BackgroundThe progressive death of retinal ganglion cells (RGCs) is the primary pathological characteristics of visual defects in glaucomatous eye.Research showed that endoplasmic reticulum stress (ERS) is involved in this progression.Glucose-regulated protein 78 ( GRP78 ) is a special marker of ERS.To understand the change in expression of GRP78 in the retina under the pressure induced is very important for the protection of visual function.Objective The present study was to observe the expression of GRP78 in rat retina with acute high intraocular pressure (IOP) and investigate the possible effect of ERS in acute glaucoma damage. MethodsFiftysix Wistar rats were randomly assigned to normal control group,anterior chamber punctured group and 12 hours,1 day,3,7,14 days groups following acute IOP rising.The acute high IOP models were established in the right eyes of 4.0 Wistar rats by paracentesis of the anterior chamber and infusion of normal saline solution into the anterior chamber.The histopathology changes of the retina were examined by hemotoxylin and eosin staining.The expression of GRP78 protein and mRNA in the retina were detected by immunohistochemistry and real-time fluorescence quantitative PCR.ResultsThe retinal layers and cells were clear with normal alignement in the rats of the normal control group and the anterior chamber punctured group.The edema and thickening of retinas appeared in 12 hours after molding and peaked in 1 day after molding.Then the retina decreased in thickness and atrophied from 3 days through 14 days.The expression levels of GRP78 protein (A value) were 0.195±0.006 in the nounal rats and gradually increased from 12 hours through 3 days (0.268±0.017) following molding with the peak value at 1 day (0.499±0.039 ),showing significant differences in comparison with the normal control group (t =0.098,0.304,0.073,P＜0.05),and the reduction in expression at 7 and 14 days were not significantly different from the normal control group ( t =0.002,0.001,P＞0.05 ).The relative value of GRP78 mRNA ( 2△△C1 ) in the retina was 1.011 ±0.013 in the normal control group and gradually up-regulated from 12 hours through 3 days with the peak value at Iday (2.141±0.171 ) and then down-regulated from the third day onwards.A significant difference was seen in 2-△△C1value between the normal control group and 12 hours group,1 day group or 3 group ( t =0.525,1.130,0.409,P＜0.05 ).However,the 2-△△C1 values of GRP78 mRNA at 7 and 14 days was similar to that of the normal control group (t=0.020,0.004,P＞0.05).ConclusionsGRP78 participates in the process of RGCs damage following acute high IOP.The results suggest that interfering with ERS may be helpful for protecting the retina and optical nerve from pressure-induced damage.

BACKGROUND: Long-term follow-up of the patients undergoing anterior cervical discectomy and fusion (ACDF) shows some incidence of degeneration at the segments adjacent to the fusion level. Cervical total disc replacement may resolve this problem. OBJECTIVE: To compare the effects of cervical total disc replacement versus ACDF on the biomechanics of the segment adjacent to the operation level. DESIGN, TIME AND SETTING: The randomized controlled trial was performed at biomechanical laboratory in Beijng Trauma and Orthopaedic Institute from August 2007 to February 2008. MATERIALS: Eighteen samples of fresh goat cervical spine; Bryan artificial cervical disk (Medtronic); CSLP-VA cervical plate (Synthes); coral bone (Beijing Yihuajian Science And Trade Co., Ltd.). METHODS: The goat spines were divided into 3 groups: control group with no specific treatment; total disc replacement group, in which C5/6 segment underwent Bryan artificial cervical disk replacement and fusion; internal fixation group, in which the C5/6 segment underwent cervical discectomy, coral bone implantation and internal fixation with CSLP-VA cervical plate. MAIN OUTCOME MEASURES: The adjacent intervertebral disk pressure (IDP) was measured in flexion, extension, rotation and lateral bending under certain loading, and the pressure changes were compared among three groups. RESULTS: At level C4/5, the IDP between total disk replacement group and the control group had no statistical significances in flexion (P 0.05) but internal fixation group was significantly higher than control group (P=0.014). There were no significant differences among the three groups in IDP in extension, rotation and lateral bending. CONCLUSION: Compared with ACDF, the total disk replacement can reduce the adjacent segment IDP and may avoid the degeneration in adjacent cervical segment.

BACKGROUND: Although the clinical effect of cervical disk replacement in short term has been ascertained, but the middle and long term result is not known, especially for the adjacent level. OBJECTIVE: To observe clinical result and effect of cervical disk replacement on adjacent level in middle and long term. DESIGN, TIME AND SETTING: Retrospective case analysis was performed at Beijing Jishuitan Hospital from December 2003 to March 2005. PARTICIPANTS: Thirty-three patients (aged 35-73 years) undergoing cervical disc replacement were followed up for 3 years. Of them, 25 patients received one-level disk replacement, and 8 received two-level disk replacement. METHODS: The clinical results and imaging before and after operation were compared. MAIN OUTCOME MEASURES: Clinical indexes including JOA grade, Odom’s grade, NDI, SF-36; X-ray: Kellgren X-ray grade, disk cervical height, disk motion, Pfirrmann disk grade, sigittal diameter of spinal cord, and compression of the spinal cord. RESULTS: The point of JOA is 13.62?2.31 before operation, 15.75?1.55 after operation; the differences were significant (P=0.000). For Kellgren X-ray, 10 levels occurred degeneration above the disk replacement level, accounted for 33% (P=0.004), and 9 levels developed degeneration below the disk replacement level, accounted for 32% (P=0.011). No obvious changes in imaging indexes were observed before and after surgery. CONCLUSION: The clinical outcome of cervical disk replacement is good in middle-term follow up. Some adjacent level degeneration may occur after cervical disk replacement, and the degeneration type is osteophyte formation in the adjacent level. This kind of adjacent level degeneration does not affect the clinical outcome in middle term follow-up.

Adenocarcinoma ; pathology ; radiotherapy ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Consensus ; Esophageal Neoplasms ; pathology ; radiotherapy ; Humans ; Lymph Nodes ; pathology ; Lymphatic Vessels ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; pathology ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Computer-Assisted ; methods ; Radiotherapy, Image-Guided ; methods ; Tumor Burden

Objective To explore the possible effect and mechanism of quercetin (QU) in inhibiting scar formation after the alkali burn of rat's cornea. Methods We established corneal alkali-burn model on right eyes of the SD rats. The rats were divided into five groups randomly. The control group received blank ophthalmic gel; the QU treatment groups received 2.5, 5, 10, or 20g/kg quercetin ophthalmic gel, respectively. The rats were checked by slit-lamp microscope every day for the degree of corneal opacity, then were killed on day 4, 7, 14, 21 and 28 after operation. The infiltration of the inflammatory cells was observed by histology, the arrangement and proliferation of the collagen fibers in the corneal stroma were observed by Masson trichrome staining. The expression of transforming growth factor-β_1 (TGF-β_1) and receptor of transforming growth factor-βⅠ(TGF-βRⅠ) in cornea was observed by immunohistochemical method. Results The corneal opacity was less severe in the QU treatment groups than in the control group (P<0.05). Corneal scar was inhibited better in 10g/kg QU and 20g/kg QU groups than in 2.5g/kg and 5g/kg QU groups, and 10g/kg and 20g/kg QU groups had no significant differences (P>0.05). HE and Masson staining showed that the density of corneal stroma collagen fibers in the QU treatment groups was lower than that in the control group. The expression of TGF-β_1 and TGF-βRⅠ reached the peak on day 7 after alkali burn, and then decreased slowly, which was close to the normal level. The expression of TGF-β_1 and TGF-βRⅠ was inhibited better in 10g/kg and 20g/kg QU groups than in 2.5g/kg and 5g/kg groups, and 10g/kg and 20g/kg QU groups had no significant differences (P>0.05). Conclusion QU ophthalmic gel can reduce formation of corneal scar to a certain extent, 10g/kg is the optimal concentration. QU may play its role by inhibiting the expression of TGF-β1 and TGF-βRⅠ.

Dideoxynucleosides ; False Positive Reactions ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Humans ; Inflammation ; diagnosis ; Neoplasm Staging ; Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; Positron-Emission Tomography ; methods ; Radiotherapy, Intensity-Modulated ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Treatment Outcome

Adult ; Aged ; Cartilage Diseases ; diagnosis ; therapy ; Humans ; Laryngeal Cartilages ; Laryngeal Diseases ; diagnosis ; therapy ; Male ; Middle Aged

Adolescent ; Child ; Child, Preschool ; Echocardiography, Three-Dimensional ; Female ; Heart Septal Defects, Atrial ; diagnostic imaging ; therapy ; Humans ; Male

Objective To observe the effect of lovastatin on plasminogen activator inhibitor -1 (PAI-1) and collagen type Ⅳ in rats with glomerularsclerosis induced by adriamycin,and to discuss its mechanism of protective effects on kidneys.Methods Twenty-four male Wistar nephritic rats induced by adriamycin were randomly divided into 3 groups:control,hyperlipidemia and lovastatin treatment group.They were fed 12 weeks.Urinary protein excretion and serum lipid were assayed,then renal glomerularsclerosis index,the expression of PAI-1 and collagen type Ⅳ were observed.Results Serum total cholesterol,triglycerides,low-density lipoprotein,urinary protein excretion,renal glomerularsclerosis index were significantly lower in treatment group than those in hyperlipidemia group.Expression of PAI-1 and collagen type Ⅳ,and number of foamcells were also sharply lower in treatment group than those in hyperlipidemia group.Conclusions Lovastatin not only reduces proteinuria,improves renal function,but also modulates glomerularsclerosis by inhibiting activity of PAI-1 and decreasing accumulation of collagen type Ⅳ.The mechanism of renal protective effect is independent of a reduction of circulating cholesterol.

Objective To investigate the clinical features of moyamoya disease complicated with Graves′disease and the efficacy of extra-and intra-cranial revascularization. Methods The clinical data of 4 patients with moyamoya disease complicated with Graves′disease were analyzed retrospectively. Among them,three were females and one was a male. Their mean age was 32 ± 7 years. After medical treatment, their thyroid function was normal. The patients were treated with superficial temporal artery-middle cerebral artery bypass grafting. Results (1) Three patients showed cerebral infarction and one showed frequent transient ischemic attack. DSA confirmed that 2 patients had unilateral moyamoya disease and 2 had bilateral moyamoya disease. Head MRI revealed brain infarcts. (2) The thyroid function was normal after drug treat-ment,the symptoms of moyamoya disease were stable in 3 cases. One patient had high metabolic symptoms, such as high fever and accelerated heart rate within one week after procedure. The patients were followedup for 6 to 18 months,one was good,3 were excellent,and there was no recurrence of Graves′disease. Postoperative head MRI revealed that the 4 patients did not have new brain infarcts. MRA showed that the arterial filling in cerebral sulci in the ischemic lesion areas was obviously improved compared with that before procedure. Retrograde filling of the ipsilateral middle cerebral artery M2-M3 segment was observed in 2 patients. Postoperative single photon emission computed tomography perfusion imaging revealed that the ischemic perfusion lesions on the operated sides were obviously improved compared with those before procedure. Conclusion When complicated with Graves′ disease,the symptoms of moyamoya disease will aggravate. It manifests as acute and chronic cerebral ischemia. After controlling the symptoms of hyperthyroidism,most cerebral ischemic symptoms can be alleviated. Superficial temporal artery-middle cerebral artery bypass grafting may establish an effective collateral circulation and improve the clinical symptoms.