Ischemia occurs in diabetic retinopathy with neuronal loss, edema, glial cell reactivity and oxidative stress. Epacs, consisting of Epac 1 and Epac2, are cAMP mediators playing important roles in maintenance of endoth...Ischemia occurs in diabetic retinopathy with neuronal loss, edema, glial cell reactivity and oxidative stress. Epacs, consisting of Epac 1 and Epac2, are cAMP mediators playing important roles in maintenance of endothelial barrier and neuronal functions To investigate the roles of Epacs in the pathogenesis of ischemic retinopathy, transient middle cerebral artery occlusion （tMCAO） was performed on Epacl-deficient （Epacl-/- ） mice, Epac2-deficient （Epac2-/-） mice, and their wild type counter-parts （Epacl＋/＋ and Epac2＋/＋）. Two-hour occlusion and 22-hour reperfusion were conducted to induce ischemia/reperfusion injury to the retina. After tMCAO, the contralateral retinae displayed similar morphology between different genotypes. Neu-ronal loss, retinal edema and increase in immunoreactivity for aquaporin 4 （AQP4）, glial fibrillary acidic protein （GFAP）, peroxiredoxin 6 （Prx6） were observed in ipsilateral retinae. Epac2 / ipsilateral retinae showed more neuronal loss in retinal ganglion cell layer, increased retinal thickness and stronger immunostaining of AQP4, GFAP, and Prx6 than those of Epac2＋/＋. However, Epacl-/- ipsilateral retinae displayed similar pathology as those in Epacl＋/＋ mice. Our observations suggest that Epac2-deficiency led to more severe ischemic retinopathy after retinal ischemia/reperfusion injury.展开更多
Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation com...Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.展开更多
基金supported by the Research Grants Council of Hong Kong(RGC)HKU 764008M to Sookja Kim Chung
文摘Ischemia occurs in diabetic retinopathy with neuronal loss, edema, glial cell reactivity and oxidative stress. Epacs, consisting of Epac 1 and Epac2, are cAMP mediators playing important roles in maintenance of endothelial barrier and neuronal functions To investigate the roles of Epacs in the pathogenesis of ischemic retinopathy, transient middle cerebral artery occlusion （tMCAO） was performed on Epacl-deficient （Epacl-/- ） mice, Epac2-deficient （Epac2-/-） mice, and their wild type counter-parts （Epacl＋/＋ and Epac2＋/＋）. Two-hour occlusion and 22-hour reperfusion were conducted to induce ischemia/reperfusion injury to the retina. After tMCAO, the contralateral retinae displayed similar morphology between different genotypes. Neu-ronal loss, retinal edema and increase in immunoreactivity for aquaporin 4 （AQP4）, glial fibrillary acidic protein （GFAP）, peroxiredoxin 6 （Prx6） were observed in ipsilateral retinae. Epac2 / ipsilateral retinae showed more neuronal loss in retinal ganglion cell layer, increased retinal thickness and stronger immunostaining of AQP4, GFAP, and Prx6 than those of Epac2＋/＋. However, Epacl-/- ipsilateral retinae displayed similar pathology as those in Epacl＋/＋ mice. Our observations suggest that Epac2-deficiency led to more severe ischemic retinopathy after retinal ischemia/reperfusion injury.
文摘Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.
