[Clinical observation of botulinum toxin A injection in the treatment of acute comitant esotropia: a retrospective cohort study]

Objective: To observe the efficacy and safety of botulinum toxin A (BTA) injection in the treatment of acute comitant esotropia (ACE) with different doses. Methods: This retrospective cohort study included data from patients with ACE who received BTA injection treatment at the First Affiliated Hospital of Zhengzhou University from June 2019 to June 2022. All patients underwent routine ophthalmic examinations, including best-corrected visual acuity (BCVA), spherical equivalent (SE), as well as specialized examinations for strabismus, including the degree of esotropia, eye movement status, and binocular visual function. Patients were categorized into small esotropia [≤60 prism diopters (PD)] and large esotropia (>60 PD) groups based on the pre-treatment degree of esotropia. Each group was further divided into 2.5 U and 5.0 U dose subgroups. Monocular injections were administered to the non-dominant eye. The esotropia degree was recorded and compared at 1, 2, 3, and 6 months of follow-up. The proportion of effectively treated patients in each group was documented. The number of cases with various levels of visual functions (including simultaneous vision, near stereopsis, and distance stereopsis) at 6 months post-treatment was compared, and complications during the follow-up period were observed. Statistical analyses were conducted using t-tests, Mann-Whitney U tests, and χ2 tests. Results: A total of 70 patients were included in the study, comprising 46 males and 24 females, with a median age of 5.0 (4.0, 8.3) years. Among them, 37 patients had small esotropia, with 25 in the 2.5 U group and 12 in the 5.0 U group. Thirty-three patients had large esotropia, with 18 in the 2.5 U group and 15 in the 5.0 U group. There were no statistically significant differences in baseline data, including age, duration of the condition, pre-treatment esotropia degree, BCVA and SE, between the two dose groups in both small and large esotropia patients (all P>0.05). In small esotropia patients, at 1 and 2 months post-treatment, the esotropia degree in the 5.0 U group was -20.00 (-37.50, -7.00) and 0.00 (0.00, 0.00) PD, respectively, which was significantly lower than the 0.00 (-10.00, 4.50) and 5.00 (0.00, 6.50) PD in the 2.5 U group (all P<0.05). At 3 and 6 months post-treatment, the esotropia degree in the 2.5 U group was 5.00 (0.00, 15.00) and 2.00 (0.00, 6.00) PD, respectively, while in the 5.0 U group, it was 0.00 (0.00, 4.50) and 0.00 (0.00, 3.75) PD, with no statistically significant differences between the two groups (all P>0.05). In the 2.5 U group, 20 cases were effectively treated, accounting for 80.0%, while in the 5.0 U group, 10 cases were effective, accounting for 10/12, with no significant difference between the two groups (P>0.05). In the 2.5 U group and the 5.0 U group, the proportions of cases with various levels of visual functions were as follows: simultaneous vision, 76.0% (19/25) and 10/12; near stereopsis, 48.0% (12/25) and 7/12; distance stereopsis, 44.0% (11/25) and 7/12, respectively. No statistically significant differences were observed in these proportions (all P>0.05). In patients with large esotropia, the esotropia degrees in the 5.0 U group at various follow-up times were -5.00 (-25.00, 5.00), 0.00 (0.00, 7.00), 2.00 (0.00, 10.00), and 5.00 (0.00, 7.00) PD, respectively. For the 2.5 U group, the corresponding values were 5.00 (2.75, 27.75), 10.00 (3.75, 24.75), 12.00 (3.75, 38.75), and 14.00 (3.50, 54.00) PD, respectively. The esotropia degrees in the 5.0 U group were consistently lower than those in the 2.5 U group (all P<0.05). The proportion of effective treatment in the 5.0 U group (13/15) was higher than that in the 2.5 U group (9/18), and the proportion of cases with distance stereopsis in the 5.0 U group (9/15) was higher than that in the 2.5 U group (4/18), both showing statistically significant differences (all P<0.05). The number of cases with simultaneous vision and near stereopsis showed no significant differences between the two groups (all P>0.05). The proportion of complications in the 2.5 U and 5.0 U groups in both large and small esotropia patients was 9/18, 13/15, 80.0% (20/25), and 10/12, respectively, with no statistically significant differences (all P>0.05). All complications spontaneously resolved within 3 months post-treatment. Conclusions: BTA injection is effective in the treatment of ACE, and for ACE patients with esotropia degrees greater than 60 PD, increasing the injection dose to 5.0 U can achieve better therapeutic outcomes.

The process of hypertension induced by high-salt diet: Association with interactions between intestinal mucosal microbiota, and chronic low-grade inflammation, end-organ damage

Inflammation and immunity play a major role in the development of hypertension, and a potential correlation between host mucosal immunity and inflammatory response regulation. We explored the changes of intestinal mucosal microbiota in hypertensive rats induced by high-salt diet and the potential link between the intestinal mucosal microbiota and inflammation in rats. Therefore, we used PacBio (Pacific Bioscience) SMRT sequencing technology to determine the structure of intestinal mucosal microbiota, used enzyme-linked immunosorbent assay (ELISA) to determined the proinflammatory cytokines and hormones associated with hypertension in serum, and used histopathology methods to observe the kidney and vascular structure. We performed a potential association analysis between intestinal mucosal characteristic bacteria and significantly different blood cytokines in hypertensive rats induced by high-salt. The results showed that the kidney and vascular structures of hypertensive rats induced by high salt were damaged, the serum concentration of necrosis factor-α (TNF-α), angiotensin II (AngII), interleukin-6 (IL-6), and interleukin-8 (IL-8) were significantly increased (p < 0.05), and the coefficient of immune organ spleen was significantly changed (p < 0.05), but there was no significant change in serum lipids (p > 0.05). From the perspective of gut microbiota, high-salt diet leads to significant changes in intestinal mucosal microbiota. Bifidobacterium animalis subsp. and Brachybacterium paraconglomeratum were the dominant differential bacteria in intestinal mucosal, with the AUC (area under curve) value of Bifidobacterium animalis subsp. and Brachybacterium paraconglomeratum were 1 and 0.875 according to ROC (receiver operating characteristic) analysis. Correlation analysis showed that Bifidobacterium animalis subsp. was correlated with IL-6, IL-8, TNF-α, and Ang II. Based on our results, we can speculated that high salt diet mediated chronic low-grade inflammation through inhibited the growth of Bifidobacterium animalis subsp. in intestinal mucosa and caused end-organ damage, which leads to hypertension.

Study on Baohe Pills Regulating Intestinal Microecology and Treating Diarrhea of High-Fat and High-Protein Diet Mice

Objective

To investigate the effects of Baohe pills on intestinal microorganisms and enzyme activities in mice with a high-fat and high-protein diet.

Methods

45 KM male mice were randomly divided into the control group, the high-fat and high-protein diet group, and the Baohe pill intervention group. The mice in the high-fat and high-protein diet group and the Baohe pill intervention group were fed with the self-made high-fat and high-protein diet as the sole food source of the mice, and the mice in the control group were fed with the normal diet. Starting from the 7th day of the feed intervention, mice in the Baohe pill intervention group were given 0.28 g/mL of Baohe pill decoction twice a day at the dose of 6.67 g/(kg·day), each time of 0.35 mL for 6 days. Mice in the control group and the high-fat and high-protein diet group were given the same amount of distilled water by gavage. The general state of mice in each group was observed, and the changes of intestinal microorganisms and intestinal enzyme activities were analyzed by culturable microorganism technology and intestinal functional enzyme detection technology.

Results

The excrement of mice fed with a high-fat and high-protein diet was relatively thin and wet, and the Baohe pill intervention could not improve the symptoms well. In the high-fat and high-protein diet group, the number of bacteria, Escherichia coli, Lactobacillus, and Bifidobacterium, was significantly lower than that in the control group (P < 0.01). Baohe pills could obviously increase the high-fat, high-protein diet for the number of culturable microorganisms in mice, the total number of bacteria, and the number of Bifidobacteria in the most significant (P < 0.01), but the number of bacteria, Escherichia coli, and the Lactobacillus are still significantly lower than the control group (P < 0.01). In terms of enzyme activity, both contents and mucosa, the Baohe pill could improve the activities of amylase, protease, sucrase, and lactase in high-fat and high-protein diet mice, which were significantly different from the control group (P < 0.05). In terms of microbial activity, the intestinal contents of high-fat and high-protein mice were lower than those of the control group, while the intestinal mucosa was higher than that of the control group, but the difference was not significant (P > 0.05). Baohe pills could improve the intestinal contents and intestinal mucosal microbial activity of mice, and the difference was significant in the high-fat and high-protein diet group (P < 0.05). Discussion. A high-fat and high-protein diet can destroy the physiological balance of the body, which is mainly reflected in the disturbance of intestinal flora and the decrease of some enzyme activities and microbial activity. Baohe pills can restore the number of intestinal flora to a certain extent and improve the activities of various digestive enzymes including protease and amylase.

Functional analysis of Trichinella spiralis serine protease 1.2 by siRNA mediated RNA interference

A T. spiralis serine protease 1.2 (TsSP1.2) was identified in the muscle larvae (ML) and intestinal larvae surface/excretory-secretory (ES) proteins by immunoproteomics. The aim of this study was to determine the TsSP1.2 function in the process of T. spiralis intrusion, growth and reproduction by using RNA interference (RNAi). RNAi was used to silence the expression of TsSP1.2 mRNA and protein in the nematode. On 2 days after the ML were electroporated with 2 µM of TsSP1.2-specific siRNA 534, TsSP1.2 mRNA and protein expression declined in 56.44 and 84.48%, respectively, compared with untreated ML. Although TsSP1.2 silencing did not impair worm viability, larval intrusion of intestinal epithelium cells (IEC) was suppressed by 57.18% (P < 0.01) and the suppression was siRNA-dose dependent (r = 0.976). Infection of mice with siRNA 534 transfected ML produced a 57.16% reduction of enteral adult burden and 71.46% reduction of muscle larva burden (P < 0.05). Moreover, silencing of TsSP1.2 gene in ML resulted in worm development impediment and reduction of female fertility. The results showed that silencing of TsSP1.2 by RNAi inhibited larval intrusion and development, and reduced female fecundity. TsSP1.2 plays a crucial role for worm invasion and development in T. spiralis life cycle, and is a potential vaccine/drug target against Trichinella infection.

Primary assessment of a T. spiralis putative serine protease for early serological detection of experimental trichinellosis

A putative serine protease of T. spiralis (TsSP) was expressed in Escherichia coli and its potential as a diagnostic antigen was primarily assessed in this study. Anti-Trichinella IgG in serum samples from T. spiralis different animal hosts (mice, rats, pigs and rabbits) were detected on Western blot analysis with rTsSP. Anti-Trichinella antibodies were detected in 100% (30/30) of experimentally infected mice by rTsSP-ELISA. Cross-reactions of rTsSPELISA were not found with sera from mice infected with other parasites (S. erinaceieuropaei, S. japonicum, C. sinensis, A. cantonensis and T. gondii) and sera from normal mice. There was no statistical difference in antibody detection rate among mice infected with the encapsulated Trichinella species (T. spiralis, T. nativa, T. britovi, and T. nelsoni) (P>0.05). The results of rTsSP-ELISA showed that serum specific antibody IgG in mice infected with 100 or 500 T. spiralis muscle larvae (ML) were detectable early at 7-8 dpi, but not detected by ML ES antigen-ELISA prior to 10-12 dpi. Specific anti-Trichinella IgG was detected in 100% (18/18) of infected pigs by rTsSP-ELISA and ES-ELISA, but no specific antibodies was not detected in 20 conventionally raised normal pigs by two antigens. The results showed the rTsSP had the potential for early serodiagnosis of animal Trichinella infection, however it requires to be assayed with early infection sera of swine infected with Trichinella and other parasites.

Effect of Banxia Xiexin decoction on gastrointestinal microbiota and enzyme activities in mice with Helicobacter pylori associated gastritis

AIM: To explore the relationship between the therapeutic effect of Banxia Xiexin decoction on Helicobacter pylori (H. pylori) associated gastritis and gastrointestinal microbiota and enzyme activities.

METHODS: A mouse model H. pylori associated gastritis was established, and the effects of clarithromycin and Banxia Xiexin decoction on the microbiota and enzyme activities were analyzed.

RESULTS: The numbers of bacteria, Escherichia coli, lactobacillus and protease activities in mice with H. pylori associated gastritis were significantly higher than those in control mice (P < 0.05 or P < 0.01), while cellulase and amylase activities were significantly lower in model mice than in control mice (P < 0.05 or P < 0.01). The numbers of bacteria, Escherichia coli, lactobacillus and bifidobacteria in clarithromycin-treated mice were significantly lower than those in control mice (P < 0.05 or P < 0.01). After Banxia Xiexin decoction treatment, the numbers of bacteria became lower, but were still higher than those in control mice. Bifidobacteria and lactobacillus in Banxia Xiexin decoction-treated mice grew very rapidly, and their numbers were much higher than those in the other groups (P < 0.01). Amylase and cellulase activities in Banxia Xiexin decoction-treated mice returned to normal levels (P > 0.05).

CONCLUSION: Banxia Xiexin decoction can significantly adjust gastrointestinal microbiotia and enzyme activities in mice with H. pylori associated gastritis.

Advances in research of intestinal lactase

DLactase is a type of disaccharidase which exists on the surface of small intestinal villi of mammals and can be generated by many beneficial intestinal bacteria. The majority of humans are deficient in lactase and approximately 2/3 of the world′s population are affected by lactase deficiency. Nowadays, the research of the metabolism of lactose, lactose enzyme expression and regulation has attracted wide attention both in China and other countries. In this article, we will review recent progresses in research of intestinal lactase.

RAIDD aggregation facilitates apoptotic death of PC12 cells and sympathetic neurons

In human cell lines, the caspase 2 adaptor RAIDD interacts selectively with caspase 2 through its caspase recruitment domain (CARD) and leads to caspase 2-dependent death. Whether RAIDD induces such effects in neuronal cells is unknown. We have previously shown that caspase 2 is essential for apoptosis of trophic factor-deprived PC12 cells and rat sympathetic neurons. We report here that rat RAIDD, cloned from PC12 cells, interacts with rat caspase 2 CARD. RAIDD overexpression induced caspase 2 CARD- and caspase 9-dependent apoptosis of PC12 cells and sympathetic neurons. Apoptosis correlated with the formation of discrete perinuclear aggregates. Both death and aggregates required the expression of full-length RAIDD. Such aggregates may enable more effective activation of caspase 2 through close proximity. Following trophic deprivation, RAIDD overexpression increased death and aggregate formation. Therefore, RAIDD aggregation is important for its death-promoting effects and may play a role in trophic factor withdrawal-induced neuronal apoptosis.