Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P 【0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P 【0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the duration of diabetes. Therefore, ocular surface of the patients with PDR should be examined regularly by conventional approaches and confocal microscopy to facilitate early diagnosis and treatment of keratopathy.

Preventive effect of Qianggan-Rongxian Decoction on rat liver fibrosis

AIM: To study the preventive effects of Qianggan-Rongxian Decoction on liver fibrosis induced by dimethylnitrosamine (DMN) in rats. METHODS: Male Wistar rats were randomly divided into hepatic fibrosis model group, control group and 3 treatment groups (12 rats in each group). Except for the normal control group, all the rats received 1% DMN (10 μL/kg body weight, i.p), 3 times a week for 4 wk. The rats in the 3 treatment groups including a high-dose DMN group (10 mL/kg), a medium-dose DMN group (7 mL/kg), and a low-dose DMN group (4 mL/kg) were daily gavaged with Qianggan-Rongxian Decoction, and the rats in the model and normal control groups were given saline vehicle. Enzyme-linked immunosorbent assay (ELISA) was used to determine the changes in serum hyaluronic acid (HA), laminin (LN), and type IV collagen levels. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured using routine laboratory methods. Pathologic changes, particularly fibrosis, were examined by hematoxylin and eosin (HE) and Sirius red staining. Hepatic stellate cells (HSC) were examined by transmission electron microscopy. RESULTS: Compared with the model control group, the serum levels of HA, LN, type Ⅳ collagen, ALT and AST were decreased markedly in the other groups after treatment with Qianggan-Rongxian Decoction, especially in the medium-dose DMN group (P < 0.05).Moreover, the area-density percentage of collagen fibrosis was lower in the Qianggan-Rongxian Decoction treatment groups than in the model group, and a more significant drop was observed in the medium-dose DMN group (P < 0.05). CONCLUSION: Qianggan-Rongxian Decoction can inhibit hepatic fibrosis due to chronic liver injury, delay the development of cirrhosis, and notably ameliorate liver function. It may be used as a safe and effective thera-peutic drug for patients with fibrosis.

Localization of ANP-synthesizing cells in rat stomach

AIM: To study the morphological positive expression of antrial natriuretic peptide (ANP)-synthesizing cells and ultrastructural localization and the relationship between ANP-synthesizing cells and microvessel density in the stomach of rats and to analyze the distribution of the three histologically distinct regions of ANP-synthesizing cells. METHODS: Using immunohistochemical techniques, we studied positive expression of ANP-synthesizing cells in rat stomach. A postembedding immunogold microscopy technique was used for ultrastructural localization of ANP-synthesizing cells. Microvessel density in the rat stomach was estimated using tannic acid-ferric chloride (TAFC) method staining. Distribution of ANP-synthesizing cells were studied in different regions of rat stomach histochemically. RESULTS: Positive expression of ANP-synthesizing cells were localized in the gastric mucosa of rats. Localization of ANP-synthesizing cells identified them to be enterochrochromaffin cells (EC) by using a postembedding immunogold electron microscopy technique. EC cells were in the basal third of the cardiac mucosa region. ANP-synthesizing cells existed in different regions of rat stomach and its density was largest in the gastric cardiac region, and the distribution order of ANP-synthesizing cells in density was cardiac region, pyloric region and fundic region in mucosa layer. We have also found a close relationship between ANP-synthesizing cells and microvessel density in gastric mucosa of rats using TAFC staining. CONCLUSION: ANP-synthesizing cells are expressedin the gastric mucosa. EC synthesize ANP. There is a close relationship between ANP-synthesizing cells and microvessel density in gastric mucosa of rats.The distribution density of ANP-synthesizing cells is largest in the gastric cardiac region.

Collision carcinoma of the rectum involving neuroendocrine carcinoma and adenocarcinoma:A case report

BACKGROUND Collision carcinoma is a rare histological pattern,and includes two or more different types of tumors coexisting in the same organ as one neoplasm.Different to the combined type,the two adjacent tumors of collision carcinoma are histologically distinct.Collision carcinoma may occur from any origin or organ,including the cecum,liver,cervix,thyroid,stomach,kidney,and esophagus.In the rectum,adenocarcinoma is the most common pathological type,the combined type is rare,and collision tumors are even rarer.To date,only a limited number of collision carcinoma cases originating from the rectum have been reported.Due to the scarcity of rectal collision carcinoma,more cases need to be reported to fully understand the clinico-pathological features and biological behavior of the tumor.CASE SUMMARY Here we report a 40-year-old female who presented with the chief complaints of persistent changes in bowel habits and hematochezia for 10 d.She underwent Miles'operation which revealed a collision carcinoma of the rectum,showing a“side by side”pattern,composed of a high grade neuroendocrine carcinoma,(small cell carcinoma)and moderately differentiated adenocarcinoma,based on its clinico-pathological features and biological behavior.The patient remained disease-free at 12 mo follow-up.We also focused on the related literature and expert opinion.CONCLUSION Collision carcinoma is a rare tumor with ambiguous biological behavior.Greater attention should be paid to its clinico-pathologic diagnosis.Regular and adequate follow-up is essential to help rule out metastasis and assess the prognosis.

Carcinoid of the Esophagus Concomitant with Adenocarcinoma of the Esophagus： One Case Report and Literature Review

Introduction Neuroendocrine tumor covers a wide range of neoplasms that originate in the neuroendocrine cells which spread throughout the body. Carcinoid tumor,

颈动脉内膜剥脱术治疗颈动脉狭窄支架术后再狭窄的临床研究

目的探讨颈动脉内膜剥脱术(CEA)在颈动脉狭窄支架成型术(CAS)后再狭窄治疗缺血性脑卒中的围术期安全性及近中期效果。方法回顾性分析2016年1月—2017年12月湖南中医药大学第一附属医院56例行CEA或CAS治疗的颈动脉中重度狭窄患者,其中颈动脉狭窄支架术后再狭窄9例(治疗组),颈动脉中重度狭窄47例(对照组)。记录两组患者手术切口长度、动脉切开长度、手术时间、血管阻断时间及围术期相关并发症;随访6～30个月,记录两组患者包括死亡在内的不良反应发生率。结果两组患者手术时间、血管阻断时间、围术期并发症及术后近中期效果比较,差异无统计学意义(P>0.05);治疗组切口长度及颈动脉切开长度较对照组长(P<0.05)。结论 CEA治疗颈动脉狭窄支架术后再狭窄安全有效。充分的术前评估、术中电生理监测、娴熟的显微手术技巧及术后管理是提高CEA安全性、降低手术风险及并发症的关键。

Morphological and serum hyaluronic acid, laminin and type Ⅳ collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM： To study the morphological and serum hyaluronic acid （HA）, laminin （LN）, and type IV collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine （DMN）.METHODS： The rat model of liver fibrosis was induced by DMN. Serum HA, type IV collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin α-SMA staining as well as Sirius-red and HE staining.RESULTS： The levels of serum HA, type IV collagen and LN significantly increased from d 7 to d 28 （P = 0.043）. The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with lie and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 Iobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of α-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope. All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of α-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group （P〈0.05） on different d （7, 14, and 28）. The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type IV collagen.CONCLUSION： The morphological and serum HA, type IV collagen, and LN are changed in DMN-induced liver fibrosis in rats.

The vanadium isotopic composition of L ordinary chondrites

Stable isotopic data of meteorites are critical for understanding the evolution of terrestrial planets. In this study, we report high-precision vanadium （V） isotopic compositions of 11 unequilibrated and equilibrated L chondrites. Our samples show an average δ^51v of -1.25‰ ±0.38‰ （2SD, n = 11）, which is ,- 0.5‰ lighter than that of the bulk silicate Earth constrained by mantle peridotites. Isotopic fractionation in type 3 ordinary chondrites vary from - 1.76‰ to - 1.29‰, whereas the δ^51V of equilibrated chondrites vary from - 1.37‰ to -1.08‰. 551V of L chondrites do not correlate with thermal metamorphism, shock stage, or weathering degree. Future studies are required to explore the reason for V isotope variation in the solar system.

Statistics matters in interpretations of non-traditional stable isotopic data

Increasing volumes of of non-traditional stable isotope data have brought new opportunities to gain important insights into geochemical and planetary processes.However,there is a worrysome trend that the isotopic data are interpreted in a fashion that its statistical approaches are chosen subjectively.This communication summarizes the rules regarding calculating the mean,standard deviation and relative standard deviation of a population,as well as error propagation and significant digits.These rules should be used when reporting geochemical data,especially for isotope ratios.Using two examples,I show that statistics matters in isotopic data interpretation.

Late veneer and the origins of volatiles of Earth

Late veneer is an important paradigm in early Earth and planetary studies.It refers to the late addition of extraterrestrial materials to the Earth’s mantle after the core formation,which leads to the overabundances of highly siderophile elements in the primitive upper mantle.In this review,the origin,evolution,and expansion of the late veneer hypothesis are summarized,including some unresolved problems.I hope this review would be helpful for the new entrants to this field.

Spermatocytic tumor:A rare case report

BACKGROUND Spermatocytic tumor is a rare,malignant neoplasm of the testes.Since the prognosis for this tumor type is favorable,accurate diagnosis and differentiation from other malignant testicular neoplasms(classic seminoma and lymphoma)are crucial.To add to the existing literature on the diagnosis of spermatocytic tumor,herein we report the detailed clinical and histopathologic findings for a case that we encountered.CASE SUMMARY A 60-year-old Chinese man presented with a solid mass in the right scrotum.The mass was surgically removed and spermatocytic tumor was diagnosed.On microscopy,the tumor cells displayed an unusual arrangement in lobules,presenting a pseudo-glandular appearance.To summarize and compare the diagnostic features of this tumor and those of the differential diagnoses,we report our case findings and those mentioned in the literature for various testicular tumors.Although imaging methods can detect masses early in development,their diagnostic capabilities are limited.Biopsy,histopathology,and immunohistochemistry are necessary for confirmatory diagnosis.CONCLUSION It is important to identify and review the key diagnostic features of spermatocytic tumor.

Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar Border from June to December 2014

Background:From 2007 to 2013,intensive control measures reduced malaria burden by 90%along the China-Myanmar border.However,despite these measures a P.falciparum malaria outbreak was reported in the Shan Special Region II of Myanmar in June of 2014.Methods:Epidemiological,parasitological and entomological investigations were performed.Dihydroartemisinin piperaquine(DAPQ)was immediately administered to treat parasite positive individuals.Long lasting insecticidal nets(LLIN),indoor residual spraying(IRS)with insecticides and behavior change communication(BCC)were also provided for outbreak control.An embedded efficacy study was conducted evaluating DP.Molecular genotyping via polymerase chain reaction(PCR)was performed on the Kelch gene on chromosome 13.Results:All infections were identified as Plasmodium falciparum by RDT and microscopy.Two fatalities resulted from the outbreak.The attack rate was 72.8%(67/92)and the incidence density rate was 14.2 per 100 person-weeks.The positive rate of rapid diagnostic test(RDT)was 72.2%(65/90)and microscopically-determine parasite rate 42.2%(38/90).Adjusted odds ratio(OR)of multivariate logistic regression analysis for aged<15 years,15–45 years,inappropriate treatment from a private healer and lack of bed nets were 13.51(95%confidence interval,2.21–105.89),7.75(1.48–44.97),3.78(1.30–46.18)and 3.21(1.21–15.19)respectively.In the six surrounding communities of the outbreak site,positive RDT rate was 1.2%(4/328)and microscopically-determine parasite rate 0.6%(2/328).Two light traps collected a total of 110 anopheline mosquitoes including local vectors,An.minimus,An.sinensis and An.maculates.After intensive control,the detection of malaria attacks,parasites and antigen were reduced to zero between July 1 and December 1,2014.The cure rate of P.falciparum patients at day 42 was 94.3%(95%CI,80.8–99.3%).The PCR did not detect K13-propeller mutations.Conclusion:Imported P.falciparum caused the outbreak.Age,seeking inappropriate treatment and lack of bed nets were risk factors for infection during the outbreak.P.falciparum was sensitive to treatment with DAPQ.The integrated measures controlled the outbreak and prevented the spread of P.falciparum effectively.The results of this study indicate that malaria control on the China-Myanmar border,especially among special populations,needs further collaboration between China,Myanmar and international societies.