应用超高速SS-OCTA定量评估DR患者的脉络膜毛细血管血流灌注

目的：利用超高速扫频源光学相干断层扫描血管成像(SS-OCTA)测量脉络膜毛细血管(CC)灌注密度(PFD)评估不同糖尿病视网膜病变(DR)患者脉络膜毛细血管血流特征。方法：横断面研究。选取2022-03/12在合肥市第二人民医院就诊的受试者139例139眼：包括糖尿病患者115例115眼和对照组24例24眼。根据早期糖尿病视网膜病病变研究(ETDRS)标准对彩色视网膜图像进行DR分级,将糖尿病患眼分为无DR组、非增殖性糖尿病视网膜病变(NPDR)组、NPDR合并糖尿病黄斑水肿(DME)组、增殖性糖尿病视网膜病变(PDR)组。采用超高速SS-OCTA设备扫描以黄斑中央凹为中心3mm×3mm的区域,利用系统内置软件测量CC灌注面积,计算PFD,采用多元线性回归评估CC的PFD与DR程度的相关性。结果：DR程度与CC血流灌注相关,调整各种混杂因素后,与对照组相比,NPDR组中心凹CC的PFD减少9.358个单位(95%CI -18.484～-0.232,P=0.045),旁中心凹减少9.284个单位(95%CI -18.487～-0.090,P=0.048); NPDR合并DME组中心凹CC PFD减少18.173个单位(95%CI -28.583～-7.762,P=0.001),旁中心凹减少17.032个单位(95%CI -27.521～-6.544,P=0.002); PDR组中心凹CC PFD减少28.309个单位(95%CI -39.978～-16.640,P<0.001),旁中心凹减少25.841个单位(95%CI -37.597～-14.085,P<0.001)。结论：超高速SS-OCTA测量CC血流密度可以客观量化黄斑灌注,黄斑区CC血流灌注密度与DR严重程度相关,随着DR进展黄斑区CC灌注密度降低,未来纵向研究可阐明CC灌注与DR进展之间的因果关系。     

车载DR在体检中的应用探讨

目的探讨直接数字化X线机(DR)在流动体检中应用的优越性。方法从体检胸片中随机抽取500例普通X光胸片和500例DR胸片进行比照分析。结果(1)车栽DR片的照片质量明显高于普通X线胸片,提高了甲片率;(2)车载DR简化了放射科的工作流程,大大降低了劳动强度;(3)车栽DR明显降低了受检者的受照剂量;(4)车栽DR储存影像资料方式多样化。结论直接数字化X线机(DR)在体检中的应用具有众多优越性。     

糖网一号对糖尿病大鼠早期视网膜毛细血管病变的影响

目的观察糖尿病大鼠视网膜毛细血管超微结构的病理改变及中药复方糖网一号对毛细血管超微结构的影响.方法链尿佐菌素(STZ)致糖尿病大鼠随机分为糖尿病模型组(M)、二甲双胍组(A)、糖网一号小剂量组(B)及糖网一号大剂量组(C)(n=12),并设正常对照组(CON).每日灌药1次,6个月后测血流变指标,取视网膜行视网膜血管铺片及透射电镜观察.结果糖网一号和二甲双胍组血流变检测,两药相比,前者优于后者,糖网一号大剂量疗效优于小剂量用药.糖尿病6个月时模型组大鼠的血液有高凝、高粘现象,并出现了影周细胞、周细胞减少、微血管瘤等早期糖尿病视网膜病变的特征性改变.其余各组视网膜病变与模型组相比明显较轻,大剂量用药组接近正常.结论大鼠糖尿病早期眼底和视网膜微血管超微结构已有改变,中药糖网一号对早期糖尿病大鼠视网膜病变具有良好的防治作用.     

荧光素眼底血管造影在糖尿病视网膜病变诊断中的应用

荧光素眼底血管造影在糖尿病视网膜病变(DR)诊断中的应用包括对非增殖性糖尿病视网膜病变的早期诊断,认识增殖前期病变,判断是否进入增殖期以及应用对糖尿病黄斑病变进行诊断与分型等.在糖尿病视网膜病变的诊治过程中,合理进行荧光素眼底血管造影检查将会提高对病变的认识和诊治水平.     

Ethylacetate extract from DraconisResina inhibits LPS-induced inflammatory responses in vascular smooth muscle cells and macrophages via suppression of ROS production

DraconisResina (DR) is a type of dragon’s blood resin obtained from Daemomoropsdraco BL. (Palmae). DR has long been used as a traditional Korean herbal medicine, and is currently used in traditional clinics to treat wounds, tumors, diarrhea, and rheumatism, insect bites and other conditions. In this study, we evaluated fractionated extracts of DR to determine if they inhibited the production of interleukin-1β (IL-1β) and the expression of cyclooxygenase (COX)-2. The results of this analysis revealed that the ethylacetate extract of DraconisResina (DREA) was more potent than that of other extracts. Moreover, DREA inhibited the production of nitric oxide (NO), reactive oxygen species (ROS), prostaglandin E₂ (PGE₂), tumor necrosis factor-α (TNF-α), IL-8 and IL-6 in lipopolysaccharide (LPS)-treated human aortic smooth muscle cells (HASMC) and RAW 264.7 macrophages. Furthermore, treatment with an NADPH oxidase assembly inhibitor, AEBSF, efficiently blocked LPS-induced mitogen-activated protein kinases (MAPKs) activation, as did DREA. These findings indicate that DREA inhibits the production of NO, PGE₂, TNF-α, IL-8, and IL-6 by LPS via the inhibition of ROS production, which demonstrates that DREA inhibits LPS-induced inflammatory responses via the suppression of ROS production. Taken together, these results indicate that DREA has the potential for use as an anti-atherosclerosis agent.     

The thalamic nucleus submedius and ventrolateral orbital cortex are involved in nociceptive modulation: A novel pain modulation pathway

Recently, a series of studies have given rise to and provided evidence for the hypothesis that the nucleus submedius (Sm) in the medial thalamus is involved in modulation of nociception. The Sm, ventrolateral orbital cortex (VLO) and the periaqueductal gray (PAG) constitute a pain modulatory pathway, activation of which leads to activation of the PAG–brainstem descending inhibitory system and depression of the nociceptive inputs in the spinal cord and trigeminal nucleus. Other studies have indicated that the Sm–VLO–PAG pathway plays an important role in the analgesia induced by electroacupuncture stimulation of the acupuncture point (acupoint) for exciting small diameter fiber (A-δ and C group) afferents. Opioid peptides, serotonin, dopamine, glutamate and their related receptors are involved in Sm- and/or VLO-mediated descending antinociception, and a GABAergic disinhibitory mechanism participates in mediating the antinociception induced by activation of μ-opioid receptors, serotonin 1_A receptors, and dopamine D₂-like receptors. This review describes these findings, which provide important new insights into the roles of the thalamus and cerebral cortex in descending pain modulation.