ObjectiveTo observe the expression of vascular endothelial growth inhibitor (VEGI, TL1A), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in diabetes rats' serum, vitreous and retina, and discuss the role of VEGI in the pathogenesis of diabetic retinopathy (DR). MethodsA total of p70 adult male Wistar rats were randomly divided into 4 groups, the control group (10 rats), the diabetes mellitus (DM) 1 month group (20 rats), the DM 3 month group (20 rats) and the DM 6 month group (20 rats). Cytokines of serum and vitreous were determined by enzyme-linked immunosorbent assay (ELISA), and the concentrations of the cytokines in the retina were determined by immunohistochemistry on paraffin retinal sections. Hematoxylin-eosin (HE) staining of retina was used to estimate the pathological change of DR. The results were analyzed by one-way analysis of variances, independent samples t-test and LSD test. ResultsThe serum TL1A levels of the control group, the DM 1 month group, the DM 3 month group and the DM 6 month group rats were (92.09±2.05), (118.36±8.30), (85.90±7.51) and (78.90±4.88) ng/L respectively, the level of TL1A in serum of the DM 1 month group, the DM 3 month group and the DM 6 month group were significantly lower than that of the control group (F=77.405, P < 0.05). The concentration of serum TNF-α and IL-1β increased after DM model was established (F=3.508, 15.416; P < 0.05); the VEGF level in serum showed no difference between the groups (F=1.242, P > 0.05). The vitreous TL1A levels of the control group, the DM 1 month group, the DM 3 month group and the DM 6 month group were (91.50±8.18), (67.03±6.74), (47.44±4.92) and (46.01±4.62) ng/L respectively, every DM groups showed significant difference with the control group (F=114.777, P < 0.05); VEGF level in vitreous increased from 1 month after DM model was established (F=8.816, P < 0.05); TNF-α and IL-1β level in vitreous also showed an upward tendency (F=4.392, 3.635; P < 0.05). Paraffin section immunohistochemistry showed that the absorbance (also called optical density) of TL1A of the DM 1 month group and the DM 3 month group were significantly lower than that of the control group (t=6.851, 6.066; P < 0.05), but the DM 6 month group showed no difference with the control group (t=1.401, P > 0.05); the level of VEGF and TNF-α in DM groups were higher than that of the control group (tVEGF=-4.709, -16.406, -9.228; tTNF-α=-4.703, -6.583, -17.762; P < 0.05); the level of IL-1β were significantly higher in the DM 1 month group and the DM 6 month group (t=-4.108, -3.495; P > 0.05); but the DM 3 month showed no difference with the control group (t=-0.997, P > 0.05). HE staining of retina showed that the retina of the control group and the DM 1 month group had normal retinal structures, the DM 3 month group had retinal edema and disorganization, the DM 6 month group had severe retinal edema, deep stain of ganglion cells, and more neovascularization in inner plexiform layer. ConclusionVEGI is involved in the pathogenesis of DR, and it might interacts with VEGF, TNF-α and IL-1β to affect the development of DR.
Objective To observe the changes in the number and activity of endothelial progenitor cell (EPC) from peripheral blood in patients with diabetic retinopathy (DR). Methods Twelve patients with DR (DR group), 18 patients with diabetic mellitus (DM) without DR (DM group), and 15 patients with age-related cataract without DM (control group) were enrolled in this study. Peripheral blood mononuclear cells were isolated by density gradient centrifugation. After 10 days culture, positive rate of EPC was counted by flow cytometry, proliferation, adhesion and migration activities were assayed by MTT chromatometry, adhesion activity assay essay and Transwell assay. Results Flow cytometric test showed that positive rate of EPC in patients of DR group, DM group and control group was (37.370plusmn;2.501)%, (30.130plusmn;3.245)% and (45.190plusmn;1.287)%. There was a significant difference between these three groups (F=27.690, P=0.001). MTT chromatometry showed that A-values of DR group, DM group and control group were 0.330plusmn;0.047, 0.225plusmn;0.042 and 0.120plusmn;0.029. There was a significant difference between these three groups(F=29.327，P=0.000). Adhesion activity assay essay showed that EPC numbers in DR group, DM group and control group were 76.400plusmn;7.503, 51.167plusmn;6.646 and 26.500plusmn;7.853. There was a significant difference between these three groups (F=56.612, P=0.000). Transwell assay showed that EPC numbers in DR group, DM group and control group were 23.600plusmn;6.504, 20.833plusmn;4.491 and 12.000plusmn;2.944. There was a significant difference between these three groups (F=6.477, P=0.012). Conclusion EPC from peripheral blood in patients with DR exhibit reduced numbers and impaired proliferation, adhesion and migration activity.
Objective To observe the clinical features and prognosis of endogenous bacterial endophthalmitis (EBE). Methods Ten eyes of 10 patients diagnosed with unilateral EBE were retrospectively reviewed, including 7 males and 3 females. The mean age was 57.6±10.8 years old. Eight patients were with diabetes and 7 of them were diagnosed over 5 years. There were 3 patients with hepatocirrhosis, 1 patient with hypertension, and 1 patient with coronary disease. Nine cases had infectious diseases, including liver abscess (7 cases), pulmonary infection (3 cases), erysipelas (1 case) and perianal abscess (1 case). Seven cases had fever history. Culture and drug sensitive tests for aerobic bacteria, anaerobic bacteria and fungal were performed for 9 eyes using vitreous samples from the procedures of vitrectomy and/or intravitreal injection. All patients were treated with broad-spectrum antibiotics and adjusted for drug use according to microbiological culture and drug sensitivity test results. After the diagnosis was established, vitrectomy combined with lens removal was performed in 5 hours (3 eyes) and 24 hours (5 eyes); Vitreous tamponade of C3F8 (1 eye) and silicone oil (7 eyes) was used; At the end of the operation, 0.1 ml vancomycin (1 mg) and 0.1 ml ceftazidime (1 mg) were injected into the vitreous cavity. One eye received intravitreal injection of 0.1 ml vancomycin (1 mg) and 0.1 ml ceftazidime (mg), one eye received evisceration. During the follow up period from 6 to 24 months, visual function, slit lamp and fundus examinations were performed at each office visit. Results All patients complained of blurred vision and 5 patients had ocular pain. The visual acuity was no light perception (3 eyes), light perception (5 eyes); hand motion (1 eye) and 0.1 (1 eye). Corneal edema was found in all 10 eyes; hypopyon in 8 eyes; diffuse vitreous opacity in 10 eyes, including 3 eyes with retinal detachment. For 8 eyes treated by vitrectomy and intravitreal injection, 1 eye was eviscerated due to uncontrolled inflammation. The eye treated with intravitreal injection was enucleated for its uncontrolled inflammation. For 9 eyes received vitreous culture and drug testing, 8 eyes (88.9％) had positive results, including 5 eyes with Klebsiellar pneumonia, and 1 eye with Staphylococcus aureus, or Streptococcus agalactiae or Enterococcus faecalis respectively. At last office visit, 2 eyes were with no light perception; 4 eyes were with hand motion; and 1 eye with visual acuity of 0.1. Conclusions Most of the patients with endogenous bacterial endophthalmitis have systemic predisposing factors. Klebsiella pneumoniae is the leading cause of ocular EBE. Vitrectomy combined with intravitreal injection of antibiotics showed efficacy in treating EBE.