[Impact of capsular tension ring implantation in cataract patients with high myopia]

The capsular tension ring (CTR) can stabilize the capsule, support the lax zonules, and inhibit the proliferation and migration of lens epithelial cells. Clinically, CTR is mostly used in patients with zonular weakness, which can improve the stability of intraocular lens (IOL) and reduce the incidence of posterior capsular opacity (PCO). The relatively large capsular bag volume, zonular weakness in cataract patients with high myopia may increase the instability of IOL and PCO. Therefore, many clinicians have implanted CTR in cataract patients with high myopia. In this review, we summarized the application of CTR in cataract patients with high myopia.

[Discussion on the application of ventilatory threshold in classification of physical workload in plateau]

Objective: To explore the application of the first ventilatory threshold (VT1) and the second ventilatory threshold (VT2) in the classification of physical workload for plateau workers, to provide reference for formulating the classification in plateau. Methods: In August 2018, 88 male workers from substations at different altitudes (500 m, 2000 m, 3000 m and 4000 m) of a company were selected as study subjects by cluster sampling. They were divided into plain group and plateau groups.The intensities of workload were simulated by power bicycle, and physiologic parameters, including VO(2), heart rate (HR) and energy metabolic rate per body surface area (E/BSA) , were recorded in test system when reaching VT1, VT2 and peak oxygen uptake (VO(2)Peak) . The ratios of VT1, VT2 and VO(2)Peak to the quiet and work potential at different altitudes were compared. Results: In a quiet state, compared with the plain group, the HR and E/BSA of the workers in the 2000 m and 3000 m groups increased, and the differences were statistically significant (P<0.05) . At VT2, compared with the plain group, the HR of the workers in the 4000 m group decreased, the difference was statistically significant (P<0.05) . VO(2) and E/BSA of workers in each plateau group were lower than those in the plain group at VO(2)Peak, and the differences were statistically significant (P<0.05) . At VT2 and VO(2)Peak, the ratios of VO(2), HR, and E/BSA relative to the quiet state of the workers in each plateau group were lower than those of the plain group, and the differences were statistically significant (P<0.05) . In the quiet state and VT1, compared with the plain group, the remaining percentages of VO(2) and E/BSA of workers in each plateau group decreased, and the differences were statistically significant (P<0.05) . Taking VT1, VT2 and VO(2)Peak as cut-off points and VO(2), HR and E/BSA as indicators, the physical workload in plateau could be divided into four levels, namely medium, heavy, extremely heavy and extreme physical workload. Conclusion: It is practicable to use ventilatory threshold to classification of physical workload. VT1 and VT2 can be applied to the classification in plateau to supplement and optimize current national standard of physical workload.

[The effect of topiramate or carbamazepine treatment on the quality of life in patients with vestibular paroxysmia]

Objective:To study the effect of topiramate or carbamazepine treatment on the quality of life (QOL) in patients with vestibular paroxysmia(VP).Method:Thirty-five cases diagnosed as VP from September 2012 to September 2015 were retrospectively studied. Medical outcomes study short form(SF-36)and the dizziness handicap inventory(DHI) were used to analyze the QOL.Result:After topiramate or carbamazepine treatment for one month, the scores of physical function, role physical, general health, vitality, social functioning, role emotional in SF-36 were significantly increased than pre-treatment(P< 0.01); and the scores of emotion, function and physiology in DHI were significantly decreased than pre-treatment(P< 0.01).Conclusion:Topiramate and carbamazepine may obviously improve the QOL of VP patients.The SF-36 and DHI scales could reflect the change of QOL in VP patients.

Selecting patients for a second hepatectomy for colorectal metastases: an systemic review and meta-analysis

BACKGROUND

Opinions on the suitability of repeat hepatectomy for patients with recurrent colorectal liver metastases (CRLMs) vary among studies. We conducted a meta-analysis to establish the criteria for selecting the best candidates for a second hepatectomy.

METHODS

Database and manual searches were performed to identify comparative or prognostic studies published up to October 2013. Outcomes of interest included disease characteristics, perioperative outcomes, and long-term survival after initial and second hepatectomies for patients with CRLM. Study quality was appraised using the Newcastle-Ottawa scale and a modified Hayden's score.

RESULTS

A total of 7226 patients from 27 studies were included. Recurrent CRLMs after initial hepatectomy were more likely to be solitary (RR = 0.86, P = 0.045), unilobar (RR = 0.60, P < 0.001), and smaller (WMD = -0.66, P < 0.001). Postoperative morbidity and mortality were comparable between initial and second hepatectomies (RR = 1.10, P = 0.191; RR = 0.78, P = 0.678, respectively). In high-quality studies, patients showed better survival after a second hepatectomy than those after a single hepatectomy (HR = 0.68, P = 0.022). Patients meeting the following six predictors survived longer after second hepatectomy: disease-free survival after initial hepatectomy >1 y (P = 0.034); solitary CRLM at second hepatectomy (P < 0.001); unilobar CRLM at second hepatectomy (P = 0.009); maximal size of CRLM at second hepatectomy ≤ 5 cm (P = 0.035); lack of extrahepatic metastases at second hepatectomy (P < 0.001); and R0 resection at second hepatectomy (P < 0.001).

CONCLUSIONS

Second hepatectomy is a safe and feasible procedure for patients with recurrent CRLM. In fact, in well-selected patients it improves overall survival. The established criteria can help clinicians to select the best candidates for second hepatectomy and to achieve better long-term outcomes after resection.

p53 directly regulates αA- and βA3/A1-crystallin genes to modulate lens differentiation

It is well established that the tumor suppressor p53 plays major roles in regulating apoptosis and cell cycle progression. In addition, recent studies have demonstrated that p53 is actively involved in regulating cell differentiation in muscle, the circulatory system and various carcinoma tissues. We have recently shown that p53 also controls lens differentiation. Regarding the mechanism, we reveal that p53 directly regulates c-Maf and Prox1, two important transcription factors to control cell differentiation in the ocular lens. In the present study, we present further evidence to show that p53 can regulate lens differentiation by controlling expression of the differentiation genes coding for the lens crystallins. First, the αA and βA3/A1 gene promoters or introns all contain putative p53 binding sites. Second, gel mobility shifting assays revealed that the p53 protein in nuclear extracts from lens epithelial cells directly binds to the p53 binding sites found in these crystallin gene promoters or introns. Third, exogenous wild type p53 induces dose-dependent expression of the luciferase reporter gene driven by different crystallin gene promoters and the exogenous dominant negative mutant p53 causes dose-dependent inhibition of the same crystallin genes. Fourth, ChIP assays revealed that p53 binds to crystallin gene promoters in vivo. Finally, in the p53 knockout mouse lenses, expression levels of various crystallins were found down-regulated in comparison with those from the wild type mouse lenses. Together, our results reveal that p53 directly regulates expression of different sets of genes to control lens differentiation.

Protein serine/threonine phosphotase-1 is essential in governing normal development of vertebrate eye

Protein serine/threonine phosphatase-1 (PP-1) is one of the key enzymes responsible for dephosphorylation in vertebrates. Protein dephosphorylation via PP-1 is implicated in many different biological processes including gene expression, cell cycle control, transformation, neuronal transmission, apoptosis, autophage and senescence. However, whether PP-1 directly controls animal development remains to be investigated. Here, we present direct evidence to show that PP-1 plays an essential role in regulating eye development of vertebrates. Using goldfish as a model system, we have shown the following novel results. First, inhibition of PP-1 activity leads to death of a majority of the treated embryos, and the survived embryos displayed severe phenotype in the eye. Second, knockdown of each catalytic subunit of PP-1 with morpholino oligomers leads to partial (PP-lα knockdown) or complete (PP-lβ or PP-lγ knockdown) death of the injected embryos. The survived embryos from PP-1α knockdown displayed clear retardation in lens differentiation. Finally, overexpression of each subunit of PP-1 also causes death of majority of the injected embryos and leads to abnormal development of goldfish eye. Mechanistically, Pax-6 is one of the major downstream targets mediating the effects of PP-1 function since the eye phenotype in Pax-6 knockdown fish is similar to that derived from overexpression of PP-1. Together, our results for the first time provide direct evidence that protein phosphatase-1 plays a key role in governing normal eye formation during goldfish development.

C-Jun terminal kinases play an important role in regulating embryonic survival and eye development in vertebrates

The c-Jun N-terminal kinases (JNKs) constitute one of the three major types of mitogen-activated protein kinases. Previous studies showed that JNK mediates multiple signaling transduction pathways implicated in cell proliferation, differentiation, inflammation, stress response and apoptosis in mammals. In the present study, we use goldfish as a model system and demonstrate that JNK kinases are necessary to promote embryonic survival and regulate eye development in vertebrates. During goldfish development, JNK1 and JNK2 are expressed at every stage from cleavage to hatching larvae. JNK3 is turned on at the gastrulation stage and then expressed at similar level to that of JNK2. JNK1 activity remains slightly fluctuated during different developmental stages. Inhibition of JNK activity caused massive apoptosis of blastula cells and significant death of goldfish embryos, which are associated with altered expression of the anti-apoptotic regulator, Mcl-1 and the proapoptotic regulator, Bak. These results provide novel information regarding the mechanisms by which JNKs promote embryonic survival. In addition, the embryos that survived inhibition of JNK activity displayed severe phenotype in the eye with clear microphthalmia and lens coloboma. To confirm that the observed phenotype is derived from JNK activity deficiency, we expressed JNK dominant negative mutant (DNM-JNK) in goldfish. Expression of DNM-JNK also caused similar phenotypes with altered expression of pax-6, Sox-2 and β-crystallin. Together, our results demonstrate that JNKs play important roles in promoting survival of vertebrate embryos and regulating development of vertebrate eye.

First Report of Dollar Spot of Seashore Paspalum (Paspalum vaginatum) Caused by Sclerotinia homoeocarpa in South China

Seashore paspalum (Paspalum vaginatum Swartz), a warm-season perennial grass, is native to tropical and subtropical regions of North and South America (1). Its fine texture and tolerance to low mowing and hypersaline environments make it a commercially promising turfgrass species for coastal regions of south China. In late March 2009, disease symptoms were observed from two golf course fairways in Shenzhen and Foshan, Guangdong Province, China. Small, round patches from 25 to 75 mm in diameter were found to be consisting of bleached, straw color leaf lesions bounded by reddish brown margins. Similar patches had previously been observed on seashore paspalum since 1997 in Guangdong Province, but this turf species has been grown in southern China only since the early 1990s. These symptoms were observed when daytime temperatures were above 25°C and with heavy dew formation at night. Greatest severity was seen in the spring and fall. Several contact and systemic fungicides were applied after first symptoms were observed and they were usually successful in suppressing disease. To confirm the disease as dollar spot, isolates from Shenzhen and Foshan were obtained by plating diseased leaf blades of P. vaginatum (cv. Salam) on potato dextrose agar media. Isolates produced white, fluffy, aerial mycelium, columnar when mature, and usually with a cinnamon base and dark brown or black substratal stroma on and in the agar. One representative isolate from each location was chosen for pathogenicity testing. Six-week-old P. vaginatum (cv. Salam) grown from seed in pots was inoculated, with 5-mm-diameter agar plugs with hyphae from 5-day-old cultures, by direct placement onto leaves and with three replicate pots per isolate. Plants treated with sterile agar plugs served as controls. Inoculated turf was incubated at 25°C with 12-h light/dark conditions. A plastic film was also placed over the pots to retain moisture. Chlorotic leaf lesions started to develop 4 days after inoculation and became a bleached straw color. The same fluffy, white fungus was reisolated from lesions, while no disease was observed on controls, thus completing Koch's postulates. The internal transcribed spacer (ITS) region of the ribosomal DNA was amplified from DNA extracted from two isolates using primers ITS5 and ITS4 (2), and the 610-bp sequences showed 98% similarity with Sclerotinia homoeocarpa F.T. Bennett in GenBank and have been deposited as Accessions GQ386985 and GU002301. Dollar spot on P. vaginatum has been commonly observed in the United States (1). To our knowledge, this is the first confirmed report of dollar spot on P. vaginatum in China or from any host plant in China. References: (1) R. R. Duncan and R. N. Carrow. Seashore Paspalum: The Environmental Turfgrass. John Wiley and Sons, Toronto, ON, Canada. 2000. (2) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press Inc., New York, 1990.

Circulating Th1 and Th2 cytokines in patients with hepatitis C virus infection

The imbalance of T-helper (Th) lymphocyte cytokine production may play an important role in immunopathogenesis of persistent hepatitis C virus (HCV) infection. To know whether an imbalance between Th1 and Th2 cytokines is present in chronic HCV infection, serum levels of Th1 cytokines, interferon gamma (IFN-gamma) and interleukin (IL)-2, and Th2 cytokines, IL-4 and IL-10, were measured using enzyme-linked immunosorbent assay in this study. Eighteen individuals with chronic HCV infection, 11 healthy subjects as normal controls and 10 chronic HBV infected patients as disease controls were observed. The results showed that the levels of Th2 cytokines (IL-4 and IL-10) were significantly increased in chronic HCV infected patients compared with normal controls (IL-4: 30.49+/-17.55 vs. 14.94+/-13.73, pg/ml, P<0.025; IL-10: 50.30+/-19.59 vs. 17.87+/-9.49, pg/ml, P<0.001). Similarly, the levels of Th1 cytokine, IL-2, was also elevated in individuals with chronic HCV infection when compared with normal controls (IL-2: 118.53+/-95.23 vs. 61.57+/-28.70, pg/ml, P<0.05). However, Th1 cytokine IFN-gamma level was not significantly changed during HCV infection (IFN-gamma: 28.09+/-15.65 vs. 24.10+/-15.61, pg/ml, P>0.05). Furthermore, the elevated levels of Th2 cytokines are greater than Th1 cytokines in HCV infection. Thus, the study indicates that an enhanced Th2 responses are present during chronic HCV infection, which may partly be responsible for the persistence of HCV infection.