不同浓度阿托品延缓近视儿童等效球镜度及眼轴长度效果的Meta分析

目的:系统评价眼用0.01%、0.025%和0.05%阿托品对于近视儿童等效球镜度及眼轴长度的影响。方法:检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据库、维普网、中国生物医学文献数据库中从建库至2022-05期间发表的关于0.01%、0.025%和0.05%阿托品进行近视控制的研究。使用Cochrane手册对纳入文献进行偏倚风险评价及质量评价,并使用Revman 5.4软件进行Meta分析,利用STATA12.0软件检测发表偏倚。结果:共计纳入6篇文献1 239眼,其中5项为随机对照试验,1项为病例对照研究。Meta分析显示,0.025%阿托品对SE及AL的抑制效果好于0.01%阿托品(SE:WMD=-0.15,95%CI:-0.23~-0.06,P<0.001;AL:WMD=0.07,95%CI:0.03~0.10,P<0.001)。0.05%阿托品对SE及AL抑制效果好于0.01%阿托品(SE:WMD=-0.35,95%CI:-0.44~-0.26,P<0.001;AL:WMD=0.16,95%CI:0.12~0.20,P<0.001)。0.05%阿托品对SE及AL增加的抑制效果好于0.025%阿托品(SE:WMD=-0.20,95%CI:-0.28~-0.11,P<0.001;AL:WMD=0.09,95%CI:0.06~0.12,P<0.001)。结论:0.05%阿托品对SE及AL的控制效果优于0.025%及0.01%阿托品,但长期使用的副作用仍有待进一步观察。

多巴胺能与胆碱能通路在近视发生发展中的作用研究进展

近视已成为全球范围的公共卫生问题,但其发病机制尚未完全阐明。多巴胺和乙酰胆碱作为视网膜上重要的神经递质,通过与其对应受体结合发挥作用,在实验性近视的形成和抑制中具有重要意义。相关信号通路在近视发生发展中的具体作用机制也备受关注。大多数研究支持多巴胺及乙酰胆碱受体拮抗剂一定程度上可抑制实验性近视的发展;药理学实验进一步揭示,两条信号通路之间相互交叉、相互影响,可能存在共同的作用位点。本文就近年来多巴胺能通路和胆碱能通路及其二者的联系在近视领域的研究现状进行简要综述,旨在为进一步探索近视的发病机制以及近视防治提供参考。

All-trans retinoic acid regulates the expression of MMP-2 and TGF-β2 via RDH5 in retinal pigment epithelium cells

·AIM: To investigate the effect of all-trans retinoic acid(ATRA) on retinol dehydrogenase 5(RDH5), matrix metalloproteinase-2(MMP-2) and transforming growth factor-β2(TGF-β2) transcription levels, and the effect of RDH5 on MMP-2 and TGF-β2 in retinal pigment epithelium(RPE) cells.·METHODS: After adult RPE cell line-19(ARPE-19 cells) intervened with gradient concentrations of ATRA(0-20 μmol/L) for 24h, flow cytometry was used to detect the proliferation and apoptosis of cells in each group, and quantitative realtime polymerase chain reaction(q RT-PCR) was used to detect RDH5, MMP-2 and TGF-β2 m RNA expression. Then, after ARPE-19 cells transfected with three different si RNA targets for 48h, the RDH5 knockdown efficiency of each group and expression of MMP-2 and TGF-β2 m RNA within them was detected by q RT-PCR. ·RESULTS: Flow cytometry results showed that ATRA could inhibit the proliferation of RPE cells and promote the apoptosis of RPE cells, and the difference of apoptosis was statistically significant when the ATRA concentration exceeded 5 μmol/L and compared with the normal control group(P=0.027 and P=0.031, respectively). q RT-PCR results showed that ATRA could significantly inhibit the expression level of RDH5 m RNA(P<0.001) and promote the expression of MMP-2 and TGF-β2 m RNA(P=0.03 and P<0.001, respectively) in a dose-dependent manner, especially when treated with 5 μmol/L ATRA. The knockdown efficiency of RDH5 si RNA varies with different targets, among which RDH5 si RNA-435 had the highest knockdown efficiency, i.e., more than 50% lower than that of the negative control group(P=0.02). When RDH5 was knocked down for 48h, the results of q RT-PCR showed that the expressions of MMP-2 and TGF-β2 m RNA were significantly up-regulated(P<0.001).·CONCLUSION: ATRA inhibits the expression of RDH5 and promotes MMP-2 and TGF-β2, and further RDH5 knockdown significantly upregulates MMP-2 and TGF-β2. These findings suggest that RDH5 may be involved in an epithelial-mesenchymal transition of RPE cells mediated by ATRA.

Role of theories in school-based diabetes care interventions:A critical review

BACKGROUND Diabetes is one of the most common chronic diseases of childhood.School plays an essential role in the management of student diabetes,which reduces the risk of short-and long-term diabetes complications and ensures that students are wellpositioned for optimal academic performance and growth.AIM The aim of this review was to systematically identify and synthesize the literature concerning theory-based diabetes care interventions in K-12 schools in the United States.It critically assessed the specific role of theories and associated essential constructs in intervention design,implementation,outcome measurement,and evaluation.METHODS Relevant literature was identified by keyword searches of the Cochrane Library,PubMed,and Web of Science.RESULTS Four interventions met the eligibility criteria and were included in the review.Of those,two evaluated online diabetes education programs for school personnel and the other two assessed in-person interventions.Three studies adopted a onegroup pre-post study design,and the remaining one adopted a one-shot casestudy design.Three of the interventions adopted social cognitive theory,and the remaining one was guided by the diffusion of innovations theory.Three studies identified core constructs of a theory as predictors of behavioral change.Two used theory to select or develop intervention techniques.Two studies used theory to customize participant intervention techniques.Two studies discussed their findings in the context of theory.No study used theory to select potential intervention participants.CONCLUSION In conclusion,despite the value of theory in intervention design and evaluation,theory-based diabetes interventions at school remain scarce.Future research may seek ways to better integrate theory and empirical research.