Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab (Avastin) in diabetic rats. Methods Forty male Sprague Dawley (SD) rats were randomly divided into normal group (Group A, 10 rats) and diabetes mellitus group (30 rats). The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model. And then randomly divided into diabetic retinopathy (DR) group (Group B,10 rats), the rats were not intervened; the left eyes of the other 20 rats were intravitreal injected with bevacizumab 3 mu;l (25 mg/ml) for 3 times as experimental group (Group C) ; the right eyes of the 20 rats were not intervened as experimental control group (Group D). 20 days after last intravitreal injection, retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide (EB) stained retinal flat mounts; retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining. Results F-ERG showed that, the differences of a-and b-waves, the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A, B, C and D were significant (F=33.165, 36.162,19.955, 23.243; P＝0.000); the differences of a-wave amplitude between group A,B,C and D was not significant (F=0.097,P＝0.961). Retinal blood vessel pattern was normal in Group A; retinal vascular vessels were tortuous and irregularly expanded in Group B; retinal vascular vessels of Group C were regular and thinner than Group A; microaneurysm were showed in Group D. Light microscope displayed that the layers of the rat retina of Group A were regular, the retinal architectures of Group B were irregular, the retinal layers were regular in Group C, the retinal layers were irregular in Group D. Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer（GCL）. Conclusion Repeated intravitreal injection of bevacizumab is toxic to retina of diabetes mellitus rats.
Objective To observe the effect of laser-Doppler retinal blood flowmeter in diabetic retinopathy. Methods The blood flow volume (VOL), the blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of peri-papillary retina were measured with the non-invasive Heidelberg Retinal Flowmeter (HRF) in 108 patients (216 eyes) with diabetes and 32 patients (64 eyes) in normal control group. The patients with diabetes were divided into non-diabetic retinopathy (NDR) group (27 patients, 54 eyes) and non-proliferative diabetic retinopathy (NPDR) group (81 patients, 162 eyes). NPDR group were subdivided into 3 groups: 26 patients (52 eyes) in mild group, 24 patients (48 eyes) in moderate group, and 31 patients (62 eyes) in severe group. The foveal avascular zone area (FAZ) was measured by fundus flourescein angiography (FFA) in patients with diabetes and some in the control group. The data in each group were statistically analyzed. Results The parameter of retinal blood flow of temporal and nasal peri-papillary retina in NDR and NPDR group was significantly lower than that in the control group (Plt;0.05). With the degree of retinopathy becoming more severe, the FLW and VEL of temporal and nasal peri-papillary retina in NDR and mild NPDR group presented ascending tendency, reached the peak in moderate NPDR group, and then decreased. The change tendency of the FLW was more obviously. The VOL of temporal and nasal peri-papillary retina in moderate NPDR group was obviously higher than that in the other groups (Plt;0.01).The FLW and the VEL of temporal and nasal peri-papillary retina in moderate NPDR group were significantly higher than that in mild NPDR and NDR group (Plt;0.01). The FLW and the VEL of temporal peri-papillary retina in severe NPDR group were obviously higher than that in NDR group (Plt;0.01). Blood sugar value positively correlated with degree of diabetic retinopathy (r=0.172，P=0.046). The FLW and the VEL of temporal peri-papillary retina positively correlated with FAZ area in patients with diabetes (r=0.268, P=0.000；r=0.275, P=0.000). The FAZ area positively correlated with the degree of macular degeneration in patients with diabetes (r=0.559, P=0.000). Conclusion As a non-invasive method for measurement of retinal blood flow, HRF has important value in revealing the mechanism and degree of pathological changes and choice of treatment for diabetic retinopathy. (Chin J Ocul Fundus Dis,2007,23:256-259)
Objective To verify the applicable significance of confocal scanning laser retinal tomography in agerelated macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD, and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P＜0.01); Z profile signal width, maximum height，and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P＜0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P＜0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD. (Chin J Ocul Fundus Dis, 2002, 18: 262-265)
ObjectiveTo detect the expression of programmed cell death ligand 1 (PD-L1) in papillary thyroid carcinoma (PTC) and PTC with coexistent Hashimoto’s thyroiditis (HT) tissues, and to explore its clinical significance of its expression.MethodsThe PTC patients who underwent thyroidectomy at the Thyroid Surgery Department of the Affiliated Hospital of Guizhou Medical University from March 2017 to May 2019 were retrospectively collected. Immunohistochemical staining was used to detect the expression of PD-L1 in the PTC tissues, PD-L1 staining positive cells ≥20% was judged as positive expression, <20% was judged as negative expression. The relationship between PD-L1 positive expression rate and clinicopathologic characteristics of patients with PTC were analyzed, and the correlation between the presence of HT in PTC tissues and PD-L1 positive expression was studied.ResultsA total of 138 patients with PTC were included in this study, including 104 patients with PTC alone and 34 PTC patients with coexistent HT. The positive rate of PD-L1 expression in the 138 cases of PTC tissues was 35.5% (49/138), among which was 43.3% (45/104) in the pure PTC tissues, and 11.8% (4/34) in the PTC tissues with HT, the latter was significantly lower than the former (P=0.001). The results of univariate analysis showed that the positive rate of PD-L1 expression was related to the tumor size, the presence or absence of extraglandular invasion and HT in PTC patients (P<0.05), and the results of Spearman correlation analysis showed that the positive rate of PD-L1 expression was positively correlated with tumor size (rs=0.173, P=0.041) and extraglandular invasion (rs=0.197, P=0.021), and negatively correlated with whether TH was merged (rs=–0.284, P=0.001). The multivariate analysis results showed that the positive rate of PD-L1 expression was closely related to whether PTC with coexistent HT [OR=5.720, 95%CI (1.879, 17.411), P=0.002], and it was not found to be related to tumor size and presence of extraglandular invasion (P>0.05).ConclusionsPositive rate of PD-L1 expression has a certain relationship with tumor size and presence or absence of extraglandular invasion, and which in PTC patients with or without HT is significantly different, that is, positive rate of PD-L1 expression in PTC with HT is lower suggests that coexistent HT might be an inhibitory factor in occurrence of PTC, and immune microenvironment-related factors of PTC might be involved in occurrence and development of thyroid cancer.
Objective To analyze the expression differences of FoxP3 protein in papillary thyroid carcinoma (PTC) and nodular goiter, and to explore the correlation between FoxP3 and the clinicopathological characteristics of PTC patients and the therapeutic dose of 131I. Methods Immunohistochemical method was used to detect the expression of FoxP3 protein in 128 cases of PTC tissues (42 cases were treated with 131I after operation) and 20 cases of nodular thyroid tissues, and the relationship between it and the clinicopathological characteristics of PTC patients and the dose of 131I treatment was also analyzed. Results The positive rate of FoxP3 protein expression in PTC tissues was 46.09%, which was higher than that in nodular goiter tissues (0.00%), and the difference was statistically significant (P<0.001). The expression of FoxP3 protein in PTC was correlated with gender, extraglandular invasion and tumor diameter (P values were 0.041, 0.039, and 0.007, respectively), but had no correlation with age, capsular invasion, TNM staging, lymph node metastasis, and distant metastasis (P>0.05). The results of binary logistic regression analysis suggest that tumor diameter was an independent risk factor affecting FoxP3 protein expression [OR=0.389, 95%CI (0.180, 0.840), P=0.016]. By drawing the receiver operating characteristic (ROC) curve, it was shown that the area under the curve (AUC) was 0.643 when the tumor diameter was 1.05 cm, the sensitivity to predict the increase in FoxP3 protein expression was 64.41%, and the specificity was 57.97%, P=0.006. Among 42 patients with PTC who underwent 131I treatment after surgery, the therapeutic dose of 131I was related to the expression of FOXP3 protein (P=0.031). It was shown that patients with positive expression of FoxP3 protein were given more dose of 131I after surgery. Conclusions The positive rate of FoxP3 protein expression in PTC is higher than that of nodular goiter. Its high expression means that the patient has poor pathological characteristics and larger 131I treatment dose, suggesting that FoxP3 may be involved in the malignant progression of PTC.
Objective To investigate the feasibility of rabbit synovial-derived mesenchymal stem cells (SMSCs) differentiating into fibrocartilage cells by the recombinant adenovirus vector mediated by bone morphogenetic protein 2/7 (BMP-2/7) genes in vitro. Methods SMSCs were isolated and purified from 3-month-old New Zealand white rabbits [male or female, weighing (2.1 ± 0.3) kg]; the morphology was observed; the cells were identified with immunocytological fluorescent staining, flow cytometry, and cell cycles. The adipogenic, osteogenic, and chondrogenic differentiations were detected. The recombinant plasmid of pAdTrack-BMP-2-internal ribosome entry site (IRES)-BMP-7 was constructed and then was used to infect SMSCs. The cell DNA content and the oncogenicity were tested to determine the safety. Then infected SMSCs were cultured in incomplete chondrogenic medium in vitro. Chondrogenic differentiation of infected SMSCs was detected by RT-PCR, immunofluorescent staining, and toluidine blue staining. Results SMSCs expressed surface markers of stem cells, and had multi-directional potential. The transfection efficiency of SMSCs infected by recombinant plasmid of pAdTrack-BMP-2-IRES-BMP-7 was about 70%. The safety results showed that infected SMSCs had normal double time, normal chromosome number, and normal DNA content and had no oncogenicity. At 21 days after cultured in incomplete chondrocyte medium, RT-PCR results showed SMSCs had increased expressions of collegan type I and collegan type II, particularly collegan type II; the expressions of RhoA and Sox-9 increased obviously. Immunofluorescent staining and toluidine blue staining showed differentiation of SMSCs into fibrocartilage cells. Conclusion It is safe to use pAdTrack-BMP-2-IRES-BMP-7 for infecting SMSCs. SMSCs infected by pAdTrack-BMP-2-IRES-BMP-7 can differentiate into fibrocartilage cells spontaneously in vitro.
Objective To evaluate the visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment (DTRD). Methods 102 eyes of 86 consecutive patients with DTRD underwent vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via indirect ophthalmoscope and B ultrasonic scan after mydriasis. Followup duration varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity (BCVA) and anatomic success were observed postoperatively. The patients were divided into visual acuity improved group and didn't improved group. Ttest, Chisquare test and Multivariate Logistic regression analysis were performed to predict the prognosis of visual acuity. Results After primary vitreoretinal surgery, 87 eyes (85.3%) were anatomically reattached, 15 eyes (14.71%) needed reoperation because of the recurrence of retinal detachment (RD). Postoperative BCVA improved and better than 0.05 in 49 eyes (48.04%), reduced or increased but less than 0.05 in 53 eyes (51.96%). Comparing natural factors between these two groups, only combined cataract surgery and optic nerve atrophy were significant different (chi;2=5.266,9.274;P=0.022,0.002). Among post-operative complications only the RD recurrence was significant different (chi;2=12.059，P=0.000). Multivariate Logistic regression revealed recurrence of RD and optic nerve atrophy were two independent risk factors in the final BCVA (P=0.003,0.041;OR=33.518、4.079). Preoperative PRP was identified as the only protecting variable in the final BCVA(P=0.034，OR=0.270).Conclusion This study revealed recurrence of RD and optic nerve atrophy were two independent risk factors in final BCVA of DTRD patients.
ObjectiveTo explore the method and effectiveness of multidirectionally three-dimensional steel wire ring sleeve fixation in the treatment of inferior patellar pole avulsion fractures.MethodsBetweern January 2015 and January 2019, 22 patients with inferior patellar pole avulsion fractures were admitted and treated. There were 12 males and 10 females. The age ranged from 20 to 69 years, with an average age of 39.4 years. The causes of injury included 9 cases of traffic accident and 13 cases of falling. All of them were unilateral closed injury of knee joint, including 7 cases of skin contusion around patella. Preoperative range of motion of the affected knee was (20.82±7.16)° (range, 10°-35°). The time from injury to operation ranged from 3 to 12 days, with an average of 5.9 days. During the operation, the inferior patellar avulsion fracture was reduced with forceps; the patella was circumferentially ligated through the distal bone surface of the fracture with 0.8 mm diameter steel wire; then 3 longitudinal bone tunnels were made in the upper patella, respectively. The 0.8 mm diameter steel wire passed through the bone tunnel, and the longitudinal ring was attached to the ring to fix the upper and inferior patellar fracture. Tighten the transverse and longitudinal rings with No.2 tendon suture line, then longitudinally ringed and sutured to strengthen the patella. The knee range of motion, fracture healing time, and complications were recorded. The functional recovery of the knee joint was evaluated by Böstman score.ResultsAll incisions healed by first intention, and no incision related complications occurred. All the 22 patients were followed up 13 months to 5 years with an average of 26.7 months. The fracture healing time was 9-12 weeks (mean, 10.9 weeks). At last follow-up, the knee range of motion was (129.77±2.35)° (range, 126°-135°), showing significant difference when compared with preoperative one (t=−67.022, P=0.000). The Böstman score ranged from 31 to 36, with an average of 34.3. No reduction loss, fracture of steel wire, failure of internal fixation, and other complications occurred during follow-up.ConclusionMultidirectionally three-dimensional steel wire ring sleeve fixation in the treatment of inferior patellar pole avulsion fractures has the advantages of reliable fixation, early functional recovery, and fewer complications, so the effectiveness is satisfactory.
ObjectiveTo systematically review the trend of tuberculosis among Chinese students. MethodsPubMed, Web of Science, EMbase, CBM, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies on the incidence and trend of tuberculosis among students in China from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using Stata 15.0 software. ResultsA total of 97 cross-sectional studies were included. The results of meta-analysis showed that: the overall incidence of tuberculosis among students in China was 18.63 per 100 000 persons. The incidence in the northwest, south, northeast, north, east, central, and southwest 46.81, 11.22, 24.38, 12.77, 12.03, 18.95, and 39.26 per 100 000 persons, respectively. The incidence among university students, senior high school students, junior school students, and primary school students 38.17, 33.84, 8.85, and 1.68 per 100 000 persons, respectively. ConclusionCurrent evidence shows that the incidence of tuberculosis among students in China is high. Among them, the incidence rate of tuberculosis in the central and western regions, universities and high school students is relatively high.