2.The impact of manual small-incision cataract surgery and phacoemulsification on corneal regularity
Fu-cun, ZHANG ; Jia, QU ; Xu, XU
Chinese Journal of Experimental Ophthalmology 2013;(4):381-385
Background Cataract surgery can induce the occurrence of dry eye because of the influence of incision on corneal nerve fibers and the change of corneal regularity derived by surgery.Objective This study was to investigate the change of regularity of anterior corneal surface,tear film and astigmatism caused by the process of manual small-incision cataract surgery (manual SICS) and phacoemulsification (Phaco).Methods A prospective non-randomized controlled study was designed.Fifty eyes of 46 age-related cataract patients were included in this clinical study.Thirty eyes of 30 patients received the manual SICS,and other 20 eyes of 16 patients underwent Phaco.Corneal irregularity measurement (CIM),shape factor (SF) and corneal astigmatism were assessed by the corneal tomography examination,the subjective symptoms were scored and tear film break up time (BUT),Schirmer Ⅰ test (S Ⅰ t) were examined before surgery and 1 day,1 week,1 month after surgery.The examined parameters were compared among different time points and two groups.This study was approved by Ethic Committee of Affiliated Eye Hospital of Wenzhou Medical College,and written informed consent was obtained prior to operation.Results The CIM values were gradually increased with the prolong of time after operation,showing a statistically significant difference dependent on time (Ftime =22.864,P =0.000),and CIM value of 1 day,1 week and 1 month after operation was higher than that of before operation (P<0.01).However,no significant difference was found in CIM value between two groups in different time points (Fgroup =0.062,P =0.804).There was no significant difference in SF values with time prolong (Ftime =4.600,P =0.428) and different groups (Fgroup =0.009,P =0.925).The BUT was gradually reduced with the time prolongs with the considerably difference (Ftime =39.384,P=0.000).Obviously decreases of BUT values were seen in 1 week and 1 month in comparison with 1 day after operation (both P=0.000).But no significant change was found in BUT between two groups in various time points (Fgroup =0.000,P=0.983).In the manual SICS group,the difference was found in S Ⅰ t values between before operation and 1 week or 1 month after surgery(P<0.01).Surgery associated astigmatism (SIA) was existed in the operative eyes in various time points after operation.With time lapse,SIA value was declined with a significant difference (Ftime =21.479,P =0.000),the difference also was found in different groups (Fgroup =8.709,P =0.005),and SIA value in the Phaco was significantly lower than that in the manual SICS group (P<0.01).Conclusions In the present study,in the early stage after manual SICS and Phaco,SIA appears due to the irregular change of the anterior corneal surface increases and stability of tear film worsens.
3.Optimization of the IMRT treatment plan undergoing megavoltage cone-beam CT Imaging for nasopharyngeal carcinoma patients
Mingxuan JIA ; Xu ZHANG ; Chengbo HAN
Chinese Journal of Radiation Oncology 2010;19(6):544-547
Objective To investigate the intensity modulated radiation therapy (IMRT) planning optimization method to reduce the additional dose resulting from megavoltage cone-beam CT (MVCBCT) imaging for nasopharyngeal carcinoma IMRT treatment. Methods MVCBCT images collection process was simulated using XiO treatment planning system. The mean doses of MVCBCT ( DMVCBCT ) were calculated in gross tumor volume ( GTV), clinical target volume ( CTV ) and risk at organ or tissue using 27. 4 cm× 27.4 cm portal radiation 8 MU,5 MU (A,C) and 27.4 cm× 15.0 cm portal radiation 8 MU,5 MU (B,D). The dose correct factor of MVCBCT (CFMVCBCT) according to IMRT TPS and DMVCBCT ,but CFMVCBCT plus MVCBCT imaging process for radiotherapy planning optimization. The paired t-test was play for A∶ B,C∶ D,A∶ C,B∶ D of DMVCBCT. Results The DMVCBCT and CFMVCBCT of A, B, C, D were 7. 78,5. 78,4. 88,3.55 cGy ( A∶ C, t =24.41,P<0.01) and 0.993 -0.997 in GTV,with 7.88,6.95,4.88,4.38 cGy (A∶ B,A∶ C,B∶ C,t=3. 85, -31.82, -8.52, all P<0. 01) and 0.992 -0.996 in CTV1 ,with 8.28,6.67,5. 17,4. 17 cGy (A ∶B,A∶C,B∶C,B∶D,t=6.41 -18.24,all P<0. 01) and 0.991 -0.996 in CTV2;with 6.88,5.00,4.28,3. 50 cGy ( A∶ B, A∶ C,t = 2. 83,11.03, all P < 0. 05 ) and 0. 989 - 0. 995 in spinal cord, with 7.88,7. 38,4. 95,4. 62 cGy and 0. 984 -0. 990 in left parotid, with 8. 67,0. 28,5. 33,0. 28 cGy and 0. 963 -0. 999 in left optic nerve,with 9. 17,0.22,5.72,0. 17 cGy and 0.821 -0.997 in left eye lens,with 6.95,2. 17,4. 38,1.38 cGy and 0. 987 -0. 997 in brain stem, with 7.78,0.45,4. 95,0. 28 cGy and 0. 978 -0. 999 ( A ∶ B,A∶ C,B∶ C,B∶ D for five organ or tissue,t =5. 06 -335. 16 ,all P <0. 01 ) in optic chiasm. Conclusions The MVCBCT imaging process resulted in radiation doses to patient. The impact of MVCBCT image acquired dose on IMRT treatment plan for NPC was eliminated by a compensation method.
4.Clinical Observation of Paroxetine Combined with Flupentixol Melitracen in the Treatment of Post-stroke Major Depressive Disorder
Liya ZHANG ; Jia HE ; Dongxun XU
China Pharmacy 2017;28(9):1170-1173
OBJECTIVE:To observe therapeutic efficacy and safety of paroxetine combined with flupentixol melitracen in the treatment of post-stroke major depressive disorder(PSMDD). METHODS:120 PSMDD patients were randomly divided into group A(40 cases),group B(40 cases)and group C(40 cases). All patients received routine stroke treatment;group A was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet 25 mg orally,once a day;group B was additionally given Flu-pentixol melitracen tablet 20 mg orally twice a day;group C was additionally given Paroxetine hydrochloride enteric-coated sus-tained-release tablet (same usage and dosage as group A)+flupentixol melitracen (same usage and dosage as group B). Three groups were treated for 28 d. Clinical efficacies of 3 groups were observed as well as NIHSS,ADL,HADM,SS-QOL score,hos-pitalization stay and the occurrence of ADR. RESULTS:Total response rate of group C was significantly higher than those of group A and B;hospitalization day was significantly less than those of group A and B,with statistical significance(P<0.05);there was no statistical significance between group A and B(P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). Before treatment,there was no statistical significance in NIHSS,ADL,HADM,SS-QOL score among 3 groups(P>0.05). After 10,28 d of treatment,NIHSS,HADM,SS-QOL score of 3 groups were significantly lower than before, above indexes were decreased gradually as time,and the group C were lower than the group A and B;ADL score of 3 groups were significantly higher than before,this index was increased gradually as time,and the group C were lower than the group A and B with statistical significance (P<0.05);there was no statistical significance between group A and B (P>0.05). CONCLUSIONS:Based on routine treatment,paroxetine combined with flupentixol melitracen in the treatment of PSMDD can relieve neurologic function injury,improve depression condition and the quality of life without increasing the occurrence of ADR.
5.Advances in cytokine immune mechanisms of allergic rhinitis.
Qiang ZHANG ; Jia XU ; Yuru LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(23):1102-1104
Allergic rhinitis is a common disease, which was released by the IgE-mediated atopic individuals exposed to allergens in the earlier researches. However, there are variety of immunocompetent cells and cytokines involved in the nasal mucosa immunologic mechanism in nowadays researches. The mechanism of AR is caused by the imbalance of the Th1/Th2, a kind of allergic inflammation who is characterized by the nasal Th2 immune response dominant. Th1 cells mainly produce of IFN-gamma (does not include IL-4 and IL-5), Th2 cells produce IL-4, IL-5, IL-9 and IL-13 (not including IFN-gamma). Recently it was found that regulatory T cells (T regulatory cells, Treg) and Th17 cell research played a crucial role in the occurrence of allergic inflammation.
Cytokines
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immunology
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Humans
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Rhinitis, Allergic
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Rhinitis, Allergic, Perennial
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immunology
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Th1 Cells
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immunology
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Th2 Cells
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immunology
6.Analysis on epidemiological characteristics of Keshan disease in Mianning County of Sichuan
Jia-yuan, XU ; You-zhang, XIANG ; Dao-yun, XU
Chinese Journal of Endemiology 2008;27(4):431-433
Objectives Understanding the characteristic changes of Keshan disease (KD) in different epidemic period to provide reference basis for prevention and teatment. Methods On the basis of medical record as fundamental element, the relative conditions of Keshan disease's prevailing and spreading period were compared. Results In high incidence years, familial aggregation [accounted for 12%(6/50)] and seasonal aggregation were found, and KD cases occurred mainly from May to September, which was 78% (39/50)of the total cases in the whole year. Circulatory dysfunction(gallop rhythm, pulmonary role, jugular venous engorgement, cyanosis of lips) was more severe in high incidence years than that in low incidence years(X2=8.53,P<0.01). The average age of incidence was (4.07±1.46) years old in high incidence years and (6.11±2.71) years old in low incidence years. The type constitution in high incidence years was significantly different from that in low incidence years (X2=40.68, P<0.01), and chronic type of KD accounted for 22.85%(707/3094),46.09%(53/115), respectively, in high and low incidence years. Conclusions Making a further research of seizure of disease, and improving diagnosis and cure management level are also the important content for prevention and cure research work of Keshan disease at right time.
7.A study on the establishment of co-culture system of peripheral blood mononuclear cells with orbital fibroblasts and the secretion of IL-6 and IL-17A induced by phytagglutinin in thyroid associated ophthalmopathy
Yuan, PAN ; Xueliang, XU ; Jia, TAN ; Bei, XU ; Lingli, ZHANG
Chinese Journal of Experimental Ophthalmology 2016;34(8):692-698
Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)% in the TAO group and (80.05 ±0.38)% in the control group respectively,with no significant difference between them(t =0.923,P>0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P<0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.
8.NEURONS OF THE HEAD OF CAUDATE NUCLEUS INHIBITING UNIT DISCHARGE OF THE CINGULATE CORTEX. AN HRP MICROIONTOPHORETIC STUDY
Shanqing ZHANG ; Sinde SUN ; Yongqin JIA ; Junmei XU ; Shenfu ZHANG
Acta Anatomica Sinica 1955;0(03):-
The cingulate cortex, especially its anterior portion has been found to be connected with the head of the caudate nucleus in our previous study. In order to ensure accurate placement of adequate amounts of HRP in the cingulate cortex, a microiontophoretic delivery technique coupled with single cell recording was employed. The use of electrophysiological criteria as aids in placing the injection is described in detail. It was found that the influence of the caudate neuron was inhibitory, and the cingulate neurons responded with monosynaptic IPSPs to caudate neuron stimulation. Following HRP injections into the cingulate cortex, the retrogradely labeled cells were found in the head of the caudate nucleus. It is obvious that some neurons of the head of caudate nucleus which have inhibitory effect on unit discharge of the cingulate cortex project to the anterior portion of the cingular cortex.
9.Value of two-dimensional speckle tracking imaging on assessing the local function and coronary collateral circulation of acute myocardial ischemia in dogs
Jianfei WANG ; Jia SHENG ; Yingyu ZHANG ; Li XU ; Guohui ZHANG
Chinese Journal of Ultrasonography 2010;19(9):801-805
Objective To evaluate the applicable value of two - dimensional speckle tracking imaging on assessing the local function and coronary collateral circulation of acute myocardial ischemia in dogs.Methods Open-chest model to induce acute myocardial ischemia in 10 dogs was established by ligating their anterior descending coronary artery(LAD). Two-dimensional dynamic gray- scale images of two standard left ventricular short axis views at the levels of mitral annulus and papillary muscle were acquired for the off -line comparative analysis before the operation and 0, 30, 60, 120, 240 and 360 minutes after the operation respectively. Peak systolic circumferential strain(CS), peak systolic radial strain(RS) and left ventricular fraction shortenting(LVFS) of 12 segments at the levels of mitral annulus and papillary muscle were analyzed with QLAB software. After the lab experiment,the fresh hearts of dogs were dyed by TTC.Results ①Compared with the preoperative value , the peak systolic CS and RS of ischemia myocardial regions(anteroseptum,anterior and lateral) in left ventricular short-axis decreased significantly( P <0. 05)during 30 to 60 minutes after ligating LAD. Sixty minutes later, the peak systolic CS and RS had a tendency to return to the level before the operation,although the statistical difference was existing. The peak systolic RS and CS also decreased in certain nonischemic regions (inferolateral and inferior). But CS and RS in inferoseptal regions didn't alter significantly. ②Compared with the preoperative value,LVFS in the ischemia regions were significantly decreased( P <0.05), while nonischemic regions had no significant difference. ③The results of TTC dyeing showed that the infarcted regions in left ventricular short-axis were anteroseptum, anterior and lateral with blood supplied by LAD, which were consistent with the results of RS and CS. Conclusions RS and CS,as the parameters of myocardial strain may reflect the range and extent of acute myocardial ischemia,and the strain changes of local myocardial segments after the construction of coronary collateral circulatory.
10.IL-17 and IL-23 expression as a predictor of response to infliximab treatment in Crohn's disease
Xin ZHANG ; Jia HU ; Ting XU ; Yan ZHANG
Chinese Journal of Internal Medicine 2015;54(11):940-944
Objective To evaluate the value of IL-17 and IL-23 expression in response prediction of infliximab treatment in Crohn's disease (CD).Methods A total of 23 CD patients were enrolled in this study including 19 males and 4 females.Another 17 patients with colonic polyps were recruited as control group.The tissue expression of IL-17 and IL-23 in intestinal mucosa was measured by immunohistochemistry (IHC).In each specimen, IL-17 or IL-23 positive cells were counted and recorded in 10 random high power fields (HPFs).Results Infliximab was effective in sixteen patients (69.6%), while 7 patients (30.4%) did not response.The numbers of IL-17 or IL-23 positive cells were much more in responders than those in nonresponders.The median numbers of IL-17 positive cells were 26.7 (18.0, 38.6)/HPF in responders, 11.8 (7.0, 14.0)/HPF in nonresponders, 3.0 (2.0,4.0)/HPF in controls (P =0.004).The median numbers of IL-23 positive cells were 74.5(44.8, 128.6)/HPF in responders, 22.4(19.0, 38.8)/HPF in nonresponders, 3.0(2.0, 4.0)/HPF in controls (P =0.018).IL-17 or IL-23 positive mucosal cells were significantly decreased after infliximab treatment.Conclusion High expression of IL-17 and IL-23 in mucosa may predict the response to infliximab in CD patients.