Melanin change of retinal pigment epithelium and choroid in the convalescent stage of Vogt-Koyanagi-Harada disease

AIM:To observe the melanin change of the retinal pigment epithelium(RPE)and choroid in the convalescent stage of Vogt-Koyanagi-Harada(VKH).METHODS:A retrospective study was performed on 40 eyes of 20 patients in the convalescent stage of VKH.Fundus photography(FP),multi-spectral imaging(MSI),and optical coherence tomography(OCT)were performed.RESULTS:In the VKH convalescent stage,focal RPE melanin accumulation(FRMA)was detected in 34 eyes(85%)on MSI and in 7 eyes(17.5%)on FP.FRMA was limited to the previous retinal detachment area in all 28 eyes(FRMA was detected in 34 eyes on MSI,which were enrolled,and 6 eyes lacked data in the acute stage).Sunset-glow fundus was detected in 20 eyes(50%)on FP.The mean density of FRMA in a 1-mm-diameter circular area of the fovea was 0.04±0.07 on MSI,which was significantly correlated with sunset-glow fundus(ρ=0.467,P=0.02).CONCLUSION:In the VKH convalescent stage,FRMA is derived from the RPE melanin change,and sunset-glow fundus is derived from the choroid melanin change.A higher density of FRMA in the fovea and sunset-glow fundus represents more serious depigmentation of melanin.

Clinical Effect of Fuyang Prescription in Treatment of Ischemic Stroke during the Convalescent Stage:An Analysis of 25 Cases

[Objectives]The paper was to investigate the clinical effect of Fuyang prescription in the treatment of yang deficiency syndrome in the convalescent stage of ischemic stroke(IS)and its mechanism of action.[Methods]A total of 50 patients with yang deficiency syndrome in the convalescent stage of IS were randomly divided into treatment group and control group,with 25 patients in each group.The patients in the treatment group were given basic treatment combined with Fuyang prescription,and those in the control group were given basic treatment combined with Buyang Huanwu decoction;the course of treatment was 28 d for both groups.The activities of daily living(ADL)score,National Institutes of Health Stroke Scale(NIHSS)score,quality of life score,TCM syndrome score,and safety in both groups were observed before treatment and at 14 and 28 d post treatment,and their clinical outcome was evaluated.[Results]There was a significant difference in overall response rate between the treatment group and the control group[92.00%(23/25)vs 76.00%(19/25),P<0.05].After treatment,both groups had significant changes in ADL score,NIHSS score,quality of life score,and TCM syndrome score,and there were significant differences in these indices between the two groups at the same time point after treatment(P<0.05 or P<0.01).There were no significant changes in routine blood,routine stool,routine urine,and liver/renal function in either group after treatment.[Conclusions]Fuyang prescription has a marked clinical effect in the treatment of yang deficiency syndrome in the convalescent stage of IS,with significantly better clinical effect than Buyang Huanwu decoction,and it provides clinical evidence for the traditional Chinese medicine theory of yang supporting in the treatment of IS in the convalescent stage.

Immune characteristics analysis reveals two key inflammatory factors correlated to the expressions of SARS-CoV-2 S1-specific antibodies

The pandemic of COVID-19 caused by SARS-CoV-2 has made serious threats to the public health.Antibodies have been considered as promising therapeutics for the prevention and treatment of pathogens.So far,effectors that can influence the sustainability of SARS-CoV-2 specific antibodies in COVID-19 patients are still unclear.In this paper,we attempted to find potential key factors correlated with SARS-CoV-2 specific antibodies.Transcriptional analysis with the peripheral blood mononuclear cells(PBMCs)revealed proportional changes of immune cell subsets in COVID-19 convalescent patients,including a substantial decrease of monocytes and evident increase of dendritic cells(DCs).Moreover,we found that the gene expressions of chemokines associated with monocyte/macrophage were significantly up-regulated during the COVID-19 recovery phase.Most importantly,we found a set of 27 immune genes corresponding to a comparatively lower amount of SARS-CoV-2 specific antibodies,and identified two hub genes,IL1βand IL6,the protein expressions of which exhibited negative correlation with the immunoglobulin G(IgG)levels in COVID-19 convalescent sera.In addition,we found that high expressions of these 2 hub genes during the convalescent stage were negatively associated with the plasma cell marker CD138.Our study presented two key inflammatory factors correlated to the low level of SARS-CoV-2 specific antibodies,which indicated the potential regulatory process of plasmatic antibodies levels in some COVID-19 convalescent patients.