Background: The goal of the present study was to analyze the macular microvacular network in mild cognitive impirment (MCI) and Alzheimer disease (AD). Methods: Twelve patients with AD and 19 patients with MCI were recruited together with 21 cognitively normal controls with a similar range of ages. Optical coherence tomography angiography was used to image the retinal microvascular network at the macular region, including retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP). Fractal analysis (box counting, D box ) representing the microvascular density was performed in different annular zones and quadrantal sectors. The macular ganglion cell–inner plexiform layer (GC-IPL) thickness was measured using Zeiss OCT. The relationship between the retinal microvasculature and clinical manifestations was analyzed. Results: Patients with AD had lower densities of RVN, SVP, and DVP in the annulus, from 0.6 to 2.5 mm in diameter ( P < 0.05) in comparison with controls. Patients with MCI had lower density of DVP in the superior nasal quadrant ( P < 0.05) than that of the controls. There were no significant differences of GC-IPL thickness among groups ( P > 0.05). There was a trend of vascular density loss from control to MCI then AD ( P < 0.05). Retinal microvascular density of DVP was correlated with GC-IPL thickness ( P < 0.05) in patients with AD, but not in patients with MCI and controls. Conclusions: Patients with AD had less density of retinal microvascular networks than controls. Our findings suggest the presence of retinal microvascular dysfunction in AD.
Tumor vaccine inducing effective and perdurable antitumor immunity has a great potential for cancer prevention and therapy. The key indicator for a successful tumor vaccine is to boost the immune system to produce more memory T cells. Although many tumor vaccines have been designed in the past two decades, few of them involve actively regulating immune memory CD8+T cells. The behavior of tumor-associated antigens (TAA) in stimulating the immune system is related to the formation of immune memory. At the same time, the metabolic pattern of memory CD8+T cells changed significantly compared to effector T cells. Here we present a tumor vaccine vector (TA-Met@MS) by encapsulating tumor antigen (TA, the whole tumor cell antigen induced with photothermal-therapy (PTT) as a TAA model), metformin (Met, an activator of AMP-activated protein kinase (AMPK)) and Hollow gold nanospheres (HAuNS, with photothermal conversion effect in the near infrared (NIR) region) into poly (lactic-co-glycolic acid) (PLGA) microspheres. TA via the treatment with PTT showed high immunogenicity and immune-adjuvant effectiveness. We found that NIR light-mediated photothermal effect lead to a pulsed-release behavior of TA and Met from the microspheres, based on their sustained release. The released TA regulated primary T cell expansion and contraction, and stimulated the production of effector T cells at the early immunization stage. The metabolic behavior of the cells was then intervened from glycolysis into fatty acids oxidation (FAO) through the activation of AMPK mediated by the released Met, which enhanced cell survival and facilitated the differentiation of memory CD8+T cells. Our study may present a valuable insight to design tumor vaccine for enhanced cancer prevention and therapy.
Purpose: Wide-field (WF) swept-source (SS) optical coherence tomography angiography (SS-OCTA) was used to image diabetic tractional retinal detachments (TRDs) before and after pars plana vitrectomy. The clinical utility of SS-OCTA was assessed. Methods: Patients with diabetic TRDs were imaged prospectively with SS-OCTA. Ultrawide-field imaging was obtained when possible. Postoperative WF SS-OCTA imaging was performed. Results: From January 2018 through December 2019, 31 eyes of 21 patients with diabetic TRDs were imaged. Wide-field SS-OCTA en-face images captured all areas of TRD and fibrovascular proliferation within the posterior pole that were visualized on ultrawide-field imaging. Optical coherence tomography angiography B-scans revealed the vascularity of preretinal membranes and identified areas of vitreoretinal traction and posterior vitreous detachment. Ten eyes underwent pars plana vitrectomy. Postoperative SS-OCTA imaging demonstrated removal of fibrovascular membranes, relief of traction, and resolution of TRDs. Retinal ischemia before and after surgical repair appeared similar. Conclusion: All clinically relevant features of diabetic TRDs were identified at baseline and assessed longitudinally after pars plana vitrectomy using WF SS-OCTA, which showed resolution of vitreoretinal traction and no apparent change in the status of retinal perfusion after surgery. If the media are clear and fixation is adequate, WF SS-OCTA is likely the only imaging modality needed for the diagnosis and longitudinal evaluation of diabetic TRDs.
Objective:To investigate the clinical curative effect of acupuncture therapy for the treatment of acute ankle sprains.Methods:Eighty-seven patients with acute ankle sprains were studied,male 28 cases,while female 59 cases;ranging in age from 19 to 46 years with a median of 37 years;ranging from 2 to 24 hrs with a median of 7 hrs in time intervals from injury to treatment.The patients were randomly divided into 2 groups according to visiting sequence,43 cases in the acupuncture group were administrated with acupuncture therapy of Chifeng Yingyuan,while the others in the voltaren group were administrated with external application of voltaren emulsion.After two-week treatment,the improvements in pain,swelling and function of ankle joint were observed,and the symptoms and signs scores of ankle joint were compared between the 2 groups before the treatment and after the treatment.Results:Before the treatment,there were no statistical differences in ankle pain scores[(4.00±1.06)points,(3.96±1.22)points],swelling scores[(3.91±1.15)points,(3.86±1.25)]points],dysfunction scores[(4.37±1.32)points,(3.95±1.32)points]and total scores[(12.28±3.22)points,(11.82±3.68)points]between the 2 groups respectively(t=0.183,P=0.855;t=0.168,P=0.867;t=1.466,P=0.146;t=0.621,P=0.536).After two-week treatment,the ankle pain scores[(1.40±1.27)points,(2.46±1.50)points],swelling scores[(1.53±1.22)points,(2.41±1.58)points],dysfunction scores[(2.09±1.37)points,(2.18±1.54)points]and total scores[(5.02±2.87)points(7.09±4.08)points] of the 2 groups declined compared with those before the treatment[(t=18.377,P=0.000;t=11.358,P=0.000);(t=17.276,P=0.000;t=10.708,P=0.000);(t=12.436,P=0.000;t=18.314,P=0.000);(t=24.363,P=0.000;t=22.886,P=0.000)].Furthermore,there was a bigger decline in pain scores,swelling scores,dysfunction scores and total scores in acupuncture group compared to voltaren group[(2.60±0.92)points,(1.50±0.87)points,t=5.706,P=0.001;(2.37±0.90)points,(1.45±0.90)points,t=4.751,P=0.001;(2.28±1.20)points,(1.77±0.64)points,t=2.443,P=0.017;(7.26±1.95)points,(4.73±1.37)points,t=7.004,P=0.001].Conclusion:Acupuncture therapy can effectively relieve the pain,reduce swelling and improve ankle functions in the treatment of acute ankle sprains,so it is worthy of popularizing in clinic.
Objective: Corticosteroid-resistant secondary immune thrombocytopenia (ITP) is a challenging condition in clinical practice. This study aimed to explore the clinical and immunological characteristics of corticosteroid-resistant secondary ITP associated with connective tissue diseases (CTD-ITP). Methods: We conducted a retrospective analysis of 201 CTD-ITP patients hospitalized between 2014 and 2022. Patients were categorized as corticosteroid-resistant or corticosteroid-sensitive, and their clinical, immunological, and demographic data were compared. Logistic regression analysis was employed to identify independent predictors of corticosteroid resistance. Results: Corticosteroid resistance was observed in 27.4% of patients. Compared with the sensitive group, the resistant group exhibited a higher percentage of CD3+T cell (71.38% versus 64.70%, p=0.004) and CD3+CD8+T cell (38.55% versus 28.95%, p=0.003), but a lower percentage of CD3−CD19+ B cell (13.70% versus 22.45%, p=0.001) in peripheral blood. No significant differences were found in demographics, clinical features, or autoantibody profiles. And the multivariable logistic regression analysis showed that percentage of CD3+CD8+T cells (OR=1.117, 95% CI: 1.014-1.350, p=0.031) was independent risk factors for corticosteroid resistance in CTD-ITP patients. Conclusion: This study highlights the role of CD3+CD8+T cells in corticosteroid resistance among CTD-ITP patients, suggesting that cellular immunity plays a key role in this resistance and providing potential biomarkers for personalized treatment strategies.
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