Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities ...Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities in antiinflammatory,anti-tumor,anti-viral,and anti-angiogenesis aspects,suggesting that artesunate might have potential in treating retinal diseases.Currently,the etiology of most retinal diseases is not fully understood,and there is a lack of effective treatment methods.This paper summarized the research progress of artesunate in the treatment of retinal diseases,including retinoblastoma,choroidal melanoma,diabetic retinopathy,central retinal vein occlusion,proliferative retinopathy,and ocular neovascularization.In addition,the potential applications and future research directions of artesunate in the treatment of retinal diseases were also discussed.展开更多
Aging is considered the main risk factor for the development of several diseases,including the leading neurodegenerative disorders.While the cellular features of aging are complex and multifaceted,neuronal senescence ...Aging is considered the main risk factor for the development of several diseases,including the leading neurodegenerative disorders.While the cellular features of aging are complex and multifaceted,neuronal senescence has emerged as a major contributor and driver of this process in the mammalian cell.Cellular senescence is a programmed response to stress and irreparable damage,which drives the cell into an apoptosis-resistant,non-proliferative state.Senescent cells can also deleteriously affect neighboring,non-senescent cells.Senescence is a complex and multifaceted process associated with a wide range of cellular events,including the secretion of pro-inflammatory molecules and the arrest of the cell cycle.展开更多
AIM:To report the incidence of epiretinal membrane(ERM)formation following panretinal photocoagulation(PRP)as the treatment for diabetic retinopathy(DR).METHODS:Retrospective cross-sectional study of patient charts be...AIM:To report the incidence of epiretinal membrane(ERM)formation following panretinal photocoagulation(PRP)as the treatment for diabetic retinopathy(DR).METHODS:Retrospective cross-sectional study of patient charts between January 1^(st),2010 to January 1^(st),2017 with at least 1y follow-up data.All 809 patients treated with PRP for DR were evaluated for exclusion criteria and 73 eyes remained after exclusion for confounding variables related to ERM formation such as other procedures or diseases.Outcomes were determined through medical record review and masked review of optical coherence tomography(OCT)images.Cohen’s kappa was completed to determine if there was an agreement between masked retinal specialists on OCT evaluations.Univariate logistic regression was used to determine the unadjusted odds ratio for patient and procedural characteristics on the formation of ERMs.Multiple logistic regression was then completed on select variables that met the cutoff of 0.25 for a statistically significant contribution by the Wald test with the sequential addition of clinical variables that contributed positively to the model.RESULTS:Among the 73 eyes studied,9.6%formed an ERM with an average time to formation of 1.4y.The minimum power uses during PRP was found to be statistically significant between non-ERM formers and ERM formers(P=0.044).When adjusting for all selected variables aside from minimum power used,multiple logistic regression determined that for every 10 mW increase in minimum power used during PRP,there is an increase in log odds of 1.009(SE:0.003,P=0.014).CONCLUSION:The incidence of ERM formation in 2y following treatment of DR with PRP is roughly 1 in every 10 eyes treated.展开更多
Aerial organs in rice,including leaves,stems,and grains,are crucial for photosynthesis,lodging resistance,and yield.Therefore,an in-depth study on the development of these organs can lay a foundation for achieving hig...Aerial organs in rice,including leaves,stems,and grains,are crucial for photosynthesis,lodging resistance,and yield.Therefore,an in-depth study on the development of these organs can lay a foundation for achieving high and stable rice yields.In this study,we isolated a novel slender aerial organ mutant sao,which is characterized by a significant reduction in the width of leaves,stems,and grains.Histological analysis revealed that the slender phenotype of aerial organs in sao is caused by impaired cell proliferation and elongation.展开更多
AIM:To summarize 10 surgical pearls for managing proliferative diabetic retinopathy(PDR)adapted from the ancient Chinese allusions and analyze the application of these pearls in a real-world fashion.METHODS:Retrospect...AIM:To summarize 10 surgical pearls for managing proliferative diabetic retinopathy(PDR)adapted from the ancient Chinese allusions and analyze the application of these pearls in a real-world fashion.METHODS:Retrospective,noncomparative,interventional study.Ten surgical pearls were summarized and adapted from the ancient Chinese philosophy.Totally 346 cases(443 eyes)that underwent pars plana vitrectomy(PPV)at our hospial from January 2016 to February 2024 were selected.Flexible combinations of these pearls were applied according to the specific condition of each patient during surgeries.The efficacy and safety were analyzed,as well as the application frequencies according to the existence of tractional retinal detachment or not.RESULTS:A total of 473 times of surgeries were performed on all the patients.According to ancient Chinese allusions,ten surgical pearls were summarized from these surgeries.All PPVs went smoothly with the application of different combinations.Finally,almost all proliferative membranes were successfully peeled except for 10 patients(11 eyes),who went through strategy No.10(minimal membranectomy)that,only necessary relaxation incisions were made with most of the proliferative membranes left on purpose.The final visual acuities were mostly improved or stable(1.92±0.83 LogMAR preoperatively vs 1.16±0.85 LogMAR postoperatively,P<0.01).Postoperative complications mainly included early inflammatory responses in the anterior chamber and nuclear sclerosis.Recurrent vitreous hemorrhage,retinal detachment,and hyphema or neovascular glaucoma occurred in 1.9%(9/473),3.2%(15/473),0.4%(2/473)and 0.4%(2/473)times of PPVs,respectively.After 12/473(2.5%)times of PPVs,retinal detachment at the macular area still existed,and multiple times of subsequent PPVs were conducted.Final retinal attachment at the macular area was realized in 98.9%eyes.Those 5 unattached eyes were with heavily reproliferated membranes and subsequent tractional retinal detachment recurrence under the oil,and three of them were scleral buckled additionally.CONCLUSION:These 10 surgical strategies and technique pearls were mostly effective and safe in the management of severe PDR patients.They were relatively easy to be memorized and applicated once the meaning of each Chinese idiom was understood.One can use different combinations flexibly according to a patient’s specific condition.展开更多
AIM:To evaluate the efficacy of second-stage phacoemulsification(PE)of complicated initial cataract after vitreoretinal surgery(VRS)in patients with advanced proliferative diabetic retinopathy(PDR).METHODS:Totally 216...AIM:To evaluate the efficacy of second-stage phacoemulsification(PE)of complicated initial cataract after vitreoretinal surgery(VRS)in patients with advanced proliferative diabetic retinopathy(PDR).METHODS:Totally 216 patients with PDR and complicated initial cataract who underwent surgery were included.These patients were divided into four groups according to their management.In the 1st group patients were subjected to a two–step surgical procedure:VRS with silicone oil tamponade was performed as the first step,followed by the second step,PE+intraocular lens(IOL)implantation+silicone oil removal.In the 2nd group PE was performed simultaneously with VRS and silicone oil tamponade.The second step differed in the removal of silicone oil from the vitreous cavity.Patients Ia(n=17)and IIa(n=17)subgroups had their tear liquid samples being examined before surgery and on the 2nd day after the 1st phase.In subgroups Ib and IIb,an angiogenesis inhibitor was implanted 10-14d before VRS at a dose of 0.5 mg once.In the 3rd group patients were subjected to a two–step surgical procedure:VRS with gas tamponade performed as the 1st step in their treatment;followed by the 2nd step,PE and the IOL implantation.In the 4th group PE performed simultaneously with VRS with gas tamponade.RESULTS:Patients in subgroup Ia and group III had better functional results than those in subgroup IIa and group IV,respectively(P<0.001).More marked inflammatory response(2-3 points)was statistically significant in patients of the IIa subgroup(P<0.001)and group IV(P<0.001)in comparison with the patients in the Ia and group III respectively.The IIa subgroup(n=9;14.5%)showed higher incidence of neovascular glaucoma(NVG)than the Ia(n=2;3.2%),P=0.027.There also was a higher rate of NVG in group IV(n=6;19.3%)compared to group III(n=1;3.1%),P=0.04.Subgroup IIa revealed a 2 to 2.5 times higher concentration of interleukin 8(IL-8),monocyte chemoattractant protein 1(MCP-1),and inter-cellular adhesion molecule 1(ICAM-1)compared to subgroup Ia.CONCLUSION:PE of initial cataract at the second stage after VRS in patients with advanced PDR provides a sparing approach to surgical treatment in this category of patients and allows to improve anatomical and functional results of VRS.In addition,it contributes to reduction of number and severity of postoperative complications.展开更多
Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatenin...Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.展开更多
AIM:To explore the causal links among circulating inflammatory proteins(CIPs)and the varying severities of diabetic retinopathy(DR).METHODS:This research utilized a two sample Mendelian randomization(MR)approach to ex...AIM:To explore the causal links among circulating inflammatory proteins(CIPs)and the varying severities of diabetic retinopathy(DR).METHODS:This research utilized a two sample Mendelian randomization(MR)approach to explore the causal relationships between 91 CIPs and various severities of DR:background DR(BDR)or non-proliferative DR(NPDR),and proliferative DR(PDR).Single-nucleotide polymorphisms(SNPs)related to the 91 CIPs as exposure factors were identified.These SNPs were selected from an extensive genome-wide association study(GWAS)analyzing large genomic datasets.Genetic variation data of various DR phenotypes provided by the FinnGen collaboration were utilized as outcomes.Inverse-variance weighting(IVW)was used as the main MR analysis.Robustness of study results was evaluated through a series of sensitivity analyses,employing the MR-pleiotropy-test and mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO)to confirm the absence of pleiotropy.RESULTS:In a bidirectional MR analysis,we uncovered a complex relationship between CIPs and DR.Elevated levels of tumor necrosis factor ligand superfamily member 14(TNFSF14),latency associated peptide transforming growth factors beta-1(LAP-TGF-beta1),interleukin-10(IL-10),and vascular endothelial growth factor A(VEGF-A)were associated with a reduced risk of NPDR.Conversely,elevated levels of fibroblast growth factor 23(FGF-23)were associated with an increased risk of NPDR.Concentrations of adenosine deaminase(ADA),matrix metalloproteinase-10(MMP-10),eotaxin,and IL-10 showed elevated levels and were linked to a reduced risk of NPDR.On the other hand,the levels of oncostatin-M,beta-nerve growth factor(β-NGF),and interleukin-7(IL-7)were elevated and associated with an increased risk of SNPDR.Elevated levels of ADA,MMP-10,and macrophage colony-stimulating factor 1(CSF1)were linked to a lower likelihood of PDR.Conversely,elevated levels of Caspase 8 and glial cell line-derived neurotrophic factor(GDNF)were associated with an increased risk of PDR.In reverse MR analysis,DR affected the expression of these factors.CONCLUSION:Our research demonstrates evidence supporting a potential causal link between key inflammatory factors and the risk and prognosis of various DR phenotypes.These findings emphasize the regulation of inflammatory factors responses as a strategic approach for preventing and managing DR.Altogether,our results validate the pathogenic role of inflammatory factors dysregulation in DR and support the rationale for exploring immunotherapeutic targets further.展开更多
AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic r...AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy(PDR)with gradable optical coherence tomography(OCT)imaging from January 2018 to March 2022.The incidence of post vitrectomy DME(PV-DME)was defined as patients with a central retinal thickness(CRT)>300µm by OCT among patients without preoperative DME.RESULTS:The cumulative incidence of PV-DME at 3mo was 40.1%(89/222),with its majority subtype of single diffused retinal thickening(66.2%)followed by single cystoid macular edema(27.0%).Multivariate Cox regression analysis indicated that a thicker preoperative CRT[hazard ratio(HR)=1.01,95%confidence interval(CI)1.00-1.02]and intraoperative internal limiting membrane peeling(HR=3.18,95%CI 1.85-5.47)were associated with the presence of PV-DME,while intraoperative intravitreal injection of triamcinolone acetonide(HR=0.28,95%CI 0.13-0.57)was protective against PV-DME.In eyes with preoperative DME(n=143),the CRT decreased gradually from 468.3±177.7μm preoperatively to 409.5±151.0μm(P=0.027),377.4±141.9μm(P<0.001),and 368.0±157.6μm(P<0.001)at 7d,1 and 3mo postoperatively,respectively.Multivariate linear regression analysis indicated that only a thicker preoperative CRT(β=0.77,95%CI 0.63-0.92)was associated with a decreasing postoperative CRT.CONCLUSION:PV-DME is a very common postoperative complication in patients with PDR.Triamcinolone acetonide could prevent its formation.Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.展开更多
BACKGROUND Proliferative lupus nephritis(PLN)is the most severe form of lupus nephritis(LN).There are limited data available on renal outcomes of PLN from developing countries.AIM To determine the clinicopathological ...BACKGROUND Proliferative lupus nephritis(PLN)is the most severe form of lupus nephritis(LN).There are limited data available on renal outcomes of PLN from developing countries.AIM To determine the clinicopathological characteristics and long-term outcomes in terms of remission,requirement of kidney replacement therapy(KRT),and patient survival.METHODS A retrospective analysis was conducted on biopsy-proven focal or diffuse PLN cases diagnosed between 1998 and 2019 at the Sindh Institute of Urology and Transplantation and followed up at the renal clinic for a minimum of 5 years.All patients were induced with a combination of intravenous cyclophosphamide and corticosteroids for 6 months,followed by maintenance treatment with azathioprine(AZA)or mycophenolate mofetil(MMF).Data were analyzed using Statistical Package for the Social Sciences,version 22.0.P≤0.05 was considered statistically significant.RESULTS The mean age at the onset of systemic lupus erythematosus was 24.12 years±8.89 years,and at LN onset,26.63 years±8.61 years.There was a female predominance of 184(88.9%)cases.Among baseline characteristics,reduced estimated glomerular filtration rate,presence of hypertension,requirement of KRT,and underlying renal histology(International Society of Nephrology/Renal Pathology Society class IV than class III)were significantly associated with end-stage kidney disease(ESKD)and mortality.The renal outcomes were negatively correlated with age,duration of symptoms,and 24-hour urinary protein excretion.The overall remission rate was 89.8%at the end of induction therapy.At 5 years,141(68.11%)patients were in complete and partial remission(94[45.4%]and 47[22.7%],respectively).In total,19(9.2%)patients required KRT on presentation,and at 5 years,38(18.4%)patients developed ESKD,and 28(13.5%)patients died.Thirty-four(16.4%)patients had a renal relapse,more with AZA than MMF(30[88.2%]vs 4[11.76%],respectively;P=0.04).Renal survival at 6 months was 89.8%,while at 5 years,it was 68.11%,showing a significant improvement in patients who did not need KRT at the time of presentation(P<0.0001).CONCLUSION Baseline renal functions,requirement of KRT,and diffuse proliferative disease were the most relevant prognostic factors for kidney survival among this cohort.Short-term renal outcomes were good.Long-term outcomes were poorer with AZA-based maintenance therapy than with MMF,with more ESKD and mortality.展开更多
AIM:To explore the correlation of gut microbiota and the metabolites with the progression of diabetic retinopathy(DR)and provide a novel strategy to elucidate the pathological mechanism of DR.METHODS:The fecal samples...AIM:To explore the correlation of gut microbiota and the metabolites with the progression of diabetic retinopathy(DR)and provide a novel strategy to elucidate the pathological mechanism of DR.METHODS:The fecal samples from 32 type 2 diabetes patients with proliferative retinopathy(PDR),23 with nonproliferative retinopathy(NPDR),27 without retinopathy(DM),and 29 from the sex-,age-and BMI-matched healthy controls(29 HC)were analyzed by 16S rDNA gene sequencing.Sixty fecal samples from PDR,DM,and HC groups were assayed by untargeted metabolomics.Fecal metabolites were measured using liquid chromatographymass spectrometry(LC-MS)analysis.Associations between gut microbiota and fecal metabolites were analyzed.RESULTS:A cluster of 2 microbiome and 12 metabolites accompanied with the severity of DR,and the close correlation of the disease progression with PDR-related microbiome and metabolites were found.To be specific,the structure of gut microbiota differed in four groups.Diversity and richness of gut microbiota were significantly lower in PDR and NPDR groups,than those in DM and HC groups.A cluster of microbiome enriched in PDR group,including Pseudomonas,Ruminococcaceae-UCG-002,Ruminococcaceae-UCG-005,Christensenellaceae-R-7,was observed.Functional analysis showed that the glucose and nicotinate degradations were significantly higher in PDR group than those in HC group.Arginine,serine,ornithine,and arachidonic acid were significantly enriched in PDR group,while proline was enriched in HC group.Functional analysis illustrated that arginine biosynthesis,lysine degradation,histidine catabolism,central carbon catabolism in cancer,D-arginine and D-ornithine catabolism were elevated in PDR group.Correlation analysis revealed that Ruminococcaceae-UCG-002 and Christensenellaceae-R-7 were positively associated with L-arginine,ornithine levels in fecal samples.CONCLUSION:This study elaborates the different microbiota structure in the gut from four groups.The relative abundance of Ruminococcaceae-UCG-002 and Parabacteroides are associated with the severity of DR.Amino acid and fatty acid catabolism is especially disordered in PDR group.This may help provide a novel diagnostic parameter for DR,especially PDR.展开更多
AIM:To identify different metabolites,proteins and related pathways to elucidate the causes of proliferative diabetic retinopathy(PDR)and resistance to anti-vascular endothelial growth factor(VEGF)drugs,and to provide...AIM:To identify different metabolites,proteins and related pathways to elucidate the causes of proliferative diabetic retinopathy(PDR)and resistance to anti-vascular endothelial growth factor(VEGF)drugs,and to provide biomarkers for the diagnosis and treatment of PDR.METHODS:Vitreous specimens from patients with diabetic retinopathy were collected and analyzed by Liquid Chromatography-Mass Spectrometry(LC-MS/MS)analyses based on 4D label-free technology.Statistically differentially expressed proteins(DEPs),Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway representation and protein interactions were analyzed.RESULTS:A total of 12 samples were analyzed.The proteomics results showed that a total of 58 proteins were identified as DEPs,of which 47 proteins were up-regulated and 11 proteins were down-regulated.We found that C1q and tumor necrosis factor related protein 5(C1QTNF5),Clusterin(CLU),tissue inhibitor of metal protease 1(TIMP1)and signal regulatory protein alpha(SIRPα)can all be specifically regulated after aflibercept treatment.GO functional analysis showed that some DEPs are related to changes in inflammatory regulatory pathways caused by PDR.In addition,protein-protein interaction(PPI)network evaluation revealed that TIMP1 plays a central role in neural regulation.In addition,CD47/SIRPαmay become a key target to resolve anti-VEGF drug resistance in PDR.CONCLUSION:Proteomic analysis is an approach of choice to explore the molecular mechanisms of PDR.Our data show that multiple proteins are differentially changed in PDR patients after intravitreal injection of aflibercept,among which C1QTNF5,CLU,TIMP1 and SIRPαmay become targets for future treatment of PDR and resolution of anti-VEGF resistance.展开更多
AIM:To analyze if a relationship between levels ofinflammatory serum biomarkers and severity of primaryproliferative vitreoretinopathy(PVR)exists.METHODS:A retrospective case-control study.Thehealthy adult patients wi...AIM:To analyze if a relationship between levels ofinflammatory serum biomarkers and severity of primaryproliferative vitreoretinopathy(PVR)exists.METHODS:A retrospective case-control study.Thehealthy adult patients with rhegmatogenous retinaldetachment and primary PVR were included in the PVRgroup.For the control group,healthy adults who underwentcataract surgery were included.The grade of PVR wasclassified according to the Retinal Society TerminologyCommittee.Blood samples were obtained before surgery,and processed in MYTHIC 18.Measures of interest wereneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyteratio(PLR),and lymphocyte-to-monocyte ratio(LMR),thetime between the decrease in visual acuity and surgery,PVRgrade,type of surgery,final best corrected visual acuity,andrate of re-detachment.RESULTS:Totally 240 patients were included,120 ineach group,79(65.8%)and 56(46.7%)were male in thePVR and control group,respectively.PVR A had greaterlevels of monocytes(0.28±0.18 vs 0.12±0.32,P=0.002),neutrophils(4.59±1.51 vs 3.92±1.27,P=0.006),and LMR(9.32±4.42 vs 7.43±3.90,P=0.01).PVR B had a greatermonocyte count(0.30±0.13 vs 0.12±0.32,P=0.001),andPVR C demonstrated higher levels in monocytes(0.27±0.12vs 0.12±0.32,P=0.004),neutrophils(4.39±1.13 vs3.92±1.27,P=0.004),and LMR(9.63±3.24 vs 7.43±3.90,P=0.002)compared to control,respectively.An LMR cut-offvalue of 9.38 predicted PVR with a sensibility of 54.2%andspecificity of 77.5%and NLR cut-off of 1.70 predicted PVRwith a sensibility of 62%and specificity of 54.2%.CONCLUSION:Patients with primary PVR demonstrategreater neutrophil,monocyte,and LMR levels than thecontrol group.Cut-off values obtained from ratios could beuseful in a clinical setting when no posterior view of thefundus is possible due to media opacity.展开更多
AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated...AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.展开更多
Objective:Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis(RA)associated with a very unfavorable prognosis.This study aimed to identify changes in renal function ...Objective:Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis(RA)associated with a very unfavorable prognosis.This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients.Methods:The study enrolled patients(126 patients)between 18 and 55 years of age with a confirmed active RA of more than 12 months.Each patient underwent the following range of laboratory and instrumental research methods:general clinical analysis of blood and urine,performing urinalysis according to Nechiporenko method;determining daily proteinuria;determining the blood content of glucose,urea,creatinine,uric acid,total bilirubin,liver transaminase level,ionogram,lipidogram,and coagulogram;determining the blood content of rheumatoid factor,anti-streptolysin O,and C-reactive protein;and X-ray of the joints of hands and feet.Renal function was examined by estimating glomerular filtration rate,tubular reabsorption index,and renal functional reserve.For studying the morphological changes in the kidneys under ultrasound examination,renal biopsy was performed in 31 patients with RA with urinary syndrome(proteinuria more than 0.3 g per day and hematuria).Results:Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve.Among morphological variations of nephropathy at RA,mesangial proliferative glomerulonephritis prevails,accounting for 48.4%of patients.Other disorders include the secondary amyloidosis(29.0%of patients),tubulointerstitial nephritis(16.1%),membranous glomerulonephritis(3.2%),and focal-segmental glomerulosclerosis(3.2%).Conclusion:Kidney damage is a common systemic manifestation of RA with a long and active course,a major nephropathy trigger.展开更多
BACKGROUND No study has investigated the change regularity between age and subfoveal choroidal thickness(SFCT)in proliferative diabetic retinopathy(PDR).AIM To investigate the relationship between the SFCT and age in ...BACKGROUND No study has investigated the change regularity between age and subfoveal choroidal thickness(SFCT)in proliferative diabetic retinopathy(PDR).AIM To investigate the relationship between the SFCT and age in Chinese patients with PDR.METHODS This was a cross-sectional retrospective study.The participants were hospitalized individuals with type 2 diabetes who underwent vitrectomy for PDR.Contralateral eyes that met the criteria were included in the study.All necessary laboratory tests were performed at the time of admission.Central macular thickness(CMT)and SFCT were two quantitative assessments made using enhanced depth imaging optical coherence tomography.CMT was measured automatically and SFCT was measured manually with digital calipers provided by the Heidelberg Eye Explorer software.RESULTS The final analysis included a total of 234 individuals with PDR.The average age was 55.60 years old±10.03 years old,and 57.69%of the population was male.Univariate analysis revealed a significant negative connection between age and SFCT in patients with PDR[β=-2.44,95%confidence interval(95%CI):-3.46 to-1.42;P<0.0001].In the fully adjusted model,the correlation between SFCT and age remained steady(β=-1.68,95%CI:-2.97 to-0.39;P=0.0117).Spline smoothing showed that the relationship between SFCT and age in patients with PDR was non-linear,with an inflection point at 54 years of age.CONCLUSION Our findings suggest that age is a key determinant of choroidal thickness.The non-linear link between SFCT and age in PDR patients should be taken into account.展开更多
AIM:To analyze the distribution of fibrovascular proliferative membranes(FVPMs)in proliferative diabetic retinopathy(PDR)patients that treated with pars plana vitrectomy(PPV),and to evaluate the outcomes separately.ME...AIM:To analyze the distribution of fibrovascular proliferative membranes(FVPMs)in proliferative diabetic retinopathy(PDR)patients that treated with pars plana vitrectomy(PPV),and to evaluate the outcomes separately.METHODS:This was a retrospective and cross-sectional study.Consecutive 25-gauge(25-G)PPV cases operated for PDR from May 2018 to April 2020.According to the FVPMs images outlined after operations,subjects were assigned into three groups:arcade type group,juxtapapillary type group,and central type group.All patients were followed up for over one year.General characteristics,operation-related variables,postoperative parameters and complications were recorded.RESULTS:Among 103 eyes recruited,the FVPMs distribution of nasotemporal and inferiosuperioral was significantly different(both P<0.01),with 95(92.23%)FVPMs located in the nasal quadrants,and 74(71.84%)in the inferior.The eyes with a central FVPM required the longest operation time,with silicon oil used in most patients,generally combined with tractional retinal detachment(RD)and rhegmatogenous RD,the worst postoperative bestcorrected visual acuity(BCVA)and the highest rates of recurrent RD(all P<0.05).FVPM type,age of onset diabetes mellitus,preoperative BCVA,and combined with tractional RD and rhegmatogenous RD were significantly associated with BCVA improvement(all P<0.05).Compared with the central type group,the arcade type group had higher rates of BCVA improvement.CONCLUSION:FVPMs are more commonly found in the nasal and inferior mid-peripheral retina in addition to the area of arcade vessels.Performing 25-G PPV for treating PDR eyes with central FVPM have relatively worse prognosis.展开更多
●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:T...●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.展开更多
The deep crustal structure is closely related to oil and gas reserves.Predicting the oil and gas enrichment of depressions based on the Moho depth and crustal thickness is a promising research topic with significant i...The deep crustal structure is closely related to oil and gas reserves.Predicting the oil and gas enrichment of depressions based on the Moho depth and crustal thickness is a promising research topic with significant implications for guiding exploration in petroliferous basins.In this study,seismic data were used as a constraint on the use of satellite gravity anomaly inversion to obtain the distribution of Moho depth and crustal thickness in the Bohai Basin.Stretching factors were calculated to analyze the differential distribution of deep crustal structural activity.Four indicators,including the minimum Moho depth,minimum crustal thickness,sum of Moho stretching factors,and sum of crustal stretching factors,were selected.Principal component analysis was applied to reduce the dimensionality of the multi-indicator system and obtain an oil and gas enrichment score for quantitative prediction of favorable prolific depressions.The deviation between the inverted Moho depth and seismic constraints was small;thus,the data effectively reflect the variations in the characteristics of each depression.The analysis revealed significant statistical features related to the minimum Moho depth/crustal thickness and the sum of Moho/crustal stretching factors associated with prolific depressions.Based on the oil and gas enrichment score,the depressions were classified into four categories related to their different deep crustal structural characteristics.Highly active ClassⅠ,ClassⅡ,and ClassⅢdepressions are predicted to be favorable prolific depressions.This study expands the research on quantitatively predicting favorable prolific depressions in the Bohai Basin using the deep crustal structure and can contribute to reducing production costs and improving exploration efficiency in future explorations.展开更多
AIM:To investigate the role of connective tissue growth factor(CTGF)and vascular endothelial growth factor(VEGF)in the protein profile of the aqueous humor in patients with proliferative diabetic retinopathy(PDR)follo...AIM:To investigate the role of connective tissue growth factor(CTGF)and vascular endothelial growth factor(VEGF)in the protein profile of the aqueous humor in patients with proliferative diabetic retinopathy(PDR)following intravitreal injection of conbercept.METHODS:This study included 72 PDR patients and 8 cataract patients as controls.PDR patients were divided into 3 groups according to the intervals of 3,5,and 7d between intravitreal conbercept(IVC,0.5 mg/0.05 mL)injection and pars plana vitrectomy(PPV)performed.Aqueous humor samples were collected before and after IVC and PPV for VEGF and CTGF levels detected with enzyme-linked immunosorbent assay(ELISA).The differential proteomics of 10 patients who underwent PPV surgery 5d after IVC and 8 normal controls was studied,Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were performed on the data,and the protein interaction network of 23 differential proteins was studied.RESULTS:Post-IVC,VEGF levels decreased and CTGF levels increased significantly in aqueous humor,with the CTGF/VEGF ratio rising significantly at all intervals.Liquid chromatography tandem mass spectrometry(LC-MS/MS)identified differentially expressed proteins between preand post-IVC samples.GO and KEGG analyses revealed involvement in immune response,stress response,complement and coagulation cascades,ferroptosis,and PPAR signaling pathways.PPI analysis highlighted key proteins like APOA1,C3,and transferrin(TF).ELISA assay confirmed the differential expression of proteins such as HBA1,SERPINA1,COL1A1,and ACTB,with significant changes in the IVC groups.CONCLUSION:The study demonstrates that IVC effectively reduces VEGF levels while increasing CTGF levels,thereby modifying the CTGF/VEGF ratio,and IVC significantly alters the protein profile in the aqueous humor of patients with PDR.Proteomic analysis reveals that these changes are associated with critical biological pathways and protein interactions involved in immune response,stress response,and cellular metabolism.展开更多
基金Supported by the Ministry of National Natural Science Foundation of China(No.82260210)General Project of Jiangxi Provincial Traditional Chinese Medicine Science and Technology Plan(No.2023B1368)Jiangxi Provincial Health Science and Technology Program(No.202510055).
文摘Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities in antiinflammatory,anti-tumor,anti-viral,and anti-angiogenesis aspects,suggesting that artesunate might have potential in treating retinal diseases.Currently,the etiology of most retinal diseases is not fully understood,and there is a lack of effective treatment methods.This paper summarized the research progress of artesunate in the treatment of retinal diseases,including retinoblastoma,choroidal melanoma,diabetic retinopathy,central retinal vein occlusion,proliferative retinopathy,and ocular neovascularization.In addition,the potential applications and future research directions of artesunate in the treatment of retinal diseases were also discussed.
文摘Aging is considered the main risk factor for the development of several diseases,including the leading neurodegenerative disorders.While the cellular features of aging are complex and multifaceted,neuronal senescence has emerged as a major contributor and driver of this process in the mammalian cell.Cellular senescence is a programmed response to stress and irreparable damage,which drives the cell into an apoptosis-resistant,non-proliferative state.Senescent cells can also deleteriously affect neighboring,non-senescent cells.Senescence is a complex and multifaceted process associated with a wide range of cellular events,including the secretion of pro-inflammatory molecules and the arrest of the cell cycle.
文摘AIM:To report the incidence of epiretinal membrane(ERM)formation following panretinal photocoagulation(PRP)as the treatment for diabetic retinopathy(DR).METHODS:Retrospective cross-sectional study of patient charts between January 1^(st),2010 to January 1^(st),2017 with at least 1y follow-up data.All 809 patients treated with PRP for DR were evaluated for exclusion criteria and 73 eyes remained after exclusion for confounding variables related to ERM formation such as other procedures or diseases.Outcomes were determined through medical record review and masked review of optical coherence tomography(OCT)images.Cohen’s kappa was completed to determine if there was an agreement between masked retinal specialists on OCT evaluations.Univariate logistic regression was used to determine the unadjusted odds ratio for patient and procedural characteristics on the formation of ERMs.Multiple logistic regression was then completed on select variables that met the cutoff of 0.25 for a statistically significant contribution by the Wald test with the sequential addition of clinical variables that contributed positively to the model.RESULTS:Among the 73 eyes studied,9.6%formed an ERM with an average time to formation of 1.4y.The minimum power uses during PRP was found to be statistically significant between non-ERM formers and ERM formers(P=0.044).When adjusting for all selected variables aside from minimum power used,multiple logistic regression determined that for every 10 mW increase in minimum power used during PRP,there is an increase in log odds of 1.009(SE:0.003,P=0.014).CONCLUSION:The incidence of ERM formation in 2y following treatment of DR with PRP is roughly 1 in every 10 eyes treated.
基金supported by the Sichuan Science and Technology Program,China(Grant No.2024JDRC0064)the Chongqing Talent Program Foundation,China(Grant No.cstc2024ycjh-bgzxm0063)+1 种基金the National Natural Science Foundation of China(Grant No.32470354)the Sichuan Science and Technology Innovation and Entrepreneurship Seedling Foundation,China(Grant No.2024JDRC0064).
文摘Aerial organs in rice,including leaves,stems,and grains,are crucial for photosynthesis,lodging resistance,and yield.Therefore,an in-depth study on the development of these organs can lay a foundation for achieving high and stable rice yields.In this study,we isolated a novel slender aerial organ mutant sao,which is characterized by a significant reduction in the width of leaves,stems,and grains.Histological analysis revealed that the slender phenotype of aerial organs in sao is caused by impaired cell proliferation and elongation.
文摘AIM:To summarize 10 surgical pearls for managing proliferative diabetic retinopathy(PDR)adapted from the ancient Chinese allusions and analyze the application of these pearls in a real-world fashion.METHODS:Retrospective,noncomparative,interventional study.Ten surgical pearls were summarized and adapted from the ancient Chinese philosophy.Totally 346 cases(443 eyes)that underwent pars plana vitrectomy(PPV)at our hospial from January 2016 to February 2024 were selected.Flexible combinations of these pearls were applied according to the specific condition of each patient during surgeries.The efficacy and safety were analyzed,as well as the application frequencies according to the existence of tractional retinal detachment or not.RESULTS:A total of 473 times of surgeries were performed on all the patients.According to ancient Chinese allusions,ten surgical pearls were summarized from these surgeries.All PPVs went smoothly with the application of different combinations.Finally,almost all proliferative membranes were successfully peeled except for 10 patients(11 eyes),who went through strategy No.10(minimal membranectomy)that,only necessary relaxation incisions were made with most of the proliferative membranes left on purpose.The final visual acuities were mostly improved or stable(1.92±0.83 LogMAR preoperatively vs 1.16±0.85 LogMAR postoperatively,P<0.01).Postoperative complications mainly included early inflammatory responses in the anterior chamber and nuclear sclerosis.Recurrent vitreous hemorrhage,retinal detachment,and hyphema or neovascular glaucoma occurred in 1.9%(9/473),3.2%(15/473),0.4%(2/473)and 0.4%(2/473)times of PPVs,respectively.After 12/473(2.5%)times of PPVs,retinal detachment at the macular area still existed,and multiple times of subsequent PPVs were conducted.Final retinal attachment at the macular area was realized in 98.9%eyes.Those 5 unattached eyes were with heavily reproliferated membranes and subsequent tractional retinal detachment recurrence under the oil,and three of them were scleral buckled additionally.CONCLUSION:These 10 surgical strategies and technique pearls were mostly effective and safe in the management of severe PDR patients.They were relatively easy to be memorized and applicated once the meaning of each Chinese idiom was understood.One can use different combinations flexibly according to a patient’s specific condition.
文摘AIM:To evaluate the efficacy of second-stage phacoemulsification(PE)of complicated initial cataract after vitreoretinal surgery(VRS)in patients with advanced proliferative diabetic retinopathy(PDR).METHODS:Totally 216 patients with PDR and complicated initial cataract who underwent surgery were included.These patients were divided into four groups according to their management.In the 1st group patients were subjected to a two–step surgical procedure:VRS with silicone oil tamponade was performed as the first step,followed by the second step,PE+intraocular lens(IOL)implantation+silicone oil removal.In the 2nd group PE was performed simultaneously with VRS and silicone oil tamponade.The second step differed in the removal of silicone oil from the vitreous cavity.Patients Ia(n=17)and IIa(n=17)subgroups had their tear liquid samples being examined before surgery and on the 2nd day after the 1st phase.In subgroups Ib and IIb,an angiogenesis inhibitor was implanted 10-14d before VRS at a dose of 0.5 mg once.In the 3rd group patients were subjected to a two–step surgical procedure:VRS with gas tamponade performed as the 1st step in their treatment;followed by the 2nd step,PE and the IOL implantation.In the 4th group PE performed simultaneously with VRS with gas tamponade.RESULTS:Patients in subgroup Ia and group III had better functional results than those in subgroup IIa and group IV,respectively(P<0.001).More marked inflammatory response(2-3 points)was statistically significant in patients of the IIa subgroup(P<0.001)and group IV(P<0.001)in comparison with the patients in the Ia and group III respectively.The IIa subgroup(n=9;14.5%)showed higher incidence of neovascular glaucoma(NVG)than the Ia(n=2;3.2%),P=0.027.There also was a higher rate of NVG in group IV(n=6;19.3%)compared to group III(n=1;3.1%),P=0.04.Subgroup IIa revealed a 2 to 2.5 times higher concentration of interleukin 8(IL-8),monocyte chemoattractant protein 1(MCP-1),and inter-cellular adhesion molecule 1(ICAM-1)compared to subgroup Ia.CONCLUSION:PE of initial cataract at the second stage after VRS in patients with advanced PDR provides a sparing approach to surgical treatment in this category of patients and allows to improve anatomical and functional results of VRS.In addition,it contributes to reduction of number and severity of postoperative complications.
文摘Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.
基金Supported by Natural Science Foundation of Hubei Province(No.2023AFC019,No.2020CFB240)Hubei Key Laboratories Opening Project(No.2023KFH019,No.2021KFY055)Fundamental Research Funds for Central Universities(No.2042020kf0065).
文摘AIM:To explore the causal links among circulating inflammatory proteins(CIPs)and the varying severities of diabetic retinopathy(DR).METHODS:This research utilized a two sample Mendelian randomization(MR)approach to explore the causal relationships between 91 CIPs and various severities of DR:background DR(BDR)or non-proliferative DR(NPDR),and proliferative DR(PDR).Single-nucleotide polymorphisms(SNPs)related to the 91 CIPs as exposure factors were identified.These SNPs were selected from an extensive genome-wide association study(GWAS)analyzing large genomic datasets.Genetic variation data of various DR phenotypes provided by the FinnGen collaboration were utilized as outcomes.Inverse-variance weighting(IVW)was used as the main MR analysis.Robustness of study results was evaluated through a series of sensitivity analyses,employing the MR-pleiotropy-test and mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO)to confirm the absence of pleiotropy.RESULTS:In a bidirectional MR analysis,we uncovered a complex relationship between CIPs and DR.Elevated levels of tumor necrosis factor ligand superfamily member 14(TNFSF14),latency associated peptide transforming growth factors beta-1(LAP-TGF-beta1),interleukin-10(IL-10),and vascular endothelial growth factor A(VEGF-A)were associated with a reduced risk of NPDR.Conversely,elevated levels of fibroblast growth factor 23(FGF-23)were associated with an increased risk of NPDR.Concentrations of adenosine deaminase(ADA),matrix metalloproteinase-10(MMP-10),eotaxin,and IL-10 showed elevated levels and were linked to a reduced risk of NPDR.On the other hand,the levels of oncostatin-M,beta-nerve growth factor(β-NGF),and interleukin-7(IL-7)were elevated and associated with an increased risk of SNPDR.Elevated levels of ADA,MMP-10,and macrophage colony-stimulating factor 1(CSF1)were linked to a lower likelihood of PDR.Conversely,elevated levels of Caspase 8 and glial cell line-derived neurotrophic factor(GDNF)were associated with an increased risk of PDR.In reverse MR analysis,DR affected the expression of these factors.CONCLUSION:Our research demonstrates evidence supporting a potential causal link between key inflammatory factors and the risk and prognosis of various DR phenotypes.These findings emphasize the regulation of inflammatory factors responses as a strategic approach for preventing and managing DR.Altogether,our results validate the pathogenic role of inflammatory factors dysregulation in DR and support the rationale for exploring immunotherapeutic targets further.
基金Supported by Zhejiang Provincial Highlevel Health Talents Training Project(No.CZ-RC2022010)Wenzhou Basic Medical and Health Technology Project(No.Y2023173)Innovation Project of School of Ophthalmology and Optometry,Eye Hospital of Wenzhou Medical University(No.YNCX3201905).
文摘AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy(PDR)with gradable optical coherence tomography(OCT)imaging from January 2018 to March 2022.The incidence of post vitrectomy DME(PV-DME)was defined as patients with a central retinal thickness(CRT)>300µm by OCT among patients without preoperative DME.RESULTS:The cumulative incidence of PV-DME at 3mo was 40.1%(89/222),with its majority subtype of single diffused retinal thickening(66.2%)followed by single cystoid macular edema(27.0%).Multivariate Cox regression analysis indicated that a thicker preoperative CRT[hazard ratio(HR)=1.01,95%confidence interval(CI)1.00-1.02]and intraoperative internal limiting membrane peeling(HR=3.18,95%CI 1.85-5.47)were associated with the presence of PV-DME,while intraoperative intravitreal injection of triamcinolone acetonide(HR=0.28,95%CI 0.13-0.57)was protective against PV-DME.In eyes with preoperative DME(n=143),the CRT decreased gradually from 468.3±177.7μm preoperatively to 409.5±151.0μm(P=0.027),377.4±141.9μm(P<0.001),and 368.0±157.6μm(P<0.001)at 7d,1 and 3mo postoperatively,respectively.Multivariate linear regression analysis indicated that only a thicker preoperative CRT(β=0.77,95%CI 0.63-0.92)was associated with a decreasing postoperative CRT.CONCLUSION:PV-DME is a very common postoperative complication in patients with PDR.Triamcinolone acetonide could prevent its formation.Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.
文摘BACKGROUND Proliferative lupus nephritis(PLN)is the most severe form of lupus nephritis(LN).There are limited data available on renal outcomes of PLN from developing countries.AIM To determine the clinicopathological characteristics and long-term outcomes in terms of remission,requirement of kidney replacement therapy(KRT),and patient survival.METHODS A retrospective analysis was conducted on biopsy-proven focal or diffuse PLN cases diagnosed between 1998 and 2019 at the Sindh Institute of Urology and Transplantation and followed up at the renal clinic for a minimum of 5 years.All patients were induced with a combination of intravenous cyclophosphamide and corticosteroids for 6 months,followed by maintenance treatment with azathioprine(AZA)or mycophenolate mofetil(MMF).Data were analyzed using Statistical Package for the Social Sciences,version 22.0.P≤0.05 was considered statistically significant.RESULTS The mean age at the onset of systemic lupus erythematosus was 24.12 years±8.89 years,and at LN onset,26.63 years±8.61 years.There was a female predominance of 184(88.9%)cases.Among baseline characteristics,reduced estimated glomerular filtration rate,presence of hypertension,requirement of KRT,and underlying renal histology(International Society of Nephrology/Renal Pathology Society class IV than class III)were significantly associated with end-stage kidney disease(ESKD)and mortality.The renal outcomes were negatively correlated with age,duration of symptoms,and 24-hour urinary protein excretion.The overall remission rate was 89.8%at the end of induction therapy.At 5 years,141(68.11%)patients were in complete and partial remission(94[45.4%]and 47[22.7%],respectively).In total,19(9.2%)patients required KRT on presentation,and at 5 years,38(18.4%)patients developed ESKD,and 28(13.5%)patients died.Thirty-four(16.4%)patients had a renal relapse,more with AZA than MMF(30[88.2%]vs 4[11.76%],respectively;P=0.04).Renal survival at 6 months was 89.8%,while at 5 years,it was 68.11%,showing a significant improvement in patients who did not need KRT at the time of presentation(P<0.0001).CONCLUSION Baseline renal functions,requirement of KRT,and diffuse proliferative disease were the most relevant prognostic factors for kidney survival among this cohort.Short-term renal outcomes were good.Long-term outcomes were poorer with AZA-based maintenance therapy than with MMF,with more ESKD and mortality.
文摘AIM:To explore the correlation of gut microbiota and the metabolites with the progression of diabetic retinopathy(DR)and provide a novel strategy to elucidate the pathological mechanism of DR.METHODS:The fecal samples from 32 type 2 diabetes patients with proliferative retinopathy(PDR),23 with nonproliferative retinopathy(NPDR),27 without retinopathy(DM),and 29 from the sex-,age-and BMI-matched healthy controls(29 HC)were analyzed by 16S rDNA gene sequencing.Sixty fecal samples from PDR,DM,and HC groups were assayed by untargeted metabolomics.Fecal metabolites were measured using liquid chromatographymass spectrometry(LC-MS)analysis.Associations between gut microbiota and fecal metabolites were analyzed.RESULTS:A cluster of 2 microbiome and 12 metabolites accompanied with the severity of DR,and the close correlation of the disease progression with PDR-related microbiome and metabolites were found.To be specific,the structure of gut microbiota differed in four groups.Diversity and richness of gut microbiota were significantly lower in PDR and NPDR groups,than those in DM and HC groups.A cluster of microbiome enriched in PDR group,including Pseudomonas,Ruminococcaceae-UCG-002,Ruminococcaceae-UCG-005,Christensenellaceae-R-7,was observed.Functional analysis showed that the glucose and nicotinate degradations were significantly higher in PDR group than those in HC group.Arginine,serine,ornithine,and arachidonic acid were significantly enriched in PDR group,while proline was enriched in HC group.Functional analysis illustrated that arginine biosynthesis,lysine degradation,histidine catabolism,central carbon catabolism in cancer,D-arginine and D-ornithine catabolism were elevated in PDR group.Correlation analysis revealed that Ruminococcaceae-UCG-002 and Christensenellaceae-R-7 were positively associated with L-arginine,ornithine levels in fecal samples.CONCLUSION:This study elaborates the different microbiota structure in the gut from four groups.The relative abundance of Ruminococcaceae-UCG-002 and Parabacteroides are associated with the severity of DR.Amino acid and fatty acid catabolism is especially disordered in PDR group.This may help provide a novel diagnostic parameter for DR,especially PDR.
基金Supported by Tianjin Key Medical Discipline Specialty Construction Project(No.TJYXZDXK-016A)Henan Provincial Department of Science and Technology(No.LHGJ20200802).
文摘AIM:To identify different metabolites,proteins and related pathways to elucidate the causes of proliferative diabetic retinopathy(PDR)and resistance to anti-vascular endothelial growth factor(VEGF)drugs,and to provide biomarkers for the diagnosis and treatment of PDR.METHODS:Vitreous specimens from patients with diabetic retinopathy were collected and analyzed by Liquid Chromatography-Mass Spectrometry(LC-MS/MS)analyses based on 4D label-free technology.Statistically differentially expressed proteins(DEPs),Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway representation and protein interactions were analyzed.RESULTS:A total of 12 samples were analyzed.The proteomics results showed that a total of 58 proteins were identified as DEPs,of which 47 proteins were up-regulated and 11 proteins were down-regulated.We found that C1q and tumor necrosis factor related protein 5(C1QTNF5),Clusterin(CLU),tissue inhibitor of metal protease 1(TIMP1)and signal regulatory protein alpha(SIRPα)can all be specifically regulated after aflibercept treatment.GO functional analysis showed that some DEPs are related to changes in inflammatory regulatory pathways caused by PDR.In addition,protein-protein interaction(PPI)network evaluation revealed that TIMP1 plays a central role in neural regulation.In addition,CD47/SIRPαmay become a key target to resolve anti-VEGF drug resistance in PDR.CONCLUSION:Proteomic analysis is an approach of choice to explore the molecular mechanisms of PDR.Our data show that multiple proteins are differentially changed in PDR patients after intravitreal injection of aflibercept,among which C1QTNF5,CLU,TIMP1 and SIRPαmay become targets for future treatment of PDR and resolution of anti-VEGF resistance.
文摘AIM:To analyze if a relationship between levels ofinflammatory serum biomarkers and severity of primaryproliferative vitreoretinopathy(PVR)exists.METHODS:A retrospective case-control study.Thehealthy adult patients with rhegmatogenous retinaldetachment and primary PVR were included in the PVRgroup.For the control group,healthy adults who underwentcataract surgery were included.The grade of PVR wasclassified according to the Retinal Society TerminologyCommittee.Blood samples were obtained before surgery,and processed in MYTHIC 18.Measures of interest wereneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyteratio(PLR),and lymphocyte-to-monocyte ratio(LMR),thetime between the decrease in visual acuity and surgery,PVRgrade,type of surgery,final best corrected visual acuity,andrate of re-detachment.RESULTS:Totally 240 patients were included,120 ineach group,79(65.8%)and 56(46.7%)were male in thePVR and control group,respectively.PVR A had greaterlevels of monocytes(0.28±0.18 vs 0.12±0.32,P=0.002),neutrophils(4.59±1.51 vs 3.92±1.27,P=0.006),and LMR(9.32±4.42 vs 7.43±3.90,P=0.01).PVR B had a greatermonocyte count(0.30±0.13 vs 0.12±0.32,P=0.001),andPVR C demonstrated higher levels in monocytes(0.27±0.12vs 0.12±0.32,P=0.004),neutrophils(4.39±1.13 vs3.92±1.27,P=0.004),and LMR(9.63±3.24 vs 7.43±3.90,P=0.002)compared to control,respectively.An LMR cut-offvalue of 9.38 predicted PVR with a sensibility of 54.2%andspecificity of 77.5%and NLR cut-off of 1.70 predicted PVRwith a sensibility of 62%and specificity of 54.2%.CONCLUSION:Patients with primary PVR demonstrategreater neutrophil,monocyte,and LMR levels than thecontrol group.Cut-off values obtained from ratios could beuseful in a clinical setting when no posterior view of thefundus is possible due to media opacity.
基金Supported by Research Grants from the fund of Suzhou Kowloon Hospital(No.SZJL202106).
文摘AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.
文摘Objective:Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis(RA)associated with a very unfavorable prognosis.This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients.Methods:The study enrolled patients(126 patients)between 18 and 55 years of age with a confirmed active RA of more than 12 months.Each patient underwent the following range of laboratory and instrumental research methods:general clinical analysis of blood and urine,performing urinalysis according to Nechiporenko method;determining daily proteinuria;determining the blood content of glucose,urea,creatinine,uric acid,total bilirubin,liver transaminase level,ionogram,lipidogram,and coagulogram;determining the blood content of rheumatoid factor,anti-streptolysin O,and C-reactive protein;and X-ray of the joints of hands and feet.Renal function was examined by estimating glomerular filtration rate,tubular reabsorption index,and renal functional reserve.For studying the morphological changes in the kidneys under ultrasound examination,renal biopsy was performed in 31 patients with RA with urinary syndrome(proteinuria more than 0.3 g per day and hematuria).Results:Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve.Among morphological variations of nephropathy at RA,mesangial proliferative glomerulonephritis prevails,accounting for 48.4%of patients.Other disorders include the secondary amyloidosis(29.0%of patients),tubulointerstitial nephritis(16.1%),membranous glomerulonephritis(3.2%),and focal-segmental glomerulosclerosis(3.2%).Conclusion:Kidney damage is a common systemic manifestation of RA with a long and active course,a major nephropathy trigger.
基金Supported by the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21025.
文摘BACKGROUND No study has investigated the change regularity between age and subfoveal choroidal thickness(SFCT)in proliferative diabetic retinopathy(PDR).AIM To investigate the relationship between the SFCT and age in Chinese patients with PDR.METHODS This was a cross-sectional retrospective study.The participants were hospitalized individuals with type 2 diabetes who underwent vitrectomy for PDR.Contralateral eyes that met the criteria were included in the study.All necessary laboratory tests were performed at the time of admission.Central macular thickness(CMT)and SFCT were two quantitative assessments made using enhanced depth imaging optical coherence tomography.CMT was measured automatically and SFCT was measured manually with digital calipers provided by the Heidelberg Eye Explorer software.RESULTS The final analysis included a total of 234 individuals with PDR.The average age was 55.60 years old±10.03 years old,and 57.69%of the population was male.Univariate analysis revealed a significant negative connection between age and SFCT in patients with PDR[β=-2.44,95%confidence interval(95%CI):-3.46 to-1.42;P<0.0001].In the fully adjusted model,the correlation between SFCT and age remained steady(β=-1.68,95%CI:-2.97 to-0.39;P=0.0117).Spline smoothing showed that the relationship between SFCT and age in patients with PDR was non-linear,with an inflection point at 54 years of age.CONCLUSION Our findings suggest that age is a key determinant of choroidal thickness.The non-linear link between SFCT and age in PDR patients should be taken into account.
基金Supported by the Program for Qinhuangdao Self-financing Science and Technology Plan of 2008 (No.201805A143).
文摘AIM:To analyze the distribution of fibrovascular proliferative membranes(FVPMs)in proliferative diabetic retinopathy(PDR)patients that treated with pars plana vitrectomy(PPV),and to evaluate the outcomes separately.METHODS:This was a retrospective and cross-sectional study.Consecutive 25-gauge(25-G)PPV cases operated for PDR from May 2018 to April 2020.According to the FVPMs images outlined after operations,subjects were assigned into three groups:arcade type group,juxtapapillary type group,and central type group.All patients were followed up for over one year.General characteristics,operation-related variables,postoperative parameters and complications were recorded.RESULTS:Among 103 eyes recruited,the FVPMs distribution of nasotemporal and inferiosuperioral was significantly different(both P<0.01),with 95(92.23%)FVPMs located in the nasal quadrants,and 74(71.84%)in the inferior.The eyes with a central FVPM required the longest operation time,with silicon oil used in most patients,generally combined with tractional retinal detachment(RD)and rhegmatogenous RD,the worst postoperative bestcorrected visual acuity(BCVA)and the highest rates of recurrent RD(all P<0.05).FVPM type,age of onset diabetes mellitus,preoperative BCVA,and combined with tractional RD and rhegmatogenous RD were significantly associated with BCVA improvement(all P<0.05).Compared with the central type group,the arcade type group had higher rates of BCVA improvement.CONCLUSION:FVPMs are more commonly found in the nasal and inferior mid-peripheral retina in addition to the area of arcade vessels.Performing 25-G PPV for treating PDR eyes with central FVPM have relatively worse prognosis.
文摘●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.
基金The Scientific and Technological Project of China National Offshore Oil Corporation(CNOOC)Research Institute Co.,Ltd.under contract No.CCL2021RCPS0167KQNthe Open Fund Project for the year 2022 of National Engineering Research Center of Offshore Oil and Gas Exploration under contract No.CCL2022RCPS0794RQN。
文摘The deep crustal structure is closely related to oil and gas reserves.Predicting the oil and gas enrichment of depressions based on the Moho depth and crustal thickness is a promising research topic with significant implications for guiding exploration in petroliferous basins.In this study,seismic data were used as a constraint on the use of satellite gravity anomaly inversion to obtain the distribution of Moho depth and crustal thickness in the Bohai Basin.Stretching factors were calculated to analyze the differential distribution of deep crustal structural activity.Four indicators,including the minimum Moho depth,minimum crustal thickness,sum of Moho stretching factors,and sum of crustal stretching factors,were selected.Principal component analysis was applied to reduce the dimensionality of the multi-indicator system and obtain an oil and gas enrichment score for quantitative prediction of favorable prolific depressions.The deviation between the inverted Moho depth and seismic constraints was small;thus,the data effectively reflect the variations in the characteristics of each depression.The analysis revealed significant statistical features related to the minimum Moho depth/crustal thickness and the sum of Moho/crustal stretching factors associated with prolific depressions.Based on the oil and gas enrichment score,the depressions were classified into four categories related to their different deep crustal structural characteristics.Highly active ClassⅠ,ClassⅡ,and ClassⅢdepressions are predicted to be favorable prolific depressions.This study expands the research on quantitatively predicting favorable prolific depressions in the Bohai Basin using the deep crustal structure and can contribute to reducing production costs and improving exploration efficiency in future explorations.
文摘AIM:To investigate the role of connective tissue growth factor(CTGF)and vascular endothelial growth factor(VEGF)in the protein profile of the aqueous humor in patients with proliferative diabetic retinopathy(PDR)following intravitreal injection of conbercept.METHODS:This study included 72 PDR patients and 8 cataract patients as controls.PDR patients were divided into 3 groups according to the intervals of 3,5,and 7d between intravitreal conbercept(IVC,0.5 mg/0.05 mL)injection and pars plana vitrectomy(PPV)performed.Aqueous humor samples were collected before and after IVC and PPV for VEGF and CTGF levels detected with enzyme-linked immunosorbent assay(ELISA).The differential proteomics of 10 patients who underwent PPV surgery 5d after IVC and 8 normal controls was studied,Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were performed on the data,and the protein interaction network of 23 differential proteins was studied.RESULTS:Post-IVC,VEGF levels decreased and CTGF levels increased significantly in aqueous humor,with the CTGF/VEGF ratio rising significantly at all intervals.Liquid chromatography tandem mass spectrometry(LC-MS/MS)identified differentially expressed proteins between preand post-IVC samples.GO and KEGG analyses revealed involvement in immune response,stress response,complement and coagulation cascades,ferroptosis,and PPAR signaling pathways.PPI analysis highlighted key proteins like APOA1,C3,and transferrin(TF).ELISA assay confirmed the differential expression of proteins such as HBA1,SERPINA1,COL1A1,and ACTB,with significant changes in the IVC groups.CONCLUSION:The study demonstrates that IVC effectively reduces VEGF levels while increasing CTGF levels,thereby modifying the CTGF/VEGF ratio,and IVC significantly alters the protein profile in the aqueous humor of patients with PDR.Proteomic analysis reveals that these changes are associated with critical biological pathways and protein interactions involved in immune response,stress response,and cellular metabolism.
