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Shi WY, Li SX. [Attach importance to the orderly development of different corneal transplant procedures]. Zhonghua Yan Ke Za Zhi 2024; 60:109-112. [PMID: 38296315 DOI: 10.3760/cma.j.cn112142-20231113-00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
There are various surgical methods for corneal transplantation, each requiring precise treatment tailored to the characteristics and different layers of corneal opacity or lesions. These layers include the corneal epithelium, stroma (lamellar), and corneal endothelium, with options for full-thickness (penetrating) corneal transplantation or artificial corneal transplantation. However, a current issue in clinical practice is that, regardless of the degree of corneal disease, the availability of corresponding eye bank support, or surgical conditions, classic penetrating (full-thickness) corneal transplantation is universally performed. Alternatively, there is a trend toward adopting technically demanding procedures such as endothelial transplantation and artificial corneal transplantation. This trend has led to increased postoperative complications and the wastage of corneal donor materials. Choosing the appropriate corneal transplant procedure can offer advantages such as preserving more healthy corneal tissue, conserving corneal donors, facilitating rapid vision recovery, and minimizing the risk of immune rejection. Corneologists need to master the indications for various corneal transplant surgeries and systematically perform different corneal transplant procedures based on the surgeon's skills, hospital conditions, and eye bank conditions. This approach aims to enhance the success rate of the surgery.
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Affiliation(s)
- W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Li SX, Wang N, Su M, Jiang XY, Gao H, Shi WY. [Intraoperative optical coherence tomography guided precise corneal suture in the treatment of acute keratoconus]. Zhonghua Yan Ke Za Zhi 2024; 60:147-155. [PMID: 38296320 DOI: 10.3760/cma.j.cn112142-20231016-00145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Objective: This study aimed to observe the clinical efficacy of precise suturing of posterior elastic layer fissures guided by intraoperative optical coherence tomography (OCT) in conjunction with anterior chamber puncture and drainage, and corneal thermokeratoplasty for the treatment of severe acute edematous keratoconus. Methods: Non-randomized controlled trial. Data were collected for a study involving 31 cases of acute edematous keratoconus patients who underwent surgical treatment at the Shandong Eye Hospital between June 2017 and July 2021. Among them, there were 30 male and 1 female patients, with an age range of 11 to 32 years and a mean age of (19.80±5.80) years. Eighteen patients in the study group underwent precise suturing of posterior elastic layer fissures guided by intraoperative OCT, in combination with anterior chamber puncture and drainage, and corneal thermokeratoplasty. Thirteen patients in the control group did not undergo suturing. Preoperative visual acuity, corneal edema diameter, corneal thickness, and posterior elastic layer fissure length were collected. Evaluation was performed using slit lamp microscopy, anterior segment OCT, and other methods to assess the time of initial postoperative corneal edema resolution and closure of the posterior elastic layer fissure. Deep lamellar keratoplasty was performed 2 to 4 weeks after edema resolution, and the corneal bed scar repair and visual acuity of the two groups were compared. Results: In the suturing group, the corneas of all 18 patients were accurately sutured to the deep stromal layer near the posterior elastic layer. The time for corneal edema resolution was 2.50 (1.00, 6.25) days in the suturing group and 7.00 (6.00, 10.50) days in the control group. The fissure healing time was 7.50 (7.00, 12.00) days in the suturing group and 14.00 (9.00, 14.00) days in the control group. The differences were statistically significant (all P<0.05). After 2 weeks, the central corneal thickness decreased to (529.80±174.50) μm in the suturing group and (612.00±205.12) μm in the control group. The suturing group showed accurate corneal suturing to the deep stromal layer near the posterior elastic layer, resulting in central corneal flattening, closure of voids in the stroma, and a significant decrease in corneal thickness. All 18 patients in the suturing group successfully completed deep lamellar keratoplasty, with 6 cases (6/18) experiencing mild graft bed leakage during surgery but without affecting the deep lamellar keratoplasty. One year postoperatively, the visual acuity (logarithm of the minimum resolution angle) was 0.23±0.12 in the suturing group and 0.33±0.11 in the control group, with a statistically significant difference (P<0.05). Conclusions: In the treatment of severe acute edematous keratoconus, precise suturing of posterior elastic layer fissures guided by intraoperative OCT, in conjunction with anterior chamber puncture and drainage, and corneal thermokeratoplasty, can rapidly alleviate corneal edema and promote the healing of posterior elastic layer fissures. This approach achieves better visual outcomes for subsequent lamellar keratoplasty surgeries. The use of intraoperative OCT guidance allows accurate positioning of the posterior elastic layer fissure in terms of location, direction, and depth of corneal stromal voids, thereby assisting surgeons in precise suturing.
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Affiliation(s)
- S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - N Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M Su
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - X Y Jiang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Zhuang XY, Gao L, Qi BX, Wang N, Zhang JY, Gao H, Shi WY, Li SX. [Analysis of factors affecting the quality of donor corneal endothelial cells]. Zhonghua Yan Ke Za Zhi 2023; 59:814-823. [PMID: 37805415 DOI: 10.3760/cma.j.cn112142-20221108-00578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To explore the factors influencing the quality of donor corneal endothelium. Methods: A retrospective case series study was conducted. Data from 568 donor corneas obtained from the Shandong Eye Bank between July 1, 2020, and June 30, 2021, were collected for analysis. The corneal endothelium of the donor corneas was observed using corneal endothelial microscopy to assess corneal endothelial cell density (ECD), coefficient of variation, and hexagonal cell ratio (HEX). Relevant factors of corneal donors were collected, including gender, age, cause of death, season of death, time from death to corneal retrieval, and methods of corpse preservation, to investigate their impact on the quality of donor corneal endothelium. The age factor was divided into five age groups: 0-20 years, 21-40 years, 41-60 years, 61-80 years, and >80 years. The time of corneal retrieval was divided into three periods based on the time elapsed since the donor's death: <6 hours, 6-12 hours, and >12 hours. The relationship between these factors and corneal endothelial conditions was analyzed. Results: The 568 donor corneas were obtained from 288 donors, including 225 males (78.13%) and 63 females (21.87%). The mean age was 51.77±18.48 years. The causes of death among donors were as follows: cardiovascular diseases 54.58% (275 individuals), cancer 17.96% (74 individuals), organ failure 14.26% (49 individuals), and accidents 13.20% (64 individuals). The mean time of corneal retrieval after donor death was 140 (76, 400) minutes (ranging from 30 minutes to 45 hours). Among the 145 corneas (25.53%) that had their initial corneal endothelial microscopy examination, the images were not clear, and after thorough rewarming, 106 corneas (18.7%) still had unclear images and could not be analyzed. Among the 462 corneas (81.3%) with clear images, the ECD was (2 602.23±318.40) cells/mm², the coefficient of variation was 36.61%±4.81%, and the HEX was 52.73%±7.15%. The ECD of corneas from older donors was lower compared to younger donors, and the differences between age groups were statistically significant (P<0.001). Corneas from donors who died due to accidents had a higher ECD [(2 829.88±313.90) cells/mm²] compared to those who died from cancer, cardiovascular diseases, and organ failure, and the differences were statistically significant (P<0.001). The ECD was highest when corneas were retrieved within 6 hours after death, and the difference was statistically significant (P<0.001). Older donors had higher coefficients of variation but lower HEX values (both P<0.05). Corneas retrieved after a longer time from death had higher coefficients of variation, and the difference was statistically significant (P<0.05), but there was no statistically significant difference in HEX (P>0.05). Organ failure, cryopreservation, and corneal retrieval time >12 hours were risk factors for unclear corneal endothelial imaging (all P<0.001). Among the 136 corneal endothelial images (23.94%), circular, oval, or band-shaped dark areas were observed, and corneas with dark areas had lower ECD (P<0.05). The longer the time elapsed from death to corneal retrieval, the more dark areas were observed (P<0.001). The presence of dark areas did not affect the coefficient of variation and HEX (P>0.05). Conclusion: Advanced donor age, death due to chronic diseases, longer time elapsed from death to corneal retrieval, and cryopreservation of the body lead to a decrease in the quality of donor corneal endothelium.
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Affiliation(s)
- X Y Zhuang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - L Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - B X Qi
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, China
| | - N Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - J Y Zhang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Wang X, Qi XL, Wang ML, Su M, Li SX, Shi WY, Gao H. [Application of intraoperative optical coherence tomography in deep lamellar keratoplasty]. Zhonghua Yan Ke Za Zhi 2023; 59:723-729. [PMID: 37670655 DOI: 10.3760/cma.j.cn112142-20230130-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Objective: To evaluate the clinical application value of intraoperative optical coherence tomography (iOCT) in deep anterior lamellar keratoplasty (DALK) using the big-bubble technique to bare Descemet's membrane. Methods: Retrospective case series. Clinical data of 92 patients (92 eyes) with monocular stromal corneal diseases who underwent big-bubble DALK in the Eye Hospital of Shandong First Medical University from January 2020 to August 2021 were collected. There were 53 males and 39 females. The average age was (53.2±16.0) years old. All patients underwent iOCT scanning to determine the location and depth of the injection needle after initial removal of the corneal lesion, to observe the integrity of the recipient bed, Descemet's membrane, after complete lesion removal, and to observe the adhesion between the corneal graft and the recipient bed and check folds on the recipient bed after suturing of the corneal graft. The intraoperative perforation of Descemet's membrane, postoperative thickness of the cornea and the recipient bed, visual acuity, and corneal astigmatism were recorded. Results: By iOCT, the thickness of the recipient bed was found to be about 1/2 of the corneal thickness and relatively uniform in all directions in 62 eyes (67.4%), so the sterile air was injected from the center of the recipient bed to separate it from the stromal layer. In 30 eyes (32.6%) with an uneven thickness of the recipient bed, the sterile air was injected from the paracentral area of the recipient bed. Under the guidance of iOCT scanning, 89 eyes (96.7%) did not experience any perforation of Descemet's membrane during surgery. The Descemet's membrane folds in the central 5-mm area of the recipient bed was observed and flattened in 20 eyes with the assistance of iOCT scanning. The postoperative corneal thickness was (578.95±108.26) μm, and the recipient bed thickness was (36.06±23.11) μm. The best corrected visual acuity of all patients at 6 months after surgery was 0.57±0.25 logMAR, which was significantly better than that before surgery (1.61±1.27 logMAR; P<0.001). The average corneal astigmatism at 6 months after surgery was (2.72±2.44) diopters. Conclusions: The application of iOCT scanning in DALK surgery assisted by the big-bubble method can provide safe guidance for surgeons to adopt correct surgical procedures, decrease the risk of Descemet's membrane perforation, reduce the recipient bed folds, and facilitate corneal interlayer adhesion, thereby improving the visual prognosis.
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Affiliation(s)
- X Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - X L Qi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M L Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M Su
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Sun D, Shi WY, Dou SQ. Single-cell RNA sequencing in cornea research: Insights into limbal stem cells and their niche regulation. World J Stem Cells 2023; 15:466-475. [PMID: 37342216 PMCID: PMC10277966 DOI: 10.4252/wjsc.v15.i5.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/28/2023] [Accepted: 04/17/2023] [Indexed: 05/26/2023] Open
Abstract
The corneal epithelium is composed of stratified squamous epithelial cells on the outer surface of the eye, which acts as a protective barrier and is critical for clear and stable vision. Its continuous renewal or wound healing depends on the proliferation and differentiation of limbal stem cells (LSCs), a cell population that resides at the limbus in a highly regulated niche. Dysfunction of LSCs or their niche can cause limbal stem cell deficiency, a disease that is manifested by failed epithelial wound healing or even blindness. Nevertheless, compared to stem cells in other tissues, little is known about the LSCs and their niche. With the advent of single-cell RNA sequencing, our understanding of LSC characteristics and their microenvironment has grown considerably. In this review, we summarized the current findings from single-cell studies in the field of cornea research and focused on important advancements driven by this technology, including the heterogeneity of the LSC population, novel LSC markers and regulation of the LSC niche, which will provide a reference for clinical issues such as corneal epithelial wound healing, ocular surface reconstruction and interventions for related diseases.
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Affiliation(s)
- Di Sun
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao 266000, Shandong Province, China
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao 266000, Shandong Province, China
| | - Wei-Yun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao 266000, Shandong Province, China
- Eye Hospital of Shandong First Medical University, Jinan 250000, Shandong Province, China
- School of Ophthalmology, Shandong First Medical University, Qingdao 266000, Shandong Province, China
| | - Sheng-Qian Dou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao 266000, Shandong Province, China
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao 266000, Shandong Province, China
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Zhang T, Wang LL, Gu JJ, Xu JJ, Chen W, Huang YF, Hong JX, Wang T, Li SX, Gao H, Wang JT, Shi WY. [A multicenter clinical trial of collar-button type keratoprosthesis implantation for the treatment of corneal blindness in high-risk transplantation]. Zhonghua Yan Ke Za Zhi 2023; 59:262-271. [PMID: 37012589 DOI: 10.3760/cma.j.cn112142-20221103-00565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Objective: To evaluate the efficiency and safety of collar-button type keratoprosthesis (c-bKPro) implantation for corneal blindness in high-risk transplantation in China. Methods: It was a case series study. High-risk corneal blind patients who planned to undergo c-bKPro implantation were prospectively and continuously enrolled in the Eye Hospital of Shandong First Medical University, Ophthalmology Division of Chinese PLA General Hospital, Zhongshan Ophthalmic Center, Department of Ophthalmology in Eye & ENT Hospital of Fudan University, and Eye Hospital of Wenzhou Medical University from July 2019 to January 2020. The cure for blindness and surgical success were assessed based on visual acuity (VA)≥0.05. The complications and keratoprosthesis retention rate were recorded to determine the safety of the surgery. Results: Thirty-seven subjects (eyes) were included, of which 32 were male and 5 were female, aged 27 to 72 years old. The indications of c-bKPro implantation were corneal graft failure (21 eyes, 56.8%), chemical injury (8 eyes, 21.6%), thermal burn (5 eyes, 13.5%), unexplained corneal opacity (2 eyes, 5.4%), and corneal perforation (1 eye, 2.7%). Two patients withdrew from the clinical trial at 3 months postoperatively. Thirty-five patients were followed up for 6 months, and 31 were followed up for 12 months. The VA was ≥0.05 in 83.8% of eyes at 6 months and in 81.8% of eyes at 12 months. Among the 11 eyes diagnosed with concurrent glaucoma, 6 eyes achieved a VA of ≥0.05. At 12 months, the c-bKPro retention rate was 100%. The surgical complications included retroprosthetic membrane formation (5 eyes, 16.1%), persistent corneal epithelial defects (5 eyes, 16.1%), macular edema (4 eyes, 12.9%), new-onset glaucoma (4 eyes, 12.5%; including one eye withdrawn from the study at 3 months), sterile corneal melting (2 eyes, 6.5%), sterile vitritis (1 eye, 3.2%), and infectious keratitis (1 eye, 3.2%). Conclusions: C-bKPro implantation is an effective and safe option for treating corneal blindness in high-risk transplantation in China. Improved visual outcomes could be achieved in most cases, with a relatively low incidence of postoperative complications.
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Affiliation(s)
- T Zhang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - L L Wang
- Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
| | - J J Gu
- Zhongshan Ophthalmic Center, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - J J Xu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - W Chen
- Eye Hospital of Wenzhou Medical University, National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China
| | - Y F Huang
- Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
| | - J X Hong
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - T Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - J T Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Liu MN, Li N, Tian G, Chen T, Lin Y, Li SX, Qi XL, Shi WY, Gao H. [Femtosecond laser-assisted minimally invasive lamellar keratoplasty for advanced keratoconus]. Zhonghua Yan Ke Za Zhi 2023; 59:288-294. [PMID: 37012592 DOI: 10.3760/cma.j.cn112142-20220517-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Objective: To evaluate the initial safety and efficacy of femtosecond laser-assisted minimally invasive lamellar keratoplasty (FL-MILK) for advanced keratoconus. Methods: It was a case series study. Patients with advanced keratoconus who underwent FL-MILK between August 2017 and April 2020 at Shandong Eye Hospital were prospectively included. The femtosecond laser was used to create an intrastromal pocket in the recipient cornea and a lamellar cornea in the donor. The lamellar cornea was then gently inserted into the intrastromal pocket through the incision and flattened. Clinical measurements included best-corrected visual acuity, 3-mm anterior corneal mean keratometry, anterior and posterior central corneal elevation, central corneal thickness, corneal biomechanics, and endothelial cell density. The follow-up was conducted at 1 month, 12 months, and 24 months after the operation. Results: There were 33 patients (35 eyes) in the study. Twenty-six patients were male and 7 patients were female. The mean age was (20.34±5.24) years old. All patients completed 12 months of follow-up, and 25 patients (27 eyes) completed 24 months of follow-up. No epithelial ingrowth, infection, or allogeneic rejection was observed. Compared with the preoperative data, the anterior central corneal elevation significantly decreased (P<0.001), the mean keratometry significantly decreased (P<0.05), and the central corneal thickness significantly increased (P<0.001). The corneal biomechanical strength was significantly improved, with the deformation amplitude ratio at 2.0 mm decreasing from 1.39±0.14 preoperatively to 1.21±0.10 at 24 months postoperatively (P<0.001) and the stiffness parameter at the first applanation increasing from 41.49±11.47 preoperatively to 88.41±18.17 at 24 months postoperatively (P<0.001). There were no significant changes in the mean best-corrected visual acuity, posterior corneal elevation, mean spherical equivalent, and endothelial cell density (all P>0.05). Conclusions: FL-MILK may be a feasible option for advanced keratoconus. This procedure may provide a new resolution for keratoconus.
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Affiliation(s)
- M N Liu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - N Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - G Tian
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - T Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - Y Lin
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - X L Qi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Gao YY, Wang T, Jiang YT, Yang MJ, Lu XH, Zheng L, Wang ST, Shi WY. Should ocular Demodex be checked and treated in refractory keratitis patients without blepharitis? Int J Ophthalmol 2023; 16:201-207. [PMID: 36816200 PMCID: PMC9922622 DOI: 10.18240/ijo.2023.02.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/27/2022] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the correlation between Demodex infestation and keratitis, and to assess demodicosis using a simple approach. METHODS A modified slit lamp illumination (at 40× magnification) was used to observe Demodex tails in 40 patients with refractory keratitis and 80 healthy controls. Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen. Tea tree oil ointment (TTOO) was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed. RESULTS Demodex tails were found in all patients compared to 42/80 of the controls (P<0.01). Seventeen patients presented blepharitis, while 23 were free of scales and inflammation at the lid margin. The demodicosis was mild, moderate, and severe in 8, 19, and 13 patients, respectively, compared to mild in 42 controls (P<0.01). The keratitis was mild, moderate, and severe in 13, 19, and 8 patients, respectively. The severity of Demodex infestation was not correlated to the severity of keratitis (P=0.126). The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment. Patients' signs and symptoms got resolved after the lid scrub with TTOO. CONCLUSION Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis. A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.
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Affiliation(s)
- Ying-Ying Gao
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ting Wang
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yu-Ting Jiang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ming-Jun Yang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiu-Hai Lu
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Ling Zheng
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Shu-Ting Wang
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Wei-Yun Shi
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
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Zhuang SQ, Mao YX, Deng FC, Luo YY, Shi WY, Li X, Cao YQ, Xu JC, Tang S. [Comparative analysis of metagenomic and 16S rDNA sequencing in gut microbiota of healthy elderly]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1618-1624. [PMID: 36372753 DOI: 10.3760/cma.j.cn112150-20211222-01177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the differences in subsequent analysis between metagenomic and 16Sr DNA sequencing in compositionally characterizing gut microbiota of healthy elderly. Methods: By using a panel study design, five monthly repeated measurements were performed among 76 healthy older people in Jinan City, Shandong Province. Their fecal samples were collected, and genomic DNA was extracted and analyzed through metagenomic and 16Sr DNA sequencing to compare the composition and diversity of gut microbiota. The correlation between species abundance and α diversity was analyzed by Pearson correlation analysis, and the correlation between species abundance and β diversity was determined by Procrustes analysis. Results: The age of 76 participants was (65.07±2.75), and the body mass index was (25.03±2.40) kg/m2. There were 38 males and 38 females. A total of 345 fecal samples were obtained from five monthly repeated measurements. Compared with 16S rDNA sequencing, metagenomic sequencing showed more annotated species at each level. The difference in the number of two sequencing species increased with the decrease of the level. Although there were significant differences in species richness between the two sequencing methods. Their species richness was highly correlated at both phylum (r=0.88, P<0.001) and genus (r=0.77, P<0.001) levels. Bacteroidetes and Firmicutes were the common dominant species. Gut microbiota diversity analysis further showed that there was a significantly positive correlation between α diversity (r=0.70, P<0.001) and β diversities (M2=0.84, P<0.05) in the two groups. Conclusion: The annotation efficiency of metagenomic sequencing is much higher than that of 16S rDNA sequencing. The two sequencing methods are consistent in phylum abundance as well as α diversity.
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Affiliation(s)
- S Q Zhuang
- Department of Epidemiology and Health Statistics, School of Public Health, Xuzhou Medical University, Xuzhou 221004, China China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y X Mao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - F C Deng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Y Luo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - W Y Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - X Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Q Cao
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - J C Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - Song Tang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Song YN, Shi WY, Chen JJ, Wang Q, Li XQ, Liu M, Cao BY, Ni X, Gong CX. [A case of ultrasound-guided microwave ablation for Graves disease]. Zhonghua Er Ke Za Zhi 2022; 60:1081-1082. [PMID: 36207860 DOI: 10.3760/cma.j.cn112140-20220301-00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Y N Song
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - W Y Shi
- Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Children's Medical Center, Beijing 100045, China
| | - J J Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Q Wang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X Q Li
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - M Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - B Y Cao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X Ni
- Department of Otolaryngology and Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Children's Medical Center, Beijing 100045, China
| | - C X Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Wang JN, Li TT, Fang JL, Tang S, Zhang Y, Deng FC, Shen C, Shi WY, Liu YY, Chen C, Sun QH, Wang YW, Du YJ, Dong HR, Shi XM. [Associations between personal fine particulate matter and blood lipid profiles: A panel study in Chinese people aged 60-69 years]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:897-901. [PMID: 35899340 DOI: 10.3760/cma.j.cn112150-20220525-00527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the association between short-term exposures to fine particulate matter (PM2.5) on blood lipids in the elderly. Methods: In this panel study, five repeated measurements were performed on 76 people aged 60-69 in Jinan city. Each participant had a PM2.5 monitor for 72 hours before each health examination, including a questionnaire survey, physical examination, and biological sample collection. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were examined, and non-HDL-C concentrations were calculated by subtracting HDL-C from TC. The generalized linear mixed-effects model was used to quantify the association of personal PM2.5 exposure at different lag with blood lipids and dyslipidemia. Results: The age of 70 participants was (65.0±2.8) years, of which 48.6% (34/70) were males. The BMI of participants was (25.0±2.5) kg/m2. Their TC, TG, LDL-C, HDL-C, and non-HDL-C concentrations were (5.75±1.32), (1.55±0.53), (3.27±0.94), (1.78±0.52), and (3.97±1.06) mmol/L, respectively. Generalized linear mixed-effects model showed that after adjusting for confounding factors, at lag 72 hours, each 10 μg/m3 increase in PM2.5 was associated with the percentage change in TC, LDL-C, HDL-C and non-HDL-C about 1.77% (95%CI: 1.22%-2.32%), 1.90% (95%CI: 1.18%-2.63%), 1.99% (95%CI: 1.37%-2.60%) and 1.74% (95%CI: 1.11%-2.37%), and the OR values (95%CI) of hypercholesterolemia, hypertriglyceridemia and hyperbetalipoproteinemia were 1.11 (1.01-1.22), 1.33 (1.03-1.71) and 1.15 (1.01-1.31), respectively. Conclusion: There is a significant association of short-term PM2.5 exposure with the concentration of blood lipids and the risk of dyslipidemia in the elderly.
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Affiliation(s)
- J N Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - T T Li
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J L Fang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - S Tang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Zhang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - F C Deng
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - C Shen
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - W Y Shi
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Y Liu
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - C Chen
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Q H Sun
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y W Wang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y J Du
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - H R Dong
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - X M Shi
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Li ZY, Chen ZL, Zhang T, Wei C, Shi WY. Correction for: TGF-β and NF-κB signaling pathway crosstalk potentiates corneal epithelial senescence through an RNA stress response. Aging (Albany NY) 2021; 13:20853. [PMID: 34483140 PMCID: PMC8436941 DOI: 10.18632/aging.203516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Zhi-Yuan Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
| | - Zhao-Li Chen
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
| | - Ting Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
- Qingdao University Medical College, Qingdao, China
| | - Chao Wei
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
| | - Wei-Yun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
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Dong QQ, Wang JG, Wang JT, Shi WY, Li SX. [Clinical characteristics and curative effect analysis of neurotrophic keratitis caused by trigeminal nerve injury]. Zhonghua Yan Ke Za Zhi 2021; 57:126-132. [PMID: 33541054 DOI: 10.3760/cma.j.cn112142-20201020-00692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Q Q Dong
- Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - J G Wang
- Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - J T Wang
- Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - W Y Shi
- Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - S X Li
- Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
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Hao XD, Chen XN, Zhang YY, Chen P, Wei C, Shi WY, Gao H. Multi-level consistent changes of the ECM pathway identified in a typical keratoconus twin's family by multi-omics analysis. Orphanet J Rare Dis 2020; 15:227. [PMID: 32867823 PMCID: PMC7457807 DOI: 10.1186/s13023-020-01512-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/13/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Keratoconus (KC) is a common, degenerative disorder of the cornea, and genetic factors play a key role in its development. However, the genetic etiology of KC is still unclear. This study used the family of twins as material, using, for the first time, multi-omics analysis, to systematically display the changes in KC candidate factors in patients at the DNA, RNA, and protein levels. These can evaluate candidate pathogenic factors in depth and lock onto pathogenic targets. RESULTS The twins in this study presented classic phenotypes, clear diagnoses, complete case data, and clinical samples, which are excellent materials for genetically studying KC. Whole-exome sequencing was conducted on both the twins and their parents. Transcriptome sequencing was conducted on proband's and health individual's primary human corneal fibroblast cells. Quantitative Real-time PCR and western blot were used to validate the differential gene expressions between the proband and controls. By integrating genomics, transcriptome, and protein level data, multiple consecutive events of KC were systematically analyzed to help better understand the molecular mechanism and genetic basis of KC. The results showed that the accumulation of rare, micro-effect risk variants was the pathogenic factor in this Chinese KC family. Consistent changes in extracellular matrices (ECMs) at the DNA and RNA levels suggested that ECM related changes play a key role in KC pathogenesis. The major gene variants (WNT16, CD248, COL6A2, COL4A3 and ADAMTS3) may affect the expression of related collagens or ECM proteins, thus reducing the amount of ECM in corneas and resulting in KC. CONCLUSIONS This study, the first to explore the genetic etiology of KC via multi-omics analysis under the polygenetic model, has provided new insights into the genetic mechanisms underlying KC and an effective strategy for studying KC pathogenesis in the future.
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Affiliation(s)
- Xiao-Dan Hao
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, 266021, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Xiu-Nian Chen
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, 266021, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Yang-Yang Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Peng Chen
- Department of Human Anatomy, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Chao Wei
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Wei-Yun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China.,Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250021, China
| | - Hua Gao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China. .,Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250021, China.
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Xie LX, Zhou QJ, Gao H, Shi WY. [Strengthening basic and clinical research on ocular infection caused by coronavirus]. Zhonghua Yan Ke Za Zhi 2020; 56:250-252. [PMID: 32306616 DOI: 10.3760/cma.j.cn112142-20200220-00091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article was published ahead of print on the official website of Chinese Jounal of Ophthalmology on February 19, 2020. The prevention and treatment of coronavirus disease 2019 (COVID-2019) has reached the critical stage in China. Ocular surface represents a possible route for infection. Based on the previous studies and our own research, we summarize the potential transmission route and clinical symptoms of COVID-2019 in the eye, as well as the further prevention and research, with the expectation of contributing to the development in the field of infectious eye disease in China. (Chin J Ophthalmol, 2020, 56:250-252).
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Affiliation(s)
- L X Xie
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China
| | - Q J Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China
| | - H Gao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China
| | - W Y Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China
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Shi WY, Guo MH, Du P, Zhang Y, Wang JN, Li TT, Lyu YB, Zhou JH, Duan J, Kang Q, Shi XM. [Association of sleep with anxiety in the elderly aged 60 years and older in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:13-19. [PMID: 32062936 DOI: 10.3760/cma.j.issn.0254-6450.2020.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China. Methods: The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety. Results: A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5% were defined with anxiety, and 18.7% reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the OR (95%CI) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the OR (95%CI) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the ORs (95%CI) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years. Conclusion: Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.
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Affiliation(s)
- W Y Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - M H Guo
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - P Du
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Zhang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J N Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - T T Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y B Lyu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J H Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Duan
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Q Kang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - X M Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Zhou JH, Wei Y, Lyu YB, Duan J, Kang Q, Wang JN, Shi WY, Yin ZX, Zhao F, Qu YL, Liu L, Liu YC, Cao ZJ, Shi XM. [Prediction of 6-year incidence risk of chronic kidney disease in the elderly aged 65 years and older in 8 longevity areas in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:42-47. [PMID: 32062941 DOI: 10.3760/cma.j.issn.0254-6450.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish a prediction model for 6-year incidence risk of chronic kidney disease (CKD) in the elderly aged 65 years and older in China. Methods: In this prospective cohort study, we used the data of 3 742 participants collected during 2008/2009-2014 and during 2012-2017/2018 from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. Two follow up surveys for renal function were successfully conducted for 1 055 participants without CKD in baseline survey. Lasso method was used for the selection of risk factors. The risk prediction model of CKD was established by using Cox proportional hazards regression models and visualized through nomogram tool. Bootstrap method (1 000 resample) was used for internal validation, and the performance of the model was assessed by C-index and calibration curve. Results: The mean age of participants was (80.8±11.4) years. In 4 797 person years of follow up, CKD was found in 262 participants (24.8%). Age, BMI, sex, education level, marital status, having retirement pension or insurance, hypertension prevalence, blood uric acid, blood urea nitrogen and total cholesterol levels and estimated glomerular filtration rate in baseline survey were used in the model to predict the 6-year incidence risk of CKD in the elderly. The corrected C-index was 0.766, the calibration curve showed good consistence between predicted probability and observed probability in high risk group, but relatively poor consistence in low risk group. Conclusion: The incidence risk prediction model of CKD established in this study has a good performance, and the nomogram can be used as visualization tool to predict the 6-year risk of CKD in the elderly aged 65 years and older in China.
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Affiliation(s)
- J H Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Wei
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Y B Lyu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Duan
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Q Kang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - J N Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - W Y Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Z X Yin
- Division of Non-communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - F Zhao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y L Qu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - L Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y C Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Z J Cao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - X M Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Jiang Y, Shi WY, Li FJ, Wang T. [Efficacy of double-incision extracapsular cataract extraction in the treatment of hard-nucleus cataract with low corneal endothelial cell density]. Zhonghua Yan Ke Za Zhi 2020; 56:126-130. [PMID: 32074823 DOI: 10.3760/cma.j.issn.0412-4081.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To discuss the efficacy and security of double-incision extracapsular cataract extraction (ECCE) in the treatment of hard-nucleus cataract with low corneal endothelial cell density. Methods: This was a retrospective case series study. Forty-six patients (47 eyes) with hard-nucleus cataract and low corneal endothelial cell density were enrolled at Shandong Eye Hospital from June 2009 to December 2018, including 22 males and 24 females, aged 50 to 74 (63.8±6.3) years. Preoperative corneal endothelial cell density was less than 1 000 cells/mm(2), and the cataract nuclear hardness was equal to or greater than grade IV. According to the surgical methods, the patients were divided into the single-incision ECCE group (24 eyes) and the double-incision ECCE group (23 eyes). The surgical procedures for the double-incision group were as follows. First, a superior scleral pre-incision was made. Then the conventional capsulorhexis was conducted through a 2.6 mm transparent corneal tunnel incision at the temporal or the nasal side, after which the hydro-dissection was performed. Next, the surgeon cut the pre-incision at the sclera, delivered the lens nucleus, sutured the scleral incision and removed the residual cortical materials from the corneal incision. Finally, a foldable intraocular lens was implanted, and the viscoelastic substance was removed. The intraoperative anterior chamber condition and the postoperative corneal edema condition were monitored. During the 6 month follow-up after surgeries, the endothelium cell density, visual acuity and astigmatism in the two groups were compared. The χ(2) test was used to compare the counting data, and the t test was used to compare the measurement data. Results: There was no statistically significant difference (t=1.12, P=0.28) in the preoperative corneal endothelial cell density between the double-incision and single-incision ECCE groups, which was (827±164) cells/mm(2) and (802±121) cells/mm(2), respectively. At 6 months after operation, in the double-incision and single-incision groups, the endothelial cell density was (793±147) cells/mm(2) and (706±101) cells/mm(2), respectively, and the difference was statistically significant (t=4.37, P<0.01). The percentage of corneal endothelial cell loss was 4.16%±3.12% and 11.69%±2.96%, respectively, and the difference was also statistically significant (t=9.52, P<0.01). The hexagon loss rate of corneal endothelial cells was 9.67%±6.11% and 28.33%±8.39%, respectively, and the difference was statistically significant (t=5.52, P<0.05). In the follow-up of 6 months, none of the eyes in the double-incision ECCE group suffered corneal endothelial decompensation compared with 3 eyes in the single-incision ECCE group. There were no statistically significant differences in postoperative astigmatism and surgically induced astigmatism between the two groups (t=-0.71, 0.15; P>0.05). Conclusions: The double-incision ECCE, in which the lens nucleus is delivered through a scleral incision and other procedures are conducted through a corneal tunnel incision, is safe and effective for cataract patients with hard nucleus and low corneal endothelial cell density. (Chin J Ophthalmol, 2020, 56: 126-130).
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Affiliation(s)
- Y Jiang
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China (Jiang Yin is now working at Department of Ophthalmology, Anqing Hospital, Anqing 246004, China)
| | - W Y Shi
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - F J Li
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - T Wang
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
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Wang Y, Shi WY, Li Y. [The rapid development and changes of corneal refractive surgery in China]. Zhonghua Yan Ke Za Zhi 2020; 56:81-85. [PMID: 32074816 DOI: 10.3760/cma.j.issn.0412-4081.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Corneal refractive surgery in China, represented by laser corneal surgery, has undergone great changes in recent 30 years. Almost one million corneal refractive surgeries are performed each year. With the rapid technological innovation, the corrective effect is constantly higher, and complications are continuously controlled and reduced. The team of practitioners keeps expanding, and the academic strength is approaching the international level. With the application and promotion of various new technologies, the formulation of relevant norms and the increase of academic researches, corneal refractive surgery in China has stepped into the stage of diversification, intelligence and standardization. However, we should recognize the shortcomings while facing the great achievements. More efforts are still needed to provide the best visual quality and natural vision correction effect for patients. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. (Chin J Ophthalmol, 2020, 56: 81-85).
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Affiliation(s)
- Y Wang
- Tianjin Eye Hospital, Tianjin Key Lab. of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Institute, Tianjin 300020, China
| | - W Y Shi
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
| | - Y Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Kang Q, Lyu YB, Wei Y, Shi WY, Duan J, Zhou JH, Wang JN, Zhao F, Qu YL, Liu L, Liu YC, Cao ZJ, Yu Q, Shi XM. [Influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:20-24. [PMID: 32062937 DOI: 10.3760/cma.j.issn.0254-6450.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China. Methods: We recruited 2 180 participants aged 65 years and older in 8 longevity areas from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey in 2017. Multivariate logistic regression analysis was performed to evaluate the relationships of socio-demographic characteristics, behavioral lifestyle, chronic disease prevalence, functional status, family and social support with depressive symptoms in the elderly. Results: The detection rate of depression symptoms was 15.0% in the elderly aged 65 years and older in 8 longevity areas of China, and the detection rate of depression symptoms was 11.5% in men and 18.5% in women. Multivariate logistic regression analysis results showed that the detection rate of depressive symptoms was lower in the elderly who had regular physical exercises (OR=0.44, 95%CI: 0.26-0.74), frequent fish intakes (OR=0.57, 95%CI: 0.39-0.83), recreational activities (OR=0.65, 95%CI: 0.44-0.96), social activities (OR=0.28, 95%CI: 0.11-0.73) and community services (OR=0.68, 95%CI: 0.50-0.93). The elderly who were lack of sleep (OR=2.04, 95%CI: 1.49-2.80), had visual impairment (OR=1.54, 95%CI: 1.08-2.18), had gastrointestinal ulcer (OR=2.97, 95%CI: 1.53-5.77), had arthritis (OR=2.63, 95%CI: 1.61-4.32), had higher family expenditure than income (OR=1.80, 95%CI: 1.17-2.78) and were in poor economic condition (OR=4.58, 95%CI: 2.48-8.47) had higher detection rate of depressive symptoms. Conclusion: The status of doing physical exercise, fish intake in diet, social activity participation, sleep quality or vision, and the prevalence of gastrointestinal ulcers and arthritis were associated with the detection rate of depressive symptoms in the elderly.
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Affiliation(s)
- Q Kang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Y B Lyu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y Wei
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - W Y Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Duan
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - J H Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J N Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - F Zhao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y L Qu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - L Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y C Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Z J Cao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - X M Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Abstract
With the growth of the global population and the acceleration of the aging process, the situation of blindness all over the world is increasingly severe. According to the latest data published by the Vision Loss Expert Group in 2017, there were an estimated 36 million blind people worldwide in 2015. The 66(th) World Health Assembly has endorsed the "Universal eye health: a global action plan 2014-2019" , which aims to reduce the prevalence of avoidable visual impairment by 25% by 2019 from the baseline of 2010. As a country with the largest number of blind people in the world, China has an arduous task of preventing and treating eye diseases.This review article summarizes and analyzes the relevant literature on the prevalence of blindness, the main blinding diseases and prevention measures in China, so as to provide reference materials for ophthalmologists to better carry out eye health work and reduce the number of blind people in China. (Chin J Ophthalmol, 2019, 55:625-628).
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Affiliation(s)
- H Gao
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University Shandong Academy of Medical Sciences, Jinan 250021, China
| | - X N Chen
- Medical College, Qingdao University, Qingdao 266071, China
| | - W Y Shi
- Shandong Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University Shandong Academy of Medical Sciences, Jinan 250021, China
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Zhang J, Qi XL, Li J, Kong LY, Wang YN, Liu MN, Shi WY, Gao H. [Therapeutic effect of rigid permeable contact lenses on irregular astigmatism after keratoplasty]. Zhonghua Yan Ke Za Zhi 2019; 55:413-418. [PMID: 31189270 DOI: 10.3760/cma.j.issn.0412-4081.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the clinical effect of rigid permeable contact lenses (RGPCL) in the correction of irregular astigmatism after keratoplasty. Methods: Retrospective case study. From June 2012 to December 2016, 31 patients (37 eyes) who underwent corneal transplantation were tested and fitted with RGPCL. The patients' data of primary disease, interval from keratoplasty to contact lens fitting, uncorrected visual acuity, best spectacle-corrected visual acuity, best RGPCL-corrected visual acuity, contrast visual acuity before and after RGPCL wear, corneal topography and corneal endothelium parameters before and after RGPCL wear were collected, including ocular complications and comfort of contact lenses. Results: Among the 31 patients, 24 were male and 7 were female, with age of (31.3±5.8) years. The mean interval between grafting and initial contact lens fitting was (4.6±2.3) years. Uncorrected visual acuity, best spectacle-corrected visual acuity, and best RGPCL-corrected visual acuity were 0.81±0.21, 0.54±0.13, and 0.10±0.07, respectively (t=7.170, 16.617, 17.866; all P<0.05). The average astigmatism was -5.76±2.23 D and -0.83±0.47 D before and after wearing RGPCL (t=8.531, P<0.05). After wearing RGPCL, the contrast visual acuity of 100%, 25%, 10%, and 5% was increased from 0.95±0.33, 1.18±0.21, 1.40±0.00, and 1.40±0.00 to 0.12±0.15, 0.37±0.17, 0.65±0.25, and 0.96±0.29, respectively (t=5.972, 8.473, 9.243, 5.104; all P<0. 05). There were no obvious changes of corneal endothelium parameters during the observation period. No obvious corneal allograft rejection or other complications occurred, and 94.6% (35/37) of the patients felt comfortable with wearing RGPCL. Conclusions: RGPCL wear is safe and effective in correcting irregular astigmatism after corneal transplantation. We can obtain good corrected vision and improve contrast visual acuity, especially for patients who can not wear spectacles. (Chin J Ophthalmol, 2019, 55: 413-418).
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Affiliation(s)
- J Zhang
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China
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Lyu YB, Zhou JH, Duan J, Wang JN, Shi WY, Yin ZX, Shi WH, Mao C, Shi XM. [Association of plasma albumin and hypersensitive C-reactive protein with 5-year all-cause mortality among Chinese older adults aged 65 and older from 8 longevity areas in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:590-596. [PMID: 31177756 DOI: 10.3760/cma.j.issn.0253-9624.2019.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To investigate the relationship of plasma albumin and hypersensitive C-reactive protein (Hs-CRP) with 5-year all-cause mortality among Chinese older adults aged 65 and older. Method: Data was collected in 8 longevity areas of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) study conducted by Chinese Center for Disease Control and Prevention and Peking University at baseline survey in 2012 and 2014, the participants enrolled in 2012 was followed-up in 2014 and 2017, the participants enrolled in 2014 was followed-up in 2017 only. Finally, 3 118 older adults aged 65 and older with complete information on albumin, Hs-CRP and body mass index (BMI) were included in this study. Plasma samples of older adults were collected for the detection of albumin and Hs-CRP at baseline survey. Survival status and follow-up time was recorded for all participants. All older adults were divided into 4 groups according to the levels of plasma albumin and Hs-CRP, and Cox proportional hazard models were constructed to assess their influence on the risk of all-cause mortality. Results: Among 3 118 older adults included, the prevalence of hypoalbuminemia was 10.1% (316/3 118), and was 22.8% (711/3 118) for elevated Hs-CRP. During 10 132 person-years of follow-up, 1 212 participants died. Participants with hypoalbuminemia had increased risk of all-cause mortality, with an hazard ratio (HR) and 95% confidential interval (CI) of 1.18 (1.01-1.38), compared to participants with normal plasma albuminemia; participants with elevated Hs-CRP had increased risk of all-cause mortality, with an HR (95%CI) of 1.18 (1.04-1.35), compared to participants with normal plasma Hs-CRP. Participants with normal plasma albumin and elevated Hs-CRP, with hypoalbuminemia and normal Hs-CRP, with hypoalbuminemia and elevated Hs-CRP also had increased risk of all-cause mortality when compared to those with normal plasma albumin and normal Hs-CRP, the HR (95%CI) were 1.16 (1.01-1.34), 1.11 (0.91-1.37) and 1.43 (1.11-1.83), respectively. Conclusion: Hypoalbuminemia and elevated Hs-CRP were responsible for increased risk of 5-year all-cause mortality among Chinese older adults from 8 longevity areas.
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Affiliation(s)
- Y B Lyu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J H Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Duan
- School of Public Health, Anhui Medical University, Hefei 230032, China
| | - J N Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - W Y Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Z X Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W H Shi
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - C Mao
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - X M Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Shi WY, Li KJ, Li Q. [Analysis of risk factors for recurrent sudden sensorineural hearing loss]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:976-978. [PMID: 29986557 DOI: 10.13201/j.issn.1001-1781.2018.13.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Indexed: 11/12/2022]
Abstract
Objective:To analyze the factors that may affect the recurrence of sudden sensorineural hearing loss (SSNHL).Method:We retrospectively analyzed the data of 665 SSNHL patients admitted to our hospital from January 2006 to December 2016, among which 12 patients were recurrent. The possible factors that may affect the recurrence of SSNHL were analyzed by Logistic regression analysis.Result: Hyperlipidemia might be one of the factors that caused the recurrence of SSNHL (Odds ratio 54.943,P=0.000). History of radiotherapy might be another factor that caused the recurrence of SSNHL (Odds ratio 64.100,P=0.000).Conclusion:Hyperlipidemia and the history of radiotherapy of head and neck might be risk factors for the recurrence of SSNHL.
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Affiliation(s)
- W Y Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, 510515,China
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Li L, Dong YL, Liu T, Luo D, Wei C, Shi WY. Increased succinate receptor GPR91 involved in the pathogenesis of Mooren's ulcer. Int J Ophthalmol 2018; 11:1733-1740. [PMID: 30450301 DOI: 10.18240/ijo.2018.11.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 09/07/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the expression of succinate receptor GPR91 and its pathogenic roles in Mooren's ulcer (MU). METHODS Biopsy specimens were obtained from 7 patients with MU and 6 healthy donors. The expression of GPR91 in MU tissues was evaluated using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). Succinate was used to activate GPR91 signaling, and the effect of GPR91 on the expression of interleukin-1β (IL-1β), NLRP3, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-13 (MMP-13) in human peripheral blood mononuclear cells (PBMCs) was determined. The influence of GPR91 on the nuclear factor-κB (NF-κB) signaling in PBMCs was investigated by detecting the phosphorylation of p65. Moreover, the expression of IL-1β, VEGF, MMP-13 and phosphorylated p65 (p-p65) in the tissues of MU was examined by qRT-PCR or IHC. RESULTS GPR91 mRNA expression showed a higher level in the MU group than in the healthy control group. IHC analysis also revealed that the expression of GPR91 was elevated in patients with MU compared with healthy controls. Moreover, ligation of GPR91 with succinate promoted the lipopolysaccharide-induced production of NLRP3, IL-1β, VEGF and MMP-13 in PBMCs through increased phosphorylation of p65. Pharmacological inhibition of the NF-κB signaling reversed GPR91 induced production of NLRP3, IL-1β, VEGF and MMP-13. These findings, coupled with the elevated amounts of IL-1β, VEGF, MMP-13 and p-p65 observed in the MU biopsies, constituted a rational basis for the involvement of GPR91 in the pathogenesis of MU. CONCLUSION This study indicates the increased succinate receptor GPR91 in conjunctival or corneal tissues is involved in the pathogenesis of MU through elevated NF-κB activity, which may provide a new therapeutic target for MU.
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Affiliation(s)
- Lin Li
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250022, Shandong Province, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yan-Ling Dong
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Dan Luo
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Chao Wei
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Wei-Yun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
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Li JJ, Li YF, Li Q, Liu XL, Liu YL, Shi WY, Liu R. [Effect of a self-createdquestionnaire to the history collection of patients with vertigo or dizziness]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:831-835. [PMID: 29921052 DOI: 10.13201/j.issn.1001-1781.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Indexed: 11/12/2022]
Abstract
Objective: To develop a self-designed questionnaire for history collection of patients with vertigo or dizziness, and to analyze its effect to clinical work.Method: An observational study was conducted to collect 69 patients who had undergone vestibular function tests in our department with main complaints of " dizziness and dizziness".Information was extracted from the questionnaires filled by patients themselves and the inpatient medical records wrote by doctors.The differences in ability to reflect clinically important information was investigated between the questionnaire and medical record.Result:Questionnaire is more comprehensive and meticulous for history collection. It is better than inpatient medical documents. It contains character of vertigo, duration, frequency of attack, time of onset, inducing and aggravating factors, relation with position and posture, concomitant symptoms, ear condition, vision, headache, conditions of other systems, consciousness, medication, VAS score of instability, previous history, personal history, family history, and positive results of examinations.It has a better detection rate in terms of vertigo frequency, duration, suspicious otolith or not, and vestibular compensation than that of inpatient medical record (P<0.05).Conclusion: This self-designed questionnaire can help doctors to collect medical history of patients with vertigo or dizziness.It is worthy of clinical promotion as an important supplement for inpatient and outpatient medical records.
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Affiliation(s)
- J J Li
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Y F Li
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Q Li
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - X L Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Y L Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - W Y Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - R Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
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Shi WY, Ban J, Li TT, Shi XM. [A review on the research progress related to ambient air pollution and depression]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:245-248. [PMID: 29495214 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is reported that depression has caused heavy disease burden across the world, with an possible association between ambient air pollution and depressive symptoms. In this paper, we reviewed relative literature in this field and summarized the research events on association between ambient air pollution and depression, both in China and abroad and found that the results of the existed studies were inconsistent, with most studies showing that there existed a positive correlation between the exposure of air pollution and depression, but few studies showing the negative correlation or no correlation between the two.
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Affiliation(s)
- W Y Shi
- Department of Environmental Health Risk Assessment, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Ban
- Department of Environmental Health Risk Assessment, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - T T Li
- Department of Environmental Health Risk Assessment, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - X M Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Liang L, Shi WY. The effects of FK506 combined with natamycin in the treatment of experimental fungal keratitis by suppressing NLRP3 inflammasome activation. EUR J INFLAMM 2017. [DOI: 10.1177/1721727x17740305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the mechanisms of combination treatment with FK506 and natamycin on alleviating damage of the cornea in mouse model of fungal keratitis. In this study, the mouse model of fungal keratitis was created by intrastromal injection with Fusarium solani or Aspergillus flavus. The mice received 5% natamycin eye drops 6–8 times a day, or the mice received 0.05% FK506 eye drops 2 times per day for 21 consecutive days. Corneal damage was evaluated by H&E staining. The protein expression levels of NLRP3 were detected by immunohistochemistry. Moreover, the markers of inflammasome activation including NLRP3, ASC, caspase-1, IL-1β, and IL-18 were detected by western blot. Histopathological results showed increased corneal thickening, dense inflammatory cell infiltration, and loss of epithelial continuity in the corneas after fungal infection. In addition, NLRP3 positive signals were observed to be obviously increased in the corneas after A. flavus or F. solani infection compared to the control group. Furthermore, the NLRP3 inflammasome is induced by fungal infection, as evidenced by increased protein expression levels of NLRP3, ASC, caspase-1, and downstream cytokines, such as interleukin (IL)-1β and IL-18. However, the corneal damage was alleviated and the activation of the NLRP3 inflammasome was significantly inhibited by drug treatment. Besides, the treatment outcomes were better in combined treatment group than that in single-agent treatment group. In conclusion, FK506 combined with natamycin alleviate fungi-induced corneal damage by suppressing NLRP3 inflammasome activation.
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Affiliation(s)
- Li Liang
- Shandong University, Jinan, China
- Department of Ophthalmology, Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Wei-Yun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan, China
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Li Q, Shi WY, Chang Q, Wang JJ, Zhou BF, Lin X. [Effects of exogenous brain-derived neurotrophic factor on the morphology and function of cochlea in the animal model of hereditary hearing loss]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1347-1351. [PMID: 29798229 DOI: 10.13201/j.issn.1001-1781.2017.17.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Indexed: 11/12/2022]
Abstract
Objective:To study the effect of early administration exogenous BDNF on the morphology and function of conditional knockout Cx26 mice cochlea.Method:Conditional knockout Cx26 mice was chosen as animal model, early after birth (P0-P2) exogenous BDNF (rAAV mediated BDNF plasmid, AAV-BDNF) was injected through scala media. Expression of BDNF in the cochlea was observed by western-blot, the growth promoting effect of nerve fibers was detected by IHC; 2 m after injection, the protective effect of BDNF on corti and spiral ganglion cells were detected by resin section; animal hearing were tested by ABR.Result:①Exogenous BDNF could be well expressed in the inner ear; ②Exogenous BDNF has a good effect on the growth of cochlea nerve fiber; ③Exogenous BDNF could protect the morphology of organ of corti; to count the number of spiral ganglion cells, using the density value of top-turn in non-injected ear as the standard unit, the values of middle and basal turn in injected ear were 0.81±0.02, 0.65±0.02, compared with non-injected ears, both statistically significant difference could be found, indicates that exogenous BDNF can effectively improve the number of spiral ganglion cells. ④By calculating the ABR threshold of different frequencies of the injected and non-injected ear, there was no statistical difference between them. Indicates that exogenous BDNF has no effect on improving the function of cochlea.Conclusion:The protective effect of early administration exogenous BDNF was effective in the cochlea and spiral ganglion cells of conditional knockout Cx26 mice, but no protective effect for auditory function.
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Affiliation(s)
- Q Li
- Department of Otolaryngologyb-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - W Y Shi
- Department of Otolaryngologyb-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Q Chang
- Department of Otolaryngology, Emory University School of Medicine
| | - J J Wang
- Department of Otolaryngology, Emory University School of Medicine
| | - B F Zhou
- Department of Otolaryngology, Emory University School of Medicine
| | - X Lin
- Department of Otolaryngology, Emory University School of Medicine
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Xiang DM, Wang YX, Jia YN, Li SX, Zhai HL, Shi WY, Gao H. [The observation of tacrolimus eye drops preventing the early immunological rejection after penetrating keratoplasty for fungal keratitis]. Zhonghua Yan Ke Za Zhi 2017; 53:305-310. [PMID: 28412805 DOI: 10.3760/cma.j.issn.0412-4081.2017.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the early immunological rejection prevention effect of tacrolimus eye drops combined with glucocorticoids on fungal keratitis patients who received penetrating keratoplasty (PKP). Methods: In a retrospective case series study, medical records of fungal keratitis patients who received PKP in Shandong Eye Institute from March 2013 to December 2015 were reviewed. Twenty-six patients (26 eyes) were given tacrolimus eye drops, and 24 patients (24 eyes) were given 1% cyclosporine A eye drops immediately after PKP. Two weeks after PKP, these patients were given low concentration of glucocorticoids if no fungal recurrence was found. Immune rejection, fungal recurrence, intraocular pressure, and drug irritation symptoms were monitored. Data were analyzed by chi-square test and independent t-test. Results: The average follow-up was 7 months (range, 3 to 12 months) postoperatively. The rejection rate was 15.3% in the tacrolimus group and 47.8% in the cyclosporine A group (χ(2)=5.510, P<0.05). One patient in the tacrolimus group and two patients in the cyclosporine A group suffered fungal recurrence. Two patients in the tacrolimus group and four patients in the cyclosporine A group had secondary glaucoma. The intraocular pressure was controlled. Three patients receiving tacrolimus eye drops and 13 patients receiving cyclosporine A eye drops had mild irritation symptoms. Conclusions: Tacrolimus eye drops combined with low concentration of glucocorticoids can prevent the early immunological rejection after PKP for fungalkeratitis effectively and safely. (Chin J Ophthalmol, 2017, 53:305-310).
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Affiliation(s)
- D M Xiang
- The Medical College of Qingdao University, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China
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Song JH, He X, Lou WS, Chen L, Chen GP, Su HB, Shi WY, Wang T, Zhao BX, Gu JP. [Application of percutaneous AngioJet thrombectomy in patients with acute symptomatic portal and superior mesenteric venous thrombosis]. Zhonghua Yi Xue Za Zhi 2017; 97:991-995. [PMID: 28395416 DOI: 10.3760/cma.j.issn.0376-2491.2017.13.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV). The venogram demonstrated the thrombosis in the PV/SMV and a 6-F AngioJet Xpeeedior catheter was advanced over the guidewire and positioned in the distal SMV. Percutaneous thrombectomy was performed after a mixture of 250 000 U of urokinase in 100 ml of normal saline for mechanical pulse spray of thrombus in all patients for approximately 15 minutes. 2 patients underwent PTA and stent implantation after the thrombectomy procedure, 1 of them and the others 6 patients received continuous transcatheter infusion of urokinase (500 000 U/d) for 24 or 48 hours until the thrombosis was completely dissolved confirmed by angiography at 24 and 48 hours.After procedure and the thrombolytic therapy was discontinued, removal of the infusion catheter and the sheath from the liver, the transhepatic tract was embolized with coils or gelfoam to reduce the risk of bleeding. The patency rate of PV /SMV was assessed by CTA at 1 and 6 months after the procedure. Patients were discharged with oral anticoagulation regimen for at least 6 months.The following criteria were used in evaluation of thrombolysis: grade Ⅰ<50% thrombus removal; grade Ⅱ 50%~90% thrombus removal, and grade Ⅲ>90% thrombus removal. Results: All 8 patients with PVMVT were treated by AngioJet thrombectomy. Angiography after the thrombectomy procedure showed complete thrombus removal (>90%) was in 3 cases, substantial thrombus removal (50%~90%) in 5 cases. Grade Ⅲ (complete) thrombolysis was achieved in 7 cases and grade Ⅱ (50%~90%) lysis in 1 case post thrombolytic therapy for 24 or 48 hours. 2 patients had underwent PTA and stent implantation. Large volume intraperitoneal hemorrhage was discovered in 1 patient after removal of the catheter and sheath from the liver. The patient restored stability after a blood transfusion.Venous patency was comfirmed in all 8 patients at 1 or 6 months after the treatment. There was no patient with major complications death related to the procedure. Conclusion: Percutaneous AngioJet thrombectomy with adjunctive thrombolytic therapy is an effective and safe treatment modality in patients with acute symptomatic PVMVT.
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Affiliation(s)
- J H Song
- Department of Interventional Radiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China
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Shi WY. [Concerns on the diagnosis and treatment of corneal epitheliopathy]. Zhonghua Yan Ke Za Zhi 2017; 53:161-163. [PMID: 28316188 DOI: 10.3760/cma.j.issn.0412-4081.2017.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Corneal epitheliopathy is a commonly seen disease in the clinical work. However, due to its complicated causes, there remain misdiagnosis and mistreatment, which would aggravate epithelial keratopathy and induce corneal scars, eventually leading to irreversible visual impairment. In this article, the primary and secondary causes of corneal epithelial lesions are described in detail. The classification, diagnosis and treatment principles of the disease are also presented to arouse more concern about corneal epitheliopathy. (Chin J Ophthalmol, 2017, 53: 161-163).
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Affiliation(s)
- W Y Shi
- Shandong Eye Hospital, Shandong Eye Institute, Jinan 250021, China
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Chen GP, Gu JP, He X, Lou WS, Wang Y, Chen L, Su HB, Shi WY, Wang T. [Efficacy comparison of interventional treatment by anterograde or retrograde catheterization for acute lower extremity deep venous thrombosis]. Zhonghua Yi Xue Za Zhi 2017; 97:353-358. [PMID: 28219192 DOI: 10.3760/cma.j.issn.0376-2491.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the clinical efficacy differences between anterograde and retrograde catheterization interventional treatment for acute low extremity deep venous thrombosis(DVT). Methods: The clinical data of 217 patients with acute low extremity DVT between January 2009 and December 2014 were analyzed retrospectively. Group A: 67 patients underwent treated with anterograde catheterization interventional treatment. Group B: 150 patients underwent treated with retrograde catheterization interventional treatment. The degree of thrombolysis in different anatomical sites, clinical effective rate, femoral-popliteal vein valve reflux and the incidence of post-thrombotic syndrome(PTS) were all analyzed. Results: There were no statistical differences in the degree of thrombolysis (≥50%) of common iliac vein, external iliac vein and common femoral vein between group A (83.6%, 88.1%, 91.0%)and B (80.7%, 82.0%, 88.0%)(all P>0.05). The degree of thrombolysis (≥50%) of superficial femoral vein in group A(94.0%) was significantly higher than that of group B (75.3%)(P=0.001). There was no significantly difference in the clinical effective rate at discharged between group A (80.6%) and B(76.7%)( P=0.519). During follow-up of 44±15 months, There was no statistical difference in the patency rate of the iliofemoral vein, the valvular regurgitation of patent femoropopliteal vein and the incidence of PTS between group A(70.2%, 25.4%, 35.8%) and B (60.0%, 31.5%, 40.0%)(all P>0.05). The incidence of PTS in patients with iliofemoral vein patency(13.1%) was significantly lower than that in patients with iliofemoral vein occlusion (82.5%)(P<0.01). Conclusions: The anterograde or retrograde catheterization interventional treatment can be used for treating acute low extremity DVT and get comparable clinical effect.The retrograde catheterization does not increase venous valve damage. The recovery of iliofemoral vein lumen patency is the main task in the treatment of DVT and can significantly reduce the incidence of PTS.
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Affiliation(s)
- G P Chen
- Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
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Lu JY, Gu JP, Xu WJ, Lou WS, Shi WY, Wang T, Shao ZF. [Clinical application and prognostic analysis of interventional treatment for cesarean scar pregnancy]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:1012-1018. [PMID: 27987506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To analyze the clinical value and prognosis of cesarean scar pregnancy (CSP) treated by uterine artery embolization (UAE). METHODS In the study, 492 cases of patients in Nanjing Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University diagnosed as CSP between January 2011 and December 2014 were chosen, of which 283 were of high-risk group and 209 of low-risk group. According to whether to take UAE, the high-risk group was subdivided into high-risk UAE group(UAE+laparoscopic group), 167 cases, and high-risk non UAE group (chemotherapy+laparoscopic group), 116 cases, while the low-risk group was subdivided into low-risk UAE group (UAE+curettage group), 113 cases, and low-risk non UAE group(chemotherapy+curettage group), 96 cases. The differences of the intraoperative bleeding, length of stay, blood beta human chorionic gonadotropin (β-HCG) dropped to normal time, menstruation recovery time and the hospitalization expenses were compared. And multivariate regression analysis was used to predict the recurrence risk of CSP. RESULTS The high-risk UAE group was better than the high-risk non UAE group in comparison of intraoperative bleeding [(36.5±14.8) mL vs.(76.5±39.7) mL], length of stay [(5.9±0.9) d vs.(9.6±1.3) d], blood β-HCG dropped to normal time [(17.9±8.7) d vs.(28.7±10.1) d] and menstruation recovery time [(18.1±1.6) d vs.(24.3±1.8) d],while the low-risk UAE group was better than the low-risk non UAE group in comparison of intraoperative bleeding [(93.2±43.3) mL vs.(284.8±110.5) mL], length of stay [(10.2±1.4) d vs. (30.7±9.6) d], blood β-HCG dropped to normal time [(50.1±17.6)d vs.(67.5±22.9)d] and menstruation recovery time[(56.3±6.7)d vs.(65.9±9.3) d], all P<0.05. The high-risk UAE group was higher than the high-risk non UAE group in comparison of hospitalization expenses [(20 140±1 520 )Yuan vs.(13 510±1 013) Yuan], and the low-risk group UAE was also higher than the low-risk non UAE group in comparison of hospitalization expenses [(10 095±962 )Yuan vs.(3 890±457) Yuan], all P<0.01. Multivariate Logistic regression analysis showed that the treatment method was independent predictor of CSP recurrence risk (OR 2.407, 95%CI 1.176-5.092, P<0.05), and using the comprehensive treatment including UAE could reduce the risk of recurrent CSP. CONCLUSION As the efficacy of interventional therapy for CSP was rapid and reliable, fewer complications, faster recovery and lower recurrence, hospitalization with good conditions, and particularly for those patients with CSP who want to fertility again, the comprehensive treatment including UAE treatment should be the first choice.
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Affiliation(s)
- J Y Lu
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China; Department of Interventional Radiology, Nanjing Maternity and Child Health Hospital,Nanjing Medical University, Nanjing 210004,China
| | - J P Gu
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China
| | - W J Xu
- Department of Interventional Radiology, Nanjing Maternity and Child Health Hospital,Nanjing Medical University, Nanjing 210004,China
| | - W S Lou
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China
| | - W Y Shi
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China
| | - T Wang
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China
| | - Z F Shao
- Department of Interventional Radiology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China
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Yu T, Shi WY, Song AP, Gao Y, Dang GF, Ding G. Changes of meibomian glands in patients with type 2 diabetes mellitus. Int J Ophthalmol 2016; 9:1740-1744. [PMID: 28003972 DOI: 10.18240/ijo.2016.12.06] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/19/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus (DM). METHODS Of 118 eyes (118 patients) with type 2 DM (DM group) and 100 eyes of 100 control subjects (control group) were enrolled. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NI-BUT) and the structure of the meibomian glands (MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0 (no loss) to grade 3 (lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy (LSCM). The primary outcomes were meibomian gland acinar unit density (MGAUD), meibomian gland acinar longest diameter (MGALD) and meibomian gland acinar shortest diameter (MGASD). RESULTS Compared with control group, the OSDI was significantly higher in DM group (Z=-5.916; P<0.001), while the NI-BUT was significantly lower (Z=-7.765; P<0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group (Z=-3.937; P<0.001). LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group (Z=-10.120, -9.4442, -7.771; P<0.001). CONCLUSION Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye. Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.
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Affiliation(s)
- Tao Yu
- Qingdao University, Qingdao 266071, Shandong Province, China; Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Wei-Yun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Jinan 250021, Shandong Province, China
| | - Ai-Ping Song
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Yang Gao
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Guang-Fu Dang
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Gang Ding
- Jinan Second People's Hospital, Jinan 250012, Shandong Province, China
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Xin M, Gong YR, Jiang SH, Dai CH, Li SX, Shi WY. Preoperative evaluation and outcome of corneal transplantation for limbal dermoids: a ten-year follow-up study. Int J Ophthalmol 2016; 9:1756-1760. [PMID: 28003975 DOI: 10.18240/ijo.2016.12.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/05/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To summarize preoperative evaluation and outcome of corneal transplantation for limbal dermoids for ten years. METHODS Eighty-five patients diagnosed with limbal dermoids and treated with corneal transplantation were analyzed retrospectively. All patients were further divided into two groups according to absence or presence of neovascularization surrounding the dermoids in the corneal stroma. Eighty-two eyes were treated with tumor excision combined with partial lamellar sclerokeratoplasty, and the other three eyes were performed by penetrating keratoplasty. The size and location of the tumor, the associated ocular and systemic anomalies, the depth of the corneal penetration of tumor tissues, the preoperative and postoperative best-corrected visual acuity (BCVA), graft survival and cosmetic outcome, and surgical complications were recorded respectively. RESULTS The average age at surgery was 5.3y (range, 3mo-36y). The mean size of dermoids was 6.1±1.6 mm. The 43.5% of eyes (37/85) were present with hair at the surface of the dermoid and 72.9% of dermoids were located inferotemporal of the eye. Amplyopia was present in 34.1% of patients (29/85) and 9.4% of patients (8/85) had lipodermoids. Eighteen patients suffered from Goldenhar's syndrome with an accessory ear. The 75% of patients in group 1 had involvement of the corneal deep stroma down to Descemet's membrane without involving it, but 71.4% of patients had Descemet's membrane involvement in group 2. Preoperative BCVA ranged from counting fingers to 20/20. Postoperatively 81.1% had a BCVA of 20/800 or better. There was no significant difference between the post-surgical BCVA of the two groups (t=1.584, P>0.05). The grafts of 70.5% patients were present as 1+ opacity, 21.1% as 2+ opacity, 8.2% as 3+ opacity and none as 4+ opacity. Surgical complications included graft rejection, microperforation, prolonged reepithelialization, steroid glaucoma, interface neovascularization, and interface hemorrhage. CONCLUSION The dermoids with neovascularization surrounding them in the corneal stroma invaded deeper tissues in the cornea than those with no neovascularization surrounding them in the corneal stroma. Therefore, surgeons should take care to avoid corneal perforation during the corneal transplantation operation. The majority of patients markedly improved their cosmetic appearance after surgery.
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Affiliation(s)
- Meng Xin
- Shandong University, Jinan 250012, Shandong Province, China; Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Yue-Rong Gong
- Department of Ophthalmology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Shan-Hao Jiang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Chun-Hua Dai
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Su-Xia Li
- Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China
| | - Wei-Yun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China
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Shi WY, Hu MX, Zhu Q, Xia CX, Zhao Y, Zhou YJ, Fang YQ, Rong XX. [Study of ultrasonographic features in predicting reginal lymph node metastasis in patients with papillary thyroid carcinoma]. Zhonghua Yi Xue Za Zhi 2016; 96:2165-8. [PMID: 27464542 DOI: 10.3760/cma.j.issn.0376-2491.2016.27.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To demonstrate the ultrasonographic features of papillary thyroid carcinoma (PTC) in predicting associated cervical lymph nodes metastasis (LNM). METHODS A total of 136 patients diagnosed with PTC in Beijing Tongren Hospital between January 2014 and September 2014 were enrolled.Of 136 cases, forty patients were confirmed with cervical lymph node metastasis.Seven were males, 33 were females, aged from 18 to 65 years old, mean age was (39.6±10.3) years .The remaining 96 were reported without lymph node metastasis.Twenty-one were males, 75 were females, aged from 23 to 86 years old, mean age was (47.7±12.8) years.Medical record was reviewed for demographic characteristics and pathological findings.The ultrasonographic features of each case were evaluated retrospectively.The difference of ultrasonographic features between the patients with and without LNM was examined. RESULTS There were 178 PTCs confirmed with pathology, 159 lesions (89.3%) were detected by ultrasonography, the remaining 19 lesions (10.7%) were under-detected.Of 136 patients with PTC, 40 cases (40/136, 29.4%) were confirmed with cervical LNM, while the remaining 96 cases (96/136, 70.6%) were determined without cervical LNM.PTC with cervical LNM was more frequently seen in the patients who were younger (P=0.000 5) and presenting with multifocal tumors (P=0.014 6). Ultrasonographic features of PTC which significantly associated with LNM were ill-defined margins (P=0.018), solid appearance (P=0.003), and presence of calcification (P=0.000). Of 40 cases with LNM, central cervical LNM was seen in 32 cases (80%), 72.5% of whom appeared as unilateral distribution. CONCLUSIONS Patients diagnosed with PTC with younger age and identified with multiple foci of tumors at the time of diagnosis are in an increased risk of associated cervical LNM.Ultrasonographic features of ill-defined margins, solid appearance and calcification in PTC are significant predictors of LNM.
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Affiliation(s)
- W Y Shi
- Department of Clinical Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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Abstract
Corneal disease ranks second among blinding diseases in China, with the corneal blindness taking up one fourth of the blind population. It has a high incidence and a low rate of sight rehabilitation. The lack of cornea donors and the shortage of corneal specialists have become the bottleneck that hampers the development in curing corneal disease. It is of primal importance to find sufficient donor sources in order to alleviate the current situation. In 2015, the world's first artificial bioengineered cornea was approved by CFDA to be applied clinically as a substitute for human cornea in lamellar keratoplasty. It will not only relieve the cornea donor shortage, but will also spur the training and practices of corneal specialists. The application and clinical trials of such an innovative product will significantly boost fundamental and clinical researches in corneal disease in our country, helping more patients with corneal blindness to recover their sights.
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Affiliation(s)
- W Y Shi
- Shandong Eye Institute, Qingdao 266071, China
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Zhang JJ, Chu SJ, Sun XL, Zhang T, Shi WY. Bevacizumab modulates retinal pigment epithelial-to-mesenchymal transition via regulating Notch signaling. Int J Ophthalmol 2015; 8:245-9. [PMID: 25938035 DOI: 10.3980/j.issn.2222-3959.2015.02.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 01/23/2015] [Indexed: 01/23/2023] Open
Abstract
AIM To investigate the effect of bevacizumab treatment on Notch signaling and the induction of epithelial-of-mesenchymal transition (EMT) in human retinal pigment epithelial cells (ARPE-19) in vitro. METHODS In vitro cultivated ARPE-19 cells were treated with 0.25 mg/mL bevacizumab for 12, 24, and 48h. Cell morphology changes were observed under an inverted microscope. The expression of zonula occludens-1 (ZO-1), vimentin and Notch-1 intracellular domain (NICD) was examined by immunofluorescence. The mRNA levels of ZO-1, α-SMA, Notch-1, Notch-2, Notch-4, Dll4, Jagged-1, RBP-Jk and Hes-1 expression were evaluated with quantitative real-time polymerase chain reaction (qRT-PCR). The protein levels of α-SMA, NICD, Hes-1 and Dll-4 expression were examined with Western blot. RESULTS Bevacizumab stimulation increased the expression of α-SMA and vimentin in ARPE-19 cells which changed into spindle-shaped fibroblast-like cells. Meanwhile, the mRNA expression of Hes-1 increased and the protein expression of Hes-1 and NICD also increased, which Notch signaling was activated. The mRNA expression of Notch-1, Jagged-1 and RBP-Jk increased at 48h, and while Dll4 mRNA and protein expression did not change after bevacizumab treatment. CONCLUSION Jagged-1/Notch-1 signaling may play a critical role in bevacizumab-induced EMT in ARPE-19 cells, which provides a novel insight into the pathogenesis of intravitreal bevacizumab-associated complication.
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Affiliation(s)
- Jing-Jing Zhang
- Qingdao University Medical College, Qingdao 266071, Shandong Province, China ; Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - San-Jun Chu
- Qingdao University Medical College, Qingdao 266071, Shandong Province, China ; Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Xiao-Lei Sun
- Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Ting Zhang
- Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Wei-Yun Shi
- Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
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Wang FH, Chen M, Liu T, Zang XJ, Gong HQ, Shi WY. Lymphocyte infiltration and activation in iris-ciliary body and anterior chamber of mice in corneal allograft rejection. Int J Ophthalmol 2012; 5:681-6. [PMID: 23275901 DOI: 10.3980/j.issn.2222-3959.2012.06.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 12/05/2012] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the infiltration and activation of lymphocyte in iris-ciliary body and anterior chamber after allogenic penetrating keratoplasty (PK), for further revealing the role of iris-ciliary body in corneal allograft immune rejection. METHODS In the mice models of PK, BALB/C mice received orthotopic isografts (n =35) or C57BL/6 donor allografts (n =25). Grafts were examined daily for 3 weeks by slit-lamp microscopy and scored for opacity. The infiltration of CD4(+) T lymphocyte in iris-ciliary body and anterior chamber was examined by immunohistology and the mRNA of CD80 and CD86 in both cornea graft and iris-ciliary body by RT-PCR was analyzed in allograft recipient at days 3, 6, 10 and the day when graft rejection occurred. Isograft recipients were examined as control at the corresponding time points. Transmission electron microscope was used to study the ultrastructure, especially cell infiltration, of iris-cilary body and corneal graft at day 3, 7 and the day when rejection occurred after allogenic PK. RESULTS Rejection was observed in all the allograft recipients followed more than 10 days, at a median time of 15 days (range 12-18 days), but not in any of isografts. CD4(+) T cells were first detected at day 6 after transplantation in limbus and Ciliary body, and then in the stroma of recipient, iris, anterior chamber and corneal allograft with an increased number until graft rejection occurred. CD80 and CD86 mRNA were detected under RT-PCR examination in both graft and iris-ciliary body of allograft recipient, but not in any of isograft recipient. Three days after operation, lymphocytes and monocytes macrophages were visible in iris blood vessels and the anterior chamber, and vascular endothelial cell proliferation and activation were significant under transmission electron microscopy examination. At day 7, corneal endothelial cells became thinner. Lymphocytes and mononuclear macrophages were found with great number in the anterior chamber and adhered to the corneal endothelium. Blood vessels in iris increased and were filled with lymphocytes. And lymphocytes were detected to migrate through endothelial cell gap out of vessels. When allograft rejection occurred, macrophages attached to endothelial cells with large number of lymphocytes and macrophages infiltrating in iris. CONCLUSION Lymphocyte infiltration and activation occurred in iris-ciliary body after allogenic PK, and the lymphocytes could migrate from iris blood vessel to the anterior chamber, which might play an important role in corneal allograft immune rejection.
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Affiliation(s)
- Fu-Hua Wang
- Qingdao University Medical College, Qingdao 266071, Shandong Province, China ; Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Science, Jinan 025021, Shandong Province, China
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Sun GH, Li SX, Gao H, Zhang WB, Zhang MA, Shi WY. Clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. Int J Ophthalmol 2012; 5:88-91. [PMID: 22553762 DOI: 10.3980/j.issn.2222-3959.2012.01.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 01/10/2012] [Indexed: 11/02/2022] Open
Abstract
AIM To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae.Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink.Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm.Anterior segment optical coherence tomography (AS-OCT) examine the depth of corneal ulcer between 1/3-1/2,infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stroma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. RESULTS Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation.7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.
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Affiliation(s)
- Guang-Hua Sun
- Department of Ophthalmology, Qingdao University Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
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Wu XG, Xin M, Yang LN, Shi WY. The Biological Characteristics and Pharmacodynamics of a Mycophenolate Mofetil Nanosuspension Ophthalmic Delivery System in Rabbits. J Pharm Sci 2011; 100:1350-61. [DOI: 10.1002/jps.22356] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 06/17/2010] [Accepted: 08/31/2010] [Indexed: 11/11/2022]
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Gao H, Shi WY, Gong HQ, Wang YQ, Xie LX. [The preliminary study of establishing animal model of chronic allograft dysfunction after penetrating keratoplasty]. Zhonghua Yan Ke Za Zhi 2011; 47:59-65. [PMID: 21418930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To establish a murine model of chronic corneal allograft dysfunction (CCAD) after penetrating keratoplasty (PK). METHODS Experimental study. PK model in mice: Semiallogeneic CB6F1 mice were obtained from matching of female BALB/c and male C57BL/6 mice. C57BL/6 (allogeneic group), CB6F1 (semiallogeneic group) and BALB/c (syngeneic group) grafts were transplanted orthotopically to BALB/c recipients respectively, and BALB/c mice as a control group. The follow-up time was more than 100 d, and graft survival time and corneal opacity score were monitored, and corneal endothelium were examined by alizarin red and PI/Hoechst stain. CD4(+) and CD8(+) T lymphocytes were examined by immunohistochemistry. Ultrastructure changes of the grafts were examined by electronmicroscopy. Log-rank test were used to compare survival curves. RESULTS (1) Graft examination:Median graft survival times were 17.0 d, 85.5 d, > 100 d and > 100 d in allogeneic, semiallogeneic, syngeneic and control groups, respectively (F = 344.0, P < 0.01). (2) Immunohistochemistry examination: There were large amount of CD4(+) and CD8(+) T lymphocyte infiltration in allografts in allogeneic group at 3 weeks after PK; Few CD4(+) and CD8(+) T lymphocytes were observed in semiallogeneic group and syngeneic groups at 3 weeks after PK; CD4(+) and CD8(+) T lymphocyte infiltration was not observed in the control group. (3) Endothelium examination: The endothelium can not be counted because the blurred image after the alizarin red combined PI/Hoechst stain and apoptotic and necrotic cells can be seen in allogeneic group; the endothelial cell density decreased and few apoptosis can be detected in semiallogeneic and syngeneic groups; no apoptotic and necrotic endothelial cells were found in the control group. (4) Ultrastructural characteristic changes mainly include fibrosis formation and endothelium atrophy and degeneration in failed grafts in all transplanted groups by electron microscopy examination. Inflammation cells can only be found in the allogeneic group. CONCLUSIONS Semiallogeneic and syngeneic transplantation groups present the changes similar to CCAD in clinical study, and both can be regarded as the model that permits molecular evaluation of CCAD.
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Affiliation(s)
- Hua Gao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shangdong Eye Institute, Qingdao 266071, China
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Shi WY. [Strengthen the study of several issues on diagnosis and treatment of the corneal herpetic endotheliitis]. Zhonghua Yan Ke Za Zhi 2011; 47:4-6. [PMID: 21418919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Herpes simplex keratitis (HSK), including epithelial keratitis, stromal keratitis, and endotheliitis, is one of the major blinding eye diseases in China. Corneal herpetic endotheliitis has a variety of clinical manifestations, which causes much difficulty for diagnosis and treatment. This paper suggests a uniform classification of corneal herpetic endotheliitis, which helps to the set up and wide application of a standard treatment protocol. As a result, the cure rate would be increased significantly, corneal endothelium loss due to misdiagnosis would be reduced, and finally the blindness rate of HSK would be lowered.
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Fang XF, Zhao J, Shi WY, Xie LX. [Reconstruction tissue-engineered corneal epithelium using xenogeneic acellular corneal stroma as scaffold]. Zhonghua Yan Ke Za Zhi 2008; 44:825-830. [PMID: 19175163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To compare two methods for preparing acellular corneal stroma and evaluate the possibility of culturing corneal epithelium on xenogeneic acellular corneal stroma. METHODS Experimental study, applying completely randomized design method. Dispase followed by Triton-X-100 detergent and sodium chloride SDS detergent followed by trypsinase were applied respectively to treat the rabbit cornea. The characteristics of corneal stroma and acellular status after treatment were examined with slit lamp, optical microscope and transmission electron microscope. The rabbit limbal cells were then cultured on the acellular porcine Bowman's membrane/stroma. Rabbit corneal epithelium lamella reconstructed in vitro and evaluated in morphology, histopathology and immunohisto-chemistry. RESULTS Acellular corneal stroma prepared by two different methods is quite similar in morphology, being gray and opaque with visible edema and soft texture. Collagen fibers of the stroma were regularly in histopathology and ultrastructure. But the one prepared by the NaCl-SDS-Trypsinase method retained a amounts of cell debris, while there was none in the other did by Dispase-Triton-X-100 method. The limbal cells began to shift out at 24 hours after being inoculated on xenogeneic acellular corneal stroma, then attached on it, formed a confluent monolayer containing normal-appearing in 7 days. The tissue engineering corneal epithelium was cryosectioned and characterized immunohistochemically at 14 days after inoculation. Meanwhile, epithelium associated antigen CK3 in endochylema was stained. CONCLUSIONS Dispase-Triton-X-100 was proved better in obtaining acellular corneal stroma. It is possible to reconstruction tissue-engineered rabbit's corneal epithelium on acellular porcine corneal Bowman's membrane/stroma.
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Affiliation(s)
- Xing-Feng Fang
- Shandong Eye Institute, Shandong Provincial Key Lab of Ophthalmology, Qingdao 266071, China
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Ma L, Xie LX, Dong XG, Shi WY. [Virulence of extracellular phospholipase B of Candida albicans in rabbit experimental keratomycosis]. Zhonghua Yan Ke Za Zhi 2008; 44:237-243. [PMID: 18785548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine the virulence of extracellular phospholipase B (PLB) of Candida albicans in experimental keratomycosis. METHODS It was an experimental study. The PLB-deficient mutant strain of Candida albicans and its isogenic parental strain were used in this study. The effects of these two strains on the model of experimental keratomycosis in 48 New Zealand albino rabbits covered with contact lens was compared by observing the dynamic changes clinically and histopathologically. In vitro, these two strains were incubated with the corneal stromal cells separately (37 degrees C, 5% CO2). The influence of these two strains on monolayer keratocytes were detected by scanning electron microscopy (SEM), enzyme linked immunosorbent assay (ELISA), and flow cytometry with Annexin V/propidium iodide. RESULTS The hyphae of these two strains grew perpendicularly to the corneal stromal lamellae. The difference of the hyphal invasion inoculated for 2 days by these two isogenic strains was statistically significant (P = 0.002), but at other intervals, no significant difference was found. The severity of the inflammation in parental keratomycosis was the same as that in PLB null strain at any time points (P > 0.05). Under SEM, the morphogenesis and the number of adherent germ tubes of these two isogenic strains appeared similarly (P > 0.05), but the number of germ tubes penetrating cell monolayer was significantly different (P = 0.009). Obviously more prostaglandin E2 (PGE2) was detected in the culture supernatants of parental strain group (65,466 +/- 5773) pg/ml than that of the null strain group (18,025 +/- 5232) pg/ml. The percentages of the cells with damaged cellular membrane in the parental group, the PLB null group and the control group, were 3.02%, 2.04% and 0.12%, respectively. The percentages of apoptosis cells in these three groups were 33.17%, 27.56% and 1.46%, respectively. The percentages of living cells were 63.81%, 70.40% and 98.41%, respectively. CONCLUSIONS PLB shows virulent effects in triggering fungal invasion in cornea immediately following fungal adherence by decomposing membrane phospholipids and leading to cell lysis. However, its virulent effect does not appear to be critical as in the hematogenous model of disseminated candidiasis.
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Affiliation(s)
- Lin Ma
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao 266071, China
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Gong HQ, Gao H, Xie LX, Shi WY. [Ultrastructure changes in chronic corneal allograft dysfunction after penetrating keratoplasty]. Zhonghua Yan Ke Za Zhi 2007; 43:307-12. [PMID: 17605925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To study the ultrastructure changes of failed graft caused by chronic corneal allograft dysfunction (CCAD) after penetrating keratoplasty (PK), and to reveal the possible mechanism of these changes. METHODS In CCAD group, corneas of 12 patients fulfilling the diagnostic criteria for CCAD who underwent repeated PK operation were studied. The average interval of these 12 patients between two PK operations was 69 months. All but two patients suffered at least once acute rejection episode during follow-up period. The mean time that the first acute immune rejection occurred was 39.4 months. Five healthy donor corneas were also studied as the control group. Both failed corneal grafts and healthy corneas were examined by light and electron microscopy. RESULTS Compared with normal cornea, the cornea epithelium of CCAD became thinner, the quantity of microvillus apparently reduced, number of dark cells was increased, fibers of cornea stroma arranged disorderly, and there was no obvious invasion of inflammation cell into the stroma. The thickness of Descemet's membrane was uneven, abnormal lacuna and red cell could be seen between the Descemet's membrane and the endothelium. The number of cornea endothelial cells was decreased, cells became thinner, the organelle was reduced obviously, notch appeared in the cell nucleus, chromatin was condensed and inflammatory cells was adherent to the endothelium. CONCLUSIONS The special ultrastructure changes of CCAD grafts consist of atrophic changes of the endothelium and fibrosis without inflammatory cells. Chronic subclinical alloantigen specific and non-alloantigen specific factors are both contributed to the CCAD process. Acute immune rejection perhaps induces and accelerates the occurrence and development of CCAD.
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Affiliation(s)
- Hua-Qing Gong
- State Key Lab Cultivation Base, Shandong Provincial Key Lab of Ophthalmology, Shandong Eye Institute, Qingdao, China
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Shi WY, Li SX. [The value of conjunctival flaps in the management of refractory corneal ulcer]. Zhonghua Yan Ke Za Zhi 2007; 43:293-6. [PMID: 17605922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Refractory corneal ulcer, include infective, sterile and graft ulcer after corneal transplantation, is oppositional to the routine medical therapy and difficult to be managed with other methods. Among amniotic transplantation, corneal transplantation, and conjunctival flaps, which is the best way to treat the refractory corneal ulcer? This problem has puzzled the ophthalmic surgeons for a long time. This paper focused the indication and technique of conjunctival flaps, analyzed the results of some common refractory corneal ulcer treated by the conjunctival flap, and evaluated the value of conjunctival flaps in the management of the refractory corneal ulcer.
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Shi WY, Xie LX. [The corneal allograft rejection features in CD4 and CD8 knock-out mice]. Zhonghua Yan Ke Za Zhi 2005; 41:350-4. [PMID: 15924699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To study the mechanism and the features of corneal allograft rejection using a model of CD4 and CD8 knock-out mice. METHODS The mice were divided into three groups with 20 mice in each group. CD4 knock-out mice, CD8 knock-out mice and C57BL/6 mice were used as recipients and BALB/c mice as corneal graft donors. Postoperative evaluation included slit-lamp biomicroscopy and immunohistological studies. The rejection times were recorded and the cytokines in the eye after the surgery were measured at 1 week, 2 weeks and 4 weeks after the transplantation. Thirty mice (each group ten mice) received skin transplantation using BALB/c as donors in the second week after penetrating keratoplasty. The time of skin grafts rejection was recorded and the cornea grafts were inspected when the skin grafts were rejected. RESULTS The rejection time varied in these three groups. The corneal grafts in CD4 knock-out mice were clear and no rejection occurred > 90 days. The corneal grafts in CD8 knock out mice were rejected at (28 +/- 3) days. The grafts in the control groups were rejected at (14 +/- 2) days (F = 2034, P < 0.01). The skin grafts rejection were recorded at (14 +/- 2), (12 +/- 1), (10 +/- 1) days in CD4 knock-out mice, CD8 knock-out mice and control groups, respectively (F = 42.54, P < 0.01). CONCLUSIONS CD4 and CD8 knock-out mice are useful models for studying of corneal graft rejection. The cornea allograft rejection after penetrating keratoplasty is mediated primarily by CD(4)(+) T lymphocytes. The CD(8)(+) T lymphocytes also participate in the rejection processes.
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Affiliation(s)
- Wei-Yun Shi
- Qingdao Eye Hospital,Shandong Eye Institute, Qingdao 266071, China
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Shi WY, Gao H, Li SW, Wang FH, Xie LX. [Clinical study of the treatment of acanthamoeba keratitis by penetrating keratoplasty]. Zhonghua Yan Ke Za Zhi 2004; 40:750-4. [PMID: 15634482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To evaluate the influence of accurate diagnosis and peri-operative management on the recurrence of acanthamoeba keratitis after penetrating keratoplasty. METHODS A retrospective study of 18 cases of medically unresponsive keratitis in Shandong Eye Institute and Hospital that were confirmed as acanthamoeba keratitis based on laboratory examination or histopathological studies. The diagnosis of acanthamoeba keratitis was made prior to the surgery in 12 cases and delayed until histopathological results in six cases. All cases ran a course of one to four months prior to penetrating keratoplasty with lesions measuring larger than 7 mm at the time of surgery. Corresponding anti-microbial agents were given pre-operatively based on the suspected etiological agents. Corticosteroids were given to two eyes diagnosed as acanthamoeba keratitis, three eyes misdiagnosed as herpes simplex keratitis and two eyes misdiagnosed as bacterial keratitis. RESULTS In 13 cases without recurrence (72%), 11 cases were correctly diagnosed as acanthamoeba keratitis prior to the surgery. In five cases with relapse (28%), four cases were misdiagnosed prior to the surgery. Seven cases received corticosteroid therapy more than one week in early post-operative period and four cases developed recurrence. In the four cases with relapse, two were misdiagnosed as herpes keratitis and two were misdiagnosed as bacterial keratitis. The odds ratis of the effect of two factors (misdiagnosis and using of corticosteroid in early post-operative period) on the rate of recurrence were 22 (P = 0.021) and 13 (P = 0.047), respectively. CONCLUSIONS Penetrating keratoplasty is an effective treatment for medically unresponsive acanthamoeba keratitis. Accurate pre-operative diagnosis, appropriate peri-operative amoebicidal therapy and avoidance from the use of corticosteroid in the early post-operative period can decrease the incidence of recurrence of acanthamoeba keratitis after penetrating keratoplasty.
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Affiliation(s)
- Wei-Yun Shi
- Shandong Eye Institute and Hospital, Qingdao 266071, China
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