Fractalkine (Fkn) is the only member of CX3C subfamily of chemokine currently found,cx3cr1 is its specific receptor.Fkn/cx3cr1 is involved in inflammation,cancer,autoimmune diseases,allergy,acquired immune deficiency syndrome and other diseases,while its variety of pathophysiological role is accomplished by microglia.Functions of Fkn/cx3cr1 and microglia in age-related macular degeneration,acute light damage disease,retinal vascular disease,diabetic retinopathy disease,uveitis and other retina disease were reviewed in this article.

Background Intravitreal injection of ranibizumab is a primary approach to the treatment of wet age-related macular degeneration (wAMD),but whether it is necessary for wAMD with subfoveal scarring and active lesion to receive the intravitreal injection of ranibizumab is in dispute.Objective This study was to evaluate the possible therapeutic effect of intravitreal injection of ranibizumab on wAMD with subfoveal scarring and active lesion.Methods The clinical data of the patients with wAMD with subfoveal scarring and active lesion were retrospectively analyzed,including 89 eyes of 89 cases who received diagnoses and treatments in Second Hospital of Yunnan Province from February 2013 to May 2015.Sixty-eight patients who received intravitreal injections of ranibizumab were treated group,and 21 patients who received clinical observations only served as the untreated group.Intravitreal injection of ranibizumab was carried out following the 3+prn principle,and all of the patients were followed-up for 6-24 months.Best corrected visual acuity (BCVA) of the patients were examined with ETDRS chart.The fundus findings was examined by fundus color photography and fundus fluoresceinangiography (FFA).The subjective assessment of visual improvements was obtained from each patient,and the recession of retinal active lesions was assessed by OCT,including the absorbing state of subretinal fluid,the change of central retinal thickness (CRT) and subfoveal scarring.Results The mean injection times were (4.1 ± 1.2) for each eye.The BCVA at the end of following-up was evidently improved in both groups,and no significant difference was found among various time points (P＞0.05).However,the patient rate of BCVA improvement was 69.12％ in the treated group,which was signnificantly higher than 28.58％ of the untreated group (P =0.016).In the treated group,subretinal fluid was gradually absorbed in all eyes in the treating duration,however,in the untreated group,the fluid was completely absorbed in 7 eyes,unchanged in 8 eyes and increased in 6 eyes.The CRT reduced by (220.16±34.76) μm in treated group,and that in the untreated group was (101.56±31.59) μm,showing significant difference between them (P =0.004).The patient rate of perceived improvement of vision was 91.12％ and 42.85％ in the treated group and untreated group respectively,with significant difference between the two groups (P=0.008).Conclusions Intravitreal injection of ranibizumab can make active lesion recess in end-stage wAMD with subfoveal scarring and active lesion and improve the life quality of the patients.

Objective To observe the clinical features of combined central retinal artery and vein occlusion.Methods The clinical data of eight patients of combined central retinal artery and vein occlusion diagnosed by fundus examination and fundus fluorescein angiography (FFA) was analyzed retrospectively,including the causes,fundus manifestations and FFA features.Results 4/8 patients had hypertension and dyslipidemia,2/8 patients had traumatic retrobulbar hemorrhage,one patient had orbital cellulitis and one patient had systemic lupus erythematosus.All the patients had posterior pole retinal edema,hemorrhage,thin retinal artery,dilated vein,and papilledema.FFA showed delayed arterial filling,and there was no filling of retinal arterial branches until the late stage of FFA.Laminar flow delayed in large retinal veins,and there was no filling or only retrograde filling in retinal vein branches.Large areas with dot-like or patchy weak choroidal fluorescence can be observed in five patients.Conclusions Combined central retinal artery and vein occlusion is rare with complex etiology.The fundus manifestations and FFA features are atypical,but have features of central retinal artery occlusion and central retinal vein occlusion.

Objective To investigate the safety and feasibility general anesthesia for cesarean section in term matemal.Methods Hospital in January-December 2014 admitted there are contraindications to spinal anesthesia or reject elective spinal anesthesia in term maternal 42 cases were general anesthesia.By intravenous injection of propofol 1.5-2 mg/kg and succinylcholine 1.5-2 mg/kg rapid induction,after video laryngoscopes with endotracheal intubation,immediate surgery to remove the fetus,neonates 1,5 min Apgar score.Results 42 cases of maternal disposable endotracheal intubation success rate of 100％,no regurgitation and aspiration;all fetuses removed within 10 min after induction of anesthesia,neonatal 1,5 min Apgar scores were 8 points or more,with no respiratory depression.Conclusion When patients have contraindications to spinal anesthesia or spinal anesthesia refused general anesthesia is a safe and viable alternative,as long as the rational use of anesthetics,general anesthesia for cesarean section and newborn is safe.

Objective To evaluate the inhibited effects of small interfering RNA targeting Rac1(Rac1-siRNA)on rat retinal neovascularization in retinae.Methods Retinal vein occlusion was indueedby retinal photodynamic medthod in 25 Sprague-Dawley rats.Rae1-siRNA vector DNA was injected intothe vitrous of one eye of those rats(gene intervention group),and empty vector DNA was injected into thefellow eye(blank control group).Rae1-siRNA vector was injected in other 25 SD rats without retinal veinocclusion(blank intervention group).Two weeks after injection,fluorescein isothiocyanate(FITC)-dextran was perfused into the hearts of all the rats,and the retinal wholemount was made to observe theneovascularization.The numbers of endothelial cells which break through the internal limiting membranewere counted after hematoxylin-eosin staining.Resuits A massive of neovascularization and FITCleakage were found in blank control group.Small part of neovaseularization and a little FITC leakage wereobserved in the gene intervention group.Retinal vessels were normal in blank intervention group.Compared with blank contrast group and blank intervention group.the difference of the mean numbers ofendothelial cells which broke through the internal limiting membrane in the gene intervention group wassignificant(F=47.168,P=0.000).Conclusion Racl-siRNA can inhibit retinal neovascularizationinduced by retinal vein occlusion in rats.

AIM: To investigate the effects of puerarin on expression and translocation of glucose transporter 4(GLUT4) in adipocyte of rats with insulin resistance induced by diets. METHODS: Experimental rats were divided into three groups: control group (n=10), model group (n=10) and puerarin group (n=10) randomly. Animals in model group and puerarin group were fed with the diets enriched with sucrose (20%, w/w), lard (10%, w/w), cholesterol( 2.5%, w/w) and cholic acid (1%, w/w) to induce insulin resistance. Puerarin group were treated with puerarin (100 mg?kg -1 body weight, ip) every day for 6 weeks. After the plasma membranes and the intracellular membranes of adipocyte were prepared and separated, GLUT4 protein was detected by Western blot analysis. Body weight, serum triglyceride and cholesterol, fasting plasma glucose and serum insulin concentration were detected termly. And the insulin sensitivity index was also calculated. RESULTS: Western blot analysis showed that intracellular membranes GLUT4 protein in adipocyte of model group rats decreased by 38.72% (P

Objective To comparatively observe features of choroidal osteoma by multimodal fundus imaging methods.Methods This is a retrospective case study.Sixteen patients (16 eyes) with choroidal osteoma were enrolled in this study.The patients included 6 males (6 eyes) and 10 females (10 eyes),with an average age of (30.5±2.4) years.All patients received examination of best-corrected visual acuity,slit lamp microscope,indirect ophthalmoscopy,fundus color photography,fundus autofluorescence (AF),fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (SD-OCT).The tumors were classified as fresh lesion (clear boundary and rosy tumor with smooth surface) and obsolete lesions (pale and flat tumor with obvious patches).The tumor features of color fundus photography,AF,FFA and SD-OCT were comparatively observed.Results There were 5 fresh lesions and 11 obsolete lesions.Color fundus photography showed the tumor color was orange-red or yellow-white with clear boundary and retinal blood vessels on the surface of the tumor.The color of fresh lesion was rosy.In general,choroidal osteoma shown weak AF,however AF of fresh tumor was slightly stronger than the obsolete tumor,and retinal detachment region showed relatively stronger AF.FFA of fresh tumor indicated uniform intense fluorescence with clear boundary at late stage,much stronger than obsolete tumor.SD-OCT showed mesh-like reflected signal in the choroidal layer,but different from the surrounding choroidal vascular structures.Conclusions The tumor color is orange-red or yellow-white in color funds photography,which shown weak AF.FFA showed mottled hyperfluorescence in the early stage and tissue staining at the late stage.SD-OCT showed mesh-like reflected signal in the choroidal layer.

OBJECTIVE:To establish a method for the simultaneous determination of coumarin compounds in Yifu pill. METH-ODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of acetonitrile-water(49∶51,V/V) at a flow rate was 1.0 ml/min,the detection wavelength was 320 nm,column temperature was 30 ℃,injection volume was 20 μl. RESULTS:The linear range was 5.16-206.4μg/ml for osthole (r=0.999 9),37.40-1 495.89μg/ml for isoimperatorin(r=0.999 9) and 9.95-318.34 μg/ml for columbianadin(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recov-eries were 96.05%-103.19%(RSD=2.18%,n=9) for osthole,96.90%-103.09%(RSD=2.07%,n=9) for isoimperatorin, 95.50%-103.57%(RSD=2.15%,n=9)for columbianadin. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and can be used for the simultaneous determination of coumarin compounds in Yifu pill.

With the development of biological techniques,the study on the pathogenesis of disease-causing genes of congenital cataracts has substantial progress.Some positive results of screen of mutation gene in congenital cataract family has been reported,but the report of negative result is rate.ObjectiveThe present study attempts to screen the mutation of CRYAA,CRYAB,CRYA1/A3,CRYBB2,CRYGC and CRYGD gene in a Chinese family with autosomal dominant congenital cataract. MethodsThe periphery blood samples were exacted from 8 patients of 4 generations of with congenital cataract in this family.The complete coding region and intron spliced sites of CRYAA,CRYAB,CRYA1/A3,CRYBB2,CRYGC and CRYGD were amplified with polymerase chain reaction (PCR),and the products of PCR were directly sequenced.The control blood samples were from 10 normal subjects.This study followed the Declaration of Helsinki.Written informed consent was obtained from all of the patients.ResultsThe patients were found in each generation in this family and the mode of inheritance was in accordance with the characteristic of autosomal dominant inheritance.The sequence of amplified genetic fragments of CRYAA,CRYAB,CRYA1/A3,CRYBB2,CRYGC and CRYGD genes were inaccordance with those of normal subjects and GeneBank.No any mutation loci was found in all of the patients of this family.ConclusionCRYAA,CRYAB,CRYA1/A3,CRYBB2,CRYGC and CRYGD genes is not the causing-disease genes in this family.

Background Study confirmed that the active microglia may injure retinal ganglion cells (RGCs) in retinal ischemia reperfusion injury (IRI), and increased cx3cr1 expression is an important factor in microglial activation,and thus blocking the expression of cx3cr1 can inhibit microglial activation, which may be useful in neuronal protection.Objective This study was to analyze the protective effects of cx3cr1 antibody on retinal neuron in rat eyes with IRI.Methods Ninety SD rats were divided into 4 groups according to random number table.IRI models were established by perfusing normal saline solution into the anterior chamber.The cx3cr1 antibody of 1 μl (0.2 μg/μl) was intravitreally injected in the right eyes in the normal rats or model rats as the only cx3cr1 antibody injected group and the model cx3cr1 antibody injected group,respectively,and no any drug was injected in the rats of the normal control group and model control group.Retinal sections were prepared 48 hours after modeling, and apoptosis of retinal neutron was observed under the transmission electron microscope;the morphology of retinas was exmined and the number of survival RGCs was calculated by histopathologic method.The expression of CD68 in activated retinal microglial cells was detected by immunochemistry, and the relative expression levels of cx3cr1 mRNA,tumor necrosis factor-α (TNF-ct) mRNA and interleukin-1 β (IL-1 β) mRNA in the retinas were assayed by real time quantitative PCR.Results The cell nucleus of RGCs showed the round and ellipse in shape and there were abundant organelles in the cells.The mophology of photoreceptors was normal with abundant mitochondrions.Irregular cell shape, disrupture of outer segment membranous disc, proliferative microglial cells in RGC layer were seen in the model group.However,these findings were mild in the model cx3crl antibody group.The mean number of survival RGCs was (38.100 ± 3.929), (37.200 ± 5.266), (26.700 ± 2.584) and (31.700 ± 2.946)/field in the normal control group,only cx3cr1 antibody injected group, model control group and model cx3cr1 antibody injected group,showing significant differences between the model group and the normal control group, only cx3cr1 antibody injected group or model cx3cr1 antibody injected group (t =7.492,6.125,-4.607, all at P＜0.01).The expression levels (absorbance) of CD68 in rat retinas were significantly higher in the model group than those in the normal control group, only cx3cr1 antibody injected group and model cx3cr1 antibody injected group (t =-3.397 ,P =0.008;t =-6.207 ,P =0.000;t =3.494, P =0.007).The relative expression levels of cx3cr1 mRNA, TNF-α mRNA and IL-1 β mRNA in rat retinas were raised in the model group compared with the only cx3er1 antibody injected group and model cx3cr1 antibody injected group (all at P＜0.01).No significant differences were observed in these indicators between the normal control group and the only cx3crl antibody injected group (all at P＜0.05).Conclusions Intravitreal injection of cx3cr1 antibody to neutralize cx3cr1 levels in retinas can effectively inhibit the activation of retinal microglia,decrease the release of inflammatory factors, reduce the apoptosis of RGCs and thereby protect the retinal neutrons against IRI in SD rats.Intravitreal injection of cx3cr1 is safe and feasible.