Comparison of Prelaminar Thickness between Primary Open Angle Glaucoma and Normal Tension Glaucoma Patients

Main Objective

The thinning of prelaminar tissue and prelamina cupping is known to occur by ischemia, as we see in anterior ischemic optic neuropathy. Since normal tension glaucoma (NTG) is thought to be more related to vascular factor than in primary open-angle glaucoma (POAG), we hypothesized that prelamina thinning may occur prominently in NTG patients. This study investigated the difference in prelaminar tissue thickness between patients with POAG and NTG and verified the factors related to prelaminar thinning.

Methods

Complete ophthalmic examination including standard automatic perimetry was performed in all patients. The prelaminar tissue thickness was measured in all patients by performing enhanced depth imaging with a Heidelberg Spectralis Optical Coherence Tomography. The retinal nerve fiber layer and optic nerve head parameters were obtained using the Heidelberg Retina Tomography II and Cirrus Optical Coherence Tomography. Various ocular factors and their relationships with prelaminar thickness were analyzed.

Results

The mean prelaminar tissue thickness was significantly thinner in patients with POAG than in those with NTG. The difference in the prelaminar thickness between patients with POAG and those with NTG was greater in the early field defect group than in the moderate and severe field groups. In multivariate analysis, the mean prelaminar thickness was related to the intraocular pressure, mean deviation, cup-disc ratio, and cup volume.

Conclusions

The prelaminar tissue was thinner in patients with POAG than in patients with NTG, and intraocular pressure had a strong influence on the prelaminar thickness in both POAG and NTG. This may indicate that mechanical compression is the main pathogenic factor in both POAG and NTG.     

Development of a Device in Detection of Glaucoma for Rural Eye Care Using Additive Manufacturing and TRIZ

Purpose: The main purpose of this study is to develop a device for the indicative measurement of intraocular pressure (IOP) of eyeball, a key cause for glaucoma. In early diagnosis and treatment of glaucoma accurate measurement of IOP is important. The methods and devices which are available for the measurement of IOP have their own limitations which cause discomfort to the patients during measurement and needs anesthesia. There is a dare need of a device for the measurement of intraocular pressure by making the contact of plunger with closed eyelid eliminating the need of anesthesia and expert ophthalmologist. Method: Additive manufacturing (AM) is an era of technical development and innovation. Developing a device for detecting glaucoma by using AM and TRIZ ‘The theory of inventive problem solving’ (A Collaborative approach) can overcome the disadvantages that classic tonometer have. The field of Ophthalmology will be experiencing a paradigm shift towards the use of collaborative approach of TRIZ with AM. The developed new device was tested on 40 patient’s eye at Government Hospital Bhandara, (M. S.), India. The results of new device were cross verified by expert clinicians using calibrated Schiotz’s tonometer and digital palpation technique. Result: The developed new device was tested on patient’s eye through eyelid and results were compared with calibrated Schiotz’s tonometer. The results from the new device were found in good agreement with results from Schiotz’s tonometer with the average error of 0.033 ± 0.18 (mean ± SD) mm of Hg and mean relative error was -0.0018 ±0.0096 (mean ± SD). Conclusion: There is a substantial need for early detection and diagnosis of glaucoma in rural and remote areas (worldwide). A new device for detection of glaucoma using AM and TRIZ was introduced in this paper and measurements by the new device were by currently well accepted Schiotz’s tonometer. The new device will help the medical practitioners in rural and remote areas for early detection of glaucoma.     

Effect of Age-Stiffening Tissues and Intraocular Pressure on Optic Nerve Damages

Age-stiffening of ocular tissues is statistically linked to glaucoma in the elderly. In this study, the effects of age-stiffening on the lamina cribrosa, the primary site of glaucomatous nerve damages, were modeled using computational finite element analysis. We showed that glaucomatous nerve damages and peripheral vision loss behavior can be phenomenologically modeled by shear-based damage criterion. Using this damage criterion, the potential vision loss for 30 years old with mild hypertension of 25mmHg intraocular pressure (IOP) was estimated to be 4%. When the IOP was elevated to 35mmHg, the potential vision loss rose to 45%; and age-stiffening from 35 to 60 years old increased the potential vision loss to 52%. These results showed that while IOP plays a central role in glaucomatous damages, age-stiffening facilitates glaucomatous damages and may be the principal factor that resulted in a higher rate of glaucoma in the elderly than the general population.     

上巩膜静脉结扎联合应用5-Fu建立大鼠慢性高眼压模型

目的建立一种稳定、持久的大鼠慢性高眼压模型,为青光眼视神经损伤及保护机制的研究提供基础资料。方法雄性SD大鼠(300±20 g)65只,分为改良实验组60只,经结扎上巩膜静脉联合术后球结膜下注射5-Fu;对照实验组5只,单独结扎上巩膜静脉。观察改良实验组模型建立后1周、4周、6周1、0周视网膜神经节细胞(retinal ganglion cells,RGCs)数量的变化情况。结果改良实验组可诱导较长时间(>10周)稳定高眼压,眼压升高1周4、周、6周、10周后,视网膜神经节细胞的存活率分别为:90.16%,83.50%,75.01%,62.37%;但对照实验组眼压升高仅维持2周左右。结论本模型具有操作简单,重复性好,成模率高,可稳定维持较长时间等优点,是较为理想的大鼠慢性高眼压模型。     

Ahmed青光眼阀植入术治疗眼外伤继发性青光眼临床疗效

目的:探讨Ahmed青光眼阀植入术治疗眼外伤继发性青光眼患者的临床效果。方法:回顾性分析2013年3月至2018年3月我院接诊的103例眼外伤继发性青光眼患者临床资料,根据手术方法不同分为观察组53例和对照组50例。观察组给予Ahmed青光眼阀植入术治疗,对照组给予小梁切除术治疗。比较两组手术疗效、治疗前后眼压、视力的变化、滤过泡、并发症的发生情况。结果:经随访显示,观察组手术完全成功率为52.83%,明显高于对照组(32.00%,P0.05);两组术后眼压较术前均降低,视力均较术前升高,组间、不同时间点比较差异有统计学意义(P0.05);观察组功能性滤过泡率为71.70%,明显高于对照组(50.00%,P0.05);两组术后浅前房、前房出血、虹膜阻塞总发生率分别为7.55%和18.00%,组间差异无统计学意义(P0.05)。结论:Ahmed青光眼阀植入术治疗眼外伤继发性青光眼的疗效显著,有助于控制眼压,改善视力。     

Meta-Analysis of the Effect of Excluding Early Deaths on the Estimated Relationship between Body Mass Index and Mortality

ALLISON, DAVID B., MYLES S. FAITH, MOONSEONG HEO, DIANA TOWNSEND-BUTTERWORTH, AND DAVID F. WILLIAMSON. Meta-analysis of the effect of excluding early deaths on the estimated relationship between body mass index and mortality. Obes Res. Objectives: Prospective cohort studies typically observe U-or J-shaped relationships between body mass index (BMI) (kg/m²) and mortality. However, some studies suggest that the elevated mortality at lower BMIs is due to confounding by pre-existing occult disease and recommend eliminating subjects who die during the first several (k) years of follow-up. This meta-analysis tests the effects of such early death exclusion on the BMI-mortality association. Research Methods and Procedures: Studies identified from MEDLINE, review articles, ancestry analyses, and the “invisible college.” Included studies: 1) measured relative body weight at baseline; 2) inchded at least 1000 subjects; 3) reported results with and without early-death exclusion, or relevant data; and 4) did not study exclusively diseased populations. Blank tables were mailed to 131 investigators covering 59 databases. Completed tables (n = 16 databases), electronic raw data (n = 7 databases), and original articles (n = 6 databases) provided final data. Meta-analytic regressions compared the BMI-mortality association with and without early death exclusion. The sample included 29 studies and 1,954,345 subjects. Results: The effect of eliminating early deaths was statistically significant but minuscule in magnitude. Implementation of early death exclusion was estimated to shift the BMI associated with minimum mortality only 0. 4 units for men and 0. 6 units for women at age 50. Even at a BMI 16, the estimated relative risk (compared to BMI 25) decreased only 0. 008 units for men and 0. 076 units for women at age 50. Discussion: Results indicate that either pre-existing disease does not confound the BMI—mortality association or eliminating early deaths is inefficient for reducing that confounding.     

Association of HK2 and NCK2 with Normal Tension Glaucoma in the Japanese Population

Although family studies and genome-wide association studies have shown that genetic factors play a role in glaucoma, it has been difficult to identify the specific genetic variants involved. We tested 669 single nucleotide polymorphisms (SNPs) from the region of chromosome 2 that includes the GLC1B glaucoma locus for association with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) in the Japanese population. We performed a two-stage case-control study. The first cohort consisted of 123 POAG cases, 121 NTG cases and 120 controls: the second cohort consisted of 187 POAG cases, 286 NTG cases, and 271 controls. Out of six SNPs showing significant association with POAG in the first round screening, seven SNPs were tested in the second round. Rs678350 in the HK2 gene coding sequence showed significant allelic (p = 0.0027 in Stage Two, 2.7XE-4 in meta-analysis) association with POAG, and significant allelic (p = 4.7XE-4 in Stage Two, 1.0XE-5 in meta-analysis) association with NTG. Although alleles in the TMEM182 gene did not show significant association with glaucoma in the second round, subjects with the A/A allele in TMEM182 rs869833 showed worse visual field mean deviation (p = 0.01). Even though rs2033008 in the NCK2 gene coding sequence did not show significant association in the first round, it had previously shown association with NTG so it was tested for association with NTG in round 2 (p = 0.0053 in Stage Two). Immunohistochemistry showed that both HK2 and NCK2 are expressed in the retinal ganglion cell layer. Once multi-testing was taken into account, only HK2 showed significant association with POAG and NTG in Stage Two. Our data also support previous reports of NCK2 association with NTG, and raise questions about what role TMEM182 might play in phenotypic variability. Our data suggest that HK2 may play an important role in NTG in the Japanese population.     

The Relationship between Fractional Flow Reserve,Platelet Reactivity and Platelet Leukocyte Complexes in Stable Coronary Artery Disease

Background

The presence of stenoses that significantly impair blood flow and cause myocardial ischemia negatively affects prognosis of patients with stable coronary artery disease. Altered platelet reactivity has been associated with impaired prognosis of stable coronary artery disease. Platelets are activated and form complexes with leukocytes in response to microshear gradients caused by friction forces on the arterial wall or flow separation. We hypothesized that the presence of significantly flow-limiting stenoses is associated with altered platelet reactivity and formation of platelet-leukocyte complexes.

Methods

One hundred patients with stable angina were studied. Hemodynamic significance of all coronary stenoses was assessed with Fractional Flow Reserve (FFR). Patients were classified FFR-positive (at least one lesion with FFR≤0.75) or FFR-negative (all lesions FFR>0.80). Whole blood samples were stimulated with increasing concentrations of ADP, TRAP, CRP and Iloprost with substimulatory ADP. Expression of P-selectin as platelet activation marker and platelet–leukocyte complexes were measured by flowcytometry. Patients were stratified on clopidogrel use. FFR positive and negative patient groups were compared on platelet reactivity and platelet-leukocyte complexes.

Results

Platelet reactivity between FFR-positive patients and FFR-negative patients did not differ. A significantly lower percentage of circulating platelet-neutrophil complexes in FFR-positive patients and a similar non-significant decrease in percentage of circulating platelet-monocyte complexes in FFR-positive patients was observed.

Conclusion

The presence of hemodynamically significant coronary stenoses does not alter platelet reactivity but is associated with reduced platelet-neutrophil complexes in peripheral blood of patients with stable coronary artery disease.     

马来酸噻吗洛尔联合拉坦前列腺素治疗高眼压型开角型青光眼的效果

目的:探讨马来酸噻吗洛尔联合拉坦前列腺素治疗高眼压型开角型青光眼的临床效果。方法:选取高眼压型开角型青光眼患者210例,随机分为治疗组和对照组,每组各105例。对照组患者给予马来酸噻吗洛尔治疗,治疗组患者给予马来酸噻吗洛尔联合拉坦前列腺素治疗。观察并比较两组患者治疗前后视力改善情况,眼压、视乳头杯盘比值变化情况,眼结膜充血、眼内干涩、角膜点状浸润以及一过性视觉模糊等不良反应的发生情况等。结果:治疗组患者视力改善率为85.7%,对照组为71.4%,治疗组高于对照组,差异具有统计学意义(P0.05);治疗后两组患者眼压、视乳头杯盘比值均明显下降,且治疗组明显低于对照组,差异具有统计学意义(P0.05)。治疗组患者眼结膜充血、眼内干涩、角膜点状浸润以及一过性视觉模糊等不良反应明显低于对照组,差异具有统计学意义(P0.05)。结论:马来酸噻吗洛尔联合拉坦前列腺素治疗高眼压型开角型青光眼能够改善患者视力水平,值得临床推广应用。此外,我们分析其作用可能与降低视乳头杯盘比值有关。     

急性心肌梗死患者冠状动脉病变严重性与脉压和脉压指数的关系

目的:探讨急性心肌梗死(AMI)患者冠状动脉病变严重程度与脉压和脉压指数的关系.方法:对185例AMI患者进行冠状动脉造影术,冠状动脉病变严重程度用冠状动脉病变支数和Gensini积分来表示,并测定收缩压(SBP)和舒张压(DBP)并计算脉压(PP)及脉压指数(PPI).结果:与脉压＜65mmHg的患者相比,脉压≥65mmHg的患者冠状动脉3支血管病变的患病率和Gensini积分显著增高(P＜0.01).与PPI＜0.500的患者相比,PPI≥0.500的患者冠状动脉3支血管病变的患病率和Gensini积分亦显著增高(P＜0.01).结论:PP和PPI与AMI患者冠状动脉病变程度密切相关,在临床上具有指导作用.     

Meta-Analysis of the Relationship between Multiple Sclerosis and Migraine

Background

Studies investigating a proposed association between multiple sclerosis (MS) and migraine have produced conflicting results and a great range in the prevalence rate of migraine in MS patients. By meta-analysing all available data we aimed to establish an overall estimate of any association in order to more accurately inform clinicians and care-givers about a potential association between MS and migraine.

Methods

Pubmed and EMBASE were searched to identify suitable studies. Studies were included if they were a case-control study or cohort study in which controls were not reported to have another neurological condition, were available in English, and specified migraine as a headache sub-type. The odds ratio (OR) of migraine in MS patients vs. controls was calculated using the inverse variance with random effects model in Review Manager 5.1.

Results

Eight studies were selected for inclusion, yielding a total of 1864 MS patients and 261563 control subjects. We found a significant association between migraine and MS (OR = 2.60, 95% CI 1.12–6.04), although there was significant heterogeneity. Sensitivity analysis showed that migraine without aura was associated with MS OR = 2.29 (95% CI 1.14–4.58), with no significant heterogeneity.

Conclusions

MS patients are more than twice as likely to report migraine as controls. Care providers should be alerted to ask MS patients about migraine in order to treat it and potentially improve quality of life. Future work should further investigate the temporal relationship of this association and relationship to the clinical characteristics of MS.     

Relationship between Nature Reserve and Local Village,Baka Case

Local villagers have important effect on the biodiversity in the nature reserve as they take advantage of the source for hundreds of years. Baka, a Jinuo village was studies with market investigation and questionnaire, especially focused on the bene-fits and costs that risen from nature reserve. It is found that the local people get a large number of income from nature reserve, at the same time, local people lost opportunity costs for lost land where is turned to nature reserve. Suggestions are given to manage-ment and development of the nature reserve.     

广西农作物种质资源遗传多样性

This paper is about PLEC,but also about small farmers and biodiversity . Until a very few years ago, all agriculture was supposed to be the enemy of biodiversity . Now it is better understood that some areas managed by small farmers contain almost as much biodiversity as the wild. This diversity, (Wood and Lenne 2000).Even in regard to the wild itself,ecological thinking has now swung away from the old view that the richest biodiversity occurs in ecosystems that have had a long period of undisturbed evolution toward acli maxstate. Since the late 1970s it has been forcefully argued that disturbances may be essential to the creation and maintenance of plant and animal diversity (eg. Zimmerer and young 1998).     

Ultrastructure of the Somatic and Buccal Cortex of the Tetrahymenine Hymenostome Glaucoma chattoni

SYNOPSIS The membranes, epiplasm, and fiber systems are described in the somatic cortex of Glaucoma chattoni strain HZ-1. Kinetodesmal fibers, postciliary and transverse microtubular ribbons, basal microtubules, transverse fibers and transverse accessory material are associated with kinetosomes. Longitudinal microtubular ribbons and mitochondria occur interkinetally. In the buccal cortex, the membranes, epiplasm and fibers of the 3 membranelles, the paroral kinety, the ribbed wall, and the cytostome are described. Comparisons between G. chattoni and other ciliates reveal ultrastructural differences of possible systematic significance. In the somatic cortex of this and other tetrahymenines. Iongitudinal microtubular ribbons and basal microtubules occur concurrently. In the buccal cortex, alveoli are absent in tetrahymenine membranelles. A table is presented of the fiber systems associated with single somatic kinetosomes of various ciliates whose cortical ultrastructure has been studied to date.     

生物缓释膜的研制及在青光眼治疗中的应用研究

目的:研制手术治疗青光眼用的生物缓释膜。方法:以曲安奈德(TA)作为模型药物,壳聚糖与明胶作为载体,溶剂挥发法成膜;用红外光谱,X-射线衍射、扫描电镜分析其结构与组成。植入兔眼巩膜辩下,观察其治疗效果。结果:生物缓释膜中TA与载体材料相容性好,药物以微晶形态存在膜中,活性完好。植入实验结果显示,缓释膜与眼组织生物相容性好,膜中持续缓慢释放的药物能有效抑制纤维增生和滤过泡瘢痕化。术后8周,结膜及巩膜瓣下房水减压房完好,能有效维持滤过,且降眼压效果明显。结论:青光眼手术中采用生物缓释膜给药,疗效优于传统给药方式,是一种安全有效的治疗青光眼的新方法。     

超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性评价

目的：探讨超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性。方法：将100例白内障合并青光眼患者按照抽签法随机地均分为对照组与观察组,对照组给予单纯超声乳化人工晶状体植入术,观察组在此基础上给予联合小梁切除术进行治疗。比较两组治疗前后相关指标以及术后并发症发生率等。结果：（1）对照组治疗前后IOP、ACD及AL均无统计学差异,观察组治疗前后IOP与CAD差异具有统计学意义（P〈0．05,P〈0．01）,但该组治疗前后AL无统计学差异;（2）两组术前与术后1周、1个月及3个月平均视野缺损值、平均模式标准差相比,差异均具有统计学意义,且观察组术后与对照组术后相比,差异均具有统计学意义;（3）对照组并发症发生率为20．00％,明显大于观察组（10．00％）。结论：超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼,疗效显著,不良反应发生率低,值得加以推广并应用。     

复合式与传统小梁切除术对青光眼患者眼压、生活质量及血清细胞因子的影响

目的:对比复合式与传统小梁切除术对青光眼患者眼压、生活质量及血清细胞因子的影响.方法:前瞻性选取2014年1月-2018年10月期间我院收治的青光眼患者80例,随机分为A组[n=38,传统小梁切除术]和B组[n=42,复合式小梁切除术],比较两组患者视力、眼压、生活质量、血清细胞因子及并发症发生情况.结果:两组患者术后...     

Effect of an Excess Intake of Casein Hydrolysate Containing Val-Pro-Pro and Ile-Pro-Pro in Subjects with Normal Blood Pressure,High-Normal Blood Pressure,or Mild Hypertension

A double-blind, placebo-controlled, randomized clinical trial was conducted to evaluate the effects of ingesting an excess of tablets containing casein hydrolysate, incorporating angiotensin I-converting enzyme (ACE) inhibitory peptides such as Val-Pro-Pro (VPP) and Ile-Pro-Pro (IPP), in subjects with blood pressure ranging from normal to mild hypertension. A total of 48 subjects were given either 5 times more than the effective amount of casein hydrolysate or a placebo in tablet form for 4 weeks. In the active group, systolic blood pressure (SBP) decreased significantly as compared with the placebo group. In stratified analysis, however, this antihypertensive effect was not found in normotensive subjects. In addition, neither an acute or nor an excessive reduction in blood pressure nor clinically important adverse events were observed in this study. These findings suggest that intake of a 5-fold excess of tablets containing casein hydrolysate can lead to a mild improvement in hypertension without side effects.     

原发性高血压患者血压昼夜节律与靶器官损害的关系研究

目的:研究原发性高血压患者血压昼夜节律异常是否与靶器官损害存在关联。方法:将2015年2~11月份在我院治疗的94例原发性高血压病人按照血压昼夜节律是否正常分为节律正常组52例和异常组42例。比较两组患者的24h、白天、夜间的收缩压(SBP)与舒张压(DBP)及血压负荷,并且比较两组患者心脏、脑、肾损伤相关指标。结果:异常组全天24h、白天、夜间SBP及DBP,血压负荷均高于正常组,差异具有统计学意义(P0.05)。异常组患者左室重量(LVM)和左室重量指数(LVMI)、发生心肌缺血次数及持续时间、发生脑梗死几率均明显高于正常组,差异有统计学意义(P0.05)。异常组尿微量白蛋白(MAU)、尿酸(UA)水平均高于正常组,差异有统计学意义(P0.05)。结论:原发性高血压患者出现昼夜节律异常,可能对相关靶器官造成损伤。     

A Meta-Analysis of the Relationship between Cigarette Smoking and Incidence of Myelodysplastic Syndromes

Background

In recent years, epidemiologic studies have reported controversial results relating cigarette smoking to myelodysplastic syndromes (MDS) risk. A meta-analysis was performed to assess such potential relationship between cigarette smoking and incidence of MDS.

Methods

A search of literature published before October 2012 for observational studies evaluating the association between cigarette smoking and MDS, returned 123 articles and of these, 14 were selected for this study. The outcomes from these studies were calculated and reported as odds ratios (OR). Quality assessments were performed with the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the I² index and source of heterogeneity was detected by sensitivity analyses. Finally, publication bias was assessed through visual inspection of funnel plots and Egger’s test.

Results

The pooled OR of developing MDS in ever-smokers was 1.45 (95% CI, 1.25 to 1.68) versus non-smokers. Current and former smokers had increased risks of MDS, with ORs of 1.81 (95% CI, 1.24 to 2.66) and 1.67 (95% CI, 1.42 to 1.96), respectively. In subset analyses, ever-smokers had increased risks of developing MDS if they were living in the United States, or in Europe, female in gender, had refractory anemia (RA)/RA with ringed sideroblasts (RARS) or RA with excess blasts (RAEB)/RAEB in transformation (RAEBt), respectively. Our results demonstrated that the association was stronger in individuals who smoked ≥20 cigarettes/day (OR, 1.62; 95% CI, 1.03 to 2.55) versus those who smoked <20 cigarettes/day (OR, 1.36; 95% CI, 1.13 to 1.64). Moreover, individuals who smoked more than 20 pack-years had increased MDS risk (OR, 1.94; 95% CI, 1.29 to 2.92).

Conclusion

Our outcomes show that smoking increases the risk of developing MDS in ever-smokers who are current or former smokers. We also demonstrate here that positive association between cigarette smoking and risk of MDS exists, and occurs in a dose-dependent manner.