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Influence of artificial luminous environment and tcm intervention on development of myopia rabbits

Asian Pacific Journal of Tropical Medicine 2015年第3期8卷 243-248页

作者： Yan Liu Yu-Liang Wang Ke-Lei Wang Fang Liu Xia Zong department of ophthalmology Nanjing University of Chinese Medicine Department of Ophthalmology.Jiangsu Province Hospital of TCM Affiliated hospital of Nanjing University of tcm department of ophthalmology Wuxi Hospital of TCM department of ophthalmology Shanghai TCM-Integrated HospitalShanghai University of TCM No.1 Clinical Medical College Nanjing Unirersity of Chinese Medicine

Objective:To explore the influence of artificial luminous environment and preventive function of traditional Chinese medicine(tcm) intervention based on "Theory of yin-yang clock" on myopia.Methods:A total of 45 New Zealand young rabbits were randomly divided into 5groups,9 for each group.Control group was exposed in natural light.Fluorescent group and full spectrum group were exposed in fluorescent light and full spectrum light,on which basis fluorescent tcm group and full spectrum tcm group were added with "Rizhong Yinyang Formulas",respectively.Optical parameters were measured and the influence of different lights on the serum and retinal dopamine(DA) levels as well as the retinal histopathological tissues was observed.Results:The spectrum of fluorescent light mainly focused at 420-490 nm with the peak value of wavelength near 450 nm,whereas that of full spectrum was wider(400-800 nm) with the peak value near 600 nm.After 4 and 12 weeks,fluorescent group was evidently lower in serum and retinal DA levels(Ptcm group and full spectrum tcm group(P>0.05).Histopathological observation showed that there was significant difference in pigment epithelium layer,photoreceptor and nerve fiber layer between fluorescent group and control group,but the difference among the test groups was not significant.Conclusions:Fluorescent light has certain influence on retinal histological construction and visual performance.However,tcm intervention may have some degree of protective function on retina.

关键词： Full spectrum Artificial luminous environment Retina Dopamine Visual performance Rizhong Yinyang formulas

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Anthrax lethal toxin suppresses high glucose induced VEGF over secretion through a post-translational mechanism

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International Journal of ophthalmology(English edition) 2015年第3期8卷 453-458页

作者： Wei-Wei Zhang Xin Wang Ping Xie Song-Tao Yuan Qing-Huai Liu department of ophthalmology the First Affiliated Hospital of Nanjing Medical University department of Endocrinology Jiangsu Province Hospital of TCM

AIM: To prove anthrax lethal toxin(Le Tx) blocks the mitogen activated protein kinases(MAPKs) activation by degrading the MAPK/ERK kinases(MEKs) to suppress vascular endothelial growth factor(VEGF) secretion.METHODS: Human adult retinal pigmented epithelium(ARPE) cells were cultured and treated with normal glucose, high glucose or high glucose with Le Tx for additional 24, 48 or 72 h for viable cell count. Total RNA from the ARPE was isolated for reverse transcription polymerase chain reaction(RT-PCR). The conditioned medium of ARPE cells treated in different group for 48 h was filtered and diluted to detect the concentration of VEGF by enzyme-linked immunosorbant assays.Evaluate the role of MEK/MAPK pathway in the secretion of VEGF by immunoblotting. RESULTS: In this study, we proved high glucose induced activation of the MAPK extracellular signal-regulated kinase(ERK1/2) and p38 in the ARPE cell line was blocked by anthrax Le Tx. Le Tx also inhibited high glucose induced ARPE cell over proliferation.CONCLUSION: Le Tx suppressed high glucose induced VEGF over secretion in the ARPE cells, mainly through a post-translational mechanism.

关键词： angiogenesis diabetic retinopathy retinal pigmented epithelium vascular endothelial growth factor anthrax lethal toxin

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Automated Detection of Optic Disc from Digital Retinal Fundus Images for Screening Systems of Diabetic Retinopathy

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Journal of Donghua University(English Edition) 2020年第1期37卷 74-79页

作者：高玮玮马晓峰左晶 College of Mechanical Engineering Shanghai University of Engineering ScienceShanghai 201620China department of ophthalmology Jiangsu Province Hospital of TCMNanjing 210029China

Optic disc(OD)detection is a main step while developing automated screening systems for diabetic retinopathy.We present a method to automatically locate and extract the OD in digital retinal fundus images.Based on the property that main blood vessels gather in OD,the method starts with Otsu thresholding segmentation to obtain candidate regions of OD.Consequently,the main blood vessels which are segmented in H channel of color fundus images in Hue saturation value(HSV)space.Finally,a weighted vessels’direction matched filter is proposed to roughly match the direction of the main blood vessels to get the OD center which is used to pick the true OD out from the candidate regions of OD.The proposed method was evaluated on a dataset containing 100 fundus images of both normal and diseased retinas and the accuracy reaches 98%.Furthermore,the average time cost in processing an image is 1.3 s.Results suggest that the approach is reliable,and can efficiently detect OD from fundus images.

关键词： fundus image spectral characteristics analysis optic disc(OD) blood vessels Otsu thresholding match filter segmentation

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A novel method for detection of hard exudates from fundus images based on SVM and improved FCM

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Journal of Chongqing University 2018年第3期17卷 77-86页

作者：高玮玮 SHEN Jian-xin WANG Ming-hong ZUO Jing College of Mechanical Engineering Shanghai University of Engineering Science College of Mechanical & Electrical Engineering Nanjing University of Aeronautics and Astronautics department of ophthalmology Jiangsu Province Hospital of TCM

Diabetic retinopathy(DR) is one of the most important causes of visual impairment. Automatic recognition of DR lesions, like hard exudates(EXs), in retinal images can contribute to the diagnosis and screening of the disease. To achieve this goal, an automatically detecting approach based on improved FCM(IFCM) as well as support vector machines(SVM) was established and studied. Firstly, color fundus images were segmented by IFCM, and candidate regions of EXs were obtained. Then, the SVM classifier is confirmed with the optimal subset of features and judgments of these candidate regions, as a result hard exudates are detected from fundus images. Our database was composed of 126 images with variable color, brightness, and quality. 70 of them were used to train the SVM and the remaining 56 to assess the performance of the method. Using a lesion based criterion, we achieved a mean sensitivity of 94.65% and a mean positive predictive value of 97.25%. With an image-based criterion, our approach reached a 100% mean sensitivity, 96.43% mean specificity and 98.21% mean accuracy. Furthermore, the average time cost in processing an image is 4.56 s. The results suggest that the proposed method can efficiently detect EXs from color fundus images and it could be a diagnostic aid for ophthalmologists in the screening for DR.

关键词： diabetic retinopathy improved FCM support vector machines hard exudates fundus images

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PTEN knockdown with the Y444F mutant AAV2 vector promotes axonal regeneration in the adult optic nerve

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Neural Regeneration Research 2018年第1期13卷 135-144页

作者： Zheng-ru Huang Hai-ying Chen Zi-zhong Hu Ping Xie Qing-huai Liu department of ophthalmology the First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu Province China department of ophthalmology the Second People's Hospital of Changshu Changshu Jiangsu Province China

The lack of axonal regeneration is the major cause of vision loss after optic nerve injury in adult mammals. Activating the PI3K/AKT/mTOR signaling pathway has been shown to enhance the intrinsic growth capacity of neurons and to facilitate axonal regeneration in the central nervous system after injury. The deletion of the mTOR negative regulator phosphatase and tensin homolog （PTEN） enhances regeneration of adult corticospinal neurons and ganglion cells. In the present study, we used a tyrosine-mutated （Y444F） AAV2 vector to efficiently express a short hairpin RNA （shRNA） for silencing PTEN expression in retinal ganglion cells. We evaluated cell survival and axonal regeneration in a rat model of optic nerve axotomy. The rats received an intravitreal injection of wildtype AAV2 or Y444F mutant AAV2 （both carrying shRNA to PTEN） 4 weeks before optic nerve axotomy. Compared with the wildtype AAV2 vector, the Y444F mutant AAV2 vector enhanced retinal ganglia cell survival and stimulated axonal regeneration to a greater extent 6 weeks after axotomy. Moreover,post-axotomy injection of the Y444F AAV2 vector expressing the shRNA to PTEN rescued ～19% of retinal ganglion cells and induced axons to regenerate near to the optic chiasm. Taken together, our results demonstrate that PTEN knockdown with the Y444F AAV2 vector promotes retinal ganglion cell survival and stimulates long-distance axonal regeneration after optic nerve axotomy. Therefore, the Y444F AAV2 vector might be a promising gene therapy tool for treating optic nerve injury.

关键词： nerve regeneration optic nerve axotomy gene therapy Müller cell retinal ganglion cell AAV2 shRNA PTEN GLAST mTOR neural regeneration

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Successful treatment of an enormous rectal mucosa-associated lymphoid tissue lymphoma by endoscopic full-thickness resection:A case report

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World Journal of Gastroenterology 2022年第10期28卷 1078-1084页

作者： Fang-Yuan Li Xiao-Long Zhang Qi-De Zhang Yao-Hui Wang Digestive Endoscopy Center Affiliated Hospital of Nanjing University of Chinese MedicineJiangsu Province Hospital of TCMNanjing 210046Jiangsu ProvinceChina department of Pathology Affiliated Hospital of Nanjing University of Chinese MedicineJiangsu Province Hospital of TCMNanjing 210046Jiangsu ProvinceChina

BACKGROUND Colorectal mucosa-associated lymphoid tissue lymphoma(MALToma),a rare kind of nongastric MALToma,lacks consensus on its endoscopic features and standard therapies.According to previous studies on the clinical characteristics and outcomes of colorectal MALToma,endoscopic resection remains a good therapeutic strategy.CASE SUMMARY A 71-year-old woman suffered intermittent hematochezia for 1 mo,accompanied with abdominal pains but without weight loss,fever,chills or fatigue.Colonoscopy showed a massive hemispheric mass with rough and hyperemic mucosa in the lower rectum.Narrow-band imaging magnifying endoscopy detected some branching abnormal blood vessels and disappearance of glandular structure,which was similar with the tree-like appearance sign in gastric MALToma.Endoscopic ultrasonography revealed the lesion to be hypoechoic,boundary-defined,and echo uniform inside,originating from the muscularis propria.Abdominal enhanced computed tomography(CT)demonstrated a soft tissue mass with defined boundary.No enlarged superficial lymph nodes were detected by B-mode ultrasound.C13-urea breath test and serum Helicobacter pylori antibody were both negative.The patient underwent endoscopic full-thickness resection.Postoperative pathological analysis indicated colorectal MALToma.The patient remained asymptomatic after discharge,and follow-up positron emission tomography–CT and colonoscopy showed no residual lesion,remnants or lymph node metastasis.CONCLUSION This case provides new information on the specific endoscopic features of colorectal MALToma and an alternative treatment for patients.

关键词： Mucosa-associated lymphoid tissue lymphoma Endoscopic full-thickness resection Endoscopic minimally invasive surgery Endoscopy Case report

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A modified method for suprachoroidal fluid drainage in kissing choroidal detachment

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International Journal of ophthalmology(English edition) 2020年第2期13卷 346-348页

作者： Zi-Zhong Hu Qing-Huai Liu Yu-Zhi Ding Yun Su Jiang-Dong Ji department of ophthalmology the First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina department of ophthalmology Zhongda Hospital Southeast UniversityNanjing 210009Jiangsu ProvinceChina

●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial drainage.A 30-guage needle was then applied to inject balanced saline solution through the existing sclerotomy for further drainage.After most of the suprachoroidal fluid was drained,standard 3-port 23-guage pars plana vitrectomy was performed.●RESULTS:We have succeeded in using this technique to treat five patients with retinal detachment and kissing choroidal detachment(KCD).The choroidal detachment was visibly recessed in all cases after drainage with no intraoperative complications.After removal of silicon oil at 3 mo follow-up,all patients obtained a reattached retina.No postoperative complications such as hypotony and endophthalmitis occurred.●CONCLUSION:The new technique is efficient and safe for suprachoroidal fluid drainage for patients with rhegmatogenous retinal detachment.In future,further larger series are needed to attest to its safety and efficacy.

关键词： choroidal detachment retinal detachment vitrectomy suprachoroidal fluid

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Risk factors,prognostic factors,and nomograms for distant metastasis in patients with diagnosed duodenal cancer:A population-based study

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1384-1420页

作者： Jia-Rong Shang Chen-Yi Xu Xiao-Xue Zhai Zhe Xu Jun Qian department of Oncology Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina department of Proctology Nanjing Hospital of Chinese MedicineNanjing 210000Jiangsu ProvinceChina department of Digestive Cancer Surgery Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina

BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal cancer.AIM To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal cancer.METHODS Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,Epidemiology,and End Results database.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with DM.Two novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of diagnosis.Logistic analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(P<0.05).Univariate and multivariate COX analyses further identified independent prognostic factors for duodenal cancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(P<0.05).The accuracy of the nomograms was validated in the training set,validation set,and expanded testing set using ROC curves,calibration curves,and DCA curves.The results of Kaplan-Meier survival curves(P<0.001)indicated that both nomograms accurately predicted the occurrence and prognosis of DM in patients with duodenal cancer.CONCLUSION The two nomograms are expected as effective tools for predicting DM risk in duodenal cancer patients

关键词： Duodenal cancer Distant metastasis Nomogram Risk factors Prognostic factors

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Perforating and ophthalmic artery variants from the anterior cerebral artery:Two case reports

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World Journal of Clinical Cases 2023年第18期11卷 4392-4396页

作者： Zhi-Xiao Mo Wen Li De-Fa Wang department of Neurosurgery Qinghai Provincial People's HospitalXining 810007Qinghai ProvinceChina department of Neurosurgery The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina department of Neurosurgery Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou 215006Jiangsu ProvinceChina

BACKGROUND The diagnosis and therapy during surgery depend largely on a full account of anatomic characteristics.Apart from regular structures,the common,less common or even uncommon anatomic variations are critical for procedural planning.This is especially true during craniocerebral microsurgery,where small vascular variations can affect the final surgical results and patient prognosis.CASE SUMMARY Herein,two rare variations concerning the A1(horizontal)segment of anterior cerebral artery(ACA1)were introduced.One enabled the communication between perforating branch of ACA1 and dural artery of anterior skull base,which was discovered during autopsy.The other was ophthalmic artery(OA)originating from ACA1,shown on digital angiography.CONCLUSION In this study,we found two rare anatomical variations.One was an abnormal OA originated from the anterior communicating artery.The other was a perforating branch of the A1 segment of the anterior cerebral artery,which communicated with meningeal vessels in the anterior skull base.This finding is of great significance for the treatment of anterior communicating artery aneurysm or in other anterior skull base surgery.

关键词： Microsurgical anatomy Arterial variations Ophthalmic artery Perforating branches Case report

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Trimethylamine N-oxide aggravates vascular permeability and endothelial cell dysfunction under diabetic condition:in vitro and in vivo study

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International Journal of ophthalmology(English edition) 2024年第1期17卷 25-33页

作者： Jia-Yi Jiang Wei-Ming Liu Qiu-Ping Zhang Hang Ren Qing-Ying Yao Gao-Qin Liu Pei-Rong Lu department of ophthalmology the First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina Suzhou Center for Disease Prevention and Control Suzhou 215004Jiangsu ProvinceChina

AIM:To provide the direct evidence for the crucial role of trimethylamine N-oxide(TMAO)in vascular permeability and endothelial cell dysfunction under diabetic condition.METHODS:The role of TMAO on the in vitro biological effect of human retinal microvascular endothelial cells(HRMEC)under high glucose conditions was tested by a cell counting kit,wound healing,a transwell and a tube formation assay.The inflammation-related gene expression affected by TMAO was tested by real-time polymerase chain reaction(RT-PCR).The expression of the cell junction was measured by Western blotting(WB)and immunofluorescence staining.In addition,two groups of rat models,diabetic and non-diabetic,were fed with normal or 0.1%TMAO for 16wk,and their plasma levels of TMAO,vascular endothelial growth factor(VEGF),interleukin(IL)-6 and tumor necrosis factor(TNF)-αwere tested.The vascular permeability of rat retinas was measured using FITC-Dextran,and the expression of zonula occludens(ZO)-1 and claudin-5 in rat retinas was detected by WB or immunofluorescence staining.RESULTS:TMAO administration significantly increased the cell proliferation,migration,and tube formation of primary HRMEC either in normal or high-glucose conditions.RT-PCR showed elevated inflammation-related gene expression of HRMEC under TMAO stimulation,while WB or immunofluorescence staining indicated decreased cell junction ZO-1 and occludin expression after high-glucose and TMAO treatment.Diabetic rats showed higher plasma levels of TMAO as well as retinal vascular leakage,which were even higher in TMAO-feeding diabetic rats.Furthermore,TMAO administration increased the rat plasma levels of VEGF,IL-6 and TNF-αwhile decreasing the retinal expression levels of ZO-1 and claudin-5.CONCLUSION:TMAO enhances the proliferation,migration,and tube formation of HRMEC,as well as destroys their vascular integrity and tight connection.It also regulates the expression of VEGF,IL-6,and TNF-α.

关键词： diabetic model trimethylamine N-oxide inflammation endothelial dysfunction rats retinal microvascular endothelial cells

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