[Research status of potential therapeutic targets for thyroid-associated ophthalmopathy]

Thyroid-associated ophthalmopathy (TAO) is an autoimmune eye disease that affects visual function and appearance, involving pathological remodeling processes of orbital tissue such as inflammatory reaction, oxidative stress, lipogenesis, and fibrosis. Current clinical first-line treatment options cannot be effective for all patients. This article summarizes the research on potential therapeutic targets of TAO at home and abroad in recent years, including receptor protein targets, immune cell targets, fat suppression targets, anti-fibrosis targets, transcription factor targets, and metabolic regulatory enzyme targets. Both non-natural compounds and natural compounds are introduced, with a view to providing clinical researchers with reference and ideas in the treatment of TAO and promoting the clinical application of new therapeutic drugs.

Solitary lung adenocarcinoma: follow-up CT, pathological-molecular characteristics, and surgical prognosis for different morphological classifications

OBJECTIVE

To investigate the dynamic changes during follow-up computed tomography (CT), histological subtypes, gene mutation status, and surgical prognosis for different morphological presentations of solitary lung adenocarcinomas (SLADC).

MATERIALS AND METHODS

This retrospective study compared dynamic tumor changes and volume doubling time (VDT) in 228 patients with SLADC (morphological types I-IV) who had intermittent growth during follow-ups. The correlation between the morphological classification and histological subtypes, gene mutation status, and surgical prognosis was evaluated.

RESULTS

Among the 228 patients, 66 (28.9%) were classified as type I, 123 (53.9%) as type II, 16 (7%) as type III, and 23 (10.1%) as type IV. Type I had the shortest VDT (254 days), followed by types IV (381 days) and III (501 days), and then type II (993 days) (p < 0.05 each). Type I had a greater proportion of solid/micropapillary-predominant pattern than type II, and the lepidic-predominant pattern was more common in type II and III than in type I (p < 0.05 each). Furthermore, type II and IV SLADCs were correlated with positive epidermal growth factor receptor mutation (p < 0.05 each). Lastly, the Kaplan-Meier curves showed that the disease-free survival was longest for patients with type II tumors, followed by those with type III and IV tumors, and then those with type I tumors (p < 0.001 each).

CONCLUSION

A good understanding of the natural progression and pathological-molecular characteristics of different morphological SLADC types can help make accurate diagnoses, develop individual treatment strategies, and predict patient outcomes.

CRITICAL RELEVANCE STATEMENT

A good understanding of the natural progression and pathological-molecular characteristics of different morphological solitary lung adenocarcinoma types can help make accurate diagnoses, develop individual treatment strategies, and predict patient outcomes.

KEY POINTS

• Type I-IV solitary lung adenocarcinomas exhibit varying natural progression on serial CT scans. • Morphological classification of solitary lung adenocarcinomas predicts histological subtype, gene status, and surgical prognosis. • This classification of solitary lung adenocarcinomas may help improve diagnostic, therapeutic, and prognosticating abilities.

[Navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach]

Objective: To explore the feasibility of navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach. Methods: Retrospective case series study. From May 2012 to December 2019, 12 patients (12 eyes) with imaging findings of cavernous hemangioma in the orbital apex were collected at the Eye Hospital Affiliated to Nanchang University, including 3 males and 9 females aged 32 to 59 years. All patients underwent navigation-guided sinusoscopy through the sphenoid approach to remove the cavernous hemangioma of the orbital apex (video attached). Changes of visual function and complications after operation were analyzed. Results: In 3 patients without visual impairment, the postoperative visual function was still normal. Among the remaining 9 patients with preoperative visual impairment, visual function was fully recovered in 3 patients after operation, was improved in 2 patients, and had no change in 4 patients. There were no complications in 3 of the 12 patients, and 9 patients had transient, mildly limited intraocular rotation with diplopia after operation, which all returned to normal within 1 month. Conclusion: Navigation-guided sinus endoscopy through the sphenoid approach is effective and feasible in the removal of the cavernous hemangioma of the orbital apex. (Chin J Ophthalmol, 2021, 57: 837-843).

[Apparent Diffusion Coefficient Histogram Analysis:Differentiation of Genetic Subtypes of Diffuse Lower-grade Gliomas]

Objective To explore the utility of apparent diffusion coefficient(ADC)histogram analysis for differentiating genetic subtypes of diffuse lower-grade gliomas. Methods A total of 55 patients with WHO grade Ⅱ/Ⅲ diffuse lower-grade gliomas who underwent preoperative routine brain magnetic resonance imaging and diffusion weighted imaging in our center were retrospectively evaluated.Among whom there were 14 patients with isocitrate dehydrogenase(IDH)wild-type gliomas(IDH ^wt group),19 patients with IDH-mutant 1p19q intact gliomas(IDH ^mut1p19q ^int group),and 22 patients with IDH-mutant 1p19q co-deleted gliomas(IDH ^mut1p19q ^del group).The whole-lesion ADC values derived from histogram analysis(including ADC_mean,ADC_minimum,ADC5%,ADC10%,ADC25%,ADC50%,ADC75%,ADC90%,ADC95%,ADC_maximum,mode,range,skewness,kurtosis,standard deviation,inhomogeneity,and entrophy)were measured for each patient.All parameters between the different genetic subtypes were compared by using the Student's t test or Mann-Whitney U test.Receiver operating curve(ROC)analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the different genetic subtypes. Results Compared with IDH ^wt group,the ADC75%(P=0.021),ADC90%(P=0.015),ADC95%(P=0.014),ADC_maximum (P=0.035),range(P=0.009),standard deviation(P=0.001)and inhomogeneity(P=0.001)were significantly lower in IDH ^mut group;in contrast,the ADC_minimum (P=0.031)and kurtosis(P=0.020)of IDH ^mut group were significantly higher than those in IDH ^wt group.The ADC_mean(P=0.010),ADC5%(P=0.016),ADC10%(P=0.012),ADC25%(P=0.007),ADC50%(P=0.005),ADC75%(P=0.015),and mode(P=0.002)were significantly higher in IDH ^mut1p19q ^int group than in IDH ^mut1p19q ^del group.Inhomogeneity achieved the highest area under ROC(AUC)(0.811)in differentiating IDH ^mut gliomas and IDH ^wt gliomas,with a cutoff value of 0.229;the sensitivity and specificity were 85.7% and 73.2%.The mode achieved the highest AUC(0.744)in differentiating IDH ^mut1p19q ^int gliomas and IDH ^mut1p19q ^del gliomas,with a cutoff value was 1448.75×10 ^-6 mm ²/s;the sensitivity and specificity were 57.9% and 90.9%.Conclusion ADC histograms analysis may be helpful to differentiate genetic subtypes in lower-grade gliomas.

[Advances in the research and application of orbital blowout fracture repair material]

Orbital blowout fractures can easily lead to defects of the orbital wall. In order to restore the continuity of the bone wall and avoid a series of clinical symptoms caused by orbital contents herniation or incarceration, the site of the defect should be reconstructed. The effect of reconstruction depends on the choice of surgical plan and repair material. The typical materials for bone wall defect repair include bone sheet, high density porous polyethylene, titanium mesh, absorbable polymer, bioactive ceramics and tissue engineering bone. This paper reviews the research findings and application of material for repairing of orbital blowout fracture. (Chin J Ophthalmol, 2019, 55: 876-880).

[Analysis of the effect of different surgical methods on the cavernous hemangioma of the deep orbit]

Objective: To explore the effect of the surgical removal of orbital deep cavernous hemangioma following the concept of minimal surgical invasion. Methods: Retrospective case series study. Sixty-three cases with surgical removal of deep orbital cavernous hemangioma were collected in the Affiliated Eye Hospital of Nanchang University from May 2012 to August 2015. There were 29 males and 34 females. The age was from 17 to 69 years with mean age (45±11) years.The surgical methods the conjunctival approach orbital surgery, lateral orbital surgery, medial skin orbital surgery, lateral orbital conjunctiva conjunctival pathway and endoscopic nasal approach were chosen for different cases. The visual acuity, visual field and electrophysiological examination were analyzed before and after operation. Result: Sixty-three patients underwent complete surgically removal of the tumor. Among them, 32 cases were conducted by conjunctival approach, 24 cases had improved visual acuity, 5 cases had no change of visual acuity, 3 cases had decreased visual acuity. Seventeen cases performed with lateral open orbital surgery had improved visual acuity in 11 cases, no change in visual acuity in 3 cases and decreased visual acuity in 3 cases postoperatively. Six cases with approach of the medial orbital surgery had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Six cases with approach of outside open orbital surgery combined with medial conjunctival pathway had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Two cases performed with endoscopic nasal approach. One of them had normal visual function and no change after surgery. Another had impaired visual function pre-operatively and it came back to normal postoperatively. Conclusions: With the concept of minimal surgical invasion, the choice of appropriate surgical approach can save patients with the greatest degree of visual function and even improve the visual function of the patients with orbital cavernous hemangioma. (Chin J Ophthalmol, 2017, 53: 288-293).

Effect of a periodized exercise training and active recovery program on antitumor activity and development of dendritic cells

AIM

Dendritic cells (DCs) are potent antigen-presenting cells that promote antitumor immunity in vivo when pulsed with tumor antigen. No studies have indicated that exercise training affects DC function. The purpose of this study was to investigate the effect of a 5-week periodized exercise training and active recovery program on the development of DCs, and to test their effect on the antitumor immunity of mononuclear cells (MNC) from blood and spleen against human leukemic U937 and murine lymphoma Yac-1 cells, respectively.

METHODS

Male Fisher 344 rats were divided into 2 groups: exercise and non-exercise group. The training protocol consisted of running on a motor-driven treadmill 6 days a week for consecutive 5 weeks, during which the running time, treadmill speed, and incline gradient were increased weekly. Active recovery parameters were set at 30% of the intensity of the previous day.

RESULTS

DC numbers increased significantly (P<0.05) in the exercise group compared to controls, but there were no significant changes in the expression of surface antigens CD80 and CD86. In exercise group MNC-conditioned medium (CM) prepared with 50 microg/mL phytohemagglutinin (PHA) significantly inhibited proliferation of U937 cells, and splenocyte-CM with PHA at 20 and 40 microg/mL significantly inhibited proliferation of YAC-1 cells greater than control group.

CONCLUSIONS

The 5-week periodized exercise training with active recovery promotes the number of DCs and enhances the activity of DCs against tumor cells.

Isolation and characterization of an active compound from black soybean [Glycine max (L.) Merr.] and its effect on proliferation and differentiation of human leukemic U937 cells

Black soybean [Glycine max (L.) Merr.] has been used as a health food and herb in China for hundreds of years. In the present study, we purified a unique polysaccharide component from black soybean (PSBS) and found that it indirectly inhibits proliferation and induces differentiation of human leukemic U937 cells via activation of mononuclear cells (MNCs). We prepared conditioned media (MNC-CM) by incubating MNCs from human peripheral blood with or without PSBS (PSBS-MNC-CM and normal MNC-CM, respectively). Treatment of human leukemic U937 cells with PSBS-MNC-CM significantly inhibited proliferation of U937 cells, reducing their growth by 98.5%. Furthermore, PSBS-MNC-CM induced U937 cells to differentiate into mature monocytes/macrophages (83% by morphological examination and 90% by the nitroblue tetrazolium test). Neither PSBS alone nor normal MNC-CM had such effects. The molecular weight of PSBS was about 480 000 by gel filtration. Structural analysis of PSBS revealed that (1,6)-alpha-D-glucan might be its major active component. Our results suggest that the PSBS may inhibit proliferation and induce differentiation in human leukemic U937 cells by activating the immune response of MNCs.

Identification of essential cysteine residues in 3-deoxy-D-arabino-heptulosonate-7-phosphate synthase from Corynebacterium glutamicum

To ascertain the functional role of cysteine residue in 3-deoxy-d-arabino-heptulosonate-7-phosphate (DAHP) synthase from Corynebacterium glutamicum, site-directed mutagenesis was performed to change each of the three residues to serine. Plasmids were constructed for high-level overproduction and one-step purification of histidine-tagged DAHP synthase. Analysis of the purified wild-type and mutant enzymes by SDS-polyacrylamide gel electrophoresis showed an apparent protein band with a molecular mass of approximately 45 kDa. Cys145Ser mutant retained about 16% of the enzyme activity, while DAHP synthase activity was abolished in Cys67Ser mutant. Kinetic analysis of Cys145Ser mutant with PEP as a substrate revealed a marked increase in Km with significant change in kcat, resulting in a 13.6-fold decrease in kcat/KmPEP. Cys334 was found to be nonessential for catalytic activity, although it is highly conserved in DAHP synthases. From these studies, Cys67 appears important for synthase activity, while Cys145 plays a crucial role in the catalytic efficiency through affecting the mode of substrate binding.

Test-retest reliability of balance tests in children with cerebral palsy

To investigate intrasession and intersession reliability of balance tests in children with or without disabilities, 50 children without disabilities (ND) and 36 children with cerebral palsy (CP) aged from 5 to 12 years were tested. Intrasession reliability of postural stability of the Smart Balance Master System and one-leg standing test were assessed in both groups and intersession reliability of the Smart Balance Master System and balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) were assessed in ND children. Intersession reliability of the postural stability test in ND children, obtained using the Smart Balance Master System, was of moderate to good reliability in centre target (CT), sway vision (SV), eyes open and sway surface (EOSS), and sway vision and sway surface (SVSS; ICC 0.72 to 0.84). In children with CP, intrasession reliability was high in CT (ICC 1). One-leg standing tests in both groups also had moderate to good intersession reliability (ICC 0.56 to 0.99). Agreement of failure score of lateral rhythmic shifting (LRS) at 1 second and 2 seconds pace was 85% and 93% respectively in ND children. Within the balance subtest of BOTMP, only two items had 100% agreement. Results suggest that postural stability tests in four conditions (CT, SV, EOSS, and SVSS), LRS, one-leg standing, and walking on a line are reliable and can be used to monitor balance control in ND children. Postural stability in CT condition and one-leg standing test are reliable in children with CP. Further study is needed to establish more reliable balance tests for children with CP.

Serine 187 is a crucial residue for allosteric regulation of Corynebacterium glutamicum 3-deoxy-D-arabino-heptulosonate-7-phosphate synthase

Corynebacterium glutamicum 3-deoxy-D-arabino-heptulosonate-7-phosphate (DAHP) synthase is sensitive to feedback inhibition by tyrosine. One feedback-insensitive mutant was obtained by in vitro chemical mutagenesis and the mutation was identified as a C-->G mutation at nucleotide 560 causing a Ser(187) to Cys(187) substitution. Replacing Ser(187) with cysteine, tyrosine or phenylalanine by site-directed mutagenesis not only reduced the enzymatic activity but also relieved its feedback inhibition by tyrosine, while Ser(187)Ala exhibited a comparable activity to that of wild-type enzyme and sensitized to allosteric regulation. The His(6)-tagged enzymes were expressed in Escherichia coli and purified to homogeneity by immobilized nickel-ion affinity chromatography. Kinetic analysis showed that tyrosine is a competitive inhibitor of phosphoenol pyruvate, one of the precursors for DAHP biosynthesis.

[Wind-damage effects on quality of heartwood of Lignum Santali Albi]

OBJECTIVE

To evaluate the wind-damage effects on quality of heartwood of Lignum Santali Albi.

METHOD

GC-MS, TLC and pharmacodynamic test.

RESULTS

The content of volatile oil from heartwood of Wind-damaged Lignum Santali Albi is 1.42%; the content of various components in the oil and the chromatography of different extracts are similar to those of reference drug and 25 years old trees.

CONCLUSION

Wind-damage should accelerate the formation of heartwood of Lignum Santali Albi without influence on its quality.

Prognostic factors for walking attainment in very low-birthweight preterm infants

The purpose of this study was to compare the age of walking attainment between very low-birthweight (VLBW) preterm infants and normal term infants, and to determine the variables that affect the walking attainment in VLBW infants. Ninety-six VLBW preterm infants and 82 normal term infants were prospectively followed to determine their age of walking attainment and to monitor gross motor development with sequential clinic visits at 6, 9, 12 and 18 months corrected age. Perinatal and sociodemographic data were collected through review of medical records. The VLBW infants were significantly older at attainment of walking (median 14 months) than the term infants (median 12 months) after correction for prematurity. By the age of 18 months, all term infants had attained walking ability; while 11% of VLBW infants were still unable to walk. Multivariate proportional hazards regression analysis revealed that low gestational age was significantly associated with late attainment of walking in VLBW infants. With the adjustment for gestational age, prolonged ventilation (or oxygen therapy) and severe retinopathy of prematurity were significant predictors of late walking attainment. Our findings indicate that VLBW preterm infants have an increased risk of delayed attainment of walking. Furthermore, the contribution of low gestational age to the delayed walking attainment in VLBW infants may occur via the plausible pathways of neonatal respiratory distress and severe retinopathy of prematurity.

Optimization of walking in children

Previous work demonstrated that adults naturally adopt a walking frequency to optimize physiological cost, symmetry, and stability. Furthermore, the optimal frequency is predictable using the force-driven harmonic oscillator (FDHO) model. However, no studies have established the developmental processes of optimization in children. Thus, the purposes of this study were to examine the predictability of the preferred stride frequency (PSF) and optimization features of 3- to 12-yr-old children using the FDHO model. Forty-five children and nine adults were measured for anthropometric data to calculate the predicted frequency. They later walked at three frequencies (PSF, PSF +25%, and PSF -25%) at a constant speed on a treadmill. The results indicated that the FDHO model was accurate in predicting the preferred frequency of children (prediction error < 0.07 s). We identified three stages of learning in the development of optimization: an early manifestation of sensitivity to resonant frequency, the subsequent development of ability to modulate walking frequency, and the final establishment of an adult optimization form at age seven. Our findings suggest that walking development may be determined by the dynamic cooperation of physiological, neural, and musculoskeletal systems with respect to the environmental context.

The relation between standing balance and walking function in children with spastic diplegic cerebral palsy

To establish and compare the relationship between standing balance and walking performance, eight children with spastic diplegic cerebral palsy (CP) and 16 non-disabled, age- and sex-matched children were studied. The results showed that the children with CP had worse static balance stability in various sensory environments and dynamic balance (rhythmic shifting ability) than the non-disabled children. Moreover, the children with CP walked at a slower speed but at a greater physiological cost than the non-disabled children. In the children with CP, dynamic balance significantly correlated with walking function. It is suggested that rhythmic weight-shift training should be encouraged to improve the walking performance of children with CP.

[Pharmacological study on Asparagus officinalis Linn]

Our experiment shows that Asparagus officinalis can increase the clearance rate of charcoal particles and the weight of immune organs in mice, and thus helps to facilitate their antifatigue, anoxia tolerance, analgesia and memory improvement, as well as decrease the contents of lipid peroxide (LPO) in plasma, liver and brain of the animal.

Locomotor strategies before independent walking: prospective study of 50 mentally retarded children

To investigate the association between pre-walking locomotor strategies and psychomotor developments in children with mental retardation (MR), 50 children with non-specific MR were included in this study. There were 29 boys and 21 girls, 96% of whom had moderate to severe MR. They were followed from 4-53 months to 25-99 months of age, and their follow-up periods ranged from 10 to 48 months (mean 30 months). According to the pre-walking locomotor strategies, these children were categorized into three groups: the crawling group (n = 34) who used crawling or creeping as their main locomotion pattern before independent walking; the shuffling group (n = 9) who used shuffling prior to independent walking; and the direct-walking group (n = 7) who did not have any other locomotor strategies except rolling. In almost all motor developmental milestones, children in the direct-walking group developed earlier than those in the crawling and shuffling groups. Children in the crawling group had more advanced developments than those in the shuffling group. The difference in the mean ratio developmental quotients of the Bayley Mental Scale among the three groups was not significant. The present study showed that crawling may not be a necessary prerequisite for early ambulation or better cognitive function in MR children.