Background Peters anomaly is a rare eye disease.Understanding the clinical features of Peters anomaly is helpful for us to correctly manage this disease.Objective This study was to investigate the clinical characteristics and treatment methods of Peters anomaly and provide available basis for the diagnosis and individualized treatment of Peters abnormal.Methods A descriptive study was performed.The clinical data from 8 eyes of 4 patients with Peters anomaly who were diagnosed and treated in Beijing Children's Hospital from January 1,2014 to March 30,2016 were retrospectively analyzed.The clinical manifestations of the anterior ocular segment were examined by handheld slit-lamp microscope,and corneal curvature,corneal thickness,axial length and intraocular pressure were measured.The therapy and outcomes of the patients were evaluated.Results Peters anomaly was classified into type Ⅰ,type Ⅱ and Peters plus syndrome based on the findings and literature'criteria.Regarding to the clinical findings,the adhesion of peripheral angle with cornea,shallow or disappeared anterior chamber were found in all the eyes,and these manifestations were type Ⅰ Peters anomaly and occurred in 2 eyes of 2 patients.The opacity and adhesion of the central lens capsula to corneal endothelium was seen in 6 eyes which belonged to type Ⅱ Peters anomaly.The mean corneal thickness was (680± 127) μm in 4 measured eyes,which was thicker than normal eyes;the mean corneal curvature was (37.40±1.79)D in 4 measured eyes;the mean axial length was (21.06±0.19)mm and the mean diameter of cornea was (9.4 ± 0.5) mm in 4 measured eyes.Iridocoloboma was found in 4 eyes and congenital aniridia was in 4 eyes.In addition,esotropia appeared in 1 patient,and nystagmus occurred in 3 patients.The 3 patients of type Ⅱ in this study were found to have the disorders associated with systemic neurogenic developmental abnormalities and diagnosed as Peters plus syndrome.Trabeculectomy with anterior vitrectomy was performed in 2 eyes with the intraocular pressure ＞30 mmHg(1 mmHg =0.133k Pa) and the introcular pressure reduced to below 21 mmHg after operation.Penetrating corneal transplantation was carried out on 1 eye with central opacity.However,rejection of graft occurred at 1 month and became complete cloudy at 3 months after surgery.Cataract extraction surgery was performed on 4 eyes with lens opacity and intraocular lens were implanted in 2 eyes or iridectomy was carried out in another 2 eyes,and the visual quality was evidently improved after operation.Conclusions The clinical characteristics of Peters anomaly include leukoma,shallow anterior chamber,peripheral iris adhesion with cornea and lens opacity due to adhesion of lens anterior capsule to corneal endothelium.Personalized operative regimen should be determined based on the clinical findings of the eyes with Peters anomaly.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

Abdominal aortic aneurysm (AAA) is a life-threatening disorder worldwide. Fibroblast growth factor 21 (FGF21) was shown to display a high level in the plasma of patients with AAA; however, its detailed functions underlying AAA pathogenesis are unclear. An in vitro AAA model was established in human aortic vascular smooth muscle cells (HASMCs) by angiotensin II (Ang-II) stimulation. Cell counting kit-8, wound healing, and Transwell assays were utilized for measuring cell proliferation and migration. RT-qPCR was used for detecting mRNA expression of FGF21 and activating transcription factor 4 (ATF4). Western blotting was utilized for assessing protein levels of FGF21, ATF4, and markers for the contractile phenotype of HASMCs. ChIP and luciferase reporter assays were implemented for identifying the binding relation between AFT4 and FGF21 promoters. FGF21 and ATF4 were both upregulated in Ang-II-treated HASMCs. Knocking down FGF21 attenuated Ang-IIinduced proliferation, migration, and phenotype switch of HASMCs. ATF4 activated FGF21 transcription by binding to its promoter. FGF21 overexpression reversed AFT4 silencing-mediated inhibition of cell proliferation, migration, and phenotype switch.ATF4 transcriptionally upregulates FGF21 to promote the proliferation, migration, and phenotype switch of Ang-II-treated HASMCs.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.