Integrin is a kind of transmembrane protein which mediates the interaction between cells and cells,cells and extracellular matrix.When activated by the ligands,integrins modify and alter the activity and function of many cytoskeleton proteins and signal molecules.Integrins are able to cooperate with growth factor receptors in several steps at both cellular membrane and downstream signaling pathway and co-adjust the adhesion,survival,growth,differentiation,proliferation and migration of the cells,constructing a network of intracellular signaling transduction system.Diabeticretinopathy ( DR )hasacloserelationshipwithproliferation,migrationand neovascularization of vascular endothelial cells driven by growth factors.Since the interaction among growth factors,growth factor receptors,cellular migration and integrins,the treatment of DR,in the future,may be shifted from a growth factor inhibition aspect to integrin inhibition pattern.The signaling pathway,relationship of integrin and growth factor,effect of integrin in DR were reviewed.

The incidence of malignancy tumors has increased significantly recent years in patients with type 2 diabetes mellitus (T2DM).As the first-line oral medicine of T2DM,in addition to the safe and effective hypoglycemic effect,metformin can reduce the incidence and mortality of cancer,and improve the prognosis in T2DM patients.While the exactly anti-tumor mechanisms of mefformin is not yet clear,which might be the inhibition of proliferation and promotion of apoptosis of tumor cells mainly by acting on an adenosine monophosphate activated protein kinase (AMPK) and microRNAs (miRNAs).And metformin can inhibit migration and invasion of tumor cells,as well as strengthen the effects of chemotherapy drugs.This article reviews the recent research progress of clinical and epidemiological studies and anticancer mechanisms of metformin.

AIM: To investigate the role of adrenomedullin (AM) in diabetic nephropathy. METHODS: We observed the changes in the expression and secretion of AM, TGF-? 1 in the cultured human mesangial cells under high glucose condition and the contents of the laminin and type IV collagen in the supernatants. The effect of intervention with AM was also observed. RESULTS: High glucose condition resulted in increase in the expression and secretion of AM TGF-? 1 laminin and type IV collagen. AM reversed the influence of high glucose on the cultured human mesangial cells. CONCLUSION: These results showed that high glucose condition is one of stimulating factors of AM and the renal protective action of AM may be associated with suppression of TGF-? 1 and reducing excessive accumulation of laminin and type IV collagen.

Objective To observe and compare the functions of two types microencapsulated adult pig pancreatic islets in vivo.Methods The diabetic rats induced by streptozocin were divided into four groups:control group,non-encapsulated islet transplantation group,encapsulated islet with sodium alginate membrane transplantation group and encapsulated islet with agarose membrane transplantation group.All rats received intraperitoneal of islet transplantation.Results There were no significant difference in mean level of the blood glucose before transplantation among four groups.On the 7th day after transplantation,the mean level of the blood glucose in four groups were (22 67?1 15)mmol/L,(18 58?2 66)mmol/L(12 27?1 36)mmol/L and (12 38?2 68) mmol/L,respectively.There were significant difference between two encapsulated islet groups as compared with the other two groups(P

Objective Valsartan, the angiotensin Ⅱ type 1 receptor blocker, is recently proved to reduce urinary albumin at the microalbuminuria stage in human diabetic nephropathy without altering glucose metabolism. But the pathway is still uncertain. In present study, we examined the changes of adrenomedullin receptor (ADMR) mRNA and protein expressions in the renal cortex of diabetic rats to investigate the protective effects of valsartan on an experimental model of diabetic renal injury. Method The SD rats were randomly divided into following groups: normal rats, STZ-induced diabetic rats, and diabetic rats treated with valsartan. STZ-induced diabetic rats were treated with valsartan (10mg/kg body weight) or vehicle for 8 weeks. The expressions of ADMR mRNA in renal cortex were analyzed by RT-PCR, as well as ADMR protein expressions were detected through western blot. Results We found (1) Valsartan treatments reduced urinary albumin excretion in 24h, compared with the untreated. But no notable difference was seen in HbA1c and blood sugar of diabetic rats between the two groups. (2) Valsartan treatments increased the expressions of ADMR mRNA and protein in diabetic rats renal cortex. Conclusion These results indicate that valsartan treatment can upgrade the expressions of ADMR in the renal cortex of diabetic rats. It may be one of renal protective pathways of Ang Ⅱ type 1 receptor blocker.

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Objective:To measure and analyze the corneal biological parameters of Tibetan junior middle school students who have lived in Mozhugongka County of Lhasa city for a long time.Methods:A cross-sectional study was performed.The basic information including gender, age and grade of 1 784 Tibetan junior high school students who have lived in Mozhugongka County of Lhasa city for a long time was collected, and the corneal biological parameters were measured in May, 2020.The available data of 690 students were obtained in this study.Unilateral eye of each subject was randomly selected for statistical analysis using computer random number method.Three hundred and forty-five right eyes and 345 left eyes from 366 males and 324 females were included.There were 461 eyes from students aged 12 to 15 years, and 229 eyes from students aged 16 to 20 years.Sirius 3D corneal topography and anterior segment analysis system were used to measure the thinnest corneal thickness (TCT), central corneal thickness (CCT), anterior chamber depth (ACD), iridocorneal corneal angle, simulated K1 and simulated K2, thinnest point position.Histogram and Q-Q chart were used to assess the distribution of continuous variables except the thinnest point position of cornea.The differences in biological parameters were compared between males and females, 12-15 years group and 16-20 years group as well as right eyes and left eyes.The literature of corneal biological parameters from other ethnic group was reviewed and compared with the Tibetan subjects.This study complied with the Declaration of Helsinki and was approved by an Ethics Committee of Tibet Hospital (No.QZYY2019-IRBPJ-21).Results:The ACD of the right eye of the students was (3.31±0.27)mm, which was significantly greater than (3.26±0.26)mm of the left eye ( t=0.745, P=0.012). Mean TCT, CCT, iridocorneal angle, simulated K1 and simulated K2 were (504.99±30.73)μm, (509.10±35.82)μm, (47.45±5.70)°, (43.15±1.89)D, and (44.16±2.29)D of the right eye, and thoes of the left eyes were (503.34±29.22)μm, (508.36±28.75)μm, (47.86±5.88)°, (43.06±1.40)D and (44.16±1.53)D, respectively, with no significant differences between the right and left eyes (all at P>0.05). The ACD and iridocorneal angle were significantly greater, and the simulated K1 and simulated K2 were significantly smaller in males compared with females (all at P<0.05). There were no significant differences in TCT and CCT between males and females (both at P>0.05). The corneal biological parameters were not signficantly different between different age groups (all at P>0.05). The thinnest point of cornea distributed mainly at inferior temporal quadrant zone for the right eyes, and superior temporal quadrant zone for the left eyes. Conclusions:Corneal biological parameters of Tibetan junior high school students in high altitude areas might be different from those of other ethnic students.Ophthalmologists should pay attention to this population in diagnosis and treatment of corneal diseases and refractive error.

Background Bilateral congenital cataract is one of the vision-threating diseases during infant age.Intraocular lens (IOL) implantation is an ideal refraction correction method for children who have already received bilateral cataract extraction.However,the timing and effectiveness of secondary IOL implantation are still under debate.Objective This study was to analyze the visual changes and affecting factors before and after secondary IOL implantation and explore the operative timing.Methods The clinical data of 58 eyes of 29 patients who received bilateral cataract extraction-refractive correction and vision training-secondary IOL implantation in Peking University People's Hospital from January 2012 to December 2014 were retrospectively analyzed.All the patients received bilateral cataract extraction and posterior capsulotomy with anterior vitrectomy during their first year of life firstly,followed by the wearing of refractive spectacles or visual training,and secondary IOL implantation was simultaneously performed until ＞2 years old.Best corrected visual acurity (BCVA) (LogMAR) was examined at 1 week before and 3 months after secondary surgery under the mydriasis.Changes,distribution alternation of BCVA and the relationship of visual prognosis with preoperative visual acuity were evaluated.Results The average age at surgery of the patients was (3.26±2.07) months and that at secondary IOL implantation was (4.79± 1.38) years,with the operative interval of (4.28± 1.33) years.The BCVA before and after secondary IOL implantation was 0.790± 0.422 and 0.570±0.307 respectively,showing a significant difference between them (t =3.223,P＜0.001).The number of eyes with BCVA ≥ 0.5 after surgery was significantly more than that before surgery (x2=53.931,P＜0.001).A positive correlation in unilateral BCVA was seen between before and after secondary IOL implantation (R2 =0.232,F =17.037,P ＜ 0.001).Conclusions A systemic management of bilateral cataract extractionrefractive correction and vision training-secondary IOL implantation for congenital cataract is beneficial to BCVA improvement and amblyopia treatment,and it should be performed as early as possible on the premise of ensuring the safety of life.Secondary IOL implantation should be timely carried out for aphakic children with poor compliance and outcomes during vision training after congenital cataract extraction.

[Summary] The relationship between serum bilirubin and serum C-peptide levels in patients with type 2 diabetes mellitus was investigated. The clinical and laboratory data of 206 healthy subjects and 271 type 2 diabetic patients were collected. The partial correlation analysis and multiple linear regression analysis showed that serum bilirubin was positively correlated with fasting C-peptide, postprandial C-peptide, and the difference between postprandial C-peptide and fasting C-peptide levels(β=0. 171, 0. 111,0. 052,P<0. 05 or P<0. 01).

Cytomegalovirus (CMV) retinitis (CMVR) is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases. It often occurs within 3 months after the operation, with CMV activation and high blood CMV peaks. It often occurs on patients with long-term CMV viremia, human leukocyte antigen incompatible transplantation, unrelated donor transplantation, haploid transplantation, childhood hematopoietic stem cell transplantation, delayed lymphocyte engraftment, acute and chronic graft-versus-host disease after surgery. The visual prognosis of patients is related to the area of CMVR lesions on the retina, the number of quadrants involved, whether the macula is involved, and the CMV load of the vitreous body is involved, and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor. The incidence of CMVR is increasing year by year. It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment, help patients improve the prognosis of vision, and reduce or even avoid the occurrence of blindness caused by CMVR.