). RESULTS: High-dose JXR significantly reduced FBG and HbA1c level at the 8th week of administration (P<0.01, P<0.05). JXR significantly increased insulin level (P<0.05), and decreased glucagon level (P<0.05). JXR showed the antioxidant defense with increased SOD activity and decreased MDA contents in diabetic rats. Histopathological studies revealed that there were no basement membrane thickening and mild destruction in the treated groups. Morphometric measurements of retina microvascular showed that acellular capillary and capillary density decreased in treated rats while pericyte and endothelial cell increasing after the treatment. CONCLUSION: JXR have protective effect of diabetic retinopathy and its mechanism may be associated with the obvious hypoglycemic and antioxidant effect.

[Effect of Jiangtang Xiaozhi Tablet on Insulin Resistance KK-AY Transgenic Mice Model of Diabetes Mellitus].

Objective To observe effects of Jiangtang Xiaozhi Tablet (JTXZT) on homeostasis model of assessment for insulin resistance index (HOMA-IR) , insulin sensitivity index ( ISI) , expres- sions of insulin (INS) and insulin receptor (InsR) in pancreas tissues of KK-A(y) transgenic mice model of diabetes mellitus (DM). Methods KK-A(y) transgenic mice were fed with high fat forage to induce hyper- glycemic obese DM model. The C,7ice at same age were used as a normal control group (fed with e- qual volume of sterile water, n =11). Successful modeled 55 mice with DM obesity were divided into 5 groups by random digit table (11 in each group) , including the model group (fed with equal volume of ster- ile water, with no treatment) , the Pioglitazone Hydrochloride Tablet treatment group (8 mg/kg; as a posi- tive control group) , and JTXZT groups [high (10. 0 g crude drugs/kg) , middle (5. 0 g crude drugs/kg) and low dose (2. 5 g crude drugs/kg) ]. All medications were fed by gastrogavage, once per day for 8 succes- sive weeks. All mice were weighed and levels of random blood glucose (RBG) determined after 8 weeks of treatment. Blood was collected from ophthalmic vein. Levels of insulin (INS) , serum total cholesterol (TC) and triglyceride (TG) were detected. HOMA-IR and ISI were calculated. The morphological changes of pancreas tissues were extracted for performed pathological examinations. The expressions of INS and insulin receptor (InsR ) were measured by immunohistochemistry ( IHC ). Expressions of insulin receptorp ßInsRP) and insulin receptor substrate-1 (IRS-1) in pancreas tissues were detected using Western blot. Results Compared with the normal control group, obesity, obviously increased blood glu- cose and blood lipids occurred in each group after modeling (P <0. 01). After 8 weeks of medication mice in the model group had put up body weight (P <0. 01) , blood glucose and blood lipids were kept on quite higher levels. Compared with the model group, body weight, serum levels of TG, INS, and HOMA-IR obvi- ously decreased in each JTXZT group (P <0. 05, P <0. 01). Besides, RBG decreased obviously lower in the high dose JTXZT group (P <0. 01). ISI obviously increased in low and high dose JTXZT groups (P < 0. 05, P <0. 01). Pathological results of HE staining in pancreas showed that atrophied islets with obvious- ly reduced numbers in the model group. They were sparsely distributed with reduced islet density.-Islet cells were compensatively hypertrophy, with degenerated vacuoles. Apoptosis of islet cells could also be seen in the model group, manifested as swollen cytoplasm and paryopyknosis. Islet number was obvious- ly increased in high and middle dose JTXZT groups, with reduced apoptosis and degenerated cells. Re- sults of IHC assay showed, as compared with the normal control group, the grey values of INS and InsR were significantly decreased in the model group (P <0. 01). Compared with the model group, IOD values of INS and InsR (IOD) were significantly increased in each JTXZT group (P <0. 05, P <0. 01). Results from Western blot showed that protein expressions of InsRP ßnd IRS-1 were obviously decreased in the model group, as compared with the normal control group (P <0. 01). Compared with the model group, protein expressions of InsRP ßnd IRS-1 were obviously increased in each JTXZT group (P <0. 01) , but with no statistical difference as compared with the Pioglitazone Hydrochloride Tablet treatment group (P > 0. 05). Conclusions JTXZT had obvious roles in decreasing levels of blood glucose, serum lipids, and improving insulin resistance in KK-Ayt(r) ansgenic mice model with diabetic obesity. Its mechanism might involve in increasing expressions of lnsRp and IRS-1 in pancreas cells, promoting the integration of INS to its receptors, and thereby improving glucose metabolism , lipid metabolism , and IR state.

[Effect of formula of removing both phlegm and blood stasis in improving hemorheology and blood fat of mini-swine with coronary heart disease of phlegm-stasis cementation syndrome].

OBJECTIVE: To observe effect of formula of removing both phlegm and blood stasis (TYTZ) in improving hemorheology and blood fat of mini-swine with coronary heart disease of phlegm-stasis cementation syndrome. METHOD: Thirty-six Chinese mini-swine were randomly divided to six groups: the normal control group, the model group, the Shujiangzhi group and TYTZ groups with doses of 2.0, 1.0 and 0.5 g x kg(-1), with six mice in each group. Except for the normal control group, all of other groups were fed with high-fat diet for 2 weeks. Interventional balloons are adopted to injure their left anterior descending artery endothelium. After the operation, they were fed with high-fat diet for 8 weeks to prepare the coronary heart disease model of phlegm-stasis cementation syndrome. In the 8th week after the operation and administration, the changes in hemorheological parameters, serum lipid level, myocardial ischemia level and range were observed. RESULT: Compared with the normal control group, the model group showed significant increase in serum TC, TG, LDL-C and VLDL-C levels (P < 0.01), whole blood viscosity under the shear rate of 5 s (-1) and 60 s (-1) (P < 0.01), and myocardial ischemia degree and range (P < 0.01). Compared with the model group, TYTZ groups revealed significant decrease in myocardial ischemia degree and range (P < 0.01), serum TC, TG, LDL-C and VLDL-C levels (P < 0.05 or P < 0.01) and whole blood viscosity under the shear rate of 5 s(-1) and 60 s(-1) (P < 0.05). CONCLUSION: TYTZ could improve the abnormal hemorheology in Chinese mini-swine with coronary heart disease of phlegm-stasis cementation syndrome, and regulate serum lipid, with a certain efficacy for coronary heart disease of phlegm-stasis cementation syndrome.

[Experimental study of jiangtang xiaozhi tablet on decreasing the levels of blood glucose and serum lipids in transgenic mice with diabetes mellitus].

OBJECTIVE: To observe the effects of Jiangtang Xiaozhi Tablet (JTXZT) on decreasing the levels of blood glucose and serum lipids in KK-Ay transgenic model mice with diabetes mellitus (DM). METHODS: KK-Ay transgenic mice were fed with high fat diet to induce DM obesity model. The C57 mice of the same age were recruited as the control group. Then the modeled KK-Ay mice were divided into 5 groups, i.e., the model group, the Pioglitazone Hydrochloride Tablet treatment group (8 mg/kg, as the positive control group), and the high dose JTXZT group (10 g/kg), the middle dose JTXZT group (5 g/kg), and the low dose JTXZT group (2.5 g/kg), 11 in each group. Eight weeks was taken as one therapeutic course. All medicines were given by gastrogavage. The food intake and body weight were measured every week. The blood glucose level was determined once every 2 weeks. The levels of fasting blood glucose (FBG), serum lipids (TC and TG), insulin (INS), and leptin (Lep) were assayed 8 weeks after medication. The weight of liver and fat were weighed to calculate their indices. Then the adipose denaturalization of the liver was classified. The numbers of the pancreatic islet and adipocytes were respectively counted. RESULTS: Compared with the model group, the food intake and the body weight obviously decreased in the 3 JTXZT groups (P < 0.05, P < 0.01). From the 6th week, the FBG level obviously decreased in the high dose JTXZT group (P < 0.01). After eight successive weeks of intragastric administration, the levels of TG and INS obviously decreased in the 3 JTXZT groups (P < 0.05, P < 0.01). The Lep level somewhat decreased in the high dose JTXZT group (P < 0.05). The indices of the liver and fat obviously decreased and the number of the pancreatic islet obviously increased in the 3 JTXZT groups (P < 0.05, P < 0.01). The number of adipocytes obviously decreased in the high and middle dose JTXZT groups (P < 0.05, P < 0.01). The liver fatty degeneration was obviously improved in the high dose JTXZT group (P < 0.05). CONCLUSION: JTXZT had obvious effects on decreasing the levels of blood glucose and serum lipids in KK-Ay transgenic model mice with DM obesity.

[Serum testosterone reduction and metabolism in aging male rats: correlation and mechanism].

OBJECTIVE: To investigate the mechanism of serum testosterone reduction, its relationship with metabolism, changes in the number and morphology of Leydig cells and endocrine function in aging male rats. METHODS: The levels of serum total testosterone (tT), LH, FSH, HDL, LDL, TG, TC, Glu, INS, IRG and LP were determined in young (9 mo) and aging rats (12, 15, 18 and 21 mo), with 6 in each group. The morphological changes of Leydig cells were observed under the microscope. The concentrations of testosterone secreted from the cultured Leydig cells with the stimulation of hCG and Forskolin were assayed. The apoptosis rates of Leydig cells were detected by TUNEL. The visceral fat was isolated and weighed, and the Lee's index calculated. All the above indexes were recorded and compared among different age groups. RESULTS: The aging rats showed a significant decrease in the levels of serum tT and TSI ([1.26 +/- 0.65] ng/ml and [0.07 +/- 0.65] ng/mIU) as compared with the young rats ([3.24 +/- 0.38] ng/ml and [0.21 +/- 0.01] ng/mIU) (P < 0.01). Obvious differences were found in the morphology of Leydig cells among different age groups. The T secretion of Leydig cells at 24, 48 and 72 h in aging rats was markedly decreased (P < 0.05) while their TUNEL positive rate remarkably increased in the aging rats (17.36% +/- 1.31%) compared with the young ones (7.02% +/- 1.05%) (P < 0.05). There were statistically significant differences between the young and aging rats in all the biochemical parameters including IRG, HDL, LDL, TG, TC and visceral fat content (P < 0.05), except the levels of serum Glu, INS and LP (P > 0.05). CONCLUSION: The serum T level and secreting capacity of Leydig cells are significantly lower in aging rats than in young ones, and the metabolic parameters undergo regular changes with the decreasing level of serum T. The reduction of testosterone in aging male rats may be associated with the decreased secreting capacity and number of Leydig cells and declined function of the pituitary.

[Effect of Jiangtang Xiaozhi capsule on morphological changes of islet and liver in rat model [corrected] of type 2 diabetes [corrected] mellitus].

OBJECTIVE: To explore the effect of Jiangtang Xiaozhi capsule (JXC) on morphological changes of islets and liver at rat model of type 2 diabetic mellitus and provide the experimental basis for the clinical therapy of type 2 diabetic mellitus. METHOD: Wister rats were fed on a diet enriched in fat and glucose to induce insulin resistan, the rats were injected intrapertoneally with a low-dose streptozotocin (STZ) twice (25 mg x kg(-1)) to induce hyperglycemia, so the successful rat model of type 2 diabetes were established. The experimental rats were divided into model group, high dose JXC group, middle dose JXC group, low dose JXC group, Erjiashuanggua group, Jinqijiangtang group and normal control group. After all the treatment groups received their own medicine for two months, all the rats were sacrificed and morphological examination on their islets and livers were performed. RESULT: Fatty liver in various degrees was seen in the model group and all the treatment groups, but the liver steatosis in middle and low dose JXC groups was significantly milder than that in model group (P < 0.05). Islets in the high dose JXC group were significantly more than that in the model group (P < 0.05). CONCLUSION: JXC can improve significantly the pathological change in islets and liver steatosis at rat model of type 2 diabetic mellitus.