Comparison of anti-inflammatory effects of intense pulsed light with tobramycin/dexamethasone plus warm compress on dry eye associated meibomian gland dysfunction

AIM: To compare the anti-inflammatory effects of intense pulsed light(IPL) with tobramycin/dexamethasone plus warm compress through clinical signs and cytokines in tears.METHODS: Eighty-two patients with dry eye disease(DED) associated meibomian gland dysfunction(MGD) were divided into two groups. Group A was treated with IPL, and Group B was treated with tobramycin/dexamethasone plus warm compress. Ocular Surface Disease Index(OSDI), tear film breakup time(TBUT), corneal fluorescein staining(CFS), meibomian gland expressibility(MGE), meibum quality, gland dropout and tear cytokine levels were evaluated before treatment, 1 wk and 1 mo after treatment. RESULTS: TBUT in Group A was higher(P=0.035), and MGE score was lower than Group B at 1 mo(P=0.001). The changes of interleukin(IL)-17 A and IL-1β levels in tears were lower in Group A compared with that in Group B at 1 wk after treatment(P=0.05, P=0.005).CONCLUSION: Treatment with IPL can improve TBUT and MGE and downregulate levels of IL-17 A and IL-1β in tears of patients with DED associated MGD better than treatment with tobramycin/dexamethasone plus warm compress in one-month treatment period.

The Impact of Lipid-metabolizing Genetic Polymorphisms on Body Mass Index and Their Interactions with Soybean Food Intake: A Study in a Chinese Population

Objective To evaluate the association of known polymorphisms in the lipid metabolic pathway with body mass index （BMI）, and estimate their interactions with soybean food intake. Methods A community-based cross-sectional survey was conducted in a Chinese Han population. BMI, soybean food intake, and single nucleotide polymorphisms of rs599839, rs3846662, rs3846663, rs12916, rs174547, rs174570, rs4938303, and rs1558861 were measured in 944 subjects. A multivariate logistic regression was used to analyze the association of the studied polymorphisms with BMIs. The expectation-maximization algorithm was employed to evaluate the extent of linkage disequilibrium between pairwise polymorphisms. The gene-environment interaction was assessed in the general multifactor dimensionality reduction model. Results The polymorphisms of rs3846662 and rs3846663 were associated with 10% highest BMIs when comparing to the 10% lowest values both in individuals and haplotype-based association tests. Although no statistically significant gene-environment interactions were found, people with the haplotype composed of C allele in rs3846662 and T allele in rs3846663 and low frequency of soybean intake had significantly hisher risk to overweight and obesity as compared with those with the haplotype consisting of T allele in rs3846662 and C allele in rs3846663 and highly frequent soybean food intake, with an odds ratio of 1.64 （95% confidence interval： 1.15-2.34, P〈0.01） after adjusting for the common confounders. Conclusion Our study has sugsested that rs3846662 and rs3846663 may be the potential candidate polymorphisms for obesity, and their effect on the pathogenesis could be mediated by the frequency of soybean food intake.

Pulmonary sarcoidosis:A novel sequelae of drug reaction with eosinophilia and systemic symptoms:A case report

BACKGROUND Drug reaction with eosinophilia and systemic symptoms(DRESS)syndrome is an uncommon yet serious adverse drug hypersensitivity reaction with the presentations including rash,fever,lymphadenopathy,and internal organ involvement.Sarcoidosis is a systematic granulomatous disease with unknown etiology.We herein report a case of pulmonary sarcoidosis secondary to allopurinol-induced DRESS.CASE SUMMARY A 37-year-old man with a history of hyperuricemia was treated with allopurinol for three weeks at a total dose of 7000 milligrams before developing symptoms including anorexia,fever,erythematous rash,and elevated transaminase.The patient was diagnosed with DRESS and was treated with prednisone for 6 mo until all the symptoms completely resolved.Three months later,the patient presented again because of a progressively worsening dry cough.His chest computed tomography images showed bilateral lung parenchyma involvement with lymph node enlargement,which was confirmed to be nonnecrotizing granuloma by pathological examination.Based on radiologic and pathological findings,he was diagnosed with sarcoidosis and was restarted on treatment with prednisone,which was continued for another 6 mo.Reexamination of chest imaging revealed complete resolution of parenchymal lung lesions and a significant reduction in the size of the mediastinal and hilar lymph nodes.Following a 6-month follow-up of completion of treatment,the patient's clinical condition remained stable with no clinical evidence of relapse.CONCLUSION This is the first case in which pulmonary sarcoidosis developed as a late complication of allopurinol-induced DRESS.The case indicated that the autoimmune reaction of DRESS may play an important role in the pathogenesis of sarcoidosis.

Regulating effect of liraglutide therapy on metabolic disorders in patients with newly diagnosed type 2 diabetes complicated with obesity

Objective: To investigate the regulating effect of liraglutide therapy on metabolic disorders in patients with newly diagnosed type 2 diabetes complicated with obesity. Methods: A total of 118 patients with newly diagnosed type 2 diabetes complicated with obesity who were treated in the hospital between September 2014 and January 2017 were collected and divided into the control group (n=59) and observation group (n=59) by random number table. Control group received metformin therapy and the observation group received liraglutide therapy. The differences in levels of glucose metabolism indexes, lipid metabolism indexes and inflammatory factors were compared between the two groups before and after 4 months of treatment. Results: Before treatment, the differences in serum levels of glucose metabolism indexes, lipid metabolism indexes and inflammatory factors were not statistically significant between the two groups. after 4 months of treatment, serum FPG, FIN, F-CP, TC, TG, IL-1β, IL-6, CRP and TNF-α levels of both groups of patients were lower than those before treatment while HDL-C levels were higher than those before treatment, and serum FPG, FIN, F-CP, TC, TG, IL-1β, IL-6, CRP and TNF-α levels of observation group were lower than those of control group while HDL-C level was higher than that of control group. Conclusion:Liraglutide therapy can effectively optimize the glucose lipid metabolism and reduce the microinflammatory response in patients with type 2 diabetes mellitus complicated with obesity.

Antimicrobial activity of linezolid combined with minocycline against vancomycin-resistant Enterococci

Background Vancomycin-resistant Enterococci （VRE） cause serious infections that are difficult to treat. We carried out this study to determine the mutant prevention concentration （MPC） of linezolid when combined with minocycline against VRE strains, to determine the mechanism of drug resistance in vitro, and to provide a theoretical basis for the rational use of drugs against VRE. Methods The minimum inhibitory concentrations （MICs） of linezolid and minocycline against 30 Enterococci （E.） isolates （including 20 VRE strains） were determined by the broth microdilution method. Drug interactions were assessed by the checkerboard microdilution tests and confirmed by time-kill studies. Two vancomycin-susceptible strains N27 and N40 （linezolid MIC, 2 g/ml; minocycline MIC, 4 tJg/ml） and control strains E. faecalis ATCC 29212 and ATCC 51299 were also tested. The MPCs of linezolid and minocycline （alone and combined） were determined using the agar dilution method. Strains showing stable resistance were analyzed by polymerase chain reaction （PCR） amplification of domain V of the 23S rRNA gene. Results Checkerboard titration studies revealed synergistic effects of combination therapy in 26.7% of 30 E. isolates. Antagonism was not observed, The G2576U mutation was detected in stable linezolid-resistant strains of ATCC 29212, N40, and N27 before and after resistance screening, and MIC values increased with the number of G2576U mutations. The MPC of linezolid against E. decreased dramatically when combined with minocycline, and vice versa. Conclusion Linezolid or minocycline alone produce resistant strains; however, their joint use may reduce the MPC of each agent against VRE, thereby decreasing resistant mutants and bacterial infections.

Influence of peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients on continuous ambulatory peritoneal dialysis

Background Extra glucose load in peritoneal dialysis is an important cause of newly-occurred diabetic mellitus, which initiates insulin treatment in some of the dialytic patients. The purpose of this study was to discuss the influence of the peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients who are on continuous ambulatory peritoneal dialysis （CAPD）. Methods One hundred and forty-five patients with total KTN per week over 2.0 were recruited, including 60 males and 85 females. Fasting blood glucose （FBG）, creatinine, blood urea nitrogen （BUN）, blood albumin, blood lipid profile and blood C-reactive protein （CRP） were analyzed at the beginning of the peritoneal dialysis and after 12 months. A peritoneal equilibration test （PET） was carried out at the 3rd month of CAPD, and meantime residual renal function, peritoneal solute clearance rate, ultrafiltration volume and urine volume were also evaluated. Results Twenty-one cases were identified as a low transfer group （L）, 32 cases as a low average transfer group （LA）, 58 cases as a high average transfer group （HA） and 34 cases as a high transfer group （H）. At the end of the 12th month, 83 cases had elevated FBG. Through stepwise multiple regression analysis we found the FBG level in these patients was positively related to glucose load and CRP, and negatively related to glucose absorption in the peritoneum （D/D0） and blood albumin （P 〈0.05）. Kaplan-Meier analysis during a 48-month follow-up found the morbidity of hyperglycemia to be 17/34 cases （50.1%） in the high transfer group, 20/58 cases （34.5%） in the high average transfer group, 11/32 cases （34.3%） in the low average transfer group, and 1/21 cases （5.4%） in the low transfer group. Conclusions Patients with high peritoneal transfer capacity might have the highest morbidity from hyperglycemia among patients with these four different peritoneal transfer status. Glucose load, baseline CRP and FBG level before peritoneal dialysis, and D/D0 can efficiently predict hyperglycemia in CAPD patients.