AIM:To analyse macular microvascular alterations in myopic choroidal neovascularization(m CNV)and the efficiency of anti-vascular endothelial growth factor(antiVEGF)therapy for m CNV by optical coherence tomography an...AIM:To analyse macular microvascular alterations in myopic choroidal neovascularization(m CNV)and the efficiency of anti-vascular endothelial growth factor(antiVEGF)therapy for m CNV by optical coherence tomography angiography(OCTA).METHODS:A total of 123 patients were included in this retrospective study,divided into m CNV group,high myopia(HM)group,and normal group at the Affiliated Eye Hospital of Wenzhou Medical University from January 2017 to January 2019.Superficial vessel density,deep capillary density,foveal avascular zone(FAZ)area,A-circularity index(AI)and vessel density around the 300μm width of the FAZ region density(FD)and the area of choroidal neovascularization(CNV)lesion(only for m CNV group)were measured on 3×3 mm2 OCTA images.FAZ area was corrected for axial length.Central macular thickness(CMT)was measured on OCT in m CNV group.Compared the parameters on OCTA of 3 groups and pre-anti-VEGF and post-anti-VEGF at 1,2,3,and 6 mo follow-up in m CNV group.RESULTS:There were significant differences among 3 groups in superficial vessel density,deep capillary density and FD(P<0.05).FAZ area in HM group was smaller than normal group(P<0.05),but there was no significant difference between m CNV group and the other two group.AI increased in m CNV group(P<0.05).The mean CMT,area and flow area of CNV lesion decreased after treatment(P<0.05),while vessel density and FAZ didn’t change.The mean CMT,area and flow area of CNV lesion statistically decreased after anti-VEGF treatment in m CNV group(P<0.05),while superficial vessel density,deep capillary density and FAZ area,AI and FD didn’t change.The mean reduction ratio of lesions was 50.32%(7.07%to 100%).Lesion regression 100%was observed in 2 cases(4.88%).There was a negative correlation between the CNV lesion area and reduction ratio(r=-0.380,P=0.042)and the flow lesion area and reduction ratio(r=-0.402,P=0.030).CONCLUSION:Macular vessel density decreases,FAZ turns smaller and more irregular in m CNV eyes.AntiVEGF therapy is efficient for m CNV without affecting vessel density and FAZ,but it is unable to completely eliminate CNV lesions in most cases.The bigger m CNV lesions have lower reduction ratio.展开更多
AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configurati...AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configuration.METHODS:Twenty eyes from 20 patients with idiopathic MH were enrolled.Optical coherence tomography angiography(OCTA)images were obtained before,2 wk,1,and 3 mo after vitrectomy with internal limiting membrane peeling.Preoperative foveal avascular zone(FAZ)area and perimeter and regional vessel density(VD)in both layers were compared according to the 3-month best-corrected visual acuity(BCVA).RESULTS:The BCVA improved from 0.98±0.59(log MAR,Snellen 20/200)preoperatively to 0.30±0.25(Snellen 20/40)at 3 mo postoperatively.The preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA<20/32 group(all P<0.05).A significant reduction was observed in FAZ parameters and all VDs 2 wk postoperatively.Except for deep perifoveal VD,all VDs recovered only to their preoperative values.The postoperative FAZ parameters were lower during follow-up.Decreases in preoperative deep VDs were correlated with worse postoperative BCVA(Pearson’s r=-0.667 and-0.619,respectively).A larger FAZ perimeter(Spearman’s r=-0.524)and a lower deep perifoveal VD preoperatively(Pearson’s r=0.486)were associated with lower healing stage.CONCLUSION:The status of the deep vasculature may be an indicator of visual acuity in patients with a closed MH.Except for the deep perifoveal region,VD recovers only to preoperative levels.展开更多
The hybrid atomistic structure-based model has been validated to be effective in investigation of G-quadruplex folding.In this study,we performed large-scale conventional all-atom simulations to complement the folding...The hybrid atomistic structure-based model has been validated to be effective in investigation of G-quadruplex folding.In this study,we performed large-scale conventional all-atom simulations to complement the folding mechanism of human telomeric sequence Htel24 revealed by a multi-basin hybrid atomistic structure-based model.Firstly,the real time-scale of folding rate,which cannot be obtained from the structure-based simulations,was estimated directly by constructing a Markov state model.The results show that Htel24 may fold as fast as on the order of milliseconds when only considering the competition between the hybrid-1 and hybrid-2 G-quadruplex conformations.Secondly,in comparison with the results of structure-based simulations,more metastable states were identified to participate in the formation of hybrid-1 and hybrid-2 conformations.These findings suggest that coupling the hybrid atomistic structure-based model and the conventional all-atom model can provide more insights into the folding dynamics of DNA G-quadruplex.As a result,the multiscale computational framework adopted in this study may be useful to study complex processes of biomolecules involving large conformational changes.展开更多
AIM:To investigate the feasibility of teaching minimally invasive vitreoretinal surgery with a robot-assisted surgical system and a three-dimensional(3D) visualization system.METHODS:Enucleated porcine eyes were estab...AIM:To investigate the feasibility of teaching minimally invasive vitreoretinal surgery with a robot-assisted surgical system and a three-dimensional(3D) visualization system.METHODS:Enucleated porcine eyes were established as an animal model for removing foreign bodies.Forty medical students were recruited to remove foreign bodies to compare the traditional microscope and the 3D system.One junior resident performed the surgical task with manual and robot-assisted operations on 20 porcine eyes for each group.One senior surgeon evaluated the retinal invasion by a graded injury degree.The learning curve for minimally invasive vitreoretinal surgery was described.RESULTS:Compared with the robot-assisted group,the injury degree was higher in the manual group.For the first ten surgeries,the manual and robot-assisted groups had injuries of 2.60±1.35(4 to 0) and 1.80±1.62(4 to 0),respectively.For the last ten surgeries,the injury degrees were 1.90±1.20(3 to 0) and 0.80±0.42(1 to 0).Considering the manual and robot-assisted groups together,95%,75% and 60% of the students considered surgical manipulation with the 3D visualization system to be more comfortable,easier and clearer,respectively.CONCLUSION:The robot-assisted surgical system and 3D visualization system may have value in teaching minimally invasive vitreoretinal surgery.展开更多
AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.MET...AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.展开更多
基金Supported by Medical and Health Platform Project of Zhejiang Province(No.2021KY810)。
文摘AIM:To analyse macular microvascular alterations in myopic choroidal neovascularization(m CNV)and the efficiency of anti-vascular endothelial growth factor(antiVEGF)therapy for m CNV by optical coherence tomography angiography(OCTA).METHODS:A total of 123 patients were included in this retrospective study,divided into m CNV group,high myopia(HM)group,and normal group at the Affiliated Eye Hospital of Wenzhou Medical University from January 2017 to January 2019.Superficial vessel density,deep capillary density,foveal avascular zone(FAZ)area,A-circularity index(AI)and vessel density around the 300μm width of the FAZ region density(FD)and the area of choroidal neovascularization(CNV)lesion(only for m CNV group)were measured on 3×3 mm2 OCTA images.FAZ area was corrected for axial length.Central macular thickness(CMT)was measured on OCT in m CNV group.Compared the parameters on OCTA of 3 groups and pre-anti-VEGF and post-anti-VEGF at 1,2,3,and 6 mo follow-up in m CNV group.RESULTS:There were significant differences among 3 groups in superficial vessel density,deep capillary density and FD(P<0.05).FAZ area in HM group was smaller than normal group(P<0.05),but there was no significant difference between m CNV group and the other two group.AI increased in m CNV group(P<0.05).The mean CMT,area and flow area of CNV lesion decreased after treatment(P<0.05),while vessel density and FAZ didn’t change.The mean CMT,area and flow area of CNV lesion statistically decreased after anti-VEGF treatment in m CNV group(P<0.05),while superficial vessel density,deep capillary density and FAZ area,AI and FD didn’t change.The mean reduction ratio of lesions was 50.32%(7.07%to 100%).Lesion regression 100%was observed in 2 cases(4.88%).There was a negative correlation between the CNV lesion area and reduction ratio(r=-0.380,P=0.042)and the flow lesion area and reduction ratio(r=-0.402,P=0.030).CONCLUSION:Macular vessel density decreases,FAZ turns smaller and more irregular in m CNV eyes.AntiVEGF therapy is efficient for m CNV without affecting vessel density and FAZ,but it is unable to completely eliminate CNV lesions in most cases.The bigger m CNV lesions have lower reduction ratio.
基金Supported by the National Natural Science Foundation of China(No.81900910,No.81700884)Natural Science Foundation of Zhejiang Province(No.LQ19H120003,No.LGF21H120005)+1 种基金Key Project Jointly Constructed by Zhejiang Pronvince and Ministry(No.WKJ-ZJ-2037)Basic Scientific Research Project of Wenzhou(No.Y20210194)。
文摘AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configuration.METHODS:Twenty eyes from 20 patients with idiopathic MH were enrolled.Optical coherence tomography angiography(OCTA)images were obtained before,2 wk,1,and 3 mo after vitrectomy with internal limiting membrane peeling.Preoperative foveal avascular zone(FAZ)area and perimeter and regional vessel density(VD)in both layers were compared according to the 3-month best-corrected visual acuity(BCVA).RESULTS:The BCVA improved from 0.98±0.59(log MAR,Snellen 20/200)preoperatively to 0.30±0.25(Snellen 20/40)at 3 mo postoperatively.The preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA<20/32 group(all P<0.05).A significant reduction was observed in FAZ parameters and all VDs 2 wk postoperatively.Except for deep perifoveal VD,all VDs recovered only to their preoperative values.The postoperative FAZ parameters were lower during follow-up.Decreases in preoperative deep VDs were correlated with worse postoperative BCVA(Pearson’s r=-0.667 and-0.619,respectively).A larger FAZ perimeter(Spearman’s r=-0.524)and a lower deep perifoveal VD preoperatively(Pearson’s r=0.486)were associated with lower healing stage.CONCLUSION:The status of the deep vasculature may be an indicator of visual acuity in patients with a closed MH.Except for the deep perifoveal region,VD recovers only to preoperative levels.
基金the National Natural Science Foundation of China(Grant Nos.11504043,61671107,31670727,and 61771093)the Science Foundation of Shandong Province of China(Grant No.ZR2016JL027)+1 种基金the Taishan Young Scholars Program of Shandong Province of China(Grant No.tsqn20161049)the Youth Science and Technology Innovation Plan of Universities in Shandong,China(Grant No.2019KJE007)。
文摘The hybrid atomistic structure-based model has been validated to be effective in investigation of G-quadruplex folding.In this study,we performed large-scale conventional all-atom simulations to complement the folding mechanism of human telomeric sequence Htel24 revealed by a multi-basin hybrid atomistic structure-based model.Firstly,the real time-scale of folding rate,which cannot be obtained from the structure-based simulations,was estimated directly by constructing a Markov state model.The results show that Htel24 may fold as fast as on the order of milliseconds when only considering the competition between the hybrid-1 and hybrid-2 G-quadruplex conformations.Secondly,in comparison with the results of structure-based simulations,more metastable states were identified to participate in the formation of hybrid-1 and hybrid-2 conformations.These findings suggest that coupling the hybrid atomistic structure-based model and the conventional all-atom model can provide more insights into the folding dynamics of DNA G-quadruplex.As a result,the multiscale computational framework adopted in this study may be useful to study complex processes of biomolecules involving large conformational changes.
基金Supported by the National Natural Science Foundation of China (No.81700884,No.81900910)Zhejiang Provincial Natural Science Foundation of China (No.LGF21H120005,No.LQ19H120003)+1 种基金Key Project jointly constructed by Zhejiang Province and Ministry (No.WKJZJ-2037)Basic Scientific Research Project of Wenzhou (No.Y20210194)。
文摘AIM:To investigate the feasibility of teaching minimally invasive vitreoretinal surgery with a robot-assisted surgical system and a three-dimensional(3D) visualization system.METHODS:Enucleated porcine eyes were established as an animal model for removing foreign bodies.Forty medical students were recruited to remove foreign bodies to compare the traditional microscope and the 3D system.One junior resident performed the surgical task with manual and robot-assisted operations on 20 porcine eyes for each group.One senior surgeon evaluated the retinal invasion by a graded injury degree.The learning curve for minimally invasive vitreoretinal surgery was described.RESULTS:Compared with the robot-assisted group,the injury degree was higher in the manual group.For the first ten surgeries,the manual and robot-assisted groups had injuries of 2.60±1.35(4 to 0) and 1.80±1.62(4 to 0),respectively.For the last ten surgeries,the injury degrees were 1.90±1.20(3 to 0) and 0.80±0.42(1 to 0).Considering the manual and robot-assisted groups together,95%,75% and 60% of the students considered surgical manipulation with the 3D visualization system to be more comfortable,easier and clearer,respectively.CONCLUSION:The robot-assisted surgical system and 3D visualization system may have value in teaching minimally invasive vitreoretinal surgery.
基金Supported by National Natural Science Foundation of China(No.81700884)Scientific Research Foundation of National Health and Health Commission(No.WKJ-ZJ-2037)+1 种基金Zhejiang Public Welfare Technology Application Project(No.LGF21H120005)Science and Technology Project of Wenzhou(No.Y20190649).
文摘AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.
