OCT参数对原发性开角型青光眼性视神经损伤的诊断价值

目的:探究频域光学相干断层成像技术(OCT)对原发性开角型青光眼性视神经损伤的诊断价值。方法:选择2018-01/2020-03我院收治的80例80眼原发性开角型青光眼患者及100例100眼健康受试者作为研究对象,将原发性开角型青光眼患者分为早期组、中期组及晚期组,采用OCT测定各组患者上方、下方、鼻侧、颞侧视乳头旁视网膜神经纤维层(pRNFL)厚度值及上方、下方黄斑区视网膜神经节细胞复合体(mGCC)厚度值,比较各组受试者OCT参数之间差异,采用Spearman相关性分析OCT参数与视野缺损程度的相关性,绘制受试者特征工作曲线(ROC)计算OCT参数诊断原发性开角型青光眼的价值。结果:入组患者早期组24例、中期组39例、晚期组17例,各组患者pRNFL、mGCC参数均有差异(P<0.05),晚期组青光眼患者上方、下方、鼻侧pRNFL、平均pRNFL及上方、下方、平均mGCC显著低于早期组、中期组,中期组患者各指标显著低于早期组(P<0.05)。Spearman相关性分析示,pRNFL、mGCC参数与原发性开角型青光眼严重程度呈负相关关系(P<0.05)。ROC曲线显示,上方pRNFL、下方pRNFL、鼻侧pRNFL、颞侧pRNFL、平均pRNFL诊断原发性开角型青光眼视神经损伤的曲线下面积为0.693、0.846、0.676、0.579、0.844,上方mGCC、下方mGCC及平均mGCC诊断原发性开角型青光眼视神经损伤的曲线下面积分别为0.542、0.677、0.676;平均pRNFL联合平均mGCC诊断原发性开角型青光眼视神经损伤的曲线下面积为0.883。结论:OCT测定pRNFL、mGCC参数与开角型青光眼视神经损伤程度密切相关,两者有较高的诊断价值,临床可将其用于诊断及病情评估。

Comparative genomic study of gastric epithelial cells co-cultured with Helicobacter pylori

AIM:To identify genes potentially involved in Helicobacter pylori(H.pylori)-induced gastric carcinogenesis.METHODS:GES-1 cells were co-cultured with H.pylori strains isolated from patients with gastric carcinoma(GC,n = 10) or chronic gastritis(CG,n = 10) for in vitro proliferation and apoptosis assays to identify the most and least virulent strains.These two strains were cagA-genotyped and used for further in vivo carcinogenic virulence assays by infecting Mongolian gerbils for 52 wk,respectively;a broth free of H.pylori was lavaged as control.Genomic profiles of GES-1 cells cocultured with the most and least virulent strains were determined by microarray analysis.The most differentially expressed genes were further verified using quantitative real-time polymerase chain reaction in GES-1cells infected with the most and least virulent strains,and by immunohistochemistry in H.pylori positive CG,precancerous diseases,and GC biopsy specimens in an independent experiment.RESULTS:GC-derived H.pylori strains induced a potent proliferative effect in GES-1 cells in co-culture,whereas CG-derived strains did not.The most(from a GC patient) and least(from a CG patient) virulent strains were cagA-positive and negative,respectively.At week 52,CG,atrophy,metaplasia,dysplasia,and GC were observed in 90.0%,80.0%,80.0%,90%,and 60.0%,respectively,of the animals lavaged with the most virulent strain.However,only mild CG was observed in 90% of the animals lavaged with the least virulent strain.On microarray analysis,800 differentially expressed genes(49 up-and 751 down-regulated),involving those associated with cell cycle regulation,cell apoptosis,cytoskeleton,immune response,and substance and energy metabolisms,were identified in cells co-cultured with the most virulent strain as compared with those co-cultured with the least virulent strain.The six most differentially expressed genes(with a betweenness centrality of 0.1-0.2) were identified among the significant differential gene profile network,including JUN,KRAS,BRCA1,SMAD2,TRAF1,and HDAC6.Quantitative real-time polymerase chain reaction analyses verified that HDAC6 and TRFA1 mRNA expressions were significantly more up-regulated in GES-1 cells cocultured with the most virulent strain than in those cocultured with the least virulent strain.Immunohistochemistry of gastric mucosal specimens from H.pyloripositive patients with CG,intestinal metaplasia(IM),dysplasia,and GC showed that moderately positive and strongly positive HDAC6 expression was detected in 21.7% of CG patients,30.0% of IM patients,54.5% of dysplasia patients,and 77.8% of GC patients(P < 0.001).The up-regulation of TRAF1 expressions was detected in 34.8%,53.3%,72.7%,and 88.9% specimens of CG,IM,dysplasia,and GC,respectively(P < 0.001).CONCLUSION:The overexpression of HDAC6 and TRAF1 in GES-1 cells co-cultured with the GC-derived strain and in H.pylori-positive dysplasia and GC suggests that HDAC6 and TRAF1 may be involved in H.pyloriinduced gastric carcinogenesis.