1.Comparison of topographic changes in optic nerve head parameters after intraocular pressure reduction and lamina cribrosa compliance between POAG and PACG
Lan WANG ; Yuanbo LIANG ; Ningli WANG ; Jing LI ; Xia SUN ; Shuzhen GUO ; Junjian WANG
Ophthalmology in China 2009;18(4):264-269
Objective To compare the changes in optic disc parameters after intraocular pressure (lOP) reduction between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG) eyes, and to determine if there is a difference of lamina eribrosa compliance between POAG and PACG. Design Prospective comparative study. Participants 36 PACG (49 eyes) and 35 POAG (49 eyes). Methods Patients underwent Heidelberg Retina Tomography (HRT Ⅱ) and Humphrey visual field test before IOP reduction. HRT and Humphrey visual field test were repeated one month after the IOP was reduced by laser, anti-glaucomatous medications or surgery treatment. Factors that affected the change in IOP were assessed including age, pretreatment IOP, IOP reduction, initial cup: disc ratio and diagnosis (POAG/PACG). Main outcome measures Changes of HRT parameters including cup area, mean cup depth, cup volume, and rim area after IOP reduction. Results The cup area, mean cup depth and cup volume decreased, and rim area in-creased significantly when the IOP was reduced (P<0.05), but there were no significant differences in the changes between PACG and POAG patients (P>0.05). Changes of these four HRT parameters were related to the amount of IOP reduction and the baseline ratio of cup to disc(P>0.05), but not related to age and pre-treatment IOP (P<0.05). Conclusions The cup became smaller and the rim area in-creased after IOP lowering with treatment in both POAG and PACG, and the magnitude of the change was similar in both groups. The lamina cribrosa compliance may not be different between POAG and PACG. (Ophthalmol CHN, 2009, 18: 264-269)
2.Advances in myopia progression and its risk factors in children and teenager
Zhong, LIN ; Yuanbo, LIANG ; Xiaoxia, LI ; Vasudevan BALAMURALI ; Ciuffreda J KENNETH
Chinese Journal of Experimental Ophthalmology 2015;33(12):1148-1152
Myopia is an important public health issue.Great attention has been paid to myopia in children and teenager since its incidence is progressing rapidly worldwide, especially in Asia.Although there are substantial reports on both myopia progression and its risk factors in children and teenager, challenges are encountered when attempting to compare results among individual studies due to different population, definition of myopia, cycloplegic eye drops, refraction methods, and so on.This review aimed to summarize the reports on myopia progression and its risk factors such as age, gender, refractive state, near work, outdoor activities, parental myopia, or parental bearing age in children and teenager (<18 years) since 1990.
3.Is glaucoma suitable for community screening?
Junhong JIANG ; Cong YE ; Yuanbo LIANG
Chinese Journal of Experimental Ophthalmology 2018;36(4):294-298
Glaucoma is the leading cause of irreversible blindness worldwide.Screening for glaucoma is a critical intervention to identify individuals at an earlier stage of the disease.However,there is controversy about the necessity of glaucoma screening.Screening is a critical intervention for primary prevention of disease.The screening which suited to the level of our economic development has important benefits for our country,society,families and individuals.Glaucoma has fulfils the criteria of WHO for population screening:(1) Glaucoma is a major public health problem in the world.(2) Glaucoma can be detected in its earlier stage.(3) There are suitable and acceptable examinations for glaucoma screening.(4) Early detection and subsequent treatment could delay or retard glaucoma disease progression.(5) With appropriate strategy design,glaucoma screening can creat good economic benefit.The screening strategies depend on the level of social economy development,the health policies of developed areas tend to prevent disease in its early stages.In poor areas,the limited medical resources are used to treat patients in the advanced stages.In the relatively developed area with complete health care facilities and incomplete referral mechanisms,screening for glaucoma is a critical intervention to identify individuals at an earlier stage of the disease.Glaucoma Screening project in Wenzhou suggested that screening should be implement in relatively developed regions of high density of population to improve efficiency;screening should aim for multiple eye diseases to lower the cost per unit benefit.
4.Feasibility and effectiveness of a health examination center-based opportunistic eye diseases screening
Shaodan ZHANG ; Yuanbo LIANG ; Jing SUN ; Shanshan LIU ; Lin XU ; Hailin WANG ; Chi LIU ; Ruoxi LI
Chinese Journal of Experimental Ophthalmology 2017;35(12):1120-1125
Background Blindness and low vision represent significant public health issues in China.Late diagnosis is the major reason for the irreversible vision impairment.A feasible,cost-effective screening and referral program is very important for the eye health care,prevention and treatment of blindness in China.Objective This study was to evaluate the feasibility and effectiveness of a health examination center-based opportunistic eye disease screening program.Methods This was a cross-sectional study.Subjects undergoing a routine physical examination at the health examination center of the Fourth People's Hospital of Shenyang were invited to attend this program.Presenting visual acuity,intraocular pressure,and nonmydriatic fundus photography were obtained.Optic diso photographs were evaluated independently by two ophthalmologists.Blindness and moderate to severe vision impairment were defined based on the criteria of World Health Organization Visual Impairment Classification in 2009.Glaucoma,diabetic retinopathy (DR) and other suspected eye diseases were diagnosed according to the fundus photography and intraocular pressure.This study was approved by Ethic Committe of the Fourth People's Hospital of Shenyang,the informed consent of each subject was obtained.Results Totally,15 303 subjects were enrolled and 15 197 of them finished the exanimations,giving a response rate of 99.3%.The overall percentage of blindness and moderate to severe visual impairment was 0.08% (12/15 197) and 2.34% (355/15 197).Two hundred and twenty-eight (1.50%) subjects were defined as glaucoma suspects and 80 individuals (0.53%) were diagnosed as epimacular membrane.Other suspected eye diseases included DR (0.41%),branchial retinal vessel occlusion (0.24%),macular degeneration (0.09 %),and macular hole (0.06%).More than 95 % of the eye disease suspects have never been previously diagnosed or treated.A total of 358 subjects (2.36%) were defined as ocular hypertension suspects.Conclusions This health examination center-based opportunistic eye disease screening shows a good efficiency and feasibility.It may become an optional program in the national eye health care project,as well as the work of prevention and treatment of blindness.
5.Analysis of abnormal results of individual dose monitoring for radiation workers in medical institutions in Henan province from 2020 to 2022
Caifang CHU ; Yanfang ZHAO ; Yuanbo CHENG ; Juanjuan LIANG ; Qinfu ZHANG
Chinese Journal of Radiological Medicine and Protection 2023;43(5):366-372
Objective:To analyze the abnormal dose monitoring result of radiation staff in medical institutions and provide a basis for standardizing the personal dose management of radiation staff in medical institutions.Methods:Through the occupational radiation disease monitoring subsystem of the National Radiation Health Information Platform, 516 individual dose monitoring abnormal result of 410 radiation workers in a single monitoring period, which in 168 medical institutions under the 18 cities in Henan province were collected from 2020 to 2022 as research objects. Based on gender, age, length of service, occupational category, medical institution level, whether the dosimeter wearing standard, the abnormal result of radiation workers were grouped to analyze the influencing factors of individual dose monitoring result.Results:The incidence of abnormal individual dose monitoring result in 2020-2022 was 6.83 × 10 -3, 5.22 × 10 -3 and 6.30 × 10 -3, respectively. Abnormal results were mainly distributed in male radiology workers (66.83%), diagnostic radiology (59.51%) and interventional radiology (34.63%), tertiary (54.39%) and secondary medical institutions (36.34%). In the case of wearing personal dosimeter in a standard or irregular way, there were statistically significant differences in the incidence of abnormal outcomes between different levels of medical institutions and different occupational categories( χ2=14.42, 6.56, 32.96, 177.15, P<0.05). The median annual individual dose of radiology workers with " abnormal exposure dose" due to increased workload was 3.95 mSv, and the annual individual dose of interventional radiology workers was higher than that of radiotherapeutic workers ( Z=5.07, P<0.05). Conclusions:The education and training of radiological protection should be strengthened, and the wearing of individual dosimeters should be standardized; focus on the occupational exposure of interventional radiology staff, and take effective measures to reduce their exposure dose.
6.Thyroxine promotes the progression of integrin α vβ 3-positive differentiated thyroid cancer through the ERK1/2 pathway
Yiqian LIANG ; Xi JIA ; Yuanbo WANG ; Huijie LI ; Yiyuan YANG ; Yuemin ZHANG ; Hui XU ; Aimin YANG ; Rui GAO
Chinese Journal of Nuclear Medicine and Molecular Imaging 2023;43(8):452-458
Objective:To explore whether thyroxine (T 4) could promote differentiated thyroid cancer (DTC) progression by binding to integrin α vβ 3in vitro and its downstream mechanism. Methods:Papillary thyroid cancer cell lines TPC-1, K1 and follicular thyroid cancer (FTC) cell line FTC133 were cultured in vitro, and the expressions of integrin α vβ 3 in those 3 DTC cell lines were determined with immunofluorescence and flow cytometry analysis. After the treatment of T 4, tetraiodo thyroacetic acid (Tetrac) and Arg-Gly-Asp (RGD) peptide alone or in combination, the proliferation and metastatic potential of DTC cell lines were detected by cell counting kit-8 (CCK-8), Transwell migration and invasion assays. The small interfering RNA (siRNA) transfection was used to verify whether integrin α v or β 3 subunit knockdown could reverse the effect of T 4 on DTC cells. The expression levels of downstream signaling proteins phosphorylated extracellular signal-regulated kinase (p-ERK)1/2 and total extracellular signal-regulated kinase (ERK)1/2 were detected by Western blot. The effects of mitogen-activated protein kinase kinase (MEK)1/2 inhibitor (GSK1120212) on the proliferation, migration and invasion of T 4-treated cells were detected. One-way analysis of variance and Tukey test were used for data analysis. Results:The integrin α vβ 3 expressions in TPC-1, K1 and FTC133 cells were all positive, with the relative mean fluorescence intensity (MFI) of 61.93±18.61, 16.89±2.43 and 32.36±0.83, and the percentages of positive cells of (94.38±1.30)%, (74.11±3.87)% and (50.67±1.78)%, respectively ( F values: 13.36 and 217.30, P=0.006 and P<0.001). Compared with control group, the proliferation, migration and invasion in the three DTC cell lines treated with T 4 were significantly enhanced (96 h, F values: 62.67-297.50, q values: 13.15-20.73, all P<0.001). T 4-induced cell proliferation, migration and invasion were markedly reversed by Tetrac or RGD (96 h, q values: 8.61-17.54, all P<0.001). T 4-induced cell proliferation, migration and invasion were also significantly inhibited by the knockdown of integrin α v or β 3 subunit (72 h, F values: 7.75-70.98, q values: 4.77-15.21, all P<0.05). Western blot results showed that the phosphorylation levels of ERK1/2 in DTC cells were significantly increased by T 4 treatment, and the T 4-induced activation of ERK1/2 signaling pathway could be blocked by Tetrac, RGD, integrin α v or β 3 subunit knockdown. T 4-induced cell proliferation, migration and invasion were significantly reversed by GSK1120212 (96 h, F values: 47.53-151.40, q values: 10.32-16.65, all P<0.001). Conclusion:T 4 can promote cell proliferation and metastasis of DTC cells by binding to integrin α vβ 3 and activating the ERK1/2 pathway.
7.Regulatory effect of autonomic nerve on aqueous humor outflow pathway
Jialing HAN ; Lijuan XU ; Xiaorui GANG ; Tao ZHOU ; Yuanbo LIANG
Recent Advances in Ophthalmology 2024;44(1):62-65
Glaucoma is the leading irreversible blinding eye disease worldwide,and intraocular pressure(IOP)plays a key role in the occurrence and development of glaucoma.However,the underlying IOP regulatory mechanism remains un-clear.Currently,clinical IOP-lowering drugs work either by reducing aqueous humor formation or increasing aqueous hu-mor outflow with limited reduction amplitude.Recent studies demonstrate that IOP may be regulated by autonomic nerves.To understand the distribution and regulatory mechanism of autonomic nerves in the aqueous humor outflow pathway and provide new ideas for IOP-lowering study and novel drug exploration,we review the roles of the autonomic nervous system in the formation and outflow of aqueous humor in this article.
8.Characteristics of optic disc parameters and its association in normal Chinese population: the Handan Eye Study.
Qing ZHANG ; Sizhen LI ; ; Yuanbo LIANG ; ; Fenghua WANG ; Weiwei CHEN ; Ningli WANG ;
Chinese Medical Journal 2014;127(9):1702-1709
BACKGROUNDAssessment of the optic disc and retinal nerve fiber layer (RNFL) is essential for the diagnosis and monitoring of glaucoma. Knowledge of normal optic disc topography provides a benchmark for evaluating glaucomatous pathologic changes, especially in its early stages. The purpose of this study was to evaluate the characteristics and correlation factors of the optic disc parameters using the Heidelberg Retina Tomograph II (HRT II) in a large sample of normal eyes of adult Chinese subjects.
METHODSDisc data were obtained from 6 830 subjects aged >30 years from the Handan Eye Study. All participants underwent comprehensive eye examinations and physical examinations. The associations of gender, age, body mass index, blood pressure, waist-to-hip ratio; refractive error, intraocular pressure, axial length, and disc area were assessed using simple and multiple regression analysis. The correlation between HRT II parameters was evaluated.
RESULTSOf the 7 557 eligible subjects, 6 830 took part in the study (90.4% response rate) and 2 633 normal eyes with good-quality HRT II images were selected. The mean disc area was 2.28 mm(2) (standard deviation (SD) 0.43) and mean neural rim area was 1.80 mm(2) (SD 0.29). In multiple regression analysis, optic disc area significantly correlated with age, gender, and axial length (P < 0.001). All optic disc parameters showed a significant correlation with disc area (0.054 CONCLUSIONSThe optic disc area in rural Chinese population is larger than reported in white and Japanese populations, similar to that of Indian population and urban Chinese population. Most optic disc measurements were moderately or weakly affected by disc area. In addition to the RNFL, there may be other factors affecting the rim area. The relationship between optic disc and axial length may suggest a link between larger disc area, thinning of the lamina cribrosa, and increased glaucoma susceptibility in myopic eyes.
Adult
;
Female
;
Glaucoma
;
epidemiology
;
Humans
;
Male
;
Middle Aged
;
Myopia
;
epidemiology
;
Optic Disk
;
anatomy & histology
9.Analysis of high risk factors for acute complex appendicitis in adults.
Shikuan LI ; Liangdong CHENG ; Yuanbo LI ; Liang NING ; Zongping YU ; Peige WANG ; Xiaobin ZHOU ; Jianan REN
Chinese Journal of Gastrointestinal Surgery 2018;21(12):1374-1379
OBJECTIVE:
To explore the high risk factors of adult complex appendicitis, and to provide a reference for the development of a reasonable treatment strategy for acute appendicitis.
METHODS:
A retrospective case-control study was conducted to collect clinical data of 312 adult patients with acute appendicitis confirmed by pathology undergoing appendectomy, including open and laparoscopic surgery, from May 2011 to August 2016 at Affiliated Hospital of Qingdao University. Age <14 years old, pregnant women, complicating abscess around the appendix, AIDS, blood system diseases, autoimmune diseases, inflammatory bowel disease or progressive cancer patients were excluded. According to the intra-operative findings and pathological types, patients were divided into complex appendicitis(112 cases, including gangrene and perforation) and non-complex appendicitis (200 cases, including simple and non-perforated appendicitis, ie suppurative appendicitis). After comparing the clinical data of these two groups, statistically significant variables were induded for multivariate logistic regression analysis to identify risk factors of complex appendicitis, and to establish a regression model. Enter method was applied to establish the regression equation: P=ExpiΣBiXi/1+ExpΣBiXi, and to calculate the relative risk of each variable. Meanwhile, retrospective and prospective verification was performed on this predictive model (cases of acute appendicitis from September 2016 to December 2017 were further collected). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of complex appendicitis were calculated with the regression model.
RESULTS:
Comparison of the clinical data between the complex appendicitis group and the non-complex appendicitis group showed that differences of 10 preoperative indexes were statistically significant, including period from abdominal pain to admission [(59.1±42.6) hours vs. (47.5±34.4) hours, t=3.051, P=0.002], white blood cell count [(12.9±3.7)×10/L vs. (9.2±4.0)×10/L, t=9.755, P<0.001], neutrophil count [(9.8±4.0)× 10/L vs.(7.1±3.9)×10/L, t=6.020, P<0.001], neutrophil percentage[(84.5±8.7)% vs.(68.2±16.0)%, t=12.754, P<0.001], C-reactive protein levels [(86.0±45.4) μg/L vs. (55.9±35.8) μg/L, t=7.614, P<0.001], serum albumin levels [(334.0±4.8) g/L vs. ( 41.0±4.3) g/L, t=16.055, P<0.001], vomiting ratio [44.6%(50/112) vs. 23.5%(47/200), χ²=14.980, P<0.001], high fever(≥39°C) ratio [16.1%(18/112) vs. 7.5%(15/200), χ²=5.577, P=0.022], the proportion of patients ≥60 years old [22.3%(25/112) vs. 13.0%(26/200), χ²=4.562, P=0.038] and previous history of appendicitis [16.1%(18/112) vs. 7.5%(15/200), χ²=5.577, P=0.022]. The above 10 variables were included in the logistic regression model for multivariate analysis. The results showed that six variables were associated with complex appendicitis. According to their strength, they were old age (≥60 years old) X1(OR=5.094), high fever (≥39°C) X2(OR=4.464), neutrophil count X6 (OR=1.269), neutrophil percentage X4 (OR=1.077), C-reactive protein level X5 (OR=1.027), and serum albumin level X3 (OR=0.763). A predictive regression model was established: P=1/[1+e], whose sensitivity and specificity of judging complex appendicitis were 76.8%(86/112) and 90.0%(180/200),respectively. Sensitivity and specificity for predictive value of complex appendicitis in further prospective validation of the model were 76.2%(48/63) and 81.1% (30/37), respectively.
CONCLUSIONS
Age ≥ 60 years old, body temperature ≥39°C, increased neutrophil count, neutrophil percentage and C-reactive protein levels, and hypoalbuminemia are risk factors for complex appendicitis. The establishment of predictive model may help determine complex appendicitis.
Acute Disease
;
Adolescent
;
Adult
;
Age Factors
;
Appendicitis
;
diagnosis
;
epidemiology
;
pathology
;
Case-Control Studies
;
Female
;
Humans
;
Leukocyte Count
;
Middle Aged
;
Models, Statistical
;
Pregnancy
;
Retrospective Studies
;
Risk Factors
10.Incidence and risk factors of early transient intraocular pressure elevation after canaloplasty for primary open-angle glaucoma.
Lijuan XU ; Xinyao ZHANG ; Yang CAO ; Yin ZHAO ; Juan GU ; Wenqing YE ; Xiaojie WANG ; Jinxin LI ; Ruiyi REN ; Yuanbo LIANG
Journal of Zhejiang University. Science. B 2023;24(4):366-370
Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans
;
Intraocular Pressure
;
Glaucoma, Open-Angle/surgery*
;
Incidence
;
Treatment Outcome
;
Risk Factors