1.Macular microvascular findings in familial exudative vitreoretinopathy on optical coherence tomography angiography
Wenting WANG ; Shuchan LI ; Keke JIANG ; Hongyun RAN ; Zhaohui AI ; Jie ZHANG ; Lifeng LIU
Chinese Journal of Ocular Fundus Diseases 2021;37(12):932-936
Objective:To evaluate macular microvessel changes in familial exudative vitreoretinopathy (FEVR) by optical coherence tomography angiography.Methods:Cross-sectional clinical case-control study. From November 2019 to November 2020, 21 FEVR patients (41 eyes) from Weifang Eye Hospital were selected; 17 healthy volunteers (28 eyes) with the same age and gender as FEVR group were selected as normal control group. According to the best corrected visual acuity (BCVA) 1.0 and <1.0, FEVR group was divided into normal visual acuity group (27 eyes) and visual acuity decreased group (14 eyes). All enrollees received BCVA and OCTA. BCVA was performed with an international standard visual acuity chart, which was converted to logarithm of the minimum angle of resolution (logMAR) vision. The OCTA instrument was used to scan the macular area of all the examined eyes in the range of 3 mm×3 mm, 6 mm×6 mm, and the blood vessel density (VD) and blood perfusion density (PD) within the range of 3 mm×3 mm, 6 mm×6 mm were measured and the area, circumference, and morphological index of the foveal avascular zone (FAZ) within the range of 6 mm×6 mm. Quantitative data were compared between groups by independent sample t test. Statistical data were compared by χ 2 test. The area under curve (AUC) of each index was determined according to receiver operating characteristic curve (ROC curve), and the predictive value of each index was evaluated. Results:In the macular area of 6 mm×6 mm, VD, PD, FAZ area and FAZ perimeter of FEVR group were all lower than those of normal control group, and the differences were statistically significant ( t=-3.350, -2.387, -3.519, -3.029; P<0.05). In macular area of 3 mm×3 mm and 6 mm×6 mm, compared with normal vision group and vision loss group, both VD and PD decreased. The differences were statistically significant ( t=2.088, 2.114, 2.160, 2.545; P<0.05). In the macular area of 6 mm×6 mm , the FAZ morphological index of the two groups was significantly different ( t=2.409, P<0.05). ROC curve analysis showed that all the indicators had low diagnostic value for FEVR (AUC<0.5). Conclusion:There are microvascular abnormalities in macular area in FEVR patients, and the decrease of blood vessels and the change of FAZ shape may be related to the loss of visual acuity.
2.Telehealth-based dialysis registration system for the improvement of renal anemia in maintenance hemodialysis:multicenter experiences
Zhaohui NI ; Haijiao JIN ; Gengru JIANG ; Niansong WANG ; Ai PENG ; Zhiyong GUO ; Shoujun BAI ; Rong ZHOU ; Jianrao LU ; Yi WANG ; Ying LI ; Shougang ZHUANG ; Chen YU ; Yueyi DENG ; Huimin JIN ; Xudong XU ; Junli ZHANG ; Junli ZHAO ; Xiuzhi YU ; Xiaoxia WANG ; Liming ZHANG ; Jianying NIU ; Kun LIU ; Xiaorong BAO ; Qin WANG ; Jun MA ; Chun HU ; Xiujuan ZANG ; Qing YU
Chinese Journal of Nephrology 2018;34(11):831-837
Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3%) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2%and 47.5%, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2% to 73.6% (P<0.001), the target rate of Hb increased from 47.5% to 56.1% (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.
3.Mechanism of Astragaloside Ⅳ in Regulating PI3K/Akt Molecular Pathway in Prevention and Treatment of Diabetes Complications: A Review
Kexin HU ; Jinru ZHU ; Qing WU ; Shengmao WANG ; Mengfan WANG ; Ai QIAN ; Zhaohui FANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):307-314
Diabetes mellitus (DM) is a metabolic disease caused by absolute or relative insulin deficiency and reduced insulin sensitivity in peripheral cells, posing a serious threat to global health. Chronic complications arising in the later stages of DM can lead to the decline or even loss of function in multiple organs, including the eyes, heart, liver, kidneys, nerves, and feet, making them the primary cause of mortality in DM patients. Although modern medicine has made some progress in the treatment of these complications, challenges such as high costs and adverse drug reactions remain. Thus, identifying highly effective drugs with minimal adverse effects has become a top priority. Astragalus membranaceus is a shining gem in the treasure trove of Chinese medicine. Numerous studies have shown that its primary active component, astragaloside Ⅳ, possesses various biological activities, including anti-inflammatory, antioxidant, and antiviral effects, as well as benefits for cardiac and cerebral function, nerve conduction, and myocardial protection. Meanwhile, the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway plays a crucial role in regulating oxidative stress, inflammatory responses, apoptosis, and autophagy. Extensive research has highlighted the significant role of this pathway in various DM complications, leading to widespread studies on its interaction with astragaloside Ⅳ. This review summarizes research findings on how astragaloside Ⅳ alleviates pancreatic cytotoxicity in DM patients by modulating the PI3K/Akt pathway. Additionally, it highlights its protective effects on basic cardiac function, inhibition of retinal cell damage, improvement of cerebral nerve dysfunction, reduction of chronic kidney and liver damage, and mitigation of neurovascular toxicity in the lower limbs. These insights provide a valuable reference for the clinical application of A. membranaceus and its active monomer, astragaloside Ⅳ, in the treatment of DM and its complications.
4.Inner Ear Delivery of Polyamino Acid Nanohydrogels Loaded with Dexamethasone
Pingping AI ; Lidong ZHAO ; Zhaohui TANG ; Chaoliang HE ; Xuesi CHEN ; Shiming YANG ; Nan WU
Medical Journal of Peking Union Medical College Hospital 2025;16(2):370-378
To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear. A fluorescein-labeled polyglutamic acid-based polyamino acid dexamethasone nanohydrogel was synthesized, and its gelation time was measured. The hydrogel was surgically injected into the round window niche of guinea pigs to determine its degradation time in the middle ear cavity in vivo. The safety, pharmacokinetics, and distribution patterns of dexamethasone in the inner ear were evaluated. The hydrogel exhibited a gelation time of 80 seconds in a 37℃ water bath. In vivo, the hydrogel was almost completely degraded within 7 days in the middle ear cavity of guinea pigs. Transient hearing loss was observed one day after administration, but hearing gradually returned to normal over time. No significant cytotoxicity, vestibular stimulation signs, or pathological abnormalities in spiral ganglion cells were observed. Histopathological examination revealed no significant inflammatory reactions. Pharmacokinetic analysis demonstrated sustained drug release and prolonged dexamethasone activity. Immunofluorescence staining confirmed the distribution of dexamethasone in both the cochlea and vestibular organs. The polyamino acid nanohydrogel exhibits excellent injectability and biodegradability, representing a safe and effective drug delivery system for the inner ear.