[Differences in anterior segment structure between Chinese Han people and American Caucasians]

Objective: To compare the difference of anterior segment structure between Chinese Han people and American Caucasians, and to explore the confounding factors of anterior chamber angle. Methods: Cross-sectional study. The study was designed to include two healthy groups of Chinese Han people (enrolled from Department of Ophthalmology, Peking University Third Hospital) and American Caucasians (enrolled from Department of Ophthalmology, University of California, San Francisco) from May 2008 to December 2010, each with approximately 120 participants, including 15 persons of each gender in each decade between 40 and 80 years of age. The parameters of the anterior segment were measured by the automatic refractive test, A-ultrasound and ultrasound biomicroscopy. Differences between the two groups were compared with the independent-sample t test or Wilcoxon two-sample test for continuous variable data and the χ(2) test for classified variable data. Multiple linear regression models were performed to analyze the associated factors of anterior chamber angle. Results: There were 118 subjects (118 eyes) and 117 subjects (117 eyes) enrolled in the Chinese and American Caucasians groups, respectively. Compared to Caucasians, Chinese had smaller A-ultrasound measured anterior chamber depth [(3.03±0.34) mm vs. (3.38±0.36) mm, t=-5.791, P<0.001], smaller relative lens position [0.227 (0.198, 0.256) vs. 0.235 (0.191, 0.262), Z=-3.063, P=0.002], smaller axial length [23.3 (20.9,28.3) mm vs. 24.2 (20.8,28.5) mm, Z=-5.510, P<0.001], smaller iris root distance [0.111 (0.000, 0.401) mm vs. 0.142 (0.000, 0.451) mm, Z=-3.188, P=0.001], smaller ciliary body thickness at 1 mm posterior to the scleral spur [0.661 (0.424, 0.892) mm vs. 0.716 (0.467, 0.942) mm, Z=-3.456, P=0.001], smaller trabecular ciliary process distance [0.780 (0.410, 1.400) mm vs. 0.930 (0.420, 1.470) mm, Z=-3.191, P=0.001], smaller trabecular ciliary process angle [73.4° (36.3°, 115.3°) vs. 81.1° (47.9°, 147.9°), Z=-3.407, P=0.001], smaller angle opening distance at 500 μm (AOD500) [0.181 (0.000, 0.703) mm vs. 0.264 (0.000, 0.806) mm, Z=-3.444, P=0.001], smaller angle recess area (ARA) [0.118 (0.011, 0.457) mm(2) vs. 0.179 (0.000, 0.626) mm(2), Z=-3.814, P<0.001], larger spherical equivalent [0.40 (-5.80, 4.00) D vs. -0.70 (-8.00, 4.00) D, Z=-5.454, P<0.001], larger lens thickness [(4.62±0.40) mm vs. (4.52±0.40) mm, t=2.077, P=0.039] and larger iris thickness [0.430 (0.280, 0.600) mm vs. 0.410 (0.240, 0.580) mm, Z=-2.263, P=0.024]. On average, with each decade of the increased age, Chinese had a greater decrease in the AOD500 than Caucasians (0.040 mm in Chinese vs. 0.030 mm in Caucasians), while the angle recess area decreased at the same rate (0.020 mm(2) in both groups). After adjusted for age, gender, spherical equivalent, axial length and other parameters of the anterior segment, the trabecular ciliary process angle [for AOD500, standardized regression coefficient (SRC)=0.487, R(2)=0.549, P<0.001; for ARA, SRC=0.372, R(2)=0.502, P<0.001] and anterior chamber depth (for AOD500, SRC=0.413, R(2)=0.476, P<0.001; for ARA, SRC=0.331, R(2)=0.403, P<0.001) were the main factors of anterior chamber angle parameters for Chinese and Caucasians, respectively. Conclusions: Compared with age and gender matched American Caucasians, Chinese Han people have more crowded anterior chambers and narrower anterior chamber angles. The more anteriorly positioned ciliary processes and shallower anterior chambers are the main factors that contributed to more crowded anterior chambers in Chinese Han people and American Caucasians, respectively. (Chin J Ophthalmol, 2018, 54: 820-826).

Antioxidant Activity of Water Extract from Fermented Mycelia of Cordyceps sobolifera (Ascomycetes) in Caenorhabditis elegans

This research aimed to evaluate the potential of Cordyceps sobolifera in mycelial biomass production via liquid culture and to assay the safety and determine the antioxidative and antiaging activities of Caenorhabditis elegans. A C. sobolifera isolate was cultured using the one-factor-at-a-time method to illustrate its carbon and nitrogen requirements. To assess safety, we determined the lethality, locomotion behavior, and reproduction of C. elegans cultured on a mycelial water extract (MWE) containing nematode growth medium (NGM). To investigate antiaging activity, C. elegans treated with MWE was incubated on NGM plates. The lethality was recorded throughout the whole life cycle. To identify antioxidant activity, C. elegans treated with MWE was exposed to paraquat, causing superoxide conditions. The results showed that C. sobolifera was favored by glucose and peptone as carbon and nitrogen sources, respectively. MWE was considered to be safe, as no abnormal behaviors were observed in C. elegans. Compared with nematodes pretreated with no MWE but with water instead, MWE at 1.0 mg/mL significantly prolonged the mean lifespan of C. elegans by 24%. We observed an obvious dose-effect relation between concentration and mean lifespan. The effective antioxidant activity was recorded at the high concentration of MWE. These findings demonstrate the potential antiaging and antioxidant properties of C. sobolifera as functional food and dietary supplement.

[Effect of anatomic features of ciliary body on primary angle closure]

The mechanisms of primary angle closure are complex and varied. It is well known that the anatomic features of iris and lens may have influence on the presence of angle closure. However, the effect of structural features of ciliary body on primary angle closure remain unclear yet. The anterior situation of ciliary processes was extensively proved to be one of the predisposing factors of angle closure. While it's still controversial how the thickness of ciliary body may affect angle closure. Recent researches found that primary angle closure was associated with thinner ciliary body thickness. This review is aimed at introducing current researches of the effects of ciliary processes position and ciliary body thickness on primary angle closure. (Chin J Ophthalmol, 2018, 54: 716-720).

[Effect of valsartan on the expression of leptin, leptin receptor and collagen in rats with hepatic fibrosis]

Objective: To investigate the effects of angiotensin II type 1 receptor antagonist valsartan on leptin, leptin receptor and collagen in rats with hepatic fibrosis. Methods: Thirty-six male wistar rats were randomly divided into control group, model group and drug-treated group, with 12 rats in each group. Liver fibrosis models were made by subcutaneous injection of carbon tetrachloride on the dorsal of the rats, simultaneously gastric gavage with Valsartan and were killed at the end of 8th week. The degree of liver fibrosis was observed by HE and Masson staining. The serum leptin (LP) and TGFβ1 were determined by ELISA. Liver LP mRNA and leptin receptor mRNA (OB-R mRNA) were detected by RT-PCR. Liver LP, OB-R and collagen I were detected by Western blot. The data of multiple groups were analyzed by one-way analysis variance (ANOVA), and linear correlation was performed between serum LP and TGF β1. Results: After the intervention of valsartan, HE and Masson staining showed that the degree of liver fibrosis was significantly reduced. The levels of serum LP and TGFβ1 in the control group were (18.92 ± 7.10) ng/ml and (9.13 ± 1.58) pg/ml respectively, which were significantly lower than those in the model group (46.92 ± 28.54) ng/ml and (16.39 ± 3.56) pg/ml, And (29.27 ± 7.27) ng/ml and (12.24 ± 2.94) pg/ml in the drug-treated group, respectively. The F values were 7.864 and 20.057 respectively. The P values were < 0.05. The differences were statistically significant. The relative expression levels of LP and OB-R mRNA in the control group were 0.35 ± 0.18 and 0.62 ± 0.18, respectively, which were significantly lower than those in the model group (1.79 ± 1.79 and 1.52 ± 1.44, and drug-treated group 0.48 ± 0.34 and 0.75 ± 0.26, respectively), F values = 6.914,3.894, P values were < 0.05, the differences were statistically significant. The relative expression levels of LP, OB-R and collaten I in liver were 0.71 ± 0.13, 0.81 ± 0.11 and 0.76 ± 0.13 in the model group, 0.97 ± 0.06, 1.04 ± 0.06, and 1.05 ± 0.04 respectively in the drug-treated group and 0.74 ± 0.05, 0.93 ± 0.05 and 0.91 ± 0.05. The F values were 15.425, 13.757 and 19.130 respectively in three groups (P < 0.001), the difference was statistically significant. Conclusion: Valsartan, an angiotensin II type 1 receptor antagonist, can reduce the expression of leptin and leptin receptor, reduce the production of TGFβ1 and collaten I, and play an anti-hepatic fibrosis effect.

[A 20-year study on microvascular autologous transplantation of submandibular gland for treatment of severe dry eye]

Severe dry eye is a refractory ophthalmologic disease. Our multidisciplinary research group treated severe dry eye by microvascular autologous transplantation of submandibular gland (SMG) during the past 20 years. The SMG, with its blood vessels and Wharton's duct, was harvested from the submandibular triangle and transferred to the temporal area. The blood vessels in the SMG were anastomosed with the temporal blood vessels using a microsurgical technique. Then, the distal end of Wharton's duct was sutured to form an opening in the upper lateral conjunctival fold. The tear was replaced by the secretion of the transplanted SMG to lubricate the ocular surface. In our study, the surgical techniques of blood vessel management were continuously modified to increase the survival rate of the transplanted SMG. A novel surgical modality of partial transplantation of SMG was established to prevent postoperative epiphora. A clinical study with the largest case number in the world was conducted and the effectiveness of transplantation of SMG for severe dry eye was fully confirmed. In order to resolve two main clinical problems including ductal obstruction resulted from low secretion rate during the latent period, and epiphora due to over secretion of the transplanted SMG in the later term of transplantation, the regulation of the secretion mechanism of the normal and transplanted SMG were investigated. New opinions on mechanisms of saliva secretion were provided. Based on the priniciple of translational medicine, the results of related basic research were applied in the clinic. The clinical guidelines for secretion regulation of transplanted SMG were established. A concept of chronic obstructive sialadenitis of transplanted SMG was provided and its diagnostic criteria, diagnostic technique of sialography, and therapeutic regimen were established. As a result, the surgical success rate was obviously elevated, the surgical complications were decreased, and life quality of the patients was greatly improved.

Oral Health Indicators for Risk of Malnutrition in Elders

OBJECTIVES

Using both clinical parameters and subjective measures of oral health, this study aimed to identify useful oral health indicators for the risk of malnutrition in elders.

DESIGN

Cross-sectional study.

SETTING

Five community centers run by non-government organizations (NGOs).

PARTICIPANTS

195 community dwelling elders (65 or above).

MEASUREMENTS

An interviewer-administered questionnaire was completed to collect information on elders' socio-demographic background and oral health perception and practice. Their number of teeth, number of occluding tooth pairs, dental caries, and periodontal condition were examined. General Oral Health Assessment Index (GOHAI), an instrument for assessing oral health related quality of life (OHQoL), was used as a subjective measure of oral health. The elders' nutritional status was evaluated by using the Mini-Nutritional Assessment (MNA).

RESULTS

The mean (SD) DFT was 3.3 (3.1). Over 60% of elders had periodontal pockets; 33% had fewer than 20 teeth and 6% were edentulous. The mean (SD) of occluding tooth pairs was 7.1 (4.8). The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.0 (2.9); 30% had malnutrition or were at risk. After controlling for socio-demographic factors, none of the clinical indicators (dental caries, periodontal status, number of teeth, and number of occluding tooth pairs) were associated with risk of malnutrition (all p>0.05). Poorer OHQoL indicated a higher chance for malnutrition in both adjusted models (OR of 0.914; 95% CI of 0.850-0.982; p=0.014 and OR of 0.915; 95% CI of 0.852-0.984; p=0.017). Tooth loss and untreated decayed teeth (DT) were significant/marginally significant determinants of poor OHQoL.

CONCLUSION

Elders' tooth loss and unmet treatment need for dental caries were associated with compromised quality of life, which indicated increased likelihood for malnutrition.

Long non-coding RNA LINC00261 sensitizes human colon cancer cells to cisplatin therapy

Colon cancer is one of the most common digestive tumors. The present study aimed to explore the functional role, as well as the underlying mechanism of long non-coding RNA LINC00261 in colon cancer. Expression of LINC00261 was analyzed in colon cancer cell lines and human normal cell lines. Acquired resistance cell lines were then built and the acquired resistance efficiency was detected by evaluating cell viability. Thereafter, the effects of LINC00261 overexpression on cisplatin-resistant colon cancer cells were measured, as well as cell apoptosis, viability, migration, and invasion. Subsequently, we investigated the interaction of LINC00261 and β-catenin. The results showed that the LINC00261 gene was down-regulated in colon cancer cell lines and tissues, and in cisplatin-resistant cells. LINC00261 overexpression might relieve cisplatin resistance of colon cancer cells via promoting cell apoptosis, and inhibiting cell viability, migration, and invasion. Moreover, LINC00261 might down-regulate nuclear β-catenin through restraining β-catenin from cytoplasm into nuclei or it could also promote β-catenin degradation and inhibit activation of Wnt pathway. Finally, LINC00261 reduced cisplatin resistance of colon cancer in vivo and enhanced the anti-colon cancer effect of cisplatin through reducing tumor volume and weight.

[Neutrophil to lymphocyte ratio in peripheral blood: a novel independent prognostic factor in patients with head and neck squamous cell carcinoma]

Objective: To investigate whether neutrophil to lymphocyte ratio (NLR) in peripheral blood can be an independent prognostic factor in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Clinical data of 97 HNSCC patients who received surgical treatment in our department between January 2008 and January 2012 were analyzed retrospectively. The 97 patients were divided into low NLR group (NLR≤5, n=69) and high NLR group (NLR>5, n=28) according to the NLR in preoperative peripheral blood. The relationships of NLR and clinicopathological features were analyzed. Kaplan-Meier method was used for univariate survival analysis and Cox proportional hazard model for multivariate survival analysis. Results: The clinical stages were significantly different between high NLR group and low NLR group (P<0.05), however, the age, gender, location, lymph node metastasis, smoking and alcohol of the two groups showed no significant differences (P> 0.05 of all). Univariate survival analysis showed that smoking, lymph node metastasis, clinical stage and NLR value were risk factors for 3-year overall survival (OS) rate and relapse-free survival (RFS) rate of HNSCC patients (P<0.05). The OS rate of high NLR and low NLR groups was 42.9% and 91.3%, and the RFS rate was 44.2% and 80.1%, respectively, with a statistically significant difference (P<0.05 for both). Cox multivariate survival analysis showed that clinical stage and NLR were independent factors for prognostic evaluation of HNSCC patients (P<0.05 for both). Conclusions: NLR level is significantly associated with clinical stage of HNSCC. High NLR is an independent prognostic rick factor and plays an important role in prognostic evaluation of HNSCC patients.

Endothelial Tight Junctions Are Opened in Cholinergic-Evoked Salivation In Vivo

Blood vessels provide the original supplies for the formation of primary saliva, which is regulated by the tight junctions (TJs) between endothelial cells. Previous studies have shown that blood flow increases with vasodilatation during cholinergic-evoked salivation. However, changes in vascular paracellular permeability and the role of endothelial TJs in salivation are unknown. Here, we established an in vivo paracellular permeability detection system and observed that the endothelial TJs were permeable to 4-kDa fluorescein isothiocyanate (FITC)-dextran while impermeable to 40- and 70-kDa FITC-dextran under an unstimulated condition in mouse submandibular glands (SMGs). Pilocarpine increased the flux of 4- and 40-kDa FITC-dextran out of blood vessels but did not affect 70-kDa FITC-dextran. Claudin 5, a TJ protein specifically localized in salivary endothelial cells, was redistributed from the apicolateral membranes to the lateral and basolateral membranes and cytoplasm in cholinergic-stimulated mouse SMGs and freshly cultured human SMG tissues. In the transplanted SMGs from epiphora patients, we found that claudin 5 was present in the basolateral membranes and cytoplasm, instead of the apical region in control SMGs. Moreover, the level of phospho-myosin light chain 2 increased within the blood vessels of the pilocarpine-stimulated mouse SMGs and transplanted human SMGs, while the downstream molecule F-actin was reorganized in the endothelial cells of the transplanted human SMGs. Taken together, our findings provide direct visual evidence that the opening of endothelial TJs and the redistribution of claudin 5 are essential events contributing to cholinergic-evoked salivation, thus enriching our understanding of the secretory mechanisms that link blood flow to primary saliva formation by regulating the endothelial paracellular permeability.

Effects of Phenylephrine on Transplanted Submandibular Gland

Autotransplantation of the submandibular gland is a potential treatment for severe kerato-conjunctivitis sicca. However, one of the major barriers to this procedure is that secretions from the transplanted gland decrease shortly after the operation, which may lead to obstruction of Wharton’s duct, or even to transplantation failure. Using a rabbit model, we investigated whether phenylephrine could improve the secretion from the transplanted gland. We found that phenylephrine treatment significantly reversed the decrease in salivary secretion after transplantation, enhanced the expressions of α1A-, α1B-, and α1D-adrenoceptor mRNA, and ameliorated atrophy of acinar cells. Furthermore, phenylephrine also induced translocation of aquaporin-5 from the cytoplasm to the apical membrane, and increased the levels of phospho-ERK1/2, ERK1/2, phospho-PKCζ, and PKCζ in the transplanted gland. These results indicate that phenylephrine treatment moderates structural injury and improves secretory function in the transplanted submandibular gland through promoting α1-adrenoceptor expression and post-receptor signal transduction.

Functional α1-Adrenoceptor Subtypes in Human Submandibular Glands

α1-Adrenoceptor has been discovered to exist in many human tissues and mediates important physiological functions. The purpose of this study was to detect the expression, distribution, and function of α1-adrenoceptor subtypes in human submandibular glands. α1A- and α1B-Adrenoceptor mRNAs were identified by reverse-transcription/polymerase chain-reaction (RT-PCR), and their proteins were detected by Western blotting. No expression of the α1D-adrenoceptor mRNA and protein was found. By in situ hybridization and immunohistochemistry, α1A- and α1B-adrenoceptor mRNAs and proteins were shown to be widespread in both ductal and acinar cells. By confocal microscopy, phenylephrine (stimulating both α1A- and α1B-adrenoceptors) or A61603 (α1A-selective agonist) induced an increase in intracellular calcium by 2.33 ± 0.18-fold and 1.81 ± 0.43-fold, respectively, while 5-methylurapidil (α1A-selective antagonist) partly blocked calcium mobility stimulated by phenylephrine. The results indicated that functional α1A- and α1B-adrenoceptors were expressed in human submandibular glands, and might contribute to the regulation of saliva synthesis and secretion.

[Effect of autonomic denervation on the secretory function of submandibular glands]

Submandibular gland is innervated by sympathetic and parasympathetic nerves, both of which work synergistically to promote the salivation of the glands. However, denervation does not always produce an inhibitive effect. Regeneration secretion was put forward to describe the situation in which the glands after denervation were found to be supersensitive to the stimulation of several agonists of saliva secretion-related receptors. It is of clinical significance to get a good understanding of the secretory mechanism changes in the autonomically denervated submandibular gland. The present paper aims to review the studies on the denervation effects on the submandibular gland.

[Retrospective study on the efficacy of different chemotherapy regimens concurrently combined with intensity modulated radiation therapyin treatment of Ⅲ-Ⅳa stage nasopharyngeal carcinoma]

Objective:To compare the near and long term efficacy and safety of paclitaxel(TAX) plus cisplatin(DDP) (TP regimen) and DDP plus 5-FU(PF regimen) concurrently combined with IMRT in treatment of patients with advanced NPC.Method: A retrospective analysis on 108 advanced NPC cases from January 2010 to December 2012 was conducted. The patients were divided into TP group(57 cases) and PF group(51 cases) according to therapy regimen. TP group received IMRT combined with TP therapy, and PF group received IMRT combined with PF regimen, two groups were both used 4 cycles of chemotherapy, toxicity reactions during concurrent radiochemotherapy were noted. Two months after treatment, near clinical efficacies of the two groups were determined, and then, a three years followingup was conducted, during which recurrence ratio, metastasis ratio, local control ratio and survival rate were analyzed. Result: Two months after treatment, the total effective ratio of TP group(84.2% vs.76.5%) was higher than PF group,however, the difference was not statistically significant(P>0.05). Gastrointestinal reaction(70.2% vs.66.7%), marrow inhibition(75.4% vs.82.4%), liver function damage(12.3% vs.13.7%), radioactive oral and pharyngeal injury(91.2% vs.98.0%)， hearing damage(15.8% vs.15.7%) in the two groups during chemoradiotherapy had no significant differences(P>0.05). During followingup, the recurrence and metastasis ratio in TP group(33.3% vs.47.1%) was lower than PF group(χ²=2.116,P=0.146). TP group with The local control rate(73.7% vs.68.5%) and survival rate(84.2% vs.78.4%) after three years treatment in TP group were higher than PF group(χ²=0.336,P=0.562；χ²=0.596,P=0.440). Conclusion: IMRT concurrently combined with TP and PF respectively are both effective methods for treatment of advanced NPC. In this study, IMPT plus TP concurrent chemoradiotherapy has a certain superiority in near and long term clinical treatment efficacy and safety.

Clinical and Hemodynamic Outcomes in Patients with Chronic Venous Insufficiency After Oral Micronized Flavonoid Therapy

The aim of this study was to prospectively investigate the clinical efficacy of Daflon therapy in patients with mild to moderate chronic venous insufficiency (CVI) (clinical class 1-4) and to assess the changes in venous hemodynamics by using air plethysmography (APG). Fifty-six limbs in 28 patients were studied. They all had primary venous insufficiency with no venous obstruction, and mixed deep and superficial venous incompetence was found in 64% of the limbs. There was a significant decrease in symptom score for swelling and heaviness after 6 months of Daflon therapy. The symptom score for cramps also showed improvement though it did not reach statistical significance. Pain was significantly reduced with a mean pain score of 21.8 + 19.3% before comparing to 10.4 ±20.2% after 6 months of Daflon therapy (p<0.01). This was also associated with a decrease in mean calf circumference from 37.0 ±4.3 to 36.4 ±4.3 cm (p<0.001). There was no significant change in the venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) before and after 6 months of Daflon therapy (VFI: 3.7 ±3.5 vs 3.4 ±2.5 mL/s, EF: 54.5 ±15.9% vs 57.7 +19.7%, RVF: 41.4 ±19.2% vs 39.4 ±24.2%). The clinical improvement without associated changes in venous hemodynamics as measured by APG suggests that Daflon mainly works by modifying the microcirculatory environment not detected by APG and this microcirculatory change is associated with clinical improvement. In this regard, Daflon would be especially useful for symptomatic relief in patients with functional venous insufficiency who do not have clinical evidence of varicose veins but suffer from symptoms of venous insufficiency.

[Effectiveness of unilateral selective laser trabeculoplasty for primary open angle glaucoma]

OBJECTIVE

To study the effectiveness of unilateral selective laser trabeculoplasty (SLT) on the both eyes of patients with primary open-angle glaucoma (POAG).

METHODS

This was a self-controlled clinical study. Thirty-two patients of 32 eyes with OAG who used same anti-glaucoma medications for both eyes were included aat the Department of Ophthalmology Peking University third Hospital from February 2010 to April 2014. SLT was performed for the poorly controlled eye for each patient. Patients were examined before operation and 1 hour, 1 week, 1 month, 3 months and 6 months after operation. The intraocular pressure was examined after 1 hour of SLT. The rest time points were examined by visual acuity, intraocular pressure (IOP), slit lamp microscope, fundus ophthalmoscope and visual field. The paired t test (Bonferroni) was used to compare the IOP at each time point after SLT with the baseline IOP before SLT. Single factor analysis of variance was used to compare the percentage of IOP drop. Linear correlation analysis was used to analyze the amplitude of the decrease of IOP between treated eyes and untreated eyes at 6-month post-operatively and analyze the IOP between preoperative eyes and 6-month post-operative eyes. The magnitude of the decrease of IOP in patients with glaucoma medication and 6 months after surgery was analyzed. We also analyzed the types of antiglaucoma medications and IOP reductions range for 6 month after SLT.

RESULTS

The preoperative mean IOP was (18.9±2.5) mmHg (1 mmHg=0.133 kPa) in the treated eye of patients with OAG. Mean IOP reduction for 1 week, 1, 3, and 6 months after SLT were (1.7±2.9) mmHg, (2.5±2.5) mmHg, (3.5±2.8) mmHg, (3.4±2.5) mmHg and the percentage of IOP reduction were (8±16) %, (13±13) % (18±14) %, (18±12) % respectively (compared with the baseline, P< 0.05) . With the success criteria of IOP reduction ≥3.0 mmHg or ≥20%, the success rate of SLT in the treated eye after 1 week, 1, 3, 6 months was 38%, 52%, 50% and 60% respectively. For the untreated fellow eyes, the preoperative mean IOP was (17.3±2.4) mmHg. Mean IOP reduction for 1 week, 1month, 3 month, and 6 month after SLT were (1.1±2.0) mmHg, (1.0±2.7) mmHg, (2.6±2.2) mmHg and (2.5±2.2) mmHg respectively (compared with the baseline, P<0.05) . There was a positive correlation between preoperative IOP and IOP reduction either in the treated or in the untreated eyes at 6-month post-SLT (R=0.63, P<0.01; R=0.60, P<0.01) . There was a positive correlation in IOP reduction between treated eyes and untreated eyes at 6-month post-operative (R=0.66, P<0.01). All patients didn't need further treatment such as another laser treatment or surgery. Anti-glaucoma medications were remained unchanged after SLT.

CONCLUSIONS

In poorly anti-glaucoma medication controlled Chinese POAG eyes with mean IOP about 18.0 mmHg, unilateral STL can reduce the IOP about 18% at 6-month post-operative for the treated eyes. There was also a continuous IOP reduction effects for the fellow eyes.(Chin J Ophthalmol, 2016, 52: 410-415).

Interleukin-17 Impairs Salivary Tight Junction Integrity in Sjögren's Syndrome

Sjögren's syndrome (SS) is an inflammatory autoimmune disease that causes secretory dysfunction of the salivary glands. It has been reported that proinflammatory cytokine interleukin-17 (IL-17) was elevated and tight junction (TJ) integrity disrupted in minor salivary glands from SS patients. However, whether the elevated IL-17 in SS affects TJ integrity and thereby alters the function of salivary gland is unknown. Here, by using nonobese diabetic (NOD) mice as SS model, we found that the stimulated salivary flow rate was significantly decreased in NOD mice. Lymphocyte infiltration was mainly observed in submandibular glands (SMGs), but not parotid glands (PGs), of NOD mice. IL-17 was significantly increased and mainly located in lymphocytic-infiltrating regions in SMGs but not detectable in PGs of NOD mice. Meanwhile, the epithelial barrier function was disrupted, as evidenced by an increased paracellular tracer clearance and an enlarged acinar TJ width in SMGs of NOD mice. Furthermore, claudin-1 and -3 were elevated especially at the basolateral membranes, whereas claudin-4, occludin, and zonula occludens-1 (ZO-1) were reduced in SMGs of NOD mice. Moreover, occludin and ZO-1 were dispersed into cytoplasm in SMGs of NOD mice. However, no change in the expression and distribution of TJ proteins was found in PGs. In vitro, IL-17 significantly decreased the levels and apical staining of claudin-4 and ZO-1 proteins in the cultured SMG tissues, as well as claudin-1, occludin, and ZO-1 in PG tissues. Moreover, IL-17 activated the phosphorylation of IκBα and p65 in SMG cells, whereas pretreatment with NF-κB inhibitor pyrrolidine dithiocarbamate suppressed the IL-17-induced downregulation of claudin-4 and ZO-1 in SMG tissues. Taken together, these findings indicate that IL-17 derived from infiltrating lymphocyte impairs the integrity of TJ barrier through NF-κB signaling pathway, and thus might contribute to salivary gland dysfunction in SS.

Colorimetric detection of Hg2+ based on inhibiting the peroxidase-like activity of DNA–Ag/Pt nanoclusters

This paper reported that the peroxidase-like activity of DNA–Ag/Pt nanoclusters (NCs) can be inhibited selectively by Hg²⁺.

Diabetic ketoacidosis at diagnosis of type 1 diabetes mellitus in Malaysian children and adolescents

BACKGROUND

Diabetic ketoacidosis (DKA) is a late presentation of newly diagnosed type 1 diabetes mellitus (DM) in children. The aim of this study was to determine the clinical characteristics of type 1 DM at presentation so that appropriate actions can be taken to promote early diagnosis.

METHODS

This was a retrospective cohort review from a patient registry database. Data on all patients younger than 20 years old diagnosed with type 1 DM who had been registered with the Malaysian Diabetes in Children and Adolescents Registry (DiCARE) from its inception in 2006 until 2009 were analysed.

RESULTS

The study included 490 children and adolescents, out of which 57.1% were female. The mean (SD) age at diagnosis was 7.5 (3.7) years, which increased from year 2000 to 2009 [6.6 (3.3) years to 9.6 (3.5) years; p = 0.001]. An increasing percentage of DKA at diagnosis was observed from year 2000 (54.5%) to year 2009 (66.7%), which remained high and leveled between 54.5% and 75.0%. DKA was more common in patients with normal weight (p = 0.002) with no significant association with age, gender, ethnicity and status of family history of diabetes mellitus.

CONCLUSION

An increasing trend of age at diagnosis of patients with type 1 DM was observed. Besides that, proportion of DKA at diagnosis had remained high over the past decade. This study found that normal weight was associated with status of DKA, thus more detailed investigations are required to determine the risk factors for DKA.

When two obese parents are worse than one! Impacts on embryo and fetal development

The prevalence of overweight and obesity in reproductive-age adults is increasing worldwide. While the effects of either paternal or maternal obesity on gamete health and subsequent fertility and pregnancy have been reported independently, the combination of having both parents overweight/obese on fecundity and offspring health has received minimal attention. Using a 2 × 2 study design in rodents we established the relative contributions of paternal and maternal obesity on fetal and embryo development and whether combined paternal and maternal obesity had an additive effect. Here, we show that parental obesity reduces fetal and placental weights without altering pregnancy establishment and is not dependent on an in utero exposure to a high-fat diet. Interestingly combined parental obesity seemed to accumulate both the negative influences of paternal and maternal obesity had alone on embryo and fetal health rather than an amplification, manifested as reduced embryo developmental competency, reduced blastocyst cell numbers, impaired mitochondrial function, and alterations to active and repressive embryonic chromatin marks, resulting in aberrant placental gene expression and reduced fetal liver mtDNA copy numbers. Further understanding both the maternal cytoplasmic and paternal genetic interactions during this early developmental time frame will be vital for understanding how developmental programming is regulated and for the proposition of interventions to mitigate their effects.

Pre- and Post-synaptic Effects of Botulinum Toxin A on Submandibular Glands

Intraglandular injection of botulinum toxin type A (BoNT/A) is an effective treatment for sialorrhea. Despite numerous experimental and clinical studies on inhibition of saliva section by BoNT/A, the proteolysis of synaptosomal-associated protein 25 (SNAP-25) following BoNT/A treatment has not yet been confirmed in the salivary gland after injection of BoNT/A. More important, it is not known whether BoNT/A exerts a direct effect in acinar cells. Here, we show that injection of BoNT/A into the rat submandibular gland (SMG) decreased salivary flow in a dose-dependent manner; the inhibitory effect lasted at least 4 wk, and salivary flow recovered to normal levels by 12 wk. During the inhibitory period, SMG neurons and synapses expressed lower levels of full-length SNAP-25, and cleavage of SNAP-25 was observed, as indicated by detection of reduced molecular weight SNAP-25 using Western blotting. In addition, the water channel aquaporin 5 (AQP5) was downregulated and abnormally distributed in rat SMG after injection of BoNT/A. The direct effects of BoNT/A on AQP5 expression and distribution were assessed in vitro to exclude the influence of BoNT/A-induced inhibitory neurotransmission. In stable GFP-AQP5-transfected SMG-C6 cells, treatment with BoNT/A reduced the cell surface protein level of AQP5 in a dose- and time-dependent manner without affecting total AQP5 protein expression. Cell surface biotinylation and immunofluorescence demonstrated translocation of AQP5 from the membrane to the cytoplasm, which was confirmed by decreased levels of AQP5 protein in the membrane fraction and increased levels in the cytoplasmic fraction, suggestive of AQP5 redistribution. Taken together, these results indicated that BoNT/A reversibly decreased saliva secretion in rat SMGs through not only the presynaptic SNAP-25 cleavage but also the postsynaptic AQP5 redistribution. These data provide the first evidence for a direct effect of BoNT/A on the salivary gland.

Prolonged overall survival in gastric cancer patients after adoptive immunotherapy

AIM: To assess the efficacy of immunotherapy with expanded activated autologous lymphocytes (EAALs) in gastric cancer.

METHODS: An observational study was designed to retrospectively analyze the clinical data of 84 gastric cancer patients, of whom 42 were treated by EAAL immunotherapy plus conventional treatment and another 42 only received conventional treatment (control group). EAALs were obtained by proliferation of peripheral blood mononuclear cells from patients followed by phenotype determination. Clinical data including age, gender, clinical stage, chemotherapeutic regimens, hospitalization, surgical, radiotherapy, and survival data were collected along with EAAL therapy details and side effects. Patients were followed and the relationship between treatment and overall survival (OS) data obtained for the immunotherapy and control groups were compared retrospectively. The safety of EAAL immunotherapy was also evaluated.

RESULTS: After in vitro culture and proliferation, the percentages of CD3+, CD3+CD8+, CD8+CD27+, CD8+CD28+, and CD3+CD16+/CD56+ cells increased remarkably (P < 0.05), while the percentages of CD3+CD4+, CD4+CD25+, and CD3-CD16+/CD56+ (natural killer cells) were overtly decreased (P < 0.05); no significant change was observed in CD4+CD25+CD127- cells (P = 0.448). Interestingly, OS in the immunotherapy group was significantly higher than that in the control group, with 27.0 and 13.9 mo obtained for the two groups, respectively (P = 0.028, HR = 0.573, 95%CI: 0.347-0.945). These findings indicated a 42.7% decrease in the risk of death. In addition, we found that clinical stage and application of EAAL immunotherapy were independent prognostic factors for gastric cancer patients. Indeed, the OS in stage IIIc and IV patients that had received surgery was prolonged after EAAL immunotherapy (P < 0.05). Importantly, in vitro induction and proliferation of EAAL were easy and biologically safe.

CONCLUSION: Overall, EAAL adoptive immunotherapy might prolong the OS in gastric cancer patients.

PAHs in sediment cores at main river estuaries of Chaohu Lake: implication for the change of local anthropogenic activities

In the present study, 28 polycyclic aromatic hydrocarbons (PAHs) were investigated in four sediment cores collected from the main river estuaries of Chaohu Lake, one of the severely polluted lakes in China. The results indicate that elevated concentrations of total PAHs (Σ28PAH) were found in the samples from the estuary of Nanfei River (ENF), considering BaP-based total toxicity equivalent (TEQ-BaP) and toxic unit (TU) results; there are potential adverse environmental implications. The total organic carbon (TOC) played an important role on the accumulation of PAHs at ENF and the estuary of Tongyang River (ETY). The predominant PAHs are high molecular weight (HMW) homologous for all samples; as a result, industrial wastewater from a steel company is expectedly the key source of PAHs in ENF, while coke consumption would be the important source of PAHs at other three sampling sites. Vertical distribution of PAHs in the sediment cores could be explained by the local social and economic activities. Furthermore, a minor variation of PAH composition in the sediment core could be justified by the stable structure of energy consumption in the Anhui Province. These results justify the need for further enhancement of industrial wastewater treatment and development of renewable energies which are the key factors on the control of PAH pollution in China.

Prognostic value of number of examined lymph nodes in patients with node-negative gastric cancer

AIM: To elucidate the potential impact of examined lymph nodes (eLNs) on long-term survival of node-negative gastric cancer patients after curative surgery.

METHODS: A total of 497 node-negative gastric cancer patients who underwent curative gastrectomy between January 2000 and December 2008 in our center were enrolled in this study. Patients were divided into 4 groups according to eLNs through cut-point analysis. Clinicopathological features were compared between ≤ 15 eLNs group and > 15 eLNs group and potential prognostic factors were analyzed. The Log-rank test was used to assess statistical differences between the groups. Independent prognostic factors were identified using the Cox proportional hazards regression model. Stratified analysis was performed to investigate the impact of eLNs on patient survival in each stage. Overall survival was also compared among the four groups. Finally, we explored the recurrent sites associated with eLNs.

RESULTS: Patients with eLNs > 15 had a better survival compared with those with eLNs ≤ 15 for the entire cohort. By the multivariate survival analysis, we found that the depth of invasion and the number of eLNs were the independent predictors of overall survival (OS) of patients with node-negative gastric cancer. According to the cut-point analysis, T2-T4 patients with 11-15 eLNs had a significantly longer mean OS than those with 4-10 eLNs or 1-3 eLNs. Patients with ≤ 15 eLNs were more likely to experience locoregional and peritoneal recurrence than those with > 15eLNs.

CONCLUSION: Number of eLNs could predict the prognosis of node-negative gastric cancer, and dissection of > 15 eLNs is recommended during lymphadenectomy so as to improve the long-term survival.

Hypersensitive mAChRs are involved in the epiphora of transplanted glands

Autologous transplantation of the submandibular gland is an effective treatment for severe dry eye syndrome. However, more than 40% of patients experience epiphora 3 to 6 months after transplantation. The underlying mechanism of epiphora remains to be elucidated. To investigate the potential roles of muscarinic acetylcholine receptors (mAChRs) in the induction of epiphora in transplanted glands, we assessed and found elevated mRNA and protein expression of M1- and M3-mAChR in transplanted glands from epiphora patients. The content of inositol 1, 4, 5-trisphosphate was also elevated. Moreover, carbachol (5 and 10 µM) induced greater increase of [Ca(2+)]i in isolated epiphora submandibular cells than in controls. Although aquaporin-5 (AQP5) content and distribution in the apical and lateral plasma of epiphora glands did not change, AQP5 content was reduced in lipid microdomains (lipid rafts and caveolae) but increased in non-lipid microdomains compared with controls. Carbachol (10 µM) increased the ratio of non-lipid microdomain to total AQP5 in the cultured control submandibular gland tissue. Taken together, these results indicated that hypersensitive mAChRs might be involved in the epiphora of transplanted submandibular glands by modulating AQP5 trafficking.