Resolution of siderotic glaucoma correlated with decreased pigmentation in the anterior chamber angle after removal of a retained ferrous foreign body

Dear Sir,I am Dr.Zhe Xu,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.We write to present a case of resolution of siderotic glaucoma after removal of a retained ferrous foreign body.This study has been performed in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Second Affiliated Hospital.

Melatonin ameliorates tau-related pathology via the miR-504-3p and CDK5 axis in Alzheimer’s disease

Background:Intracellular accumulation of the microtubule-associated protein tau and its hyperphosphorylated forms is a key neuropathological feature of Alzheimer’s disease(AD).Melatonin has been shown to prevent tau hyperphosphorylation in cellular and animal models.However,the molecular mechanisms by which melatonin attenuates tau hyperphosphorylation and tau-related pathologies are not fully understood.Methods:Immunofluorescence,immunoblotting analysis and thioflavin-S staining were employed to examine the effects of early and late treatment of melatonin on tau-related pathology in hTau mice,in which nonmutated human tau is overexpressed on a mouse tau knockout background.High-throughput microRNA(miRNA)sequencing,quantitative RT-PCR,luciferase reporter assay and immunoblotting analysis were performed to determine the molecular mechanism.Results:We found that both early and late treatment of melatonin efficiently decreased the phosphorylation of soluble and insoluble tau at sites related to AD.Moreover,melatonin significantly reduced the number of neurofibrillary tangles(NFTs)and attenuated neuronal loss in the cortex and hippocampus.Furthermore,using miRNA microarray analysis,we found that miR-504-3p expression was upregulated by melatonin in the hTau mice.The administration of miR-504-3p mimics dramatically decreased tau phosphorylation by targeting p39,an activator of the well-known tau kinase cyclin-dependent kinase 5(CDK5).Compared with miR-504-3p mimics alone,co-treatment with miR-504-3p mimics and p39 failed to reduce tau hyperphosphorylation.Conclusions:Our results suggest for the first time that melatonin alleviates tau-related pathologies through upregulation of miR-504-3p expression by targeting the p39/CDK5 axis and provide novel insights into AD treatment strategies.

Chinese Medicine for Idiopathic Parkinson's Disease:A Meta Analysis of Randomized Controlled Trials

Objective：To evaluate the efficacy of Chinese medicine（CM）adjunct to conventional medications for idiopathic Parkinson’s disease（PD）.Methods：Electronic English and Chinese databases including Pub Med,Cochrane Library,Web of Science,Chinese Medical Current Contents,China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Med Database,and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy.The extracted data was analyzed by the Review Manager 5.0.Results：Twelve trials involving 869 participants were included in the meta-analysis.Unified PD Rating Scale（UPDRS）Ⅰ,Ⅱ,Ⅲ,Ⅳscores and UPDRSⅠ–Ⅳtotal scores were used to be the primary outcomes,Parkinson Disease Question-39（PDQ-39）and Scores of Chinese Medical Symptoms were the secondary outcomes.CM adjunct therapy had greater improvement in UPDRSⅠ[2 trials;standardized mean difference（SMD）–0.40,95%confidence interval（CI）–0.71 to–0.09;Z=2.49（P=0.01）],Ⅱ[5 trials;SMD–0.47,95%CI–0.69 to–0.25;Z=4.20（P〈0.01）],Ⅲ[5 trials;SMD-0.35,95%CI–0.57 to–0.13;Z=3.16（P=0.002）],Ⅳscores[3 trials;SMD-0.32,95%CI–0.60 to–0.03;Z=2.17（P=0.03）],UPDRSⅠ–Ⅳtotal scores[7 trials;SMD-0.36,95%CI–0.53 to–0.20;Z=4.24（P〈0.05）].PDQ-39 and Chinese medical symptoms compared to the conventional medication only.Conclusion：CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.

Sleep fragmentation as an important clinical characteristic of sleep disorders in Parkinson's disease: a preliminary study

Background:Sleep disorders are one of the earliest non-motor symptoms of Parkinson's disease (PD).Sleep disorders could,therefore,have value for recognition and diagnosis in PD.However,no unified classification and diagnostic criteria exist to evaluate sleep disorders by polysomnography (PSG).Utilizing PSG to monitor sleep processes of patients with PD and analyze sleep disorder characteristics and their relationship with demographic parameters could aid in bridging this gap.This preliminary study aimed to evaluate the clinical characteristic of sleep disorders in PD using PSG.Methods:PSG was used to evaluate sleep disorders in 27 patients with PD and 20 healthy volunteers between August 2015 and July 2018 in Fujian Medical University Union Hospital.Total sleep time (TST),sleep efficiency (SE),total wake time,and other parameters were compared between the two groups.Finally,the correlation between sleep disorders and age,disease duration,Unified Parkinson's Disease Rating Scale-Ⅲ scores,Hoehn-Yahr stage,and levodopa dose were analyzed.The main statistical methods included Chi-square test,two independent samples t test,Fisher exact test,and Pearson correlation.Results:Sleep fragmentation in the PD group was significantly increased (74.1%) while difficulty falling asleep and early awakening were not,as compared to healthy controls.No significant differences were found in time in bed,sleep latency (SL),non-rapid eye movement (NREM) stage 1 (N1),N1%,N2,N2%,N3%,and NREM% between PD and control groups;but TST (327.96± 105.26 min vs.414.67 ± 78.31 min,P =0.003),SE (63.26%± 14.83% vs.76.8%± 11.57%,P =0.001),R N3 (20.00 [39.00] min vs.61.50 [48.87] min,P=0.001),NREM (262.59 ± 91.20 min vs.337.17± 63.47 min,P=0.003),rapid-eyemovement (REM)(32.50 [33.00] min vs.85.25 [32.12] min,P < 0.001),REM%(9.56 ± 6.01 vs.15.50 ± 4.81,P =0.001),REM sleep latency (157.89 ± 99.04 min vs.103.47 ± 71.70 min,P =0.034) were significantly reduced in PD group.Conclusion:This preliminary study supported that sleep fragmentation was an important clinical characteristic of sleep disorders in PD.Whether sleep fragmentation is a potential quantifiable marker in PD needs to be further investigated in the future study.

Relationship between composite hydration volume (Intravenous plus oral) and contrast-induced nephropathy after emergent percutaneous coronary intervention

Background Few studies have investigated the safe limits of total intravenous plus oral hydration to prevent contrast-induced nephropathy （CIN）. The present study was conducted to evaluate the effects of different composite hydration rate （intravenous plus oral） on CIN prevention in patients undergoing emergent percutaneous coronary intervention （PCI）. Methods This was a retrospective observational study that included 307 eligible patients, who were stratified into quartiles of rate of the composite hydration volumn to body weight and time （HV/ W/T）. CIN was defined as an absolute≥0.5 mg/dL or a relative ≥25% increase in the serum creatinine level within 72 hours after the procedure. Results In terms of risks of CIN, there were no statistical differences among individuals in four groups with different composite HV/W/T （27.6%, 19.0%, 23.0%, and 26.9% respectively in quartiles Q1, Q2, Q3, and Q4, P=0.565）. Additionally, higher composite hydration ratio seemed not to decrease the risk of in-hospital death, worsening heart failure and stroke （all P〉0.05）. After adjusting for other risk factors, multivariate analysis showed no statistical difference between Q2, Q3 or Q4, compared with Q1 （Q2 vs. QI： adjusted odds ratio [OR], 0.67, P=0.383; Q3 vs QI： adjusted OR, 0.77, P=0.550; Q4 vs. QI： adjusted OR, 0.75, P= 0.489）. Conclusion Excessive composite hydration may not provide supplemental benefit of CIN prevention and in-hospital outcomes in patients following emergent PCI, and moderate and prophylactic hydration is warranted.