Background Lowing intraocular pressure (IOP) is the only effective treating method in glaucoma.Making sure the change of optic disc parameters and retinal nerve fiber layer thickness(RNFLT) in primary open-angle glaucoma (POAG) patients after IOP reduced can provide objective evidence for evaluating the effect of lowing-IOP on the function of optic nerve.Objective The present study was to evaluate the change of optic disc parameters and RNFLT in POAG patients after trabeculectomy,and analyze the affecting factors of image parameters.Methods A serial case-observational study was adapted.Forty eyes of 39 patients with POAG underwent trabeculectomy were recruited in the study.IOP was examined and perimetry was performed before operation and 2 weeks,1 month,3 months,6 months and 1 year after surgery.Optical parameters and RNFLT were measured using Heidelberg retina tomography (HRT) and optical coherence tomography (OCT) in above-mentioned time points.The correlations between lowing-IOP range or disease severity and optical disc parameters or mean RNFLT (mRNFLT) were analyzed by Pearson linear correlation.Results Mean IOP of the 40 eyes was (32.77±8.64) mmHg before operation and (12.45 ±3.65) mmHg,(13.05±3.90) mmHg,(13.42± 3.33) mmHg,(14.22± 2.60) mmHg and (14.74±2.46)mmHg 2 weeks,1 month,3 months,6 months and 1 year after operation,with a significant difference among various time points (F=13.73,P =0.00).However,no significant difference was seen in the mean defect of perimetry among the different time points (F=1.02,P=0.41).The cup area (CA),cup/disc area ratio (C/DAR),cup volume (CV),mean cup depth (MCD),cup shape measurement (CSM),horizontal C/D,vertical C/D,rim area (RA),rim/disc area ratio (R/DAR),height variation contour (HVC),rim volume (RV),mRNFLT,RNFL cross sectional area (RNFLA) were gradually improved after operation in comparison with before operation.One year after operation,RV,CSM,mRNFLT,RNFLA were still increased,but vertical C/D was reduced after operation than that of before (P＜0.05).No significant differences were found in the whole mRNFLT and superior quadrant mRNFLT,inferior quadrant mRNFLT,nasal quadrant mRNFLT and temporal quadrant mRNFLT among before and after operation (F=1.63,P=0.16; F=0.51,P=0.77; F=1.44,P=0.20;F=1.02,P=0.32; F=1.31,P=0.30).Positive correlations were found between lowing-IOP range and the improvement of RV,CSM,vertical C/D (r =0.45,P =0.02; r=0.41,P=0.04; r=0.58,P=0.00),and negative correlations were seen between absolute value of MD and the improvement of RV,CSM 1 year after operation (r=-0.43,P=0.03; r=-0.62,P=0.00).Conclusions Reduction of IOP after trabeculectomy results in the reversal of optic disc parameters.The improvement of the optic disc parameters may be a protective factor for progression of glaucomatous optical nerve damage.

AIM:To evaluate the effects of pilocarpine, brinzolamide and the preservatives of them on corneal epithelial cells and the histopathology of rabbit conjunctiva. METHODS: Fifteen New Zealand white rabbits weighing 1.5 kg to 2.5 kg were randomly divided into three groups. One group with three rabbits served as untreated controls. Pilocarpine 1% and brinzolamide 1% each were administered to the right eyes in one treated group, and the preservatives (chlorobutanol 0.01% in pilocarpine, benzalkonium chloride 0.01% in brinzolamide) to the left eyes. Corneal epithelial damage was evaluated by scanning electron microscopy, and conjunctival specimens were examined under light microscopy. RESULTS: Compared with normal controls, brinzolamide and BAC caused corneal epithelium damage and increased number of inflammatory cells in the conjunctiva, while pilocarpine and the preservative chlorobutanol mainly influenced the corneal epithelium. Brinzolamide produced significantly more damage than pilocarpine (P

Background Retinal retinoic acid (RA) plays an important role in the formation of the lensinduced myopia.However,it is not clear how RA transfer the myopic signal to choroid throughout the retinal pigment epithelium (RPE) barrier.Objective The aim of this study was to investigate the effect of all-trans retinoic acid (atRA) on the barrier of RPE in lens-induced myopic eye of guinea pig.Methods Thirty left eyes of 30 21-dayold clean guinea pigs were randomized into normal control group and the model group.The models of out of focus were induced by covering of-6.00 D concave lens on the left eyes for 15 days.Radius of corneal curvature was measured using corneal curvimeter,and diopeter of the guinea pig was examined by mydriatic optometry.The length of ocular axis was detected by A-sonography.The animals were sacrificed and the retinas of the left eyes were isolated for the culture and passage of RPE cells.The third generation of cells were incubated Millcell-PET microporous film,and atRA at the concentration of 1 × 10-6,1 × 10-7,1 × 10-8 and 1 × 10-9 mol/L was added to the micropore respectively for 12 hours,and the micropores with equal-solvent served as negative control group.Methyl thiazolyl tetrazolium (MTT)colorimetric method was used to detect the survival rate of the cells.Subsequently,the transepithelial electrical resistance (TER) of the monolayer cells was determined with CN10-EVOM2 resistance measuring meter.The vesicular transport change of RPE membrane in different groups was evaluated by FM1-43 fluorescence staining.Results The mean diopter was (-2.20±0.95) D in the models,and that in the controls was (+ 1.15 ±0.30) D,with a significant difference between them (t =14.57,P＜ 0.01).The axial length was (8.24 ± 0.09) mm in the models and it was significantly longer than (7.81±0.05) mm in the controls (t=17.20,P＜0.01).RPE cells grew well to form a monolayer in Millcell culture pool after one week.After 24 hours of the atRA treatment,the survival rate of RPE cells reduced gradually with the increase of atRA concentration with the highest rate in the 1 × 10-9 mol/L atRA group (93.3 ％) and followed by the 1 × 10-8 mol/L atRA group (88.2％).More than half of the cells dead in the 1 × 10-6mol/L and 1 × 10-7mol/L atRA groups (53.8％ and 47.1％).Significant differences in the TER value and fluorescence staining intensity of the cells were seen among the various groups (F =43.89,P =0.00 ; F =26.13,P =0.00),with the maximal values in the 1 × 10-8mol/L atRA group.The FM1-43 fluorescence located on the cellular membrane and cytoplasm.Conclusions AtRA can increase the functional state of tight junction and vesicular transport,which regulated the RPE cell barrier in the guinea pig.

OBJECTIVE: To study the apoptosis of retina and the expression of c-myc protein in form-deprivation myopia. METHODS: Two-day-old chickens were sutured with right eyelid for 4, 8 and 12 weeks. After measurement of refracation, the eyeballs were observed by light microscope and taken photos. Retinal apoptotic cells were measured by TUNEL staining and flow cytometry. C-myc protein were examined by immunohistochemistry and flow cytometry. RESULTS: Lacquer crack lesions were found in sutured eyes at 12 weeks. Apoptotic cells were observed in retinal outer and inner nuclear layer of the sutured eyes at 12 weeks and obvious peak of apoptosis was observed in sutured eyes at 12 weeks. The expression of c-myc protein was significantly more than control eyes at 8 and 12 weeks. CONCLUSION The apoptosis of retinal was present in form-deprivation myopia with the degeneration of retina. C-myc protein plays an important role in retinal apoptosis of myopia.
Animals ; Animals, Newborn ; Apoptosis ; physiology ; Chickens ; Flow Cytometry ; Myopia ; metabolism ; pathology ; Proto-Oncogene Proteins c-myc ; biosynthesis ; genetics ; Random Allocation ; Retina ; metabolism ; pathology

This article introduced the history and development,and the mechanism of manual lymph drainage(MLD),as well as the classification and identification of edema in clinic.Then the indication and contraindication,and the application in clinical areas,including postoperative cancer,infection with subclinical conditions and surgery,were also elaborated.

BACKGROUNDLong-term use of benzalkonium chloride (BAC)-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients' quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate (SH) on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment.

METHODSFifty-eight patients (101 eyes), who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group (56 eyes), unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group (55 eyes), phosphate-buffered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index (OSDI) questionnaire, break-up time (BUT) test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were performed sequentially on days 0 and 91.

RESULTSCompared with the control group, SH-treated group showed decrease in OSDI scores (Kruskal-Wallis test: H = 38.668, P < 0.001), fluorescein and rose Bengal scores (Wilcoxon signed-ranks test: z = -3.843, P < 0.001, and z = -3.508, P < 0.001, respectively), increase in tear film BUT (t-test: t = -10.994, P < 0.001) and aqueous tear production (t-test: t = -10.328, P < 0.001) on day 91. The goblet cell density was increased (t-test: t = -9.981, P < 0.001), and the morphology of the conjunctival epithelium were also improved after SH treatment.

CONCLUSIONSSH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.

Adolescent ; Adult ; Aged ; Benzalkonium Compounds ; adverse effects ; Dry Eye Syndromes ; chemically induced ; prevention & control ; Eye ; drug effects ; Eye Injuries ; chemically induced ; prevention & control ; Female ; Glaucoma ; drug therapy ; Humans ; Hyaluronic Acid ; therapeutic use ; Male ; Middle Aged ; Young Adult

OBJECTIVETo observe the effect on intervention of sub-health with pestle needle (Chuzhen).

METHODRandomized controlled trail was adopted for this research. One hundred and fifty-three cases were randomly divided into two groups of a Chuzhen group (79 cases) and a massage group (74 cases). Acupoint of Bazhen (Baihui Bazhen, Shendao Bazhen, Zhiyang Bazhen, Mingmen Bazhen, Yaoyangguan Bazhen), Hechelu on the head, the neck and the lumbar area were adopted in Chuzhen group. While regular whole-body massage was applied in the massage group. The human sub-health score, the cornell medical index (CMI) and thermal texture maps system (TTM) technology of the two groups before and after the intervention were observed.

RESULTS1) After treatment, sub-health condition score, the CMI score, the M-R score and the TTM index were all increased in both groups (all P<0.01) 2) Comparison of D-value of the two groups before and after the intervention: the level of the sub-health score, the total score of CMI, and the index of sleep, pressure, Governor Vessel, Hukou (first web), blood lipid, viscosity of blood, microcirculation of TTM index of the Chuzhen group changed more obvious (all P<0.01), but there was no statistic significances in the M-R score and blood sugar of the TTM (both P>0.05). 3) The sub-health condition score in Chuzhen group was higher than that in the massage group (P<0.01).

CONCLUSIONChuzhen therapy has definite effect on intervention of sub-health, which is better than regular general massage.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Cornell Medical Index ; Female ; Humans ; Male ; Massage ; Middle Aged ; Young Adult

OBJECTIVETo observe postoperative glucose tolerance, gastric inhibitory polypeptide (GIP) , and glucogan-like peptide-1 (GLP-1) in normal glucose level dogs after undergoing gastric bypass procedures, and to explore the mechanism of gastric bypass procedures to treat type 2 diabetes.

METHODSThe 6 dogs with normal glucose tolerance had undergone gastric bypass procedures, and measure preoperative and postoperative oral and intravenous glucose tolerance (at time points 1, 2, and 4 weeks) through changes in blood glucose, insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and measure preoperative and postoperative week 4 pancreatic tissue morphology.

RESULTSSecond weeks after operation, the fasting blood sugar was (3.58 ± 0.33) mmol/L, and significantly lower than preoperative (t = 3.571, P < 0.05). The GLP-1 level before oral glucose tolerance test (OGTT) and 30 minutes after OGTT were (0.90 ± 0.21) and (0.91 ± 0.19) pmol/L respectively, and significantly higher than preoperative (t value were -3.660 and -2.971, P < 0.05). GLP-1 levels began to decrease in the second week after surgery. After 4 weeks, the index recovered to the preoperative level. Four weeks after surgery when compared with preoperative, islet morphology, islet number (6.8 ± 0.8 and 7.1 ± 0.8 respectively) and islet cells (16.7 ± 2.5 and 16.3 ± 3.1 respectively) did not change significantly (P > 0.05).

CONCLUSIONGastric bypass procedures could be briefly affect normal glucose tolerance in dogs' blood glucose, insulin and diabetes-related gastrointestinal hormones.

Animals ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Dogs ; Gastric Bypass ; Gastric Inhibitory Polypeptide ; Glucagon ; Glucagon-Like Peptide 1 ; blood ; Glucose ; Insulin ; blood

BACKGROUNDMultidrug-resistant Acinetobacter baumannii (MDRAB) is an important and emerging hospital-acquired pathogen worldwide. This study was conducted to identify the sources of MDRAB and its role in respiratory tract colonization and nosocomial pneumonia in intensive care unit (ICU) patients.

METHODSWe conducted a prospective active surveillance study of MDRAB in three ICUs at a Chinese Hospital from April to August 2011, to identify the sources of MDRAB and its role in respiratory tract colonization and nosocomial pneumonia.

RESULTSOne hundred and fourteen (13.0%) MDRAB isolates were detected from 876 specimens, with a sensitivity of 11.6% (55/474) in screening of the pharyngeal and tracheal swabs, and 14.7% (59/402) of the sputum/endotracheal aspirates. MDRAB colonization/infection was found in 34 (26.8%) of 127 patients, including 16 (12.6%) cases of pure colonization and 18 (14.2%) cases of pneumonia (two pre-ICU-acquired cases of pneumonia and 16 ICU-acquired cases of pneumonia). Previous respiratory tract MDRAB colonization was found in 22 (17.3%) patients: eight (6.3%) were pre-ICU-acquired colonization and 14 (11.0%) ICU-acquired colonization. Of eight pre-ICU-colonized patients, five were transferred from other wards or hospitals with hospitalization > 72 hours, and three came from the community with no previous hospitalization. Overall, 6/22 colonized patients presented with secondary pneumonia; only two (9.1%) colonized MDRAB strains were associated with secondary infections. Respiratory tract MDRAB colonization had no significant relationship with nosocomial pneumonia (P = 0.725). In addition, acute respiratory failure, mechanical ventilation, renal failure, and prior carbapenem use were risk factors for MDRAB colonization/infection.

CONCLUSIONSA high proportion of cases of MDRAB colonization/infection in ICU patients were detected through screening cultures. About one-third were acquired from general wards and the community before ICU admission. The low incidence of MDRAB colonization-related pneumonia questions the appropriateness of targeted antibiotic therapy.

Acinetobacter baumannii ; drug effects ; pathogenicity ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Cross Infection ; drug therapy ; microbiology ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia ; drug therapy ; microbiology ; Prospective Studies ; Respiratory Tract Infections ; drug therapy ; microbiology

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Oxygen ; blood ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed