Study of Pigment Epithelium-derived Factor in Pathogenesis of Diabetic Retinopathy

Diabetic retinopathy(DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However,aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential..Some emerging evidence now indicates that pigment epithelium-derived factor(PEDF), a multifunctional protein,can target multiple pathways to exert neurotropic,.neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Meta-analysis of the effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy

Background:The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy(PDR) was systematically evaluated using a meta-analysis.Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, Pub Med, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan 5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios(ORs) and 95% confidence intervals(CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group(perioperative Lucentis injection) was significantly lower than that in the control group(OR, 56.93; 95% CI: 21.81-148.57, P<0.01).Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.

Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy

The aim of this study was to understand the characteristics of blood pressure(BP)variability in subjects with diabetic nephropathy(DN),and identify the probable predictors affecting BP variability.Fifty-one chronic kidney disease(CKD)-hypertensive patients without diabetes(NDN group)and sixty type 2 diabetic patients with overt DN(DN group)were enrolled in this study.The values of short-term BP variability were obtained from 24 h ambulatory BP monitoring(ABPM).Variance analysis or nonparametric analysis revealed that 24-h systolic BP variability and nighttime systolic BP variability of the DN group were significantly higher than those of the NDN group[(12.23±3.66)vs.(10.74±3.83)mmHg,P<0.05;(11.23±4.82)vs.(9.48±3.69)mmHg,P<0.05].Then the patients of the DN group were divided into two groups according to glycated hemoglobin(HbA1c)level:Group A(HbA1c<7%)and Group B(HbA1c≥7%),and the t-test showed that patients in Group B had larger 24-h diastolic,daytime diastolic,and nighttime systolic/diastolic BP variability compared with Group A.In the DN group,partial correlation analysis revealed that HbA1c exhibited a strong association with 24-h diastolic,daytime diastolic,nighttime systolic and diastolic BP variability(P<0.001,P<0.001,P<0.05,and P<0.001,respectively).Taken together,larger short-term BP variability was detected in hypertensive type 2 diabetic patients with overt nephropathy and renal insufficiency.It may imply that the optimal BP variability level could benefit from a better glycaemic control.