Pachychoroid spectrum diseases includes central serous chorioretinopathy (CSC),pachychoroid pigment epitheliopathy,pachychoroid neovasculopathy,and polypoidal choroidal vasculopathy,which share common characteristics,including focal or diffused increased choroidal thickness,choroidal hyperpermeability,and dilated choroidal vessels.These diseases are likely to represent a continuum of the same pathogenic process.Similar features and association among them suggest that they may have similar etiology.It is of great clinical significance to understand the composition and typical morphological changes of pachychoroid-related diseases and to explore its possible pathogenesis.

Background Researches showed that the mitochondrial-mediated apoptosis and autophagy play an important role in the survival of retinal ganglion cells (RGCs) in glaucoma.However,whether high pressure will lead to mitochondrial-mediated apoptosis and autophagy is not elucidated.Objective This study was conducted to explore whether elevated pressure can directly induce the mitochondrial-mediated apoptosis and autophagy in cultured RGC-5 cells in vitro.Methods RGC-5 cells were exposed to self-made pressure device and treated by 0,20,40 and 60 mmHg pressure for four hours in pressurized bottles.RGC-5 cells were incubated simultaneously in sealed incubator bottles and served as normal control.The morphological changes of the cells were examined under the inverted phase-contrast microscope.The apoptosis percentages of the cells were detected by flow cytometry.Mitochondrial membrane potentials of the cells were assessed using the JC-1,a fluorescent dye.And the expressions of cytochrome C (Cyt-c),microtubule associated protein light chain 3 (LC3) and Beclin-1 protein in the cells was detected by Western blot.Results Cultured cells showed fusiform shape in the normal control group and 0 mmHg group with more dendritic process.The cell density was obviously reduced and the number of dead cells was increased in the 20,40 and 60 mmHg groups.The apoptotic percentage was (15.69 ± 0.77)％,(15.77 ± 1.14)％,(18.30± 1.07) ％,(23.28 ± 1.33)％ and (34.47± 1.17)％ in the normal control group and 0,20,40 and 60 mmHg groups,respectively,showing a significant intergroup difference (F =150.90,P＜0.001),and the apoptotic percentage in the 40 mmHg group and 60 mmHg group was significantly increased in comparison with the normal control group (both at P＜0.01).The mitochondrial membrane potential was high in the normal control group and 0 mmHg group,with the reddish fluorescence in the cells,and the reddish fluorescence was weakened in the 20 mmHg group and 40 mmHg group.The lowing of mitochondrial membrane potential was seen in the 60 mmHg group,with the green fluorescence.Compared with the normal control group,the expression of Cyt-c,LC3-Ⅱ and Beclin-1 proteins in pressured groups was correspondingly increased (all at P＜0.05).Conclusions Elevated pressure induces the morphologic change of RGC-5 cells,results in mitochondrial membrane potential reduction and mitochondrial-mediated apoptosis and autophagy.

Objective To explore the impact of TIMP 3 regulated by miR-181b as a target gene on invasion and migration of hepatocellular carcinoma (HCC) in vitro.Methods The expressions of miR-181b were detected using SYBR Green real-time fluorescence quantitative polymerase chain reaction on liver cancer specimens and on HCC cell lines.The protein expression of TIMP 3 in HCC was detected using westen blot,and SKHep-1 as a cell line expressing high miR-181b was chosen through reporter gene experiment.TIMP-3 as a target gene regulated by miR-181b and its effect on invasion and migration treated by anti-miR-181 b were studied using transwell and cell scarification test,respectively.Results The expression of miR-181b in HCC was higher than cancer-adjacent tissues and normal liver tissues.The differences among them were significant.There was a correlation between the high expression of miR-181b and invasiveness and metastasis in HCC.The protein expression of TIMP-3 in HCC was significantly lower than normal liver tissues and cancer-adjacent tissues.Expression of miR-181b mRNA was detected in various HCC cell lines such as Hep3B,HepG2,Huh 7,SKHep-1,SNU182,SNU449 and hepatocyte,with the expression of miR-181b in SKHep-1 being the highest (P＜0.01).TIMP3-3UTR was low when the expression of miR-181b was high (P＜0.05).The invasion and migration abilities of SKHep-1 were significantly inhibited by anti-miR-181b (P＜0.05).Conclusion The data suggested that miR-181b promoted invasion and migration of SKHep-1 by down-regulating TIMP-3 in HCC.

Objective To evaluate the reliability and validity of the Chinese version of the Diabetes,Hypertension and Hyperlipidemia(DHL) Knowledge Instrument in community diabetic patients.Methods A face-to-face interview was conducted among 513 patients with diabetes in the community from January to March 2016 by using the Chinese version of DHL Knowledge Instrument.Forty of them were randomly sampled and reinvestigated 4 weeks later.The analyses on Cronbach's α coefficient,test-retest reliability,content validity,discriminant validity and construct validity were performed to evaluate reliability and validity of the DHL Knowledge Instrument.Results The qualified questionnaires were collected from 488 participants,including 232 males and 256 females with a mean age of (66 ± 6)years.The overall scores of the Chinese version of DHL Knowledge Instrument was 67.7 ± 18.0 and the scores of diabetes,hypertension,hyperlipidemia,medications and general issues sub-scales were 82.0 ± 22.5,65.9 ± 25.2,38.2 ± 34.3,75.5 ± 20.8 and 72.1 ± 22.9,respectively.The standardized Cronbach's α coefficient of the total scale was 0.849 and the test-retest reliability of the total scale was 0.706 (P ＜ 0.01).In term of content validity,the correlation coefficient was from 0.580 to 0.827 among total scale and sub-scales (P ＜ 0.01).In term of discriminant validity,the difference between the high and the low score group on total scale and sub-scales were significant (t value =-13.486 to-35.528,all P ＜ 0.01).In term of construct validity,based on exploratory factor analysis,the scale was revised.According to confirmatory factor analysis of revised scale,four factor model containing 20 items was well fitted (X2 =159.689,df =134,P =0.064);the GFI (goodness of fit index) =0.966,AGFI (adjusted goodness of fit index) =0.952,RMSEA (root mean square error of approximation) =0.020.Conclusion The Chinese version of DHL Knowledge Instrument possesses good reliability and validity and is suitable to evaluate the knowledge of community diabetic patients,and the modified version may work better than the original one.

Objective With a computer-assisted program,retinal vascular calibers were measured quantitatively.In this study the relationship between retinal vascular calibers and components of the metabolic syndrome was examined.Methods A total of 450 hypertensive patients were collected.Medical history,physical examination,blood tests,and retinal photographs were taken.Retinal vascular calibers were measured quantitatively from digital retinal photographs.In the hypertensive population the associations of retinal vascular calibers with components of the metabolic syndrome were described,and the factors that influenced retinal vascular calibers were analyzed.Results In the enrolled population,mean age was (57.53 ± 10.01) years,mean systolic blood pressure (138 ± 17) mm Hg(1 mm Hg =0.133 kPa),diastolic blood pressure (84 ± 10) mm Hg.Mean central retinal arteriolar equivalent(CRAE) was(129.26 ± 12.68) μm,and mean central retinal venular equivalent (CRVE) (198.25 ± 18.37) μm.After adjusting for age,gender,etc,CRAE in group with poor blood pressure control was smaller than that in the group with good blood pressure control [(126.45 ± 15.74) μm vs (130.30 ± 11.30) μm,P =0.029].CRAE tended to be narrower with worsened blood pressure control (P =0.075).CRVE was smaller in patients with normal high density lipoprotein-cholesterol (HDL-C) than in those with abnormal level [(197.36 ±17.62) μm vs (203.07 ± 21.52) μm,P =0.040].The diastolic blood pressure was raised along with the decreasing CRAE(P=0.009).And the HDL-C level was reduced as CRVE was increasing(P=0.042).Old age (r =-0.090,P=0.013) and poor blood pressure control(r=-0.098,P=0.038) were independent risk factors for narrow CRAE,while lowered HDL-C (r =0.105,P =0.024) and smoking (r =0.141,P =0.010) were independent risk factors for wide CRVE.Conclusions Narrow CRAE was related to poor blood pressure control,while wide CRVE was related to lowed HDL-C.Aging and poor blood pressure control were independent risk factors for narrow CRAE,while lowed HDL-C and smoking were independent risk factors for wide CRVE in the hypertensive patients.

Objective To investigate the application of the multiple locus variable numbers of tandem repeats(MLVA) in genotype Mycobacterium tuberculosis(MTB) strains isolated from Uygur in south of Xinjiang, and to understand the characteristics of genotype and distribution. Methods One hundred and fifty-one Mycobacterium tuberculosis strains were collected from Uygur in south of Xinjiang which contains three regions, Kashgar, Hotan and Kizilsu kirghiz. Twenty-four tandem repeats loci in the total genome of MTB were analyzed by PCR and agarose gel electrophoresis method. The characteristics on polymorphism of DNA fingerprinting of 151 MTB strains were analyzed with BioNumerics 5.0 software. Results Twenty-four MLVA loci of 151 MTB strains were analyzed respectively. The results showed that there were obvious polymorphisms of VNTRs. The clustering of genotype showed that these strains could be categorized into 8 gene groups( Ⅰ , Ⅱ , Ⅲ ,Ⅳ, Ⅴ ,Ⅵ,Ⅶ ,Ⅷ) and 151 genotypes. Sixty-seven isolates(44.4% ) belonged to group Ⅵ. 23.2% were group Ⅷ including 35 genotypes, 20. 5% were group Ⅳ including 31 genotypes. The group Ⅵ prevailed mostly in the Kashgar. The group Ⅲ prevailed mostly in the HOTAN. Conclusion The results showed there were obvious polymorphisms of VNTRs of Mycobacterium tuberculosis clinical strains preliminarily. Group Ⅵ was the predominant prevalent strain in south of Xinjiang.

Objective To analyze characteristics of Nef-specific T lymphocyte responses in Chinese HIV-1 recombinant subtype B/C infectors. Methods 19 HIV-1 recombinant subtype B/C infectors infected within 1 year, 40 chronic infectors infected for more than 3 years were enrolled in this cohort study. Elispot assay was used to observe HIV-1 specific T lymphocyte responses in HIV-1 recombinant subtype B/C infectors. Results Nef-specific T lymphocyte responses of interferon-gamma secretion were identified in 15 Chinese HIV-1 recombinant subtype B/C infectors infected within 1 year. The specific T lymphocytes were mainly targeted at four peptides which span from Nef 83 to 135: EVA7081.1, EVAT081.5, EVA7081.6 and EVAT081.48. Responses were identified in 29(75. 2%) infectors with more than 3 years of infection and the specific T lymphocytes were mainly targeted at three peptides which span from Nef 63 to 101 : EVA7081.43, EVA7081.44, EVAT081.45, EVA7081.47, EVA7081.48 and EVA7081.49. The average magnitude of response in infectors with less than 1 year of infection was 284. 13 SFC/106 PBMC. The average magnitude of response in infectors with more than 3 years of infection was 152. 44 SFC/106 PBMC. There was a significant difference between the two groups (U = 91. 000, P = 0. 002). Conclusions HIV-1recombinant subtype B/C infectors at different stages of diseases (less than 1 year and more thank 3 years) can recognize central region of Nef. The magnitude of Nef-specific IFN-γ secretion T lymphocyte responses in this cohort gradually decrease with disease progression.

Objective To analyze character of Nef-specific T lymphocyte responses in Chinese HIV-1 recombinant subtype C/B' and subtype B' infectors and to identify the common immunodominant re-gions recognized by these infectors. Methods Fifty-nine HIV-1 recombinant subtype C/B' infectors and 27 subtype B' infectors were tested by IFN-γ enzyme linked immunospot (ELISPOT) assay using HIV-1 C/B' Nef overlapping peptides. Results Nef-specific T-cell responses of IFN-γ secretion were identified in 44 (74.58%) out of 59 HIV-1 recombinant subtype C/B' infectors. Ten peptides, EVA7081.1,5, 6, 7,43, 44, 45, 47, 48, 49 were mainly recognized. Amino acid position was from Nef63 to 115 and 117 to 139. Twenty of 27 (74.07%) HIV-1 subtype B' infectors recognized peptides. EVA7081.1,2, 43 and 49 were mainly recognized. Amino acid position was from Nef 63 to 77 and 87 to 119. There was no correlation be-tween the Nef-specific IFN-production of HIV-1-specific T cells responses and viral load or CD4 T cell count in both subtype infectors. Conclusion The immunodominant regions, from Nef63 to 77 and 87 to 115 were recognized by both Chinese HIV-1 recombinant subtype C/B' infectors and subtype B' infectors. These re-gions could be used in design of vaccine.

Objective:To investigate the effect of myopia on retinal vascular geometry in young subjects.Methods:A retrospective cross-sectional study. From June 2018 to December 2018, 235 participants (235 eyes) who took part in routine physical examination in Huadong Sanatorium were included. There were 94 males and 141 females; age was (34.89±6.15) years old; equivalent spherical refraction (SE) was (-3.78±3.25) D. 59 (25.11%, 59/235) were divided into high myopia group (SE≤-6.0 D), along with 131 (55.74%, 131/235) low to moderate myopia group (-0.5 D> SE>-6.0 D), and 45 (19.15%, 45/235) emmetropia group (0.5 D≥SE≥-0.5 D). Retinal vascular geometric measurements, including central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), fractal dimension arteriole (FDa), fractal dimension venule (FDv), curvature tortuosity arteriole (CTORTa), curvature tortuosity venule, branch angle arteriole (BAa), branch angle venule, branch coefficient arteriole and branching coefficient venule, were extracted by using a validated computer program. One-way analysis of variance and analysis of covariance were performed to compare the measurements across the high myopia, low to moderate myopia, and emmetropia groups. Linear regression analysis was used to explore the relationship between SE and retinal vascular geometric parameters.Results:The differences in CRAE ( F=65.11), CRVE ( F=61.52), FDa (F=14.26), FDv ( F=8.31), CTORTa ( F=5.07) and BAa (F=6.51) among eys of high myopia group, low to moderate myopia group and emmetropia group remained significant ( P<0.05) after adjusting for age, glycosylated hemoglobin, mean arterial pressure, body mass index, and intraocular pressure. CRAE and CRVE were linearly correlated with the SE ( P<0.05). FDa, FDv, cTORTa and BAa decreased with the decrease of SE in high myopia ( P<0.05). Conclusions:Myopia is associated with the change of the retinal vascular geometric characteristics. With the deepening of myopia, the change of retinal vascular geometric characteristics gradually worsens.

Objective To investigate the etiological features and visual outcomes of endogenous endophthalmitis (EE).Methods A retrospective consecutive case series of 19 patients (23 eyes) presenting with presumed EE from 2009 to 2016 in the Ophthalmology Department of Zhongshan Hospital and Huashan Hospital,Fudan University were included.Patients' medical history (main risk factors),microbial culture results,treatment regimen and visual outcomes were evaluated.Results In total,19 patients (23 eyes) were identified,including 7 female (8 eyes) and 12 male (15 eyes).Mean age was 54.0 ±17.9,ranging from 24 to 85.Most patients had severe underlying diseases,mainly diabetic mellitus (9/19) and liver abscess (8/19).Twenty vitreous samples from 17 cases were cultured,and 12 eyes from 10 cases were positive with a positive rate of 12/20.Fifteen cases had blood or body fluids cultures and 10 were positive,with the positivity rate of 10/15.Candida albicans (5/6) was the most common pathogen isolated in fungal endophthalmitis,and Klebsiella pneumonia (7/13) was the most common pathogen in bacterial endophthalmitis.Patients mainly received vitrectomy,intravitreal injection,and systemic/local antibiotic therapy.Only five eyes had improved visual acuities,and 6 eyes were enucleated or eviscerated.Among the 10 eyes from 8 cases who were treated within one week after onset,5 eyes from 3 cases (5/10) had improved visual acuities;one eye from one case had no visual improvement;four eyes from four cases had no light perception or enucleated.No improved visual acuity occurred in patients who were treated after one week.Conclusions Although the incidence is low,EE has poor visual outcomes.Timely diagnosis and treatment may be helpful to maximize the recovery of vision.