Objective To evaluate the effect of Schwann cell (SC) on the proliferation of marrow mesenchymal stem cells (MSCs) and provide evidence for application of SC in construction of the tissue engineered vessels.Methods SC and MSCs were harvested from SD rats(weight 40 g). SC were verified immunohstochemically by the S-100 staining, and MSCs were verified by CD 44, CD 105, CD 34 and CD 45. The 3rd passages of both the cells were cocultured in the Transwell system and were amounted by the 3H-TDR integration technique at 1, 3, 5 and 7 days,respectively. The results were expressed by the CPM(counts per minute, CPM) values. However, MSCs on both the layers were served as the controls. The Westernblot was performed to assess the expression of the vascular endothelial growth factor (VEGF), its receptor Flk-1, and the associated receptor neuropilin 1(NRP-1) in SC, the trial cells, and the controls. Results SC had a spindle shape in the flasks, and more than 90% of SC had a positive reaction for the S-100 staining.MSCs expressed CD44 and CD105, and had a negativesignal in CD 34 and CD 45. The CPM values of MSCs in the trial groups were 2 411.00±270.84，3 016.17±241.57，6 570.83±2 848.27 and 6 375.8±1 431.28at 1, 3, 5 and 7 days, respectively. They were significantly higher in their values than the control group (2 142.17±531.63，2 603.33±389.64，2 707.50±328.55，2 389.00±908.01), especially at 5 days （P＜0.05）. The Western blot indicated that VEGF was expressedobviously in both the SC group and the cocultured MSCs grou,p and was less visible in the control cells. The expressions of Flk-1 and NRP-1 inthe cocultured MSCs were much ber than in the controls. Conclusion SC can significantly promote the proliferation of MSCs when they are cocultured. The peak time of the proliferation effect appeared at 5 days. This effect may be triggered by the up-regulation of VEGF in MSCs, which also leads to the upregulation of Flk-1 and NRP-1 .
Choroidal thickness and its relevance with retinal disease has been widely studied in recent years, as choroid is an important source of retina blood supply. Diabetic retinopathy (DR) studies have been focused on retinal vascular injury and related circulatory disorders for a long time, however recent studies have found that choroidal blood vessels are also affected by diabetes, including the thickness changes. The choroidal thickness of diabetic patients is thinner than normal. There is no conclusive conclusion about choroidal thickness and the severity of DR lesions, as the choroid thickness results are determined by multiple factors, including diseases, ocular conditions (choroidal vascular status, ocular axial length, refractory errors and other eye parameters), systemic factors (age and sex) and measurement methods. Therefore, it is necessary to calibrate the ocular and extra-ocular factors affecting choroidal thickness when trying to further clarify the relationship between the choroidal thickness and DR.
ObjectiveTo explore the reoperation on aortic diseases in patients with previous aortic valve surgery due to rheumatic aortic valve disease, improve the understanding of aortic valve disease secondary to surgery of aortic valve. MethodsWe retrospectively analyzed the data of twenty-seven patients with previous aortic valve replacement due to rheumatic aortic valve disease underwent aortic root or other aortic operation in Fu Wai Cardiovascular Hospital because of new aortic root or aortic diseases between August 2003 and May 2012. All the patients with new aortic diseases were diagnosed by cardiac ultrasound and aortic computed tomography. The new diseases included type A aortic dissection in 13 patients, ascending aortic aneurysm in 6 patients, and aortic root aneurysm in 8 patients. There were 20 males and 7 females with mean age of 50±10 years (ranged 28-69 years). Seven patients underwent aortic root replacement, 6 patients received ascending aorta and total aortic arch replacement combined with stented graft implantation into the descending aorta, 6 patients received aortic root and total aortic arch replacement combined with stented graft, and 8 patients received the ascending aorta replacement. All patients were followed by clinic interview or telephone. ResultsThe interval time for reoperation was 6-110 (57±32) months. No patient died within 30 days after operation. Cardiopulmonary bypass time was 50-274 (143±65) minutes; hospital stay was 13-27 (19±11) days. Four patients had renal insufficiency after operation and all were cured by hemofiltration before departure. Three patients had neurological complications of transient brain dysfunction, and there was no postoperative spinal cord deficits occurred. Four patients had pulmonary complication. The mean follow up time were 4-118 (43.5±32.2) months. Five patients were missed and 4 cases died during the follow-up. The follow-up rate was 81.5%. Three-year survival rate was 85.1%. There was no case received third operation due to aortic disease during the follow-up. ConclusionWe should pay more attention to patients with previous surgery due to rheumatic aortic valve disease, especially to patients combined with enlarged ascending aorta, so that aortic adverse events following to aortic valve operation can be reduced or be avoided in long term.
ObjectiveTo observe the changes of blood flow density in the macular area of normal eyes, and to analyze its correlation with age. MethodsA cross-sectional study. Two hundred and fifty normal healthy subjects (125 males and 125 females, aged 44.76±14.77) in routine ophthalmologic examination at the Department of Ophtalmology of Guangdong Provincial People’s Hospital during June 2017 to June 2018 were enrolled. Among them, 20 to 29, 30 to 39, 40 to 49, 50 to 59, and ≥ 60 years old were 50 subjects (50 eyes) in each. BCVA, slit lamp microscope, indirect ophthalmoscope, OCT angiography (OCTA) examinations were conducted for all eyes. The subjects were examined by both eyes, and the data of 1 eye was selected by EXCEL to generate random numbers, including 126 right eyes and 124 left eyes. The range of 6 mm × 6 mm in the macular area was scanned using a frequency domain OCTA instrument. The software automatically divides it into three concentric circles centered on the macular fovea, which were foveal area with a diameter of 1 mm, parafoveal area of 1 to 3 mm, and foveal peripheral area of 3 to 6 mm. The blood flow density of superficial capillary vessel, deep capillary vessel and foveal avascular area (FAZ) within a 300 μm width (FD-300), FAZ area, perimeter (PERIM), non-circularity index, center retinal thickness (CRT) were measured. The relationship between the blood flow density in macula, CRT, FAZ and age was analyzed by Pearson correlation analysis. ResultsThe mean blood flow density of superficial capillary vessel and deep capillary vessel were (51.61±2.54)% and (54.04±5.46)%, respectively. The average FD-300, CRT, PERIM and non-circularity index were (285.55±12.13) μm, (2.150±0.367) mm, 1.10±0.04, respectively. The relevance of the results showed that the age was negatively correlated with the blood flow density of whole area (r=−0.335, −0.279; P＜0.01), parafoveal area (r=−0.255, −0.368; P＜0.01), foveal peripheral area (r=−0.330, −0.269; P＜0.01) in superficial capillary vessel and deep capillary vessel as well as FD-300 (r=−0.311, P＜0.01), but not correlated with the blood flow density of foveal area (r=−0.071, −0.118; P=0.264, 0.064). There was no relationship between the age and the FAZ area, PERIM, non-circularity index (r=−0.070, −0.055, 0.074; P=0.267, 0.385, 0.142). The age was negatively correlated with the average CRT (r=−0.217, P＜0.01), but not correlated with the CRT in foveal area (r=0.115, P=0.068). The CRT was positively correlated with the blood flow density of superficial capillary vessel and deep capillary vessel in foveal area (r=0.715, 0.653; P＜0.01), but negatively correlated with the FAZ area (r=−0.669, P＜0.01). ConclusionThe capillary blood flow density of macular area in the normal eyes decreases with age.
Diabetic macular edema (DME) is the main cause of vision loss and even blindness in patients with diabetic retinopathy. Intravitreal anti-vascular endothelial factor therapy has become the gold standard management of DME. However, not all eyes response optimally to common management of DME, which could be due to the differences of individual factors. Increasing age could be the predictive factors for poor outcome. The influence of glycemic control, hypertension, dyslipidemia, chronic kidney disease and relative factors on treatment response require further investigation. Identifying the systemic factors that influence the treatment response of DME can provide the evidence to predict the prognosis of DME, and improve the efficacy of clinical treatment.
Objective To learn the prevalence and risk factors of diabetic retinopathy (DR) of provincial civil servants (more than 40 years old) in Guangdong, China. Methods Total of 3844 Guangdong provincial civil servants over 40 years old were enrolled in this study. All participants diagnosed with diabetes underwent a complete ophthalmologic examination, including stereoscopic fundus photography and optical coherence tomography. Photographs were graded in a masked manner to assess the presence and severity of DR and diabetic macular edema (DME). Results Of 3844 civil servants, DM was confirmed in 155 patients, the prevalence was 4.03%. Of 155 DM patients, DR was in 11 patients, the DR prevalence was 7.10%. There were statistically differences on the fasting blood glucose (FBG), total cholesterol, low density lipoprotein and whether or not to use insulin between DR group and non DR group (t=3.158, 2.200, 2.050;chi;2=5.128; P＜0.05). High-FBG values, high blood lipids, INS applications had accelerated the occurrence and development of DR. The high FBG and the insulin using were the independent risk factors of DR. Conclusions DR prevalence is 7.10% in Guangdong provincial civil servants more than 40 years old. The high FBG and the insulin using are the independent risk factors of DR.
Objective To observe the expression of programed death-1 (PD-1) and its ligands including PD-L1 and PD-L in peripheral blood mono-nuclear cells (PBMCs) of patients with diabetic retinopathy (DR) patients. Methods Forty patients with DR (DR group) and 20 healthy controls (control group) were included in this study. There were 20 patients with non-proliferative DR (NPDR) and 20 patients with proliferative DR (PDR). Peripheral Blood samples were obtained from two groups. Real time polymerase chain reaction (RT-PCR) was used to analyze PD-1, PD-L1, and PD-L2 mRNA expression in PBMCs. The clinical data was analyzed in DR group and controls, also in PDR group and NPDR group. Results The results of RT-PCR showed that the expression of PD-1 and PD-L1 mRNA in DR group were significantly lower than those in the control group (t=-2.060, -2.562; P=0.043, 0.013). There was no significant difference in PD-L2 mRNA expression between DR and control group (t=-0.857，P=0.395). Compared with the NPDR group, the lower expression level of PD-1 mRNA and higher expression level of PD-L1 and PD-L2 mRNA in PDR group were observed, but the differences were not statistically significant (t=-1.335, 0.987, 0.131; P=0.190, 0.334, 0.897). Conclusion PD-1 and PD-L1 mRNA expression in PBMCs of DR patients is decreased compared with controls, but there are no differences in PD-L2 mRNA expression in them.
Objective To compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute type A aortic dissection, including aortic valve (AV) resuspension, isolated supracoronary ascending aorta replacement, and aortic root replacement procedure (Bentall). Methods All patients who underwent acute Type A aortic dissection repair between January 2010 and December 2015 in Fuwai Hospital were retrospectively analyzed in our study. There were 673 patients with 512 males and 161 females at mean age of 48.80±11.22 years. There were 403 patients as an AV resuspension group (287 males and 116 females at average age of 50.61±9.95 years), 95 patients as an isolated supracoronary ascending aorta replacement group (76 males and 19 females at average of 49.83±12.21 years), and 175 patients as an AV resuspension group (149 males and 26 females at average of 44.07±11.99 years). The differences of preoperative aortic insufficiency, intraoperative variables and postoperative aortic insufficiency were compared in the three groups. Results Five hundred ninety-one patients (87.8%) had aortic valve commissure involved. The proportion of mild degree, moderate degree, and severe degree among the three groups were statistically significant (31.7%, 52.4%, 15.9%; 87.4%, 12.6%, 0.0%; 23.4%, 56.0%, 20.6%; P < 0.01). The diameter of aortic sinus in the three groups was 39.06±5.11 mm, 38.27±4.41 mm, 50.39±6.22 mm, respectively, with a statistical difference ( P< 0.01). The duration of surgery, cardiopulmonary bypass time, aorta cross-clamp time were also statistically significant (P < 0.01). The in-hospital mortality was 11.73% in the whole group. There was no difference among the three groups (12.2% vs. 13.7% vs. 9.7%, P=0.58). Five-year survival rate was similar (83.06% vs. 81.27% vs. 83.05%, P=0.85). The 5-year free from over moderate aortic insufficiency rate were 95.2%, 98.6% and 100% respectively, with no statistical difference (P=0.07). There was no re-do operation for aortic root diseases in the whole group. Conclusion According to aortic root processing strategy in our center, AV resuspension, isolated supracoronary ascending aorta replacement, and aortic root replacement can achieve satisfactory results. However, there is higher incidence of aortic insufficiency through AV resuspension. Further study is needed to evaluate its efficacy.