Photodynamic therapy ( PDT ) is a new technique to diagnose and treat diseases with photodynamic effect produced by photosensitizer and light, and is now a main method of treating exudative age - related macular degeneration ( AMD ) . ln recent years, with the development of science and technology, combinations of PDT have become a research hot spot. ln this paper, we reviewed the research status of treatments on exudative AMD with PDT combined anti-VEGF drugs.

AIM: To study the concentration of vascular endothelial growth factor(VEGF)in aqueous humor in patients with wet age-related macular degeneration(wAMD)before and after Ranibizumab treating at high altitude and the correlation of VEGF concentration with central fovea macula thickness.

METHODS: The patients with wAMD in our hospital from Jun. 2014. to Oct. 2015 were retrospectively analyzed, diagnosed after best corrected visual acuity, intraocular pressure, fundus examination, fundus color photography, fluorescence fundus angiography(FFA)and optical coherence tomography(OCT)inspection. Seventy- six patients with cataract without choroidal neovascularization(CNV)were selected as control group. In the 76 patients(76 eyes), 46 were male, 30 were female, aged 40-80(55±11.18). The course was 0.3-6mo. The corrected visual acuity was 0.01-0.6. The intraocular press was 15.24±3.12mmHg. The CNV in all cases was within the range of the 500μm in diameter. Under surface anesthesia, Ranibizumab(0.5mg)was injected into vitreous cavity. Before and after injection, aqueous humor was obtained and used to detect the concentration of VEGF through ELISA. Best corrected visual acuity, slit lamp microscope, intraocular pressure, OCT and FFA were observed after treatment.

RESULTS:The clinical curative effect is the best at 1mo after treatment with statistical significance(P<0.05). The concentration of VEGF in aqueous humor in wAMD patients before treatment(95.48±50.09pg/mL)was higher than that of control group(43.01±16.17pg/mL). The concentration of VEGF decreased at 1mo after treatment as 31.89±14.14pg/Ml(P<0.05). The concentration of VEGF was positive related with central fovea macula thickness(P<0.05).

CONCLUSION: For wAMD patients, Ranibizumab injection is effective for it reduces the concentration of VEGF in aqueous humor and the central fovea macula thickness. The VEGF concentration in aqueous humor and foveal retinal thickness has a positive correlation.

This study was conducted to investigate the paclitaxel loaded by hydrazone bonds in poly(ethylene glycol)-poly(caprolactone) micelles (mPEG-PCL-PTX) on proliferation and apoptosis of human lung cancer A549 cells and its possible mechanisms of anti-tumor activity. The cell proliferation was measured with MTT assay. Flow cytometry were used to analyze the cell cycle. The cell apoptosis was analyzed using Hoechst/P staining. The expression levels of apoptotic genes expression in the mitochondrial apoptosis pathway were detected by RT-PCR and Western blotting, respectively. The mPEG-PCL-PTX could inhibit the proliferation of A549 cells and promote the apoptosis. The Bax, caspase-3 protein expression were increased while Bcl-2 protein expression was decreased in A549 cells. Results showed that the polymer containing hydrazone bond is non-toxic in vitro, the mPEG-PCL-PTX micelles can inhibit the proliferation and induce the apoptosis of A549 cells. Key words: paclitaxel; micelle; A549 cell; proliferation; cell cycle; apoptosis
Apoptosis ; Caspase 3 ; metabolism ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Micelles ; Paclitaxel ; pharmacology ; Polyesters ; Polyethylene Glycols ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo study the characteristics of clinicopathology and prognosis of 3 pediatric cases diagnosed as C3 glomerulopathy, and to improve the understanding of C3 glomerulopathy in children.

METHODThe medical record, plasma complement C3, Factor H (FH) and its autoantibody, and therapeutic response of the 3 cases were analyzed, and their prognosis were followed up.

RESULTOf the 3 cases, 2 were male and 1 was female, the age of onset was 9 years, 12 years, 5 years 4 months, the duration from onset to renal biopsy was 3 months, 7 months and 20 days, and the follow-up period were 2.6 years, 8 months and 1.5 years respectively.

CLINICAL MANIFESTATIONSAll the 3 cases showed microscopic hematuria, with or without gross hematuria and proteinuria. Two showed persistently decreased plasma complement C3, in the other one C3 was in normal lower limit, all presented with decreased FH concertration, in 1 case anti-FH antibody was positive. Their clinical diagnosis was post-streptococcal glomerulonephritis, nephrotic syndrome (NS) nephritis type, and mesangial proliferative glomerulonephritis respectively.

PATHOLOGICAL FINDINGSAll showed evident deposition of C3 on glomerular basement membrance (GBM) and mesangial region by immunofluorescence (IF) and electron dense deposit in GBM, mesangial region or para-mesangial region by Electron microscopic (EM) examination Treatment and prognosis: The case with NS showed no response to steroid, so steroid was gradually stopped after renal biopsy and replaced by angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor antagonist (ARB). The other two cases were treated with ACEI and renal protective treatment. Of the 3 cases, one gradually showed elevated serum creatinine (Scr) and decreased creatinine clearance rate (Ccr), the other two were normal, but slightly increased indications for early kidney injury.

CONCLUSIONC3 glomerulopathy is characterized by evident C3 deposition under IF. Its clinical and pathological manifestations vary a lot. The decreased plasma C3 and FH suggest that the abnormal regulation of complement system play an importment role in its pathogenesis.

Angiotensin Receptor Antagonists ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Child ; Child, Preschool ; Complement C3 ; metabolism ; Complement Factor H ; deficiency ; metabolism ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis ; complications ; drug therapy ; metabolism ; pathology ; Hematuria ; etiology ; pathology ; Humans ; Kidney Glomerulus ; metabolism ; pathology ; Male ; Nephrotic Syndrome ; etiology ; pathology ; Proteinuria ; etiology ; pathology

At present, gene detection technology has become increasingly mature and integrated with multi-disciplinary, which provides help for clinicians to diagnose, treat andprognosis of the disease. In recent years, gene detection technology in diabetic retinopathy(DR)has made some progress, mainly applied to the risk factors of diabetic retinopathy and follow-up personalized treatment plan. Therefore, we summarize and analyze the gene loci related to diabetic retinopathy that can be detected by gene detection technology.

AIM: To determine the risk factors of age-related macular degeneration(ARMD)in high altitude areas and establish Nomoto prediction model.

METHODS:Using the method of cluster random sampling, the subjects were selected from some communities in Xining City, with an average altitude of 2 100m. The subjects were ≥40 years old, and the investigation method was field investigation. Single factor and multi factor analysis were used to determine the risk factors of ARMD, and R software was used to draw Nomoto.

RESULTS: The actual number of subjects in this survey is 2 595. Age, cataract, living time at high altitude, smoking, drinking, high blood pressure and mobile phone use are risk factors of ARMD. Old age was the most risk factor for ARMD(OR: 53.078, 95% CI: 28.405-77.183, P<0.001), followed by long-term use of mobile phones(OR: 9.142, 95% CI: 1.906-43.846, P<0.001). The DCA decision curve showed that when the Nomo score existed, the probability of predicting ARMD was almost the same as that of actual ARMD.

CONCLUSION: The risk factors of ARMD are old age, high altitude living time, cataract, smoking, drinking, high blood pressure and mobile phone using time, especially the old people who live in high altitude for a long time. Nomo scoring system can accurately predict ARMD and provide theoretical basis for clinicians to intervene ARMD in high altitude areas.

OBJECTIVETo investigate and compare the clinical implications of p16 deletion in childhood and adult B-lineage acute lymphoblastic leukemia (B-ALL).

METHODSA total of 129 cases of de novo childhood (73 cases) and adult (56 cases) B-ALL were examined genetically and immunologically using G-banding techniqhe, interphase fluorescence in situ hybridization (I-FISH) and immunophenotyping by flow cytometry, and their clinical data were retrospectively analyzed.

RESULTSOf 73 childhood cases, the prevalences of homozygous deletion, hemizygous deletion and no deletion of p16 were 24.7% (18 cases), 6.8% (5 cases) and 68.5% (50 cases) respectively, and of 56 adult cases, the incidences as of 14.3% (8 cases), 8.9% (5 cases) and 76.8% (43 cases) respectively. The incidence of p16 deletion between the two groups had no significant difference (P = 0.338). In both groups, patients with or without p16 deletion had no significant difference in terms of white blood cells (WBC) count at diagnosis, BM blast percentage, chromosome karyotype, extra-infiltration and CR1 rate. Of note, there were 2 cases, each in childhood and adult, showed no deletion at the time of diagnosis, their p16 deletions occurred at relapse. The deletion of p16 was associated with poor overall survival and event-free survival (EFS) in both childhood and adults. According to the standard of NCI risk stratification, we divided patients of two groups into standard and high risk category respectively, and performed further analysis. The significance of different risk category in children and adults was disparity. The overall survival (OS) rates of deletion and no deletion of p16 were 45.3% and 79.8% (P = 0.006) in children, and 7.7% and 22.6% (P = 0.002) in adults, respectively. EFS rates of deletion and no deletion of p16 were 33.5% and 58.1% (P = 0.008) in children, and 0 and 10.9% (P < 0.01) in adults, respectively. Of the standard risk category in children, OS rates of deletion and no deletion of p16 were 46.8% and 89.3% (P = 0.015) respectively, and EFS rates of deletion and no deletion of p16 as of 40.9% and 82.1% (P = 0.007) respectively. Of the high risk category in children, OS rates of deletion and no deletion of p16 were 41.7% and 67.4% (P = 0.193) respectively, and EFS rates of deletion and no deletion of p16 were 25.0% and 25.6% (P = 0.305) respectively. Of the standard risk category in adults, OS rates of deletion and no deletion of p16 were 20.0% and 46.9% (P = 0.092) respectively, and EFS rates of deletion and no deletion of p16 were 0 and 25.0% (P = 0.062) respectively. Of the high risk category in adults, OS rates of deletion and no deletion of p16 were 0 and 12.4% (P < 0.001) respectively, and EFS rate of deletion and no deletion of p16 was 0 and 4.8%(P < 0.001), respectively.

CONCLUSIONThis study indicated that deletion of p16 was associated with poor prognosis in both childhood and adult B-ALL, which highlighted an important significance to define the status of p16 in both childhood and adult B-ALL for predicting prognosis and guiding clinical intervention.

Adult ; Child ; Female ; Gene Deletion ; Genes, p16 ; Humans ; Male ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test (SPT) in patients allergic to Dermatophagoides pteronyssinus.

METHODSTwo hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen. Three kinds of house dust mite allergen extracts were used for SPT, including the Dermatophagoides pteronyssinus extract prepared by our laboratory (group A), standardized Dermatophagoides pteronyssinus extract (group B), and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae (group C). Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.

RESULTSSPT results showed that the median wheal diameter of group A, group B, and group C was 0.43, 0.35, and 0.28 cm, respectively, with significant difference among three groups (P<0.05). The difference was significant between group A and B (P<0.01) as well as group A and C (P<0.01), but not between group B and C (P>0.05). There was no local urticaria or systemic allergic reactions following the procedure of SPT. Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A. As for group B and C, local reaction occurred in 3 cases and delayed reaction in 2 cases in each group. The area under ROC curve of SPT with extract in group A, group B, and group C was 0.765, 0.801, and 0.782, respectively. Based on the detection results of serum specific IgE, the sensitivity of SPT in diagnosis of Dermatophagoides pteronyssinus allergy with extract of group A, group B, and group C was 92.4%, 87.0%, and 81.5%, and the specificity was 60.6%, 73.2%, and 74.8%, respectively.

CONCLUSIONThe Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts, and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Male ; ROC Curve ; Sensitivity and Specificity ; Skin Tests ; methods

High myopia is the main cause of visual impairment in the world. With the development of society, the myopia rate is increasing year by year. The development of high myopia is closely related to the progressive extension of the eye axis, and a series of fundus changes will inevitably occur with the extension of the eye axis, such as comus, lacquer cracks, choroidal neovascularization, macular choroidal atrophy, retinal detachment, posterior scleral staphyloma, etc. At present, characterized by younger age and high degree, myopia has become the main cause of blindness in China. This paper briefly summarizes the latest research on the morphological changes of the optic disc, macula, retina, choroid and sclera of high myopia, aiming to provide references for the development of intelligent prediction models, clinical diagnosis and further research on the treatment measures in combination with the fundus morphology of high myopia.

AIM: To analyze the risk factors related to pterygium in plateau area and establish a prediction model.METHODS: Using the method of cluster random sampling, the long-term residents living in the plateau with an average altitude of 3 000m were selected to conduct a field survey of pterygium from June 2020 to June 2021. Single factor and multi-factor analysis were used to analyze the risk factors related to pterygium, and the R software was used to establish the prediction model.RESULTS: The actual number of people investigated in this study was 1 514, and the number of patients with pterygium was 210, the overall prevalence rate was 13.87%. The age >43 years old, plateau area residence history, sunshine time, gender, smoking history, drinking history, hypertension, diabetes and hyperlipidemia are risk factors for pterygium. Among them, the long-term sunshine was the most dangerous factor for pterygium(OR: 6.215, 95%CI: 4.008-9.636, P<0.001), followed by >43 years old(OR: 5.348, 95%CI: 2.06-13.88, P=0.001). The decision curve analysis(DCA)showed that when the Nomo score system was applied, the predicted probability of pterygium was completely consistent with the actual probability of pterygium.CONCLUSION: The risk factors of pterygium as follows, the age >43 years old, plateau area residence history, sunshine time, gender, smoking history, drinking history, hypertension, diabetes and hyperlipidemia. The Nomo scoring system prediction model can accurately predict pterygium and provide a theoretical basis for the intervention of pterygium in plateau areas.