Objective: To analyze the effects of community-based interventions for diabetic eye diseases in Xinjing community, Shanghai from 2016 to 2018. Methods: Based on the project of "Establishment of Service Model for Comprehensive Prevention and Treatment of Diabetic Eye Diseases in Shanghai", the participants were not suffering diabetic retinopathy (DR) in Xinjing community in 2016 before interventions and received community-based interventions for diabetic eye diseases. The incidence of DR, visual acuity and awareness of DR were used as evaluation indicators to analyze the effects of interventions for diabetic eye diseases in the community. Results: A total of 537 patients were included in this study, the incidence of DR among diabetic patients in Xinjing community was 7.6% after interventions. The duration of diabetes (OR= 1.065) and HbA1c (OR= 1.090) were the risk factors of DR. Before and after the interventions, the patients with monocular low vision and binocular low vision were 27 cases (5.0%), 8 cases (1.5%), 19 cases (3.5%) and 7 cases (1.3%) respectively. After interventions, the awareness on the prevention and treatment of DR increased significantly, and the proportion of regular visits to ophthalmology examination, diet control and physical exercise also increased significantly. Conclusion: Community-based interventions for diabetic eye diseases are helpful to improve the awareness of DR prevention and control, reduce the incidence of DR.
China/epidemiology* ; Cross-Sectional Studies ; Diabetes Mellitus ; Diabetic Retinopathy/prevention & control* ; Exercise ; Humans ; Risk Factors

Diabetic retinopathy (DR), one of the chronic complications of diabetes, is a serious and irreversible blinding disease. It is difficult to detect in the early stage, to control in the progressive stage, to operate in the advanced stage of DR. Recently, the "14th Five-year plan" for National Eye Health proposed to "improve the management mode of chronic eye disease, and build a chronic disease management system". The project team used artificial intelligence technology based on cloud platform, joint outpatient service, virtual ward to explore the comprehensive management of DR from the aspects of early screening, multidisciplinary collaborative diagnosis and treatment, and refined blood glucose management during perioperative period. In the future, it is urgent to integrate DR chronic disease management with other systemic chronic diseases to reduce the blindness caused by DR.
Humans ; Diabetic Retinopathy/diagnosis* ; Artificial Intelligence ; Mass Screening ; Blindness/prevention & control* ; Diabetes Mellitus

OBJECTIVETo investigate the impacts of steady high-glucose or fluctuated glucose conditions on glutamate (Glu) release in purified retinal ganglion cells (RGCs) cultured in vitro, and the effect of serum contained Chinese drugs for nourishing Shen and activating blood (S-NSAB) on it.

METHODSRGCs of neonatal SD rats were cultured by antibody combined two-step purified method in different conditions: the simulated normal condition, the steady high-glucose condition and the fluctuated glucose condition, and they were intervened with S-NSAB. Thereby, the experiment was carried out in 6 groups, i.e. the normal control group (A), the S-NSAB intervened group (B), the steady high-glucose cultured group (C), the steady high-glucose cultured and S-NSAB intervened group (D), the fluctuated glucose cultured group (E), and the fluctuated glucose cultured and S-NSAB intervened group (F). Content of Glu in the extracellular fluid was detected at 24, 48 and 72 h after intervention with a full-automatic biochemical analyzer. And the data obtained were statistically analyzed with SPSS 13.0 soft ware.

RESULTSRelease of Glu at 24 h after intervention in Group E (256.33 +/- 25.73 mg/L) was obviously higher than that in Group A and Group C (134.22 +/- 9.14 mg/L and 141. 17 +/- 22.13 mg/L, P < 0.05); at 24 h and 72 h in Group B (124.50 +/- 10.30 mg/L and 30. 17 +/- 2.97 mg/L) was obviously lower than in Group A respectively (P < 0.05); in Group D at 24 h (127.50 +/- 16.94 mg/L), 48 h (26.17 +/- 3.99 mg/L) and 72 h (27.67 +/- 3.49 mg/L) were lower than in Group C; in Group F at 24 h (228.33 +/- 18.41 mg/L) and 72 h (28.00 +/- 2.41 mg/L) were lower than in Group E respectively at the corresponding time points.

CONCLUSIONSFluctuated glucose condition could obviously increase the Glu release of RGCs, to cause extracellular large amount Glu accumulation, which induces the exciting neurotoxicity to RGCs and finally to aggravate the injury on cells. S-NSAB could reduce the Glu release to some extent in the steady-high or fluctuated glucose conditions, diminish the injury of RGCs from exciting neurotoxicity of Glu, and it might be one of the intervening pathways of Chinese drugs for NSAB in preventing and treating DRP.

Animals ; Animals, Newborn ; Cells, Cultured ; Diabetic Retinopathy ; prevention & control ; Drugs, Chinese Herbal ; pharmacology ; Glucose ; pharmacology ; Glutamic Acid ; metabolism ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells ; cytology ; metabolism

INTRODUCTIONThe aim of this study was to compare the occurrence of diabetic retinopathy in targeted screening diabetic patients (Group I) with newly diagnosed diabetic patients in general practice (Group II).

MATERIALS AND METHODSThis was an observational cross-sectional study. Data were obtained from 25,313 subjects who participated in the diabetic screening camps, and 128 newly diagnosed diabetes who presented to the diabetic retinopathy screening camps in general practice in rural and urban south India. The study variables were collected from all patients who underwent eye examination from the target screening detected diabetics [(n = 173) Group I] and those newly diagnosed in general practice [(n = 128) Group II]. The variations in prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in Group I and Group II and the factors affecting it were identified.

RESULTSThe occurrence of diabetic retinopathy was 6.35% (95% CI, 2.5-9.5) in Group I and 11.71% (95% CI, 5.6-16.4) in Group II. No significant difference was observed on occurrence of diabetic retinopathy, including sightthreatening retinopathy, in rural versus urban population and in Group I versus Group II. Patients diagnosed in general practice (Group II) with systolic blood pressure (BP) >140 were more likely to have retinopathy (P = 0.02).

CONCLUSIONSDiabetic retinopathy including sightthreatening complications was found at the time of diagnosis of diabetes in the targeted screening group as well as in newly diagnosed diabetics in the general practice group.

Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; epidemiology ; prevention & control ; Family Practice ; Female ; Humans ; Hypertension ; complications ; India ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Rural Population ; Urban Population

OBJECTIVETo investigate the protective effect of Qihuang Mingmu capsule (QHMM) on retina of diabetic mice and its impact on VEGF expression.

METHODForty KK/Upj-Ay mice were randomly divided into the model group and high, middle and low dose QHMM (8.32, 4.16, 2.08 g x kg(-1)) groups. Additional 10 C57BL/6 mice were selected as the control group. Mice were orally administered for three months. Their general appearance, fasting blood-glucose (FBG) and glycosylated hemoglobin (HbA1c) were observed. Pathological changes of retina were observed by light microscope and electron microscope. The expressions of vascular endothelial growth factor (VEGF), growth factor receptors-1 (Flt-1) and growth factor receptors-2 (Flk-1) were examined by Real-time PCR (qPCR) and Western blot.

RESULTQHMM could ameliorate the symptoms of diabetic mice to varying degrees, decrease FBG and HbA1c, alleviate pathological lesions of retina and decrease the expressions of VEGF, Flt-1, Flk-1 mRNA and protein.

CONCLUSIONQHMM has the protective effect on diabetic retinopathy of mice by inhibiting the expressions of VEGF, Flt-1 and Flk-1 and intervening VEGF-VEGFR signal transduction pathway.

Animals ; Capsules ; administration & dosage ; Diabetic Retinopathy ; drug therapy ; genetics ; metabolism ; prevention & control ; Drugs, Chinese Herbal ; administration & dosage ; Gene Expression ; drug effects ; Humans ; Male ; Mice ; Mice, Inbred C57BL ; Protective Agents ; administration & dosage ; Retinal Diseases ; drug therapy ; genetics ; metabolism ; prevention & control ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

The purpose of this study was to investigate the protective effect of puerarin on retina pigment epithelial (RPE) cells of diabetic rats against apoptosis. One hundred and eight Sprague-Dawley (SD) rats were randomly divided into 3 groups: control group, streptozotocin (STZ) group and puerarin group. STZ and puerarin groups received 3 d of STZ injection (45 mg/kg per day, i.p.). Additionally, puerarin groups were treated with puerarin (140 mg/kg, i.p.) from the 4th day to the end of experiment. The rats from different groups were sacrificed on 20, 40 and 60 d after STZ injection for harvesting RPE cells. Western blot analysis, DNA laddering, RT-PCR and immunohistochemistry were used for determining the expression of nitrotyrosine (NT, the foot print of peroxynitrite), cell apoptosis, iNOS mRNA and Fas/Fas ligand (FasL) signal transduction in RPE cells, respectively. The results showed that control group maintained low apoptosis level and little NT, iNOS mRNA, Fas/FasL protein expressions, as well as normal blood glucose and body weight during 60 d of the experiment. Compared with control group, STZ group showed obvious apoptosis and higher NT, iNOS mRNA, Fas/FasL protein expressions from 20 d after STZ injection. Puerarin relieved apoptosis of RPE cells and decreased NT, iNOS mRNA, Fas/FasL protein expressions in puerarin group 20 or 40 d after STZ injection, compared with STZ group. These results suggest puerarin can decrease RPE cells apoptosis in diabetic rats by reducing peroxynitrite level and iNOS expression, thus being a potential therapeutic agent in controlling of diabetic retinopathy.
Animals ; Apoptosis ; drug effects ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Diabetic Retinopathy ; prevention & control ; Fas Ligand Protein ; metabolism ; Isoflavones ; pharmacology ; Male ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Peroxynitrous Acid ; metabolism ; Protective Agents ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Retinal Pigment Epithelium ; pathology ; fas Receptor ; metabolism

To evaluate the effect of chlorogenic acid (CGA), a polyphenol abundant in coffee, on retinal vascular leakage in the rat model of diabetic retinopathy, Sprague-Dawley rats were divided into four groups: controls, streptozotocin-induced diabetic rats, and diabetic rats treated with 10 and 20 mg/kg chlorogenic acid intraperitoneally daily for 14 days, respectively. Blood-retinal barrier (BRB) breakdown was evaluated using FITC-dextran. Vascular endothelial growth factor (VEGF) distribution and expression level was evaluated with immunohistochemistry and Western blot analysis. Expression of tight junction proteins, occludin and claudin-5, and zonula occludens protein, ZO-1 was also evaluated with immunohistochemistry and Western blot analysis. BRB breakdown and increased vascular leakage was found in diabetic rats, with increased VEGF expression and down-regulation of occludin, claudin-5, and ZO-1. CGA treatment effectively preserved the expression of occludin, and decreased VEGF levels, leading to less BRB breakdown and less vascular leakage. CGA may have a preventive role in BRB breakdown in diabetic retinopathy by preserving tight junction protein levels and low VEGF levels.
Animals ; Blood-Retinal Barrier/*drug effects ; Chlorogenic Acid/metabolism/*pharmacology ; Claudin-5/metabolism ; Dextrans/chemistry ; Diabetes Mellitus, Experimental/complications/metabolism/*pathology ; Diabetic Retinopathy/etiology/prevention & control ; Down-Regulation ; Fluorescein-5-isothiocyanate/chemistry ; Male ; Occludin/metabolism ; Rats ; Rats, Sprague-Dawley ; Retina/*metabolism ; Tight Junction Proteins/metabolism ; Vascular Endothelial Growth Factor A/metabolism ; Zonula Occludens-1 Protein/metabolism