AIM：To describe a novel technique of creating a landing strip within the trabecular meshwork to guide trabecular micro-bypass stent（iStent） implantation in patients who underwent phacoemulsification.METHODS：Thirty...AIM：To describe a novel technique of creating a landing strip within the trabecular meshwork to guide trabecular micro-bypass stent（iStent） implantation in patients who underwent phacoemulsification.METHODS：Thirty-four eyes from 30 patients who underwent i Stent implantation after phacoemulsification from May 2014 to February 2015 were included in our retrospective study. All iStents were implanted via the ＂landing strip＂ technique. A 25-gauge microvitreoretinal blade was used to bisect the trabecular meshwork to less than 1 clock-hour, effectively creating a landing strip. The iStent applicator was pressed along the landing strip and then the stent was released into the trabecular meshwork. RESULTS：Of the 34 eyes with iStent implantation, 27（79.4%） eyes had primary open-angle glaucoma, 6（17.6%） eyes had pseudoexfoliation glaucoma, and 1（2.9%） eye had ocular hypertension. At 6-month follow-up（n=17）, the mean number of hypotensive medications decreased from 2.2±1.2 at baseline to 0.8±1.3（P=0.05） and mean intraocular pressure decreased from 19.7±4.1 mm Hg at baseline to 16.7±2.1 mm Hg（P=0.58）. Two eyes（5.9%） required subsequent trabeculectomy. CONCLUSION：The ＂landing strip＂ technique appears to be an effective way to assist with iS tent implantation.展开更多
Background:Trabecular microbypass stents have allowed improved multidirectional flow with good efficacy and safety profile in primary open-angle glaucoma(OAG).The efficacy of these devices in primary angle closure gla...Background:Trabecular microbypass stents have allowed improved multidirectional flow with good efficacy and safety profile in primary open-angle glaucoma(OAG).The efficacy of these devices in primary angle closure glaucoma has been understudied.We aimed to assess the one-year postoperative outcomes following implantation of trabecular micro-bypass stents with concomitant cataract surgery in angle-closure glaucoma patients.Methods:We evaluated the baseline clinical characteristics and the 12-month outcomes of patients with mild to severe primary angle-closure glaucoma who underwent cataract surgery with implantation of either a first generation trabecular microbypass stent(iStent group)or two second generation trabecular microbypass stents(iStent-inject group).The primary outcomes included intraocular pressure(IOP)and anti-glaucoma medication use.The secondary outcomes were success rate(defined by IOP between 5-18 mmHg with IOP reduction of at least 20%)and visual acuity.Results:A total of 83 eyes(58 from the iStent and 25 from the iStent-inject group)were included with an average age of 68.9±8.6 and 67.6±8.3 years,respectively.All eyes had mild to severe angle-closure glaucoma.At one-year follow-up,the IOP decreased by 21%(from 18.8±4.5 mmHg)and 25%(from 18.7±3.6 mmHg),in each group respectively(P<0.001).Additionally,the medication burden dropped by 52%and 50%at one-year follow-up(P<0.001).The 12-month success rate was 45%in the iStent group compared to 64%in the iStent-inject group(P=0.086)and visual acuity remained stable.Conclusions:The present study provides clinically relevant,real-world data on the utility of iStent and iStent inject with cataract surgery in angle-closure glaucoma-a population that has been understudied in the world of trabecular micro-bypass stents.Our data demonstrated efficacy of these stents in reducing intraocular pressure and medication burden among patients with primary angle closure glaucoma.展开更多
Osteoporosis is a major cause of bone fracture and can be characterised by both mass loss and microstructure deterioration of the bone.The modern way of osteoporosis assessment is through the measurement of bone miner...Osteoporosis is a major cause of bone fracture and can be characterised by both mass loss and microstructure deterioration of the bone.The modern way of osteoporosis assessment is through the measurement of bone mineral density,which is not able to unveil the pathological condition from the mesoscale aspect.To obtain mesoscale information from computed tomography(CT),the super-resolution(SR)approach for volumetric imaging data is required.A deep learning model AESR3D is proposed to recover high-resolution(HR)Micro-CT from low-resolution Micro-CT and implement an unsupervised segmentation for better trabecular observation and measurement.A new regularisation overcomplete autoencoder framework for the SR task is proposed and theoretically analysed.The best performance is achieved on structural similarity measure of trabecular CT SR task compared with the state-of-the-art models in both natural and medical image SR tasks.The HR and SR images show a high correlation(r=0.996,intraclass correlation coefficients=0.917)on trabecular bone morphological indicators.The results also prove the effectiveness of our regularisation framework when training a large capacity model.展开更多
BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegra...BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.展开更多
The changes in the expression of aquaporin-1 （AQP1） mRNA and protein in cultured human trabecular meshwork （HTM） cells treated with dexamethasone and transfected with antisense oligonucleotides （AS-ODN） were stu...The changes in the expression of aquaporin-1 （AQP1） mRNA and protein in cultured human trabecular meshwork （HTM） cells treated with dexamethasone and transfected with antisense oligonucleotides （AS-ODN） were studied, and the implication of AQP1 regulation in corticosteroid-glaucoma and the possibility of AS-ODN inhibiting the AQP1 expression were evaluated. The cultured HTM cells in vitro were treated with different concentrations of dexamethasone and transfected with oligonucleotides for 5 days respectively. Then, total RNA and protein of HTM cells were extracted. The changes of AQP1 mRNA and protein were demonstrated qualitatively and quantitatively by RT-PCR and Western blot. Band intensities were detected by imaging analysis. There was a parallel relationship between the results of RT-PCR and those of Western blot. The expression levels of AQP1 mRNA and protein in dexamethasone-treated groups were increased initially and decreased later as dexamethasone concentration was stepped up. In the 0.04 μg/mL and 0.4 μg/mL groups, the levels of AQP1 were higher than in control group （0 μg/mL）. In the 4 μg/ mL and 40 μg/mL groups, the AQP1 expression levels were lower than in control group. AS-ODN could down-regulate the expression of AQP1 mRNA and protein in a dose-dependent manner. At 5 μg/mL, down-regulation efficiency reached the maximum. There was no statistically significant difference in the expression of AQP1 mRNA and protein between all sense oligonucleotides groups and control group. It was suggested that dexamethasone may induce the changes of the AQP1 expression in HTM cells to be involved in the occurrence of corticosteroid-glaucoma. AS-ODN can down-regulate the AQP1 expression in HTM cells to some extent.展开更多
As the aqueous humor leaves the eye, it first passes through the trabecular meshwork （TM）. Increased flow resistance in this region causes elevation of intraocular pressure （IOP）, which leads to the occurrence of ...As the aqueous humor leaves the eye, it first passes through the trabecular meshwork （TM）. Increased flow resistance in this region causes elevation of intraocular pressure （IOP）, which leads to the occurrence of glaucoma. To quantitatively evaluate the effect of high IOP on the configuration and hydraulic permeability of the TM, second harmonic generation （SHG） microscopy was used to image the microstructures of the TM and adjacent tissues in control （normal） and high IOP conditions. Enucleated rabbit eyes were perfused at a pressure of 60 mmHg to achieve the high lOP. Through the anterior chamber of the eye, in situ images were obtained from different depths beneath the surface of the TM. Porosity and specific surface area of the TM in control and high IOP conditions were then calculated to estimate the effect of the high pressure on the permeability of tissue in different depths. We further photographed the histological sections of the TM and compared the in situ images. The following results were obtained in the control condition, where the region of depth was less than 55 μm with crossed branching beams and large pores in the superficial TM. The deeper meshwork is a silk-like tissue with abundant fluorescence separating the small size of pores. The total thickness of pathway tissues composed of TM and juxtacanalicular （JCT） is more than 100 p.m. After putting a high pressure on the inner wall of the eye, the TM region progressively collapses and decreases to be less than 40 μm. Fibers of the TM became dense, and the porosity at 34 μm in the high IOP condition is comparable to that at 105 μm in the control condition. As a consequent result, the permeability of the superficial TM decreases rapidly from 120 μm2 to 49.6 μm2 and that of deeper TM decreases from 1.66 μm2 to 0.57 μm2. Heterogeneity reflected by descent in permeability reduces from 12.4 μm of the control condition to 3.74 μm of the high IOP condition. The persistently high IOP makes the TM region collapse from its normal state, in which the collagen fibers of the TM are arranged in regular to maintain the physiological permeability of the outflow pathway. In the scope of pathologically high IOP, the microstructure of the TM is sensitive to pressure and hydraulic permeability can be significantly affected by IOP.展开更多
AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)pat...AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)patients with POAG were included in the study.Each patient underwent a limbus-based trabeculectomy.The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at-80t until they were assayed.Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years(53-68 years)vs 58.9±8.9 years(47-70 years)in group 1and group 2(P=0.859).The mean treatment time in group 2 was 22.2±7.3 months(12-34 months).Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication(group 2)compared to treatment-naive POAG patients(group 1)(P=0.004,0.015;respectively).CONCLUSION:Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.展开更多
This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） an...This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） and CMB-disk （1979 to 2009） for the randomized clinical trials （RCT） concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration＇s RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure （IOP） between non-penetrating trabecular surgery and trabeculectomy （Z=6.05 P0.00001）. There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures （Z=4.92, P0.00001）. Difference in the success rate was also found between the two surgeries （Z=3.82, P=0.0001）. It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.展开更多
Osteoporosis represents one major health condition for our growing elderly population. It accounts for severe morbidity and increased mortality in postmenopausal women and it is becoming an emerging health concern eve...Osteoporosis represents one major health condition for our growing elderly population. It accounts for severe morbidity and increased mortality in postmenopausal women and it is becoming an emerging health concern even in aging men. Screening of the population at risk for bone degeneration and treatment assessment of osteoporotic patients to prevent bone fragility fractures represent useful tools to improve quality of life in the elderly and to lighten the related socio-economic impact. Bone mineral density(BMD) estimate by means of dual-energy X-ray absorptiometry is normally used in clinical practice for osteoporosis diagnosis. Nevertheless, BMD alone does not represent a good predictor of fracture risk. From a clinical point of view, bone microarchitecture seems to be an intriguing aspect to characterize bone alteration patterns in aging and pathology. The widening into clinical practice of medical imaging techniques and the impressive advances in information technologies together with enhanced capacity of power calculation have promoted proliferation of new methods to assess changes of trabecular bone architecture(TBA) during aging and osteoporosis. Magnetic resonance imaging(MRI) has recently arisen as a useful tool to measure bone structure in vivo. In particular, high-resolution MRI techniques have introduced new perspectives for TBA characterization by non-invasive non-ionizing methods. However, texture analysis methods have not found favor with clinicians as they produce quite a few parameters whose interpretation is difficult. The introduction in biomedical field of paradigms, such as theory of complexity, chaos, and fractals, suggests new approaches and provides innovative tools to develop computerized methods that, by producing a limited number of parameters sensitive to pathology onset and progression, would speed up their application into clinical practice. Complexity of living beings and fractality of several physio-anatomic structures suggest fractal analysis as a promising approach to quantify morphofunctional changes in both aging and pathology. In this particular context, fractal lacunarity seems to be the proper tool to characterize TBA texture as it is able to describe both discontinuity of bone network and sizes of bone marrow spaces, whose changes are an index of bone fracture risk. In this paper, an original method of MRI texture analysis, based on TBA fractal lacunarity is described and discussed in the light of new perspectives for early diagnosis of osteoporotic fractures.展开更多
The effects of suppression of CD44 by CD44-specific antisense oligonucleotide on attachment of human trabecular meshwork cells to hyaluronic acid (HA) were observed and the possible relationship between CD44 and prim...The effects of suppression of CD44 by CD44-specific antisense oligonucleotide on attachment of human trabecular meshwork cells to hyaluronic acid (HA) were observed and the possible relationship between CD44 and primary open-angle glaucoma (POAG) investigated. CD44-specific antisense oligonucleotide was delivered with cationic lipid to cultured human trabecular meshwork cells. The expression of CD44 suppressed by CD44-specific antisense oligonucleotide was detected by RT-PCR and Western blotting. The effect of CD44 suppression by specific antisense oligonucleotide on attachment of trabecular meshwork cells to HA was measured by MTT assay. Results showed that expression of CD44 was suppressed by CD44-specific antisense oligonucleotide. Antisense oligonucleotide also suppressed the adhesion of human trabecular meshwork cells to HA in a concentration dependent manner. It was concluded that attachment of human trabecular meshwork cells to HA was decreased when CD44 was suppressed by specific antisense oligonucleotide. CD44 might play a role in pathogenesis of POAG by affecting the adhesion of trabecular meshwork cells to HA.展开更多
AIM: To determine the effects of a low dose latrunculin (LAT)-A on dexamethasone (Dex)-induced upregulation of extracellular matrix proteins fibronectin (FN) in cultured human trabecular meshwork (HTM) cells. METHODS:...AIM: To determine the effects of a low dose latrunculin (LAT)-A on dexamethasone (Dex)-induced upregulation of extracellular matrix proteins fibronectin (FN) in cultured human trabecular meshwork (HTM) cells. METHODS: HTM cells were cultured to confluent and incubated with 0.4 mu mol/L Dex and/or 0.05 mu mol/L LAT-A. FN expression in HTM cells was evaluated by Western blot and immunofluorescence microscopy. RESULTS: Dex up-regulated FN production in HTM cells, failed to do so when co-incubated with LAT-A. LAT-A decreased production of FN in cultured HTM cells. CONCLUSION: This study indicated that LAT-A may modulate the expression of fibronectin in trabecular meshwork to achieve treatment for steroids and other types of glaucoma. It has an important prospect as an intraocular pressure-lowering drug.展开更多
The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens we...The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography （micro-CT） system, then converted to micro- finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level yon Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions （transverse directions） were derived and compared between two age groups. The results showed that at the apparent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction- related adaptation of Chinese male lumbar vertebral trabecular bone from two different levels： stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.展开更多
文摘AIM：To describe a novel technique of creating a landing strip within the trabecular meshwork to guide trabecular micro-bypass stent（iStent） implantation in patients who underwent phacoemulsification.METHODS：Thirty-four eyes from 30 patients who underwent i Stent implantation after phacoemulsification from May 2014 to February 2015 were included in our retrospective study. All iStents were implanted via the ＂landing strip＂ technique. A 25-gauge microvitreoretinal blade was used to bisect the trabecular meshwork to less than 1 clock-hour, effectively creating a landing strip. The iStent applicator was pressed along the landing strip and then the stent was released into the trabecular meshwork. RESULTS：Of the 34 eyes with iStent implantation, 27（79.4%） eyes had primary open-angle glaucoma, 6（17.6%） eyes had pseudoexfoliation glaucoma, and 1（2.9%） eye had ocular hypertension. At 6-month follow-up（n=17）, the mean number of hypotensive medications decreased from 2.2±1.2 at baseline to 0.8±1.3（P=0.05） and mean intraocular pressure decreased from 19.7±4.1 mm Hg at baseline to 16.7±2.1 mm Hg（P=0.58）. Two eyes（5.9%） required subsequent trabeculectomy. CONCLUSION：The ＂landing strip＂ technique appears to be an effective way to assist with iS tent implantation.
文摘Background:Trabecular microbypass stents have allowed improved multidirectional flow with good efficacy and safety profile in primary open-angle glaucoma(OAG).The efficacy of these devices in primary angle closure glaucoma has been understudied.We aimed to assess the one-year postoperative outcomes following implantation of trabecular micro-bypass stents with concomitant cataract surgery in angle-closure glaucoma patients.Methods:We evaluated the baseline clinical characteristics and the 12-month outcomes of patients with mild to severe primary angle-closure glaucoma who underwent cataract surgery with implantation of either a first generation trabecular microbypass stent(iStent group)or two second generation trabecular microbypass stents(iStent-inject group).The primary outcomes included intraocular pressure(IOP)and anti-glaucoma medication use.The secondary outcomes were success rate(defined by IOP between 5-18 mmHg with IOP reduction of at least 20%)and visual acuity.Results:A total of 83 eyes(58 from the iStent and 25 from the iStent-inject group)were included with an average age of 68.9±8.6 and 67.6±8.3 years,respectively.All eyes had mild to severe angle-closure glaucoma.At one-year follow-up,the IOP decreased by 21%(from 18.8±4.5 mmHg)and 25%(from 18.7±3.6 mmHg),in each group respectively(P<0.001).Additionally,the medication burden dropped by 52%and 50%at one-year follow-up(P<0.001).The 12-month success rate was 45%in the iStent group compared to 64%in the iStent-inject group(P=0.086)and visual acuity remained stable.Conclusions:The present study provides clinically relevant,real-world data on the utility of iStent and iStent inject with cataract surgery in angle-closure glaucoma-a population that has been understudied in the world of trabecular micro-bypass stents.Our data demonstrated efficacy of these stents in reducing intraocular pressure and medication burden among patients with primary angle closure glaucoma.
基金Beijing Natural Science Foundation-Haidian original Innovation Joint Foundation,Grant/Award Number:L192016Joint Funds of the National Natural Science Foundation of China,Grant/Award Number:U21A20489+3 种基金National Natural Science Foundation of China,Grant/Award Number:62003330Shenzhen Fundamental Research Funds,Grant/Award Numbers:JCYJ20220818101608019,JCYJ20190807170407391,JCYJ20180507182415428Natural Science Foundation of Guangdong Province,Grant/Award Number:2019A1515011699Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems,Shenzhen Institute of Advanced Technology。
文摘Osteoporosis is a major cause of bone fracture and can be characterised by both mass loss and microstructure deterioration of the bone.The modern way of osteoporosis assessment is through the measurement of bone mineral density,which is not able to unveil the pathological condition from the mesoscale aspect.To obtain mesoscale information from computed tomography(CT),the super-resolution(SR)approach for volumetric imaging data is required.A deep learning model AESR3D is proposed to recover high-resolution(HR)Micro-CT from low-resolution Micro-CT and implement an unsupervised segmentation for better trabecular observation and measurement.A new regularisation overcomplete autoencoder framework for the SR task is proposed and theoretically analysed.The best performance is achieved on structural similarity measure of trabecular CT SR task compared with the state-of-the-art models in both natural and medical image SR tasks.The HR and SR images show a high correlation(r=0.996,intraclass correlation coefficients=0.917)on trabecular bone morphological indicators.The results also prove the effectiveness of our regularisation framework when training a large capacity model.
文摘BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.
文摘The changes in the expression of aquaporin-1 （AQP1） mRNA and protein in cultured human trabecular meshwork （HTM） cells treated with dexamethasone and transfected with antisense oligonucleotides （AS-ODN） were studied, and the implication of AQP1 regulation in corticosteroid-glaucoma and the possibility of AS-ODN inhibiting the AQP1 expression were evaluated. The cultured HTM cells in vitro were treated with different concentrations of dexamethasone and transfected with oligonucleotides for 5 days respectively. Then, total RNA and protein of HTM cells were extracted. The changes of AQP1 mRNA and protein were demonstrated qualitatively and quantitatively by RT-PCR and Western blot. Band intensities were detected by imaging analysis. There was a parallel relationship between the results of RT-PCR and those of Western blot. The expression levels of AQP1 mRNA and protein in dexamethasone-treated groups were increased initially and decreased later as dexamethasone concentration was stepped up. In the 0.04 μg/mL and 0.4 μg/mL groups, the levels of AQP1 were higher than in control group （0 μg/mL）. In the 4 μg/ mL and 40 μg/mL groups, the AQP1 expression levels were lower than in control group. AS-ODN could down-regulate the expression of AQP1 mRNA and protein in a dose-dependent manner. At 5 μg/mL, down-regulation efficiency reached the maximum. There was no statistically significant difference in the expression of AQP1 mRNA and protein between all sense oligonucleotides groups and control group. It was suggested that dexamethasone may induce the changes of the AQP1 expression in HTM cells to be involved in the occurrence of corticosteroid-glaucoma. AS-ODN can down-regulate the AQP1 expression in HTM cells to some extent.
基金supported by the National Natural Science Foundation of China(Grant Nos.31070840,10802053,and 81201123)the Natural Science Foundation of Beijing,China(Grant No.3122010)+2 种基金the Natural Science Foundation of Guangdong Province,China(Grant No.S2012040006576)the Shenzhen Science and Technology Innovation Committee,China(Grant No.KQCX20120816155352228)the Funding Project for Academic Human Resources Development in Institutions of Higher Learning under the Jurisdiction of Beijing Municipality,China(Grant No.PHR201110506)
文摘As the aqueous humor leaves the eye, it first passes through the trabecular meshwork （TM）. Increased flow resistance in this region causes elevation of intraocular pressure （IOP）, which leads to the occurrence of glaucoma. To quantitatively evaluate the effect of high IOP on the configuration and hydraulic permeability of the TM, second harmonic generation （SHG） microscopy was used to image the microstructures of the TM and adjacent tissues in control （normal） and high IOP conditions. Enucleated rabbit eyes were perfused at a pressure of 60 mmHg to achieve the high lOP. Through the anterior chamber of the eye, in situ images were obtained from different depths beneath the surface of the TM. Porosity and specific surface area of the TM in control and high IOP conditions were then calculated to estimate the effect of the high pressure on the permeability of tissue in different depths. We further photographed the histological sections of the TM and compared the in situ images. The following results were obtained in the control condition, where the region of depth was less than 55 μm with crossed branching beams and large pores in the superficial TM. The deeper meshwork is a silk-like tissue with abundant fluorescence separating the small size of pores. The total thickness of pathway tissues composed of TM and juxtacanalicular （JCT） is more than 100 p.m. After putting a high pressure on the inner wall of the eye, the TM region progressively collapses and decreases to be less than 40 μm. Fibers of the TM became dense, and the porosity at 34 μm in the high IOP condition is comparable to that at 105 μm in the control condition. As a consequent result, the permeability of the superficial TM decreases rapidly from 120 μm2 to 49.6 μm2 and that of deeper TM decreases from 1.66 μm2 to 0.57 μm2. Heterogeneity reflected by descent in permeability reduces from 12.4 μm of the control condition to 3.74 μm of the high IOP condition. The persistently high IOP makes the TM region collapse from its normal state, in which the collagen fibers of the TM are arranged in regular to maintain the physiological permeability of the outflow pathway. In the scope of pathologically high IOP, the microstructure of the TM is sensitive to pressure and hydraulic permeability can be significantly affected by IOP.
文摘AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)patients with POAG were included in the study.Each patient underwent a limbus-based trabeculectomy.The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at-80t until they were assayed.Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years(53-68 years)vs 58.9±8.9 years(47-70 years)in group 1and group 2(P=0.859).The mean treatment time in group 2 was 22.2±7.3 months(12-34 months).Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication(group 2)compared to treatment-naive POAG patients(group 1)(P=0.004,0.015;respectively).CONCLUSION:Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.
文摘This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） and CMB-disk （1979 to 2009） for the randomized clinical trials （RCT） concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration＇s RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure （IOP） between non-penetrating trabecular surgery and trabeculectomy （Z=6.05 P0.00001）. There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures （Z=4.92, P0.00001）. Difference in the success rate was also found between the two surgeries （Z=3.82, P=0.0001）. It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.
文摘Osteoporosis represents one major health condition for our growing elderly population. It accounts for severe morbidity and increased mortality in postmenopausal women and it is becoming an emerging health concern even in aging men. Screening of the population at risk for bone degeneration and treatment assessment of osteoporotic patients to prevent bone fragility fractures represent useful tools to improve quality of life in the elderly and to lighten the related socio-economic impact. Bone mineral density(BMD) estimate by means of dual-energy X-ray absorptiometry is normally used in clinical practice for osteoporosis diagnosis. Nevertheless, BMD alone does not represent a good predictor of fracture risk. From a clinical point of view, bone microarchitecture seems to be an intriguing aspect to characterize bone alteration patterns in aging and pathology. The widening into clinical practice of medical imaging techniques and the impressive advances in information technologies together with enhanced capacity of power calculation have promoted proliferation of new methods to assess changes of trabecular bone architecture(TBA) during aging and osteoporosis. Magnetic resonance imaging(MRI) has recently arisen as a useful tool to measure bone structure in vivo. In particular, high-resolution MRI techniques have introduced new perspectives for TBA characterization by non-invasive non-ionizing methods. However, texture analysis methods have not found favor with clinicians as they produce quite a few parameters whose interpretation is difficult. The introduction in biomedical field of paradigms, such as theory of complexity, chaos, and fractals, suggests new approaches and provides innovative tools to develop computerized methods that, by producing a limited number of parameters sensitive to pathology onset and progression, would speed up their application into clinical practice. Complexity of living beings and fractality of several physio-anatomic structures suggest fractal analysis as a promising approach to quantify morphofunctional changes in both aging and pathology. In this particular context, fractal lacunarity seems to be the proper tool to characterize TBA texture as it is able to describe both discontinuity of bone network and sizes of bone marrow spaces, whose changes are an index of bone fracture risk. In this paper, an original method of MRI texture analysis, based on TBA fractal lacunarity is described and discussed in the light of new perspectives for early diagnosis of osteoporotic fractures.
文摘The effects of suppression of CD44 by CD44-specific antisense oligonucleotide on attachment of human trabecular meshwork cells to hyaluronic acid (HA) were observed and the possible relationship between CD44 and primary open-angle glaucoma (POAG) investigated. CD44-specific antisense oligonucleotide was delivered with cationic lipid to cultured human trabecular meshwork cells. The expression of CD44 suppressed by CD44-specific antisense oligonucleotide was detected by RT-PCR and Western blotting. The effect of CD44 suppression by specific antisense oligonucleotide on attachment of trabecular meshwork cells to HA was measured by MTT assay. Results showed that expression of CD44 was suppressed by CD44-specific antisense oligonucleotide. Antisense oligonucleotide also suppressed the adhesion of human trabecular meshwork cells to HA in a concentration dependent manner. It was concluded that attachment of human trabecular meshwork cells to HA was decreased when CD44 was suppressed by specific antisense oligonucleotide. CD44 might play a role in pathogenesis of POAG by affecting the adhesion of trabecular meshwork cells to HA.
基金National Natural Science Foundation of China (No.30772379)Education Department Project of Hunan Province, China(No.04A049)
文摘AIM: To determine the effects of a low dose latrunculin (LAT)-A on dexamethasone (Dex)-induced upregulation of extracellular matrix proteins fibronectin (FN) in cultured human trabecular meshwork (HTM) cells. METHODS: HTM cells were cultured to confluent and incubated with 0.4 mu mol/L Dex and/or 0.05 mu mol/L LAT-A. FN expression in HTM cells was evaluated by Western blot and immunofluorescence microscopy. RESULTS: Dex up-regulated FN production in HTM cells, failed to do so when co-incubated with LAT-A. LAT-A decreased production of FN in cultured HTM cells. CONCLUSION: This study indicated that LAT-A may modulate the expression of fibronectin in trabecular meshwork to achieve treatment for steroids and other types of glaucoma. It has an important prospect as an intraocular pressure-lowering drug.
基金The project supported by the Hong Kong Polytechnic University Research Grants(G-U273) the National Natural Science Foundation of China(10502021 and 10529202)
文摘The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography （micro-CT） system, then converted to micro- finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level yon Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions （transverse directions） were derived and compared between two age groups. The results showed that at the apparent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction- related adaptation of Chinese male lumbar vertebral trabecular bone from two different levels： stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.
