ObjectiveTo investigate the effects and mechanisms of G protein-coupled receptor 91 (GPR91) on blood-retinal barrier (BRB) in diabetic rats. MethodsA lentiviral vector of shRNA targeting rat GPR91 and scrambled shRNA were constructed. Healthy male Sprague-Dawley (SD) rats were selected in this study. The 60 rats were randomized into 4 groups and treated as follows:(1) control group (Group A, n=15), the rats received injections of an equal volume of 0.1% citrate buffer; (2) streptozocin (STZ) group (Group B, n=15), the rats received injections of STZ; (3) LV.shScrambled group (Group C, n=15), diabetic rats received an intravitreal injection of 1 μl 1×108 TU/ml scrambled shRNA lentiviral particles at 2 weeks after the induction of diabetes; (4) LV.shGPR91 group (Group D, n=15), diabetic rats received an intravitreal injection of 1 μl 1×108 TU/ml pGCSIL-GFP-shGPR91 lentiviral particles. At 12 weeks after intravitreal injection, immunohistochemistry and Western blot were used to assess the expression of GPR91, p-extracellular signal-regulated kinase(ERK)1/2, t-ERK1/2, p-Jun N-terminal kinase (JNK), t-JNK, p-p38 mitogen-activated protein kinase (MAPK) and t-p38 MAPK. Haematoxylin and eosin (HE) staining and Evans blue dye were used to assess the structure and function of the retinal vessel. Immunohistochemistry enzyme-linked immunosorbent assay (ELISA) was used to test the protein level of VEGF. ResultsImmunohistochemistry staining showed that GPR91 was predominantly localized to the cell bodies of the ganglion cell layer. Western blot showed that GPR91 expression in Group D decreased significantly compared with Group C (F=39.31, P < 0.01). HE staining showed that the retina tissue in Group B and C developed telangiectatic vessels in the inner layer of retina, while the telangiectatic vessels attenuated in Group D. It was also demonstrated in Evans blue dye that the microvascular leakage in Group D decreased by (33.8±4.11)% compared with Group C and there was significant difference (F=30.35, P < 0.05). The results of ELISA showed the VEGF secretion of Group B and C increased compared with Group A and the VEGF expression in Group D was significantly down regulated after silencing GPR91 gene (F=253.15, P < 0.05).The results of Western blot indicated that compared with Group A, the expressions of p-ERK1/2, p-JNK and p-p38 MAPK were significantly upregulated (q=6.38, 2.94, 3.45;P < 0.05). Meanwhile, the activation of ERK1/2 was inhibited by GPR91 shRNA and the difference was statistically significant (F=22.50, P < 0.05). ConclusionsThe intravitreal injection of GPR91 shRNA attenuated the leakage of BRB in diabetic rats. GPR91 regulated the VEGF release and the leakage of BRB possibly through the ERK1/2 signaling pathway.
Retinal blood vessels are the only circulatory system that can be observed under non-invasive conditions. By observing the morphological changes of retinal blood vessels, the changes of blood circulation can be indirectly reflected. The occurrence, development and evolution of different diseases can be discovered. With the development of new detection technologies, especially the wide application of fundus photography and optical coherence tomography, a more intuitive and non-invasive quantitative index is provided for retinal vascular measurement. It is important for the diagnosis, guiding treatment and follow-up of related vascular diseases. This article reviews the development of retinal vessel diameter measurement methods and related applications in clinical diagnosis and treatment.
Objective To review the clinical operation methods of abdominal incisional hernia. Methods Classification, operation method and fellow-up of 78 patients with abdominal incisional hernia were retrospectively analyzed. Results The average time of fellow-up was 26 months. Nineteen cases were repaired with simple suture with 3 cases (15.8%) recurrence, 57 cases were repaired with man-made material with 2 case (3.4%) recurrence. Conclusions Individual operation method should be chosen according to body condition, classification of the size of abdominal loss and abdominal hypertension. It is an effective method to repair the hernia of abdominal incision with man-made material.
目的 观察运用两种不同缝线固定修补材料对疝修补术后的复发、切口感染、慢性疼痛等并发症发生情况。方法 对2008年4月至2010年4月期间笔者所在科室收治的250例腹股沟疝患者行无张力疝修补手术时,采用多股丝线或可吸收合成缝线固定修补材料进行前瞻性对比研究。结果 2组患者术后疝复发、切口感染和切口疼痛(包括慢性疼痛)发生率间的差异均无统计学意义(P>0.05)。结论 腹股沟疝无张力修补术后的复发、切口感染、慢性疼痛等并发症的发生与缝线选择无关。术者的操作技巧、严格的无菌操作原则、彻底止血以及组织损伤小才是防止术后感染、慢性疼痛等并发症发生的重要因素。
Objective To investigate the relationship between glomerular filtration rate (GFR) and diabetic retinopathy (DR) and macular thickness in patients with type 2 diabetes mellitus (T2DM). Methods A total of 161 T2DM inpatients were enrolled in this study. There were 95 males (95 eyes) and 66 females (66 eyes), with an average age of (62.2±11.0) years. The average duration of diabetes was (14.8±7.9) years. The patients were grouped according to the degree of DR. Among them, 91 patients were no DR, 24 patients were mild non-proliferative DR (NPDR), 24 patients were moderate NPDR, 13 patients were severe NPDR and 9 eyes were proliferative DR (PDR). Severe NPDR and PDR were combine into severe DR group for statistical analysis. All patients underwent direct ophthalmoscope, fundus colorized photography, spectral domain optical coherence tomography (SD-OCT), fasting blood-glucose, glycated hemoglobin and renal function examinations. GFR was evaluated by99 mTcDTPA. DR degree was evaluated by direct ophthalmoscope and fundus colorized photography. Central subfield (CSF), central macular volume and mean retinal thickness (MRT) were measure by SD-OCT. The correlation between GFR and DR staging and macular retinal thickness were analyzed by Spearman correlation analysis and Pearson correlation analysis. Logistic regression analysis was used to analyze the correlation between GFR and presence of DR. Results GFR was gradually decreased in patients with no DR, mild NPDR, moderate NPDR and severe DR (F=12.32,P<0.001). Pearson correlation analysis demonstrated that GFR was negatively correlated to CSF (r=−0.202,P=0.010); but no correlation with MRT (r=−0.087,P=0.272). Spearman correlation analysis demonstrated that GFR was negatively correlated to DR staging (r=−0.325,P<0.001). The difference of DR prevalence rate in normal, slight abnormal renal function and renal insufficiency patients was significant (χ2=12.32,P=0.002). Logistic regression analysis demonstrated that lower levels of GFR was significantly associated with presence of DR (95% confidence interval=1.71–4.32, odds ratio=2.72,P<0.001). Conclusion In T2DM patients, GFR is negatively correlated to DR staging and CSF. Lower GFR is independent risk factors for DR.