[Clinical observation of orthokeratology with increased compression factor in the treatment of myopia]

Objective: To discuss the efficacy and safety of orthokeratology with increased compression factor (ICF) in myopia correction in children. Methods: It was a prospective cohort study. Data of the right eyes of myopic children who visited the First Affiliated Hospital of Chengdu Medical College for orthokeratology were collected continuously from May 2016 to Dec 2018. All children had low myopia (<3.00 D) or moderate myopia (≥3.00 D), and were grouped using random numbers in Excel to receive orthokeratology with ICF or conventional compression factor (CCF). The axial length (AL), spherical equivalent (SE), best corrected visual acuity (BCVA), near visual acuity (NVA), Efron grade, corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), tear film break-up time (BUT), higher-order aberrations (HOAs), accommodative amplitude (AA) and accommodative facility (AF) were compared between groups during the 1-year treatment period. The Chi-squared test was used to compare the categorical data, while the independent-sample t-test was performed to assess the measurement data. Results: After 1 year of treatment, there were no statistical differences in AL, SE, BCVA, NVA, Efron grade, CH, CRF, IOPcc, BUT, HOAs, AA and AF between the low myopia ICF group and the low myopia CCF group (all P>0.05). After 6 months of treatment, the AL increased by (0.05±0.03) mm in the moderate myopia ICF group and by (0.08±0.04) mm in the moderate myopia CCF group (t=-3.416, P=0.001). After 1 year of treatment, the AL increased by (0.12±0.04) mm in the moderate myopia ICF group and by, (0.16±0.05) mm in the moderate myopia CCF group (t=-4.017, P<0.001). The SE was (-0.16±0.40) D in the moderate myopia ICF group, significantly different from that in the moderate myopia CCF group [(-0.58±0.60) D; t=3.529, P=0.001]. There were also statistical differences in HOAs_, spherical aberrations and AF (all P<0.05), but no statistical differences in BCVA, NVA, Efron grade, CH, CRF, IOPcc, BUT and AA between the two groups (all P>0.05). Conclusions: Orthokeratology with ICF safely and effectively corrected myopia in children during the observation period. It could control the progression of moderate myopia more effectively than that of low myopia.

[The 496th case:recurrent syncope for 8 years]

A 25-year-old women was admitted to the department of Neurology in Affiliated 2nd Hospital of Hainan Medical University due to recurrent syncope for 8 years and return for 2 months. She had multiple episodes of syncope at onset. She presented with the feeling of weakness in both lower limbs, and fatigue in the past year. She experienced pain in the waist and limbs joint in recent three months. Physical examination showed joint hyperactivity in metacarpophalangeal joints of both upper limbs, increased skin elasticity. Active-standing transcranial Doppler (TCD) test showed that the average heart rate (HR) and the average middle cerebral artery (MCA) blood flow velocity in the supine position were 79 beats/min and 62 cm/s, respectively; while the average HR and the average MCA blood flow velocity in the standing position were 126 beats/min, 47 cm/s. Meanwhile,the blood pressure was normal during the test of supine-to-standing TCD. Genetic testing indicated LDB3 transgenation. The patient was diagnosed as postural tachycardia syndrome (joint-hypermobility-related), Ehlers-Danlos syndrome, and relieved by fluid infusion and rehabilitation therapy.

TRAV gene expression in PBMCs and TILs in patients with breast cancer analyzed by a DNA melting curve (FQ-PCR) technique for TCR α chain CDR3 spectratyping

PURPOSE

To explore the expression of the TRAV gene in peripheral blood mononuclear cells (PBMCs) and in tumor-infiltrating lymphocytes (TILs) in the patients with breast cancer using a DNA melting curve (FQ-PCR) technique for T cell receptor (TCR) alpha chain CDR3 spectratyping. Peripheral blood samples and tissue samples were obtained from thirty breast cancer patients. Total RNA was extracted from PBMCs and tumor tissues and then reverse transcribed into cDNA. FQ-PCR was used to amplify the human TCR alpha chain CDR3 region with the primers to the TRAV and TRAC genes. TCR alpha chain CDR3 spectratyping and partial CDR3 sequencing were used to determine use of TRAV gene product in T cell responses. TCR alpha CDR3 spectratyping showed preferential usage of certain TRAV genes in the PBMCs and TILs of all patients with breast cancer. The frequencies of TRAV1.1, TRAV9, and TRAV29 exceeded 30% in PBMCs and the frequencies of TRAV1.1 and TRAV22 exceeded 30% in TILs. More than three quarters of the patients (23/30) overexpressed the same gene in both PBMCs and TILs; for example, patient-1 highly expressed TRAV9 in the PBMCs and TILs. Patients with positive or negative tumor markers of estrogen receptor (ER), progesterone receptor (PR), pS2, C-erbB-2, nm23, P53, and Ki-67 showed no significant common TRAV gene expression, but some TRAV gene preferential usage frequencies exceeded 20%. For example, five of seven patients positive for ER had high levels of expression of TRAV1.1 and TRAV3. Finally, the amino acid sequence of TCR CDR3 region showed some common motifs in some of the patients.

CONCLUSIONS

TRAV gene expression was complex and diverse in the patients with breast cancer. The TRAV gene usage may be closely related to the diversity of breast tumor antigens and the differential immune responses observed in individual patients. Research into the immunological mechanism of T cells may provide guidance for individual T cell-directed therapy for breast cancer.

Young Investigator's Award: induction of apoptosis following traumatic head injury in humans

Apoptosis or programmed cell death plays an important role in many developmental and pathological processes of the central nervous system. In head injury, apoptosis has been recently implicated in many studies on animal brain samples the phenomenon of apoptotic gene expression (bax and bcl-2). Twenty specimens of contused brain tissue (temporal and frontal lobe) from 20 patients who underwent emergency craniotomy and removal of mass lesions were obtained from May to October 1997. The samples collected were immediately snap frozen in liquid nitrogen and stored at -80 degrees C. Immunohistochemical analysis was performed to detect the expression of bcl-2, bax and p53 using standard avidin-biotin complex second antibody conjugate methodology utilising commercially available primary and secondary antibodies. The average age of cohort was 46.24 +/- 22.17 years, the average Glasgow Coma Scale on admission was 9.19 +/- 4.72, and the average duration from injury to collection of the sample was 20.62 +/- 40.57 hours. There was documented hypoxia and hypotension seen in 5 of the 20 patients (25%). Significant levels of bax protein expression were noted in all samples, and p53 expression in 30% of samples. No bcl-2 expression was observed. Our study showed that for the first time the strong expression of the pro-apoptotic gene (bax) and low levels of the anti-apoptotic gene (bcl-2), thus implicating the mechanism of apoptosis in brain injury following trauma. The use of agents to inhibit apoptosis may be beneficial in head injury patients.