Catquest-8SF量表分析年龄相关性白内障患者的效果

目的：应用Catquest-8SF量表研究PHACO+SIOL植入术患者主观报告的效果,评估Catquest-8SF量表在中国北方白内障人群的适用性及其对白内障手术的敏感性。

方法：前瞻性临床病例随访研究。泰安市中心医院白内障患者术前和术后3mo完成面对面的Catquest-8SF量表填写。

结果：术前共120例白内障患者完成了Catquest-8SF量表。术前Catquest-8SF量表得分与术前双眼加权logMAR视力及年龄呈显著负相关(P<0.05),与文化程度呈正相关(P<0.001),无全身合并症的患者量表得分高于有全身合并症的患者(P<0.05)。102名(85%)患者完成术后3mo量表,单眼手术组和双眼手术组比较,术后视力均显著提高(t=10.404, P<0.001),术后量表得分均明显提高(P<0.001)。两组在量表得分提高值上差异无统计学意义。92.2%的患者对手术效果满意。满意度与量表得分的提高值显著相关(P<0.05)。

结论：中文版Catquest-8SF量表在我国北方ARC人群中适用性好,简短高效,可以作为白内障常规临床评估的一部分。     

高糖诱导的人晶状体上皮细胞葡萄糖关键代谢酶的表达

目的：探讨葡萄糖关键代谢酶在高糖诱导的人晶状体上皮(HLEB3)细胞中的表达情况。

方法：将体外培养的HLEB3细胞分为正常对照组(采用DMEM培养液培养,含葡萄糖5mmol/L)、氧化应激组(采用含H₂O₂ 200μmol/L的DMEM培养液培养)、高糖诱导组(采用含葡萄糖30mmol/L的培养液培养),培养24h后检测细胞凋亡情况和细胞活力及6种葡萄糖关键代谢酶(6-磷酸果糖激酶-1、丙酮酸激酶、己糖激酶、柠檬酸合成酶、α-酮戊二酸脱氢酶、6-磷酸葡萄糖脱氢酶)的mRNA表达情况。

结果：高糖诱导HLEB3细胞凋亡,高糖诱导组(63.43%±3.40%)细胞活力低于正常对照组(100.00%±0.00%)和氧化应激组(91.90%±5.11%),且高糖诱导组细胞6种葡萄糖代谢关键酶的mRNA表达水平均低于正常对照组和氧化应激组(均P<0.05)。

结论：高糖可以诱导HLEB3细胞葡萄糖关键代谢酶的表达水平降低,诱导细胞凋亡,影响细胞活性。     

Construction of a full-thickness human corneal substitute from anterior acellular porcine corneal matrix and human corneal cells

AIM: To construct functional human full-thickness corneal replacements. METHODS: Acellular porcine corneal matrix (APCM) was developed from porcine cornea by decellulariztion. The biomechanical properties of anterior-APCM (AAPCM) and posterior-APCM (PAPCM) were checked using uniaxial tensile testing. Human corneal cells were obtained by cell culture. Suspending ring was designed by deformation of an acupuncture needle. MTT cytotoxicity assay was used to check the cytotoxicity of suspending ring soaking solutions. A new three-dimensional organ culture system was established by combination of suspending ring, 48-well plate and medium together. A human full-thickness corneal substitute was constructed from human corneal cells with AAPCM in an organ coculture system. Biochemical marker expression of the construct was measured by immunofluorescent staining and morphological structures were observed using scanning electron microscopy. Pump function and biophysical properties were examined by penetrating keratoplasty and follow-up clinical observations. RESULTS: There were no cells in the AAPCM or PAPCM, whereas collagen fibers, Bowman’s membrane, and Descemet’s membrane were retained. The biomechanical property of AAPCM was better than PAPCM. Human corneal cells grew better on the AAPCM than on the PAPCM. There was no cytotoxicity for the suspending ring soaking solutions. For the constructed full-depth human corneal replacements keratocytes scattered uniformly throughout the AAPCM and expressed vimentin. The epithelial layer was located on the surface of Bowman’s membrane and composed of three or four layers of epithelial cells expressing cytokeratin 3. One layer of endothelial cells covered the stromal surface of AAPCM, expressed Na+/K+ATPase and formed the endothelial layer. The construct was similar to normal human corneas, with many microvilli on the epithelial cell surface, stromal cells with a long shuttle shape, and zonula occludens on the interface of endothelial cells. The construct withstood surgical procedures during penetrating keratoplasty. The corneal transparency increased gradually and was almost completely restored 7d after surgery. CONCLUSION: AAPCM is an ideal scaffold for constructing full-thickness corneal replacement, and functional human full-thickness corneal replacements are successfully constructed using AAPCM and human corneal cells.     

The impact of GJA3 SNPs on susceptibility to age-related cataract

AIM: To determine the association of gap junction protein alpha 3 (GJA3) gene tag single-nucleotide polymorphisms (SNPs) with susceptibility to age-related cataract (ARC). METHODS: In total, 486 ARC patients were matched with 500 healthy controls. All the participants underwent complete ophthalmic examinations. Haplotype-tagging SNPs of GJA3 gene were selected from the HapMap Beijing Han Chinese population. Genomic DNA was extracted from the peripheral blood leukocytes of all the subjects. Under three different genetic models: dominant, recessive, and additive, the association between SNPs and ARC was examined. After adjusting for age and sex, the genetic effects of the GJA3 SNPs were evaluated with logistic regression analysis. RESULTS: Four tag GJA3 SNPs (rs6490519, rs9506430, rs9509053, and rs9552089) were included in the present study. None of the SNPs showed a significant relationship with an altered risk of total ARC under the dominant, recessive, or additive models. In the subgroup analysis, rs9506430 had a significant effect on the formation of a posterior subcapsular cataract (P=0.002, OR: 0.227, 95%CI: 0.088-0.590) under the recessive model. CONCLUSION: Our study indicates that GJA3 variants may influence the development of posterior subcapsular cataracts. Further studies need to be designed to confirm this possibility.     

5-aza-2’-deoxycytidine in the regulation of antioxidant enzymes in retinal endothelial cells and rat diabetic retina

AIM: To investigate the roles of a DNA methyltransferase (DNMT) inhibitor 5-aza-2’-deoxycytidine (5-aza-dC) in the regulation of antioxidant enzymes in diabetic retinopathy (DR) models. METHODS: DNMTs expressions and activity, and changes of two key antioxidant enzymes in DR, MnSOD (encoded by SOD2 gene) and glutathione S-transferase theta 1 (GSTT1), were quantified in the isolated human retinal endothelial cells (HRECs) exposed to high glucose (HG) with or without 5-aza-dC treatment. The downstream exacerbating factors including vascular endothelial growth factor (VEGF), intercellular adhesion molecule 1 (ICAM-1) and matrix metalloproteinase 2 (MMP2), which are implicated in the pathogenesis of DR and closely related to oxidative stress were also analyzed. The key parameters were confirmed in the retina from streptozotocin (STZ) diabetic rats. RESULTS: DNMTs expression and DNMT activity was induced in HRECs exposed to HG. Hyperglycemia decreased MnSOD and GSTT1 expression. 5-aza-dC administration effectively suppressed DNMTs expression and activity and reversed the MnSOD and GSTT1 expression under HG condition. VEGF, ICAM-1 and MMP2 induced by HG were also suppressed by 5-aza-dC treatment. Similar results were observed in the retina from STZ diabetic rats. CONCLUSION: Our findings suggest that DNA methylation may serves as one of the mechanisms of antioxidant defense system disruption in DR progression. Modulation of DNA methylation using pharmaceutic means such as DNMT inhibitors could help maintain redox homeostasis and prevent further progression of DR.     

Constructing Large Scale Cohort for Clinical Study on Heart Failure with Electronic Health Record in Regional Healthcare Platform: Challenges and Strategies in Data Reuse

Regional healthcare platforms collect clinical data from hospitals in specific areas for the purpose of healthcare management. It is a common requirement to reuse the data for clinical research. However, we have to face challenges like the inconsistence of terminology in electronic health records (EHR) and the complexities in data quality and data formats in regional healthcare platform. In this paper, we propose methodology and process on constructing large scale cohorts which forms the basis of causality and comparative effectiveness relationship in epidemiology. We firstly constructed a Chinese terminology knowledge graph to deal with the diversity of vocabularies on regional platform. Secondly, we built special disease case repositories (i.e., heart failure repository) that utilize the graph to search the related patients and to normalize the data. Based on the requirements of the clinical research which aimed to explore the effectiveness of taking statin on 180-days readmission in patients with heart failure, we built a large-scale retrospective cohort with 29647 cases of heart failure patients from the heart failure repository. After the propensity score matching, the study group (n=6346) and the control group (n=6346) with parallel clinical characteristics were acquired. Logistic regression analysis showed that taking statins had a negative correlation with 180-days readmission in heart failure patients. This paper presents the workflow and application example of big data mining based on regional EHR data.     

MSCT参数优化和图像质量的相关性研究

目的探讨多层螺旋CT（MSCT）诸扫描参数对图像质量的影响，以进一步提高MSCT图像的质量。方法固定扫描条件，分别对两种不同密度材料的质量控制体模进行扫描。在质量控制体模的左、中、右各选取1个431．43mm2的感兴趣区（ROI），改变其中某个扫描条件（如层厚、电压、曝光量、螺距），对质量控制模各扫描10次，计算CT值（X±SD），并比较各条件下两种质量控制体模的CT值。结果在固定扫描条件下，随曝光量、层厚的增加，CT图像对应各材料的平均CT值变化不明显，而SD明显减小；随着管电压的升高，CT图像对应各材料的平均CT值和SD明显减小；随着螺距的增大，CT图像对应各材料的平均CT值无明显变化，而SD增加较为明显。结论CT图像质量与扫描参数密切相关，并且各扫捕参数之间既相互影响，又相互制约。     

HPLC法测定固定化青霉素酰化酶合成头孢羟氨苄的活力

目的 建立一种HPLC法测定固定化青霉素酰化酶合成头孢羟氨苄活力的方法。方法 酶与其底物7-ADCA及D-对羟基苯甘氨酸甲酯，在20℃的溶液中，搅拌转速为250r/min条件下反应10min，通过测定反应液中头孢羟氨苄的含量，从而换算出合成酶活力的数值。采用十八烷基硅烷键合硅胶为填充剂；流动相：0.02mol/L磷酸二氢钾溶液(用lmol/L氢氧化钾溶液调节pH值至5.0)-甲醇(98:2)；流速：1.0mL/min；柱温：25℃；检测波长：230nm。结果 头孢羟氨苄在0.24~0.39mg/mL范围内线性关系良好(r=1.0000)，回收率均在99%~101%范围内，RSD为0.40%。结论 该测定方法专属性强、准确可靠、重现性好，适用于青霉素酰化酶合成酶活力的检测。     

高龄患者生活行为与冠心病发病的相关性研究

目的研究生活行为与高龄患者冠心病发病的关系。方法对91例年龄≥80岁的高龄老年冠心病人的生活行为及5年来的生活事件进行流行病学调查。采用问卷访问、体格检查、查阅住院病历的方法获得数据。结果对高龄老年冠心病人影响较大的负性生活事件依次为丧偶、子女病重或去世、重大财产损失、搬家等。心绞痛组和心肌梗死组A型行为倾向与正常组比较差异有统计学意义。结论负性生活行为与冠心病有关,起诱导剂的作用。     

大鼠视神经挫伤后生长相关蛋白的变化及重组人促红细胞生成素的作用

目的 研究大鼠视神经挫伤后视神经生长相关蛋白( GAP-43)的变化及重组人促红细胞生成素(rhEPO)的作用.方法 建立外伤性视神经损伤的动物模型,随机分为正常对照组、损伤组(视神经钳夹+生理盐水)及rhEPO组(视神经钳夹+rhEPO),于损伤后1d、4d、7d、14 d和28 d对各组视网膜及视神经进行形态学观察,免疫组化染色法测定视神经GAP-43的活性.结果 rhEPO组较损伤组视网膜及视神经病变明显减轻；在损伤后4d和7d趼组间损伤远端GAP-43表达差异无统计学意义(P＞0.05)；14 d和28 d rhEPO组损伤远端GAP-43表达较损伤组明显升高(P＜0.05).结论 rhEPO对视神经不完全损伤可促进视网膜神经节细胞存活与视神经纤维再生修复.