Diabetic retinopathy(DR)is a leading cause of vision-loss globally.Of an estimated 285 million people with diabetes mellitus worldwide,approximately one third have signs of DR and of these,a further one third of DR is...Diabetic retinopathy(DR)is a leading cause of vision-loss globally.Of an estimated 285 million people with diabetes mellitus worldwide,approximately one third have signs of DR and of these,a further one third of DR is vision-threatening DR,including diabetic macular edema(DME).The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR.Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME,especially those involved in inflammation and oxidative stress.Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility.In this review,major trends in the prevalence,incidence,progression and regression of DR and DME are explored,and gaps in literature identified.Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.展开更多
The gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome ca...The gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome caused by environmental changes(e.g., infection, diet and/or lifestyle) can disturb this symbiotic relationship and promote disease, such as inflammatory bowel diseases and cancer. Colorectal cancer is a complex association of tumoral cells, non-neoplastic cells and a large amount of micro-organisms, and the involvement of the microbiota in colorectal carcinogenesis is becoming increasingly clear. Indeed, many changes in the bacterial composition of the gut microbiota have been reported in colorectal cancer, suggesting a major role of dysbiosis in colorectal carcinogenesis. Some bacterial species have been identified and suspected to play a role in colorectal carcinogenesis, such as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, Enterococcus faecalis, Clostridium septicum, Fusobacterium spp. and Escherichia coli. The potential pro-carcinogenic effects of these bacteria are now better understood. In this review, we discuss the possible links between the bacterial microbiota and colorectal carcinogenesis, focusing on dysbiosis and the potential pro-carcinogenic properties of bacteria, such as genotoxicity and other virulence factors, inflammation, host defenses modulation, bacterial derived metabolism, oxidative stress and anti-oxidative defenses modulation. We lastly describe how bacterial microbiota modifications could represent novel prognosis markers and/or targets for innovative therapeutic strategies.展开更多
Background This study was to review the distribution and shifting trend of fungal of culture specimens isolated from eyes of patients at the Beijing Institute of Ophthalmology, Tongren Hospital, Beijing, China.Method...Background This study was to review the distribution and shifting trend of fungal of culture specimens isolated from eyes of patients at the Beijing Institute of Ophthalmology, Tongren Hospital, Beijing, China.Methods The fungal culture-positive rate, the distribution and change of isolates of 2609 specimens collected in a 12-year period (1989-2000) were retrospectively analyzed.Results In 775 positive cultures, 707 specimens (91.2%) were from the cornea, 22 (2.8%) from the conjunctiva, 15 (1.9%) from the anterior chamber, 9 (1.2%) from the vitreous body, 3 (0.4%) from the lacrimal sac, and 19 (2.5%) from other parts of the eye. The average culture-positive rate was 29.7%. The ratio of the positive cultures in the first half year (from January to June) to those in the second half (from July to December) was 1∶2.1. The main genus cultured was Fusarium sp (58.7%), followed by Aspergirum sp (16.8%). The percentage of Fusarium sp was increased from 53.6% (1989-1994) to 60.2% (1995-2000), whereas the percentage of Aspergirum sp was decreased from 22.3% (1989-1994) to 15.1% (1995-2000). Conclusions Fusaruim sp is one of the most predominant pathogens of ocular fungal infection in northern China and its incidence tends to increase, but that of Aspergirum sp to decrease. It is very important to recognize the distribution and shifting trend of pathogenic fungi in the diagnosis, prevention and treatment of fungal keratitis.展开更多
Many randomized clinical controlled trials have confirmed the efficacy and safety of calcium dobesilate in treating diabetic retinopathy(DR).This systematic review critically evaluated the evidence that links calcium ...Many randomized clinical controlled trials have confirmed the efficacy and safety of calcium dobesilate in treating diabetic retinopathy(DR).This systematic review critically evaluated the evidence that links calcium dobesilate to DR.In this fixed-effects meta-analysis,a total of 221 pertinent English-language articles published between January 1975 and October 2013 were identified.Systematic searches of PUBMED,Springer Link and the Cochrane Clinical Trials Database were conducted using the keywords "diabetic retinopathy" and "calcium dobesilate".The extracted information included the study design,inclusion and exclusion criteria,setting,sample size,participant mean age,treatment regime,mean change in best corrected visual acuity,laboratory parameters,capillary fragility,intraocular pressure and fundus manifestations based on the findings of fluorescent angiography.The summary statistics indicated that calcium dobesilate was significantly associated with improving retinal microaneurysms(RR: 0.62,95%CI: 0.42?0.90,P=0.01),retinalhemorrhages(RR: 0.39,95% CI: 0.17?0.88,P=0.02); exudates(RR: 0.31,95% CI: 0.12?0.81,P=0.02),reduction of whole blood viscosity(MD: ?0.57 CP,95% CI: ?0.75 to ?0.38,P<0.001),plasma viscosity(MD: ?0.36 CP,95% CI: ?0.63 to ?0.09,P=0.01) and blood cholesterol(MD: ?0.48 mg m L?1,95% CI: ?0.64?0.33,P<0.00001).Intraocular pressure was also significantly reduced(MD: ?5.59 mm Hg,95% CI: ?6.69 to ?4.50,P<0.00001).The results indicate that calcium dobesilate effectively treats DR at the systematic and local ocular levels.展开更多
Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative me...Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections. Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity （BCVA）, fundus fluorescein angiography, and associated ocular and systemic manifestations. Results Eleven patients had ophthalmic artery occlusion （OAO） and one patient each had central retinal artery occlusion （CRAO） and anterior ischemic optic neuropathy （AION）. Injected materials included autologous fat （seven cases）, hyaluronic acid （five cases）, and bone collagen （one case）. Injection sites were the frontal area （five cases）, periocular area （two cases）, temple area （two cases）, and nose area and nasal area （4 cases）. Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA. Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid iniection.展开更多
目的探讨杞菊地黄丸治疗干眼症的效果。方法 2010年1月—2010年6月在PCO(Pennsylvania College of Optometry)眼科医院就诊的干眼症患者120例(240只眼),均以干眼为主诉,年龄45～72岁,身体健康无其他眼疾,无吸烟史,无接触镜佩戴史。所有...目的探讨杞菊地黄丸治疗干眼症的效果。方法 2010年1月—2010年6月在PCO(Pennsylvania College of Optometry)眼科医院就诊的干眼症患者120例(240只眼),均以干眼为主诉,年龄45～72岁,身体健康无其他眼疾,无吸烟史,无接触镜佩戴史。所有患者的McMonnies DEQ(McMonnies DryEye Questionnaire)量表评分为阳性,辨证为肝肾阴虚。随机分为杞菊地黄丸组和人工泪液组,各60例。分别予口服杞菊地黄丸,局部羧甲基纤维素钠滴眼液(Refresh Plus滴眼液)点眼,均治疗30 d。比较2组患者的治疗效果。结果1.泪液分泌试验(Schirmer I test,SIt):杞菊地黄丸组(14.27±1.41)mm/5 mins,人工泪液组(12.55±1.37)mm/5 mins(Z=-4.573,P=0.0000)。2.泪膜破裂时间(tear break-up time,TBUT):杞菊地黄丸组(18.07±3.58)s,人工泪液组(13.38±3.17)s(t=7.578,P=0.0000)。3.总有效率:杞菊地黄丸组96.70%,人工泪液组86.7%(Z=-3.310,P=0.001)。4.西医临床积分:杞菊地黄丸组6.27±3.27,人工泪液组9.47±3.57(Z=-4.87,P=0.000)。5.中医症状积分:杞菊地黄丸组3.10±1.398,人工泪液组3.81±1.387(Z=-2.370,P=0.018)。结论杞菊地黄丸治疗干眼症有效;除了西医常规的人工泪液外,也可以考虑使用相关的中医方法治疗干眼症。展开更多
Human neurocristopathies include a number of syndromes, tumors, and dysmorphologies of neural crest （NC） stem cell derivatives. In recent years, many white spotting genes have been associated with hypopigmentary dis...Human neurocristopathies include a number of syndromes, tumors, and dysmorphologies of neural crest （NC） stem cell derivatives. In recent years, many white spotting genes have been associated with hypopigmentary disorders and deafness in neurocristopathies resulting from NC stem cell-derived melanocyte deficiency during development. These include PAX3, SOX10, MITF, SNAI2, EDNRB, EDN3, KIT, and KITL. Recent studies have revealed surprising new insights into a central role of MITF in the complex network of interacting genes in melanocyte development. In this perspective, we provide an overview of some of the current findings and explore complex functional roles of these genes during NC stem cell-derived melanocyte development.展开更多
Diabetic retinopathy, characterized as a microangiopathy and neurodegenerative disease, is the leading cause of visual impairment in diabetic patients. Many clinical features observed in diabetic retinopathy, such as ...Diabetic retinopathy, characterized as a microangiopathy and neurodegenerative disease, is the leading cause of visual impairment in diabetic patients. Many clinical features observed in diabetic retinopathy, such as capillary occlusion, acellular capillaries and retinal non-perfusion, aggregate retinal ischemia and represent relatively late events in diabetic retinopathy. In fact, retinal microvascular injury is an early event in diabetic retinopathy involving multiple biochemical alterations, and is manifested by changes to the retinal neurovascular unit and its cellular components. Currently, intravitreal anti-vascular endothelial growth factor therapy is the firstline treatment for diabetic macular edema, and benefits the patient by decreasing the edema and improving visual acuity. However, a significant proportion of patients respond poorly to anti-vascular endothelial growth factor treatments, indicating that factors other than vascular endothelial growth factor are involved in the pathogenesis of diabetic macular edema. Accumulating evidence confirms that low-grade inflammation plays a critical role in the pathogenesis and development of diabetic retinopathy as multiple inflammatory factors, such as interleukin-1β, monocyte chemotactic protein-1 and tumor necrosis factor-α, are increased in the vitreous and retina of diabetic retinopathy patients. These inflammatory factors, together with growth factors such as vascular endothelial growth factor, contribute to blood-retinal barrier breakdown, vascular damage and neuroinflammation, as well as pathological angiogenesis in diabetic retinopathy, complicated by diabetic macular edema and proliferative diabetic retinopathy. In addition, retinal cell types including microglia, Müller glia, astrocytes, retinal pigment epithelial cells, and others are activated, to secrete inflammatory mediators, aggravating cell apoptosis and subsequent vascular leakage. New therapies, targeting these inflammatory molecules or related signaling pathways, have the potential to i展开更多
Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading ca...Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading cause of blindness worldwide. Due to several mechanisms, there is an increased incidence of cataract formation in the diabetic population. Advancements in technology have now made cataract surgery a common and safe procedure. However, the diabetic population is still at risk of vision-threatening complications, such as diabetic macular edema (ME), postoperative ME, diabetic retinopathy progression, and posterior capsular opacification.展开更多
Background:This review aims to explain the reasons why intraocular lens(IOL)power calculation is challenging in eyes with previous corneal refractive surgery and what solutions are currently available to obtain more a...Background:This review aims to explain the reasons why intraocular lens(IOL)power calculation is challenging in eyes with previous corneal refractive surgery and what solutions are currently available to obtain more accurate results.Review:After IOL implantation in eyes with previous LASIK,PRK or RK,a refractive surprise can occur because (i)the altered ratio between the anterior and posterior corneal surface makes the keratometric index invalid;(ii)the corneal curvature radius is measured out of the optical zone;and (iii)the effective lens position is erroneously predicted if such a prediction is based on the post-refractive surgery corneal curvature.Different methods are currently available to obtain the best refractive outcomes in these eyes,even when the perioperative data(i.e.preoperative corneal power and surgically induced refractive change)are not known.In this review,we describe the most accurate methods based on our clinical studies.Conclusions:IOL power calculation after myopic corneal refractive surgery can be calculated with a variety of methods that lead to relatively accurate outcomes,with 60 to 70%of eyes showing a prediction error within 0.50 diopters.展开更多
Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the dispar...Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.展开更多
Age-related macular degeneration(AMD)is the leading cause of irreversible blindness in adults over 50 years old.Genetic,epidemiological,and molecular studies are beginning to unravel the intricate mechanisms underlyin...Age-related macular degeneration(AMD)is the leading cause of irreversible blindness in adults over 50 years old.Genetic,epidemiological,and molecular studies are beginning to unravel the intricate mechanisms underlying this complex disease,which implicate the lipid-cholesterol pathway in the pathophysiology of disease development and progression.Many of the genetic and environmental risk factors associated with AMD are also associated with other complex degenerative diseases of advanced age,including cardiovascular disease(CVD).In this review,we present epidemiological findings associating AMD with a variety of lipid pathway genes,cardiovascular phenotypes,and relevant environmental exposures.Despite a number of studies showing significant associations between AMD and these lipid/cardiovascular factors,results have been mixed and as such the relationships among these factors and AMD remain controversial.It is imperative that researchers not only tease out the various contributions of such factors to AMD development but also the connections between AMD and CVD to develop optimal precision medical care for aging adults.展开更多
Background： Corneal stromal cells （CSCs） are components of the corneal endothelial microenvironment that can be induced to form a functional tissue-engineered corneal endothelium. Adipose-derived mesenchymal stem c...Background： Corneal stromal cells （CSCs） are components of the corneal endothelial microenvironment that can be induced to form a functional tissue-engineered corneal endothelium. Adipose-derived mesenchymal stem cells （ADSCs） have been reported as an important component of regenerative medicine and cell therapy for corneal stromal damage. We have demonstrated that the treatment with ADSCs leads to phenotypic changes in CSCs in vitro. However, the underlying mechanisms of such ADSC-induced changes in CSCs remain unclear. Methods： ADSCs and CSCs were isolated from New Zealand white rabbits and cultured in vitro. An Exosome Isolation Kit, Western blotting, and nanoparticle tracking analysis （NTA） were used to isolate and confirm the exosomes from ADSC culture medium. Meanwhile, the optimal exosome concentration and treatment time were selected. Cell Counting Kit-8 and annexin V-fluorescein isothiocyanate/ propidium iodide assays were used to assess the effect of ADSC-derived exosomes on the proliferation and apoptosis of CSCs. To evaluate the effects ofADSC-derived exosomes on CSC invasion activity, Western blotting was used to detect the expression of matrix metalloproteinases （MMPs） and collagens. Results： ADSCs and CSCs were successfully isolated from New Zealand rabbits. The optimal concentration and treatment time of exosomes for the following study were 100 μg/ml and 96 h, respectively. NTA revealed that the ADSC-derived exosomes appeared as nanoparticles （40-200 nm）, and Western blotting confirmed positive expression of CD9, CDSI, flotillin-1, and HSP70 versus ADSC cytoplasmic proteins （all P〈 0.01 ）. ADSC-derived exosomes （50μg/ml and 100μg/ml） significantly promoted proliferation and inhibited apoptosis （mainly early apoptosis） of CSCs versus non-exosome-treated CSCs （all P 〈 0.05）. Interestingly, MMPs were downregulated and extracellular matrix （ECM）-related proteins including collagens and fibronectin were upregulated in the exosome-treated CSCs versus展开更多
The amniotic membrane(AM) is the inner layer of the fetal membranes and consist of 3 different layers: the epithelium, basement membrane and stroma which further consists of three contiguous but distinct layers: the i...The amniotic membrane(AM) is the inner layer of the fetal membranes and consist of 3 different layers: the epithelium, basement membrane and stroma which further consists of three contiguous but distinct layers: the inner compact layer, middle fibroblast layer and the outermost spongy layer. The AM has been shown to have anti-inflammatory, anti-fibrotic, anti-angiogenic as well as anti-microbial properties. Also because of its transparent structure, lack of immunogenicity and the ability to provide an excellent substrate for growth, migration and adhesion of epithelial corneal and conjunctival cells, it is being used increasingly for ocular surface reconstruction in a variety of ocular pathologies including corneal disorders associated with limbal stem cell deficiency, surgeries for conjunctival reconstruction, as a carrier for ex vivo expansion of limbal epithelial cells, glaucoma surgeries and sceral melts and perforations. However indiscriminate use of human AM needs to be discouraged as complications though infrequent can occur. These include risk of transmission of bacterial, viral or fungal infections to the recipient if the donors are not adequately screened for communicable diseases, if the membrane is not processed under sterile condi-tions or if storage is improper. Optimal outcomes can be achieved only with meticulous case selection. This review explores the ever expanding ophthalmological indications for the use of human AM.展开更多
Resurrection plants, which are the ＂gifts＂ of natural evolution, are ideal models for studying the genetic basis of plant desiccation tolerance. Here, we report a high-quality genome assembly of 301 Mb for the diplo...Resurrection plants, which are the ＂gifts＂ of natural evolution, are ideal models for studying the genetic basis of plant desiccation tolerance. Here, we report a high-quality genome assembly of 301 Mb for the diploid spike moss Selaginella tamariscina, a primitive vascular resurrection plant. We predicated 27 761 protein-coding genes from the assembled S. tarnariscina genome, 11.38% （2363） of which showed signifi- cant expression changes in response to desiccation. Approximately 60.58% of the S. tamariscina genome was annotated as repetitive DNA, which is an almost 2-fold increase of that in the genome of desiccation- sensitive Selaginella moellendorffii. Genomic and transcriptomic analyses highlight the unique evolution and complex regulations of the desiccation response in S. tamariscina, including species-specific expan- sion of the oleosin and pentatricopeptide repeat gene families, unique genes and pathways for reactive oxygen species generation and scavenging, and enhanced abscisic acid （ABA） biosynthesis and potentially distinct regulation of ABA signaling and response. Comparative analysis of chloroplast genomes of several Selaginella species revealed a unique structural rearrangement and the complete loss of chloroplast NAD（P） H dehydrogenase （NDH） genes in S. tamariscina, suggesting a link between the absence of the NDH com- plex and desiccation tolerance. Taken together, our comparative genomic and transcriptomic analyses reveal common and species-specific desiccation tolerance strategies in S. tamariscina, providing signifi- cant insights into the desiccation tolerance mechanism and the evolution of resurrection plants.展开更多
文摘Diabetic retinopathy(DR)is a leading cause of vision-loss globally.Of an estimated 285 million people with diabetes mellitus worldwide,approximately one third have signs of DR and of these,a further one third of DR is vision-threatening DR,including diabetic macular edema(DME).The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR.Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME,especially those involved in inflammation and oxidative stress.Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility.In this review,major trends in the prevalence,incidence,progression and regression of DR and DME are explored,and gaps in literature identified.Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
基金Supported by Inserm and Universitéd’Auvergne(UMR 1071)INRA(USC-2018)+1 种基金grants from“Conseil regional d’Auvergne”“Nuovo Soldati Foundation for Cancer Research”and“Fondation pour la recherche médicale”
文摘The gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome caused by environmental changes(e.g., infection, diet and/or lifestyle) can disturb this symbiotic relationship and promote disease, such as inflammatory bowel diseases and cancer. Colorectal cancer is a complex association of tumoral cells, non-neoplastic cells and a large amount of micro-organisms, and the involvement of the microbiota in colorectal carcinogenesis is becoming increasingly clear. Indeed, many changes in the bacterial composition of the gut microbiota have been reported in colorectal cancer, suggesting a major role of dysbiosis in colorectal carcinogenesis. Some bacterial species have been identified and suspected to play a role in colorectal carcinogenesis, such as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, Enterococcus faecalis, Clostridium septicum, Fusobacterium spp. and Escherichia coli. The potential pro-carcinogenic effects of these bacteria are now better understood. In this review, we discuss the possible links between the bacterial microbiota and colorectal carcinogenesis, focusing on dysbiosis and the potential pro-carcinogenic properties of bacteria, such as genotoxicity and other virulence factors, inflammation, host defenses modulation, bacterial derived metabolism, oxidative stress and anti-oxidative defenses modulation. We lastly describe how bacterial microbiota modifications could represent novel prognosis markers and/or targets for innovative therapeutic strategies.
文摘Background This study was to review the distribution and shifting trend of fungal of culture specimens isolated from eyes of patients at the Beijing Institute of Ophthalmology, Tongren Hospital, Beijing, China.Methods The fungal culture-positive rate, the distribution and change of isolates of 2609 specimens collected in a 12-year period (1989-2000) were retrospectively analyzed.Results In 775 positive cultures, 707 specimens (91.2%) were from the cornea, 22 (2.8%) from the conjunctiva, 15 (1.9%) from the anterior chamber, 9 (1.2%) from the vitreous body, 3 (0.4%) from the lacrimal sac, and 19 (2.5%) from other parts of the eye. The average culture-positive rate was 29.7%. The ratio of the positive cultures in the first half year (from January to June) to those in the second half (from July to December) was 1∶2.1. The main genus cultured was Fusarium sp (58.7%), followed by Aspergirum sp (16.8%). The percentage of Fusarium sp was increased from 53.6% (1989-1994) to 60.2% (1995-2000), whereas the percentage of Aspergirum sp was decreased from 22.3% (1989-1994) to 15.1% (1995-2000). Conclusions Fusaruim sp is one of the most predominant pathogens of ocular fungal infection in northern China and its incidence tends to increase, but that of Aspergirum sp to decrease. It is very important to recognize the distribution and shifting trend of pathogenic fungi in the diagnosis, prevention and treatment of fungal keratitis.
基金supported by grant from the National Natural Science Foundation of China(81170859)Bejing Municipal Education Commission Key Project(KZ201210025027)Beijing Science and Technology New Star Project(2004B28)
文摘Many randomized clinical controlled trials have confirmed the efficacy and safety of calcium dobesilate in treating diabetic retinopathy(DR).This systematic review critically evaluated the evidence that links calcium dobesilate to DR.In this fixed-effects meta-analysis,a total of 221 pertinent English-language articles published between January 1975 and October 2013 were identified.Systematic searches of PUBMED,Springer Link and the Cochrane Clinical Trials Database were conducted using the keywords "diabetic retinopathy" and "calcium dobesilate".The extracted information included the study design,inclusion and exclusion criteria,setting,sample size,participant mean age,treatment regime,mean change in best corrected visual acuity,laboratory parameters,capillary fragility,intraocular pressure and fundus manifestations based on the findings of fluorescent angiography.The summary statistics indicated that calcium dobesilate was significantly associated with improving retinal microaneurysms(RR: 0.62,95%CI: 0.42?0.90,P=0.01),retinalhemorrhages(RR: 0.39,95% CI: 0.17?0.88,P=0.02); exudates(RR: 0.31,95% CI: 0.12?0.81,P=0.02),reduction of whole blood viscosity(MD: ?0.57 CP,95% CI: ?0.75 to ?0.38,P<0.001),plasma viscosity(MD: ?0.36 CP,95% CI: ?0.63 to ?0.09,P=0.01) and blood cholesterol(MD: ?0.48 mg m L?1,95% CI: ?0.64?0.33,P<0.00001).Intraocular pressure was also significantly reduced(MD: ?5.59 mm Hg,95% CI: ?6.69 to ?4.50,P<0.00001).The results indicate that calcium dobesilate effectively treats DR at the systematic and local ocular levels.
文摘Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections. Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity （BCVA）, fundus fluorescein angiography, and associated ocular and systemic manifestations. Results Eleven patients had ophthalmic artery occlusion （OAO） and one patient each had central retinal artery occlusion （CRAO） and anterior ischemic optic neuropathy （AION）. Injected materials included autologous fat （seven cases）, hyaluronic acid （five cases）, and bone collagen （one case）. Injection sites were the frontal area （five cases）, periocular area （two cases）, temple area （two cases）, and nose area and nasal area （4 cases）. Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA. Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid iniection.
基金We would like to thank Dr HeinzAmheiter （NIH/NINDS） for generously contributing to the images, and Dr Laura Baxter and Dr Yingzi Yang （NIH/NHGRI） for thoughtful comments on the manuscript. We also acknowledge the support by the National Natural Science Foundation of China （30771149） and the Intramural Research Program of the National Human Genome Research Institute, National Institutes of Health.
文摘Human neurocristopathies include a number of syndromes, tumors, and dysmorphologies of neural crest （NC） stem cell derivatives. In recent years, many white spotting genes have been associated with hypopigmentary disorders and deafness in neurocristopathies resulting from NC stem cell-derived melanocyte deficiency during development. These include PAX3, SOX10, MITF, SNAI2, EDNRB, EDN3, KIT, and KITL. Recent studies have revealed surprising new insights into a central role of MITF in the complex network of interacting genes in melanocyte development. In this perspective, we provide an overview of some of the current findings and explore complex functional roles of these genes during NC stem cell-derived melanocyte development.
基金supported by the National Natural Science Foundation of China,No. 82171062 (to JFZ)。
文摘Diabetic retinopathy, characterized as a microangiopathy and neurodegenerative disease, is the leading cause of visual impairment in diabetic patients. Many clinical features observed in diabetic retinopathy, such as capillary occlusion, acellular capillaries and retinal non-perfusion, aggregate retinal ischemia and represent relatively late events in diabetic retinopathy. In fact, retinal microvascular injury is an early event in diabetic retinopathy involving multiple biochemical alterations, and is manifested by changes to the retinal neurovascular unit and its cellular components. Currently, intravitreal anti-vascular endothelial growth factor therapy is the firstline treatment for diabetic macular edema, and benefits the patient by decreasing the edema and improving visual acuity. However, a significant proportion of patients respond poorly to anti-vascular endothelial growth factor treatments, indicating that factors other than vascular endothelial growth factor are involved in the pathogenesis of diabetic macular edema. Accumulating evidence confirms that low-grade inflammation plays a critical role in the pathogenesis and development of diabetic retinopathy as multiple inflammatory factors, such as interleukin-1β, monocyte chemotactic protein-1 and tumor necrosis factor-α, are increased in the vitreous and retina of diabetic retinopathy patients. These inflammatory factors, together with growth factors such as vascular endothelial growth factor, contribute to blood-retinal barrier breakdown, vascular damage and neuroinflammation, as well as pathological angiogenesis in diabetic retinopathy, complicated by diabetic macular edema and proliferative diabetic retinopathy. In addition, retinal cell types including microglia, Müller glia, astrocytes, retinal pigment epithelial cells, and others are activated, to secrete inflammatory mediators, aggravating cell apoptosis and subsequent vascular leakage. New therapies, targeting these inflammatory molecules or related signaling pathways, have the potential to i
文摘Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading cause of blindness worldwide. Due to several mechanisms, there is an increased incidence of cataract formation in the diabetic population. Advancements in technology have now made cataract surgery a common and safe procedure. However, the diabetic population is still at risk of vision-threatening complications, such as diabetic macular edema (ME), postoperative ME, diabetic retinopathy progression, and posterior capsular opacification.
基金The contribution of G.B.Fondazione Bietti IRCCS was supported by the Italian Ministry of Health and Fondazione Roma.
文摘Background:This review aims to explain the reasons why intraocular lens(IOL)power calculation is challenging in eyes with previous corneal refractive surgery and what solutions are currently available to obtain more accurate results.Review:After IOL implantation in eyes with previous LASIK,PRK or RK,a refractive surprise can occur because (i)the altered ratio between the anterior and posterior corneal surface makes the keratometric index invalid;(ii)the corneal curvature radius is measured out of the optical zone;and (iii)the effective lens position is erroneously predicted if such a prediction is based on the post-refractive surgery corneal curvature.Different methods are currently available to obtain the best refractive outcomes in these eyes,even when the perioperative data(i.e.preoperative corneal power and surgically induced refractive change)are not known.In this review,we describe the most accurate methods based on our clinical studies.Conclusions:IOL power calculation after myopic corneal refractive surgery can be calculated with a variety of methods that lead to relatively accurate outcomes,with 60 to 70%of eyes showing a prediction error within 0.50 diopters.
文摘Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.
基金This work was supported by the National Institutes of Health National Eye Institute(EY014800)the National Institutes of Health National Eye Institute Ruth L.Kirschstein National Research Service Award T32(EY024234)+5 种基金an Unrestricted Grant from Research to Prevent Blindness,Inc.,New York,NY,to the Department of Ophthalmology&Visual Sciences,University of Utahthe ARVO Foundation for Eye ResearchThe Skaggs Foundation for ResearchThe Carl Marshall Reeves&Mildred Almen Reeves Foundation,Inc.the Center of Aging Pilot Award,Division of Geriatrics,University of Utahthe Macular Degeneration Foundation,Inc.
文摘Age-related macular degeneration(AMD)is the leading cause of irreversible blindness in adults over 50 years old.Genetic,epidemiological,and molecular studies are beginning to unravel the intricate mechanisms underlying this complex disease,which implicate the lipid-cholesterol pathway in the pathophysiology of disease development and progression.Many of the genetic and environmental risk factors associated with AMD are also associated with other complex degenerative diseases of advanced age,including cardiovascular disease(CVD).In this review,we present epidemiological findings associating AMD with a variety of lipid pathway genes,cardiovascular phenotypes,and relevant environmental exposures.Despite a number of studies showing significant associations between AMD and these lipid/cardiovascular factors,results have been mixed and as such the relationships among these factors and AMD remain controversial.It is imperative that researchers not only tease out the various contributions of such factors to AMD development but also the connections between AMD and CVD to develop optimal precision medical care for aging adults.
基金This work was supported by grants from the National Natural Science Foundation of China （No. 81700795）, and the Natural Science Foundation of Zhejiang Province （No. LY13H120007）.
文摘Background： Corneal stromal cells （CSCs） are components of the corneal endothelial microenvironment that can be induced to form a functional tissue-engineered corneal endothelium. Adipose-derived mesenchymal stem cells （ADSCs） have been reported as an important component of regenerative medicine and cell therapy for corneal stromal damage. We have demonstrated that the treatment with ADSCs leads to phenotypic changes in CSCs in vitro. However, the underlying mechanisms of such ADSC-induced changes in CSCs remain unclear. Methods： ADSCs and CSCs were isolated from New Zealand white rabbits and cultured in vitro. An Exosome Isolation Kit, Western blotting, and nanoparticle tracking analysis （NTA） were used to isolate and confirm the exosomes from ADSC culture medium. Meanwhile, the optimal exosome concentration and treatment time were selected. Cell Counting Kit-8 and annexin V-fluorescein isothiocyanate/ propidium iodide assays were used to assess the effect of ADSC-derived exosomes on the proliferation and apoptosis of CSCs. To evaluate the effects ofADSC-derived exosomes on CSC invasion activity, Western blotting was used to detect the expression of matrix metalloproteinases （MMPs） and collagens. Results： ADSCs and CSCs were successfully isolated from New Zealand rabbits. The optimal concentration and treatment time of exosomes for the following study were 100 μg/ml and 96 h, respectively. NTA revealed that the ADSC-derived exosomes appeared as nanoparticles （40-200 nm）, and Western blotting confirmed positive expression of CD9, CDSI, flotillin-1, and HSP70 versus ADSC cytoplasmic proteins （all P〈 0.01 ）. ADSC-derived exosomes （50μg/ml and 100μg/ml） significantly promoted proliferation and inhibited apoptosis （mainly early apoptosis） of CSCs versus non-exosome-treated CSCs （all P 〈 0.05）. Interestingly, MMPs were downregulated and extracellular matrix （ECM）-related proteins including collagens and fibronectin were upregulated in the exosome-treated CSCs versus
文摘The amniotic membrane(AM) is the inner layer of the fetal membranes and consist of 3 different layers: the epithelium, basement membrane and stroma which further consists of three contiguous but distinct layers: the inner compact layer, middle fibroblast layer and the outermost spongy layer. The AM has been shown to have anti-inflammatory, anti-fibrotic, anti-angiogenic as well as anti-microbial properties. Also because of its transparent structure, lack of immunogenicity and the ability to provide an excellent substrate for growth, migration and adhesion of epithelial corneal and conjunctival cells, it is being used increasingly for ocular surface reconstruction in a variety of ocular pathologies including corneal disorders associated with limbal stem cell deficiency, surgeries for conjunctival reconstruction, as a carrier for ex vivo expansion of limbal epithelial cells, glaucoma surgeries and sceral melts and perforations. However indiscriminate use of human AM needs to be discouraged as complications though infrequent can occur. These include risk of transmission of bacterial, viral or fungal infections to the recipient if the donors are not adequately screened for communicable diseases, if the membrane is not processed under sterile condi-tions or if storage is improper. Optimal outcomes can be achieved only with meticulous case selection. This review explores the ever expanding ophthalmological indications for the use of human AM.
文摘Resurrection plants, which are the ＂gifts＂ of natural evolution, are ideal models for studying the genetic basis of plant desiccation tolerance. Here, we report a high-quality genome assembly of 301 Mb for the diploid spike moss Selaginella tamariscina, a primitive vascular resurrection plant. We predicated 27 761 protein-coding genes from the assembled S. tarnariscina genome, 11.38% （2363） of which showed signifi- cant expression changes in response to desiccation. Approximately 60.58% of the S. tamariscina genome was annotated as repetitive DNA, which is an almost 2-fold increase of that in the genome of desiccation- sensitive Selaginella moellendorffii. Genomic and transcriptomic analyses highlight the unique evolution and complex regulations of the desiccation response in S. tamariscina, including species-specific expan- sion of the oleosin and pentatricopeptide repeat gene families, unique genes and pathways for reactive oxygen species generation and scavenging, and enhanced abscisic acid （ABA） biosynthesis and potentially distinct regulation of ABA signaling and response. Comparative analysis of chloroplast genomes of several Selaginella species revealed a unique structural rearrangement and the complete loss of chloroplast NAD（P） H dehydrogenase （NDH） genes in S. tamariscina, suggesting a link between the absence of the NDH com- plex and desiccation tolerance. Taken together, our comparative genomic and transcriptomic analyses reveal common and species-specific desiccation tolerance strategies in S. tamariscina, providing signifi- cant insights into the desiccation tolerance mechanism and the evolution of resurrection plants.
