非增生型糖尿病视网膜病变患者黄斑水肿与中心凹下脉络膜厚度的关系

目的 观察非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)伴临床有意义的黄斑水肿(clinically significant macular edema,CSME)时黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)的情况,探讨糖尿病患者SFCT与糖尿病视网膜病变发生发展的关系.方法 按2014年我国糖尿病视网膜病变临床诊疗指南分期标准将NPDR患者分为伴CSME(NPDR CSME+)组15例(21眼),不伴CSME(NPDR CSME-)组21例(36眼).比较两组之间最佳矫正视力、黄斑中心凹视网膜厚度(central retinal thickness,CRT)及SFCT是否存在差异性.采用SPSS 18.0软件进行统计学分析处理.结果 NPDR CSME+组与NPDR CSME-组间性别、眼别、年龄、眼轴长度、眼压相比差异均无统计学意义(均为P＞0.05),两组间最佳矫正视力相比差异有统计学意义(P =0.001).NPDR CSME+组SFCT为(328.24±101.92) μm,NPDR CSME-组为(235.31±66.98)μm,两组间差异具有统计学意义(t=4.156,P=0.000).NPDR患眼CRT与SFCT呈正相关关系(r=0.473,P=0.000).结论 NPDR伴有CSME时,SFCT显著增厚,并且SFCT的增厚与CSME的发生发展具有一定相关性.     

高迁移率蛋白1在糖尿病大鼠视网膜组织中的表达及其机制

目的：探讨高迁移率蛋白1( high lobility group box 1, HMGB1)在糖尿病大鼠视网膜中的表达及其可能机制。
　　方法：将SD大鼠60只随机分为糖尿病组和对照组。采用STZ腹腔注射制作糖尿病大鼠模型,糖尿病组大鼠腹腔注射STZ 60lg/kg,对照组腹腔注射同等剂量的生理盐水。分别于1、2和4lo时处死大鼠,摘取视网膜,HE染色观察视网膜结构变化,荧光血管造影观察视网膜血管变化, TUNEL染色观察视网膜细胞凋亡情况, Western Blot检测视网膜中HMGB1和NF-κB的表达。
　　结果：与对照组相比,糖尿病组大鼠视网膜各层细胞排列紊乱,细胞密度减低,可见微血管病变,以及内、外核层变薄和神经节细胞的凋亡;荧光血管造影见周边毛细血管迂曲,可见血管闭塞及无灌注区;Western Blot 检测HMGB1和NF-κB表达呈时间依赖性增高,且两者表达呈正相关(P<0.05)。
　　结论：HMGB1在糖尿病大鼠视网膜中表达增加, HMGB1可能通过NF-κB信号通路参与了糖尿病视网膜病变的发生。     

Two new clerodane diterpenoids and a new pyran-2-one derivative with anti-neuroinflammatory activities from Croton crassifolius

Journal of Natural Medicines - Two new clerodane diterpenoids (1 and&nbsp;2), a new pyran-2-one derivative (3), along with five known compounds (4?8), were isolated from Croton...     

Diagnostic accuracy and its affecting factors of dual-source CT for assessment of coronary stents patency and in-stent restenosis

Background  In-stent restenosis is a common complication after stent implantation. However, the assessment of stent lumen in computed tomography (CT) coronary angiography is limited by multiple factors. Our study aimed to evaluate the accuracy and the suspected affecting factors in diagnosing coronary in-stent restenosis by dual-source CT (DSCT) compared with coronary angiography.

Methods  One hundred and fifteen stents in 50 patients were evaluated with DSCT before coronary angiography for the detection of coronary in-stent restenosis (≥ 50% luminal narrowing). Patency of each stent was analyzed by two independent expert radiologists blinded to the results of coronary angiography. The relationship between diagnostic accuracy and the suspected factors including age, body mass index (BMI), heart rate, variation of heart rate, radiation dose, image quality, location and stent characteristics (type, material, diameter, length and strut thickness) was assessed with both univariate and multivariate analysis. The fitting of a Logistic regression model was evaluated using a receiver operating characteristic (ROC) curve.

Results  Mean stent diameter was (2.9±0.4) mm. Sensitivity, specificity, positive and negative predictive values and accuracy of DSCT in detection of in-stent restenosis were 69.2%, 91.2%, 50.0%, 95.9%, and 88.7%, respectively. In a subgroup of stents with a diameter ≥3.0 mm, sensitivity, specificity, positive and negative predictive values and accuracy were 100.0%, 96.5%, 75.0%, 100.0%, and 96.8%, respectively. Stent diameter <3.0 mm and poor image quality were associated with poor diagnostic accuracy (P <0.05). The area under curve of ROC was 0.79.

Conclusion  DSCT can provide high accuracy for the assessment of in-stent restenosis in stents with a diameter ≥3.0 mm, and can play an important role in ruling out in-stent restenosis.     

RPE细胞发生上皮间充质转化机制及PVR的治疗研究进展

增殖性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)是眼外伤、糖尿病性视网膜病变、血管性视网膜病变和炎症性视网膜病变等眼部疾病的严重并发症,也是孔源性视网膜脱离手术失败的最重要原因,对视功能的危害较大。大量研究已证明PVR发生的主要危险因素是视网膜损伤后血视网膜屏障受损,视网膜色素上皮(retinal pigment epithelial,RPE)细胞受到玻璃体腔内细胞因子的刺激,RPE细胞发生上皮间充质转化(epithelial-mesenchymal transition,EMT),转分化为成纤维样细胞,细胞的形态发生了变化,细胞间的紧密连接消失,细胞极性丧失,增殖、迁移、侵袭能力增强。在视网膜前表面或视网膜下形成具有收缩性的纤维增殖膜,形成的纤维增殖膜会使视网膜形成皱褶,牵拉视网膜导致视网膜脱离,最终会导致患者视力下降甚至失明。国内外对预防和治疗PVR进行了大量的研究,本文对RPE细胞发生上皮间充质转化相关信号通路及PVR的治疗进行简要综述。     

Hemodynamics model of fluid–solid interaction in internal carotid artery aneurysms

The objective of this study is to present a relatively simple method to reconstruct cerebral aneurysms as 3D numerical grids. The method accurately duplicates the geometry to provide computer simulations of the blood flow. Initial images were obtained by using CT angiography and 3D digital subtraction angiography in DICOM format. The image was processed by using MIMICS software, and the 3D fluid model (blood flow) and 3D solid model (wall) were generated. The subsequent output was exported to the ANSYS workbench software to generate the volumetric mesh for further hemodynamic study. The fluid model was defined and simulated in CFX software while the solid model was calculated in ANSYS software. The force data calculated firstly in the CFX software were transferred to the ANSYS software, and after receiving the force data, total mesh displacement data were calculated in the ANSYS software. Then, the mesh displacement data were transferred back to the CFX software. The data exchange was processed in workbench software. The results of simulation could be visualized in CFX-post. Two examples of grid reconstruction and blood flow simulation for patients with internal carotid artery aneurysms were presented. The wall shear stress, wall total pressure, and von Mises stress could be visualized. This method seems to be relatively simple and suitable for direct use by neurosurgeons or neuroradiologists, and maybe a practical tool for planning treatment and follow-up of patients after neurosurgical or endovascular interventions with 3D angiography.     

OCT与mf-ERG在CSCR中的应用进展

中心性浆液性脉络膜视网膜病变(CSCR)为我国常见眼底疾病。近年来OCT在研究CSCR视网膜下渗出及分析视网膜结构改变等方面发挥着重要作用,同时脉络膜深层成像OCT(EDI-OCT)清晰地呈现了脉络膜形态学改变。此外,多焦视网膜电图(mf-ERG)证实了CSCR所引起的视网膜功能障碍,OCT和mf-ERG联合应用可以更好的理解CSCR结构和功能异常间的相关性。众多新技术的广泛应用,为CSCR的临床诊治、预后评估及随访提供了线索和依据。     

碘酸钠对小鼠视网膜形态和功能变化的影响

目的：：探讨碘酸钠鼠尾静脉注射导致的C57 BL/6 J小鼠视网膜形态和功能的变化。方法：将60只6~8周龄C57 BL/6 J小鼠分为正常对照组和碘酸钠组。碘酸钠组经鼠尾静脉注射碘酸钠(35mg/kg),分别于注射后6h,1、3、5、8d进行眼底照相、OCT和电生理检测;正常对照组注射同等剂量的生理盐水。所有小鼠摘除眼球制作石蜡切片进行HE染色。结果：正常对照组小鼠视网膜呈淡红色,视盘呈黄色,视网膜血管呈放射状走行。鼠尾静脉注射碘酸钠后6h即可见到眼底黄白色类似玻璃膜疣样改变,但此时OCT和ERG尚无明显变化。注射后1d,眼底改变加重,类玻璃膜疣的改变逐渐增加,OCT可见RPE层色素紊乱,光感受器和外核层受损。注射后3d,视网膜损伤进一步加重,视网膜出现水肿,注射后5d水肿消失,视神经变白,眼底病灶进一步增多。注射后8d,RPE层、感光细胞层及外核层结构破坏明显,几乎没有正常结构。在此过程中, ERG表现为a波、b波振幅下降,并呈时间依赖性加重。 HE染色结果显示,对照组小鼠视网膜各层细胞排列规则整齐,密度均匀。碘酸钠组小鼠外层视网膜呈波浪状改变,RPE层正常结构消失,可见黑色圆形沉积物,随时间延长,黑色沉积物逐渐增多,至注射后第8 d时几乎没有正常RPE结构。结论：碘酸钠经鼠尾静脉注射后,可以很好地模拟年龄相关性黄斑变性的发病过程,视网膜出现明显的形态和功能变化,为年龄相关性黄斑变性的研究提供一个较好的动物模型。     

一个中国原发性开角型青光眼家系致病基因研究

目的：鉴定一个江苏省南通市原发性开角型青光眼(POAG)家系的青光眼致病基因,分析该基因的临床表型和致病机制。

方法：于2020-01/12回顾并招募了一个POAG家系,该家系跨越5代共33名,有13名家庭成员参与了研究,其中4名诊断为POAG,1名诊断为高眼压症,剩余8名未受影响。详细询问病史并进行全面的眼科检查,采用高通量测序筛选可能的致病基因,Sanger测序验证候选致病基因。

结果：该家系患者均在青年时期发现眼压升高并诊断为青光眼,需手术治疗控制眼压,先证者最高眼压(IOP)达55mmHg。全外显子测序在先证者LTBP2基因上发现了一个杂合突变(c.1197C>A, p.Phe399Leu),Sanger测序验证该突变位点与家系疾病并不分离。

结论：LTBP2(c.1197C>A)突变不是该家系POAG的致病基因。但是LTBP2突变在POAG病例中的致病作用值得研究。     

Potential antihyperlipidemic polyketones from endophytic Diaporthe sp. JC-J7 in Dendrobium nobile

Eleven new polyketones named diaporthsins A–K (1–11) were isolated from the fermentation of Diaporthe sp. JC-J7. The chemical structures of compounds (1–11) were elucidated by spectroscopic methods including HRESIMS, 2DNMR, NMR and chemical methods. Compound 11 features an unusual acyclic polyketone–phenolic polyketone hybrid structure that integrates the characteristics of different fungal metabolites (cytosporone and multiplolide). Compound 3 was the only C₁₂-polyketone obtained in this research. These new polyketones showed inhibitory activity on triglycerides (TG) in steatosis hepatocyte L-02 cells. Among them, compound 5 and (4E)-6,7,9-trihydroxydec-4-enoic acid displayed inhibitory activities on TG in steatotic L-02 cells with inhibition ratios of 26% and 21% at concentration of 5 μg mL⁻¹; also, inhibition ratios of 8-O-acetylmultiplolide A and phomopsisporone A at concentration of 5 μg mL⁻¹ were calculated to be about 24% and 16%, respectively, which were equivalent to the antihyperlipidemic activity of lovastatin. The preliminary structure–activity relationship indicated that acetyl at C-8 can increase the antihyperlipidemic activity of multiplolide A and the glycol ester and hydroxyl at C-6 can also increase the corresponding activity of diaporthsin B.

Eleven new polyketones were isolated from Diaporthe sp. JC-J7, and some compounds indicated antihyperlipidemic activity.