The Study Of Picture Achiving And Diagnosis System On Retinopathy Of Prematurity And Their Relationship With Neogenetic Vessel Cytokines

Background:ROP is the domestic and international pediatric and eye research hot spots.1984 International Conference ROP staging system developed ROP, retinopathy of 2003 and early preterm children to further improve the ROP cooperative group staging criteria. In recent years, foreign researchers have ROP risk factors, etiology and treatment of the foundation has carried out tests related to research and clinical practice, and achieved gratifying results. However, ROP means of checking is still not very mature. Present not only the lack of a unified, efficient, safe, universal diagnostic tool, from a clinical point of view, the incidence of ROP law of the morphological changes in retinal research can not depth.Clinical studies found that about 85% of the ROP with spontaneous regression of untreated concurrent incubation fully vascularized retina, the standard treatment to prevent the remaining 5% of the vision loss of children, about 6% to 10% of severe ROP final visual acuity of patients loss. In the end what kind of situation in the ROP with spontaneous regression, what kind of situation development and even there it will eventually lead to retinal detachment and blindness? The incidence of these rules of ROP, enable us to further understand the development trend of ROP, ROP patients to accurately selective treatment for early intervention, more effective treatment for the best time to grasp not only can prevent over-treatment, they can avoid the grasp of disease progression or even lead to improper control of the situation can not appear. Therefore, how to determine the pathological features of early ROP, objectively and accurately make a diagnosis of early ROP, and tracking and effective early intervention therapy has become the direction of domestic and foreign scholars. At present, domestic and foreign ophthalmologists mainly use binocular indirect ophthalmoscope for ROP screening, it has a three-dimensional feeling, lighting intensity, wide field of vision, clear imaging and so on, ROP screening is recognized as the "gold standard" and preferred checker. However, under the binocular indirect ophthalmoscope fundus image capture and output problems, fundus examination results can not be recorded, has been the method described by drawing the saved data, the lack of objectivity of the results. To solve this problem, although many foreign scholars have tried, but never the best way. In Guangzhou City, Guangdong Province, with the support of scientific research institutions, we use the binocular indirect ophthalmoscope fundus imaging and image output technology to check the means to establish a computer-aided inspection microscope binocular indirect ROP examination system.Mature retinal neovascularization occurs often leads to vision loss and even loss of vision. Retinal neovascularization (retinal neovascularization, RNV) more common in diabetic retinopathy, retinopathy of premature children, ischemic retinal vein occlusion, complex etiology and pathogenesis remain unclear. With the establishment of neonatal intensive care and medical care and technology advances, preterm low birth weight greatly increased the survival rate of children, premature children retinopathy (ROP) the incidence is rising, in the ultra-low-birth weight less than 10009 the incidence of birth weight in children up to 80% or more, accounting for the proportion of visual impairment in children increases every year, has attracted attention. However, the pathogenesis of the disease remains unclear, the current study shows that angiogenesis may play a leading role. Angiogenesis inhibition can be achieved the purpose of combating ROP. Thus more and more scholars start from the pathogenesis of the disease, I hope by inhibiting the growth of new blood vessels blocking the progress of the disease, which in animal studies been shown to be feasible. However, angiogenesis inhibitors also inhibit normal vascular development and hinder the normal anatomical and functional ocular development, which is not yet resolvedMost studies on the basis of ROP stays in the single-gene and gene level. However, the true physiological function of the body is the executor of protein, studies have shown that intracellular expression of mRNA and protein levels of kurtosis does not correspond exactly to the level of disease from the study of protein is of particular importance. However, the traditional single protein or several proteins in a manner difficult to study thoroughly the whole system, the formation and progression of ROP explain the basic mechanism. Complex activities you want to have a complete understanding, is bound to the overall, dynamic, network studies the protein level. Proteome is encoded by a gene set of all possible combinations of proteins. Proteomics is a genome, an organism, a cell, tissue, expressed proteins and their interactions of all of the information provided a more realistic reflection of genes, tissues, organs, the actual functional status. Cytokine antibody array technology is a concept in the protein group developed high-throughput assay method. In the diagnosis, course observation, therapeutic evaluation and monitoring cytokine therapy is important. Study help to clarify the molecular level of cytokines in functional regulation mechanisms, in particular the use of cytokine treatment of cancer, infections, hematopoietic disorders and autoimmune diseases such as had received the initial effect, has a very broad application prospectsPurpose1. This study was based on previous work, the establishment of ROP graphic reporting system, and through the analysis of retinal images, premature children to understand the morphology of retinal anatomy to explore the characteristics of retinal development in preterm children, master ROP retinal lesions, and further Clarify the incidence of ROP in the early characteristics and rules for the clinical treatment of ROP intervention time. At the same time through the reporting system of the Statistical and graphic analysis, to understand children in Guangzhou premature occurrence of retinopathy, and retinopathy found in preterm children for early treatment, and explore the prevention of the disease,2. This study intends to use angiogenesis-related cytokine antibody microarray detected in normal preterm children, ROP patients in the preoperative and postoperative serum 55-related cytokine expression, contribute to the overall perspective from the global and angiogenesis related cytokines The formation and development of ROP process.Methods1. Using computer-assisted recording of binocular indirect ophthalmoscope video premature children retinopathy screening;2. Construction of graphic diagnosis system, in a timely manner after recording the video capture, print reports3. From the report, obtained by graphic analysis of a large number of premature children retinal anatomy and morphology; 4. Random sample of normal preterm children, ROP week before and after surgery serum, blood blood on the ice after standing 1 h,0℃centrifuge 5000 r/min 10 min. Serum separated and frozen at-80℃for later use.5. RayB ioTM angiogenic cytokines in human serum antibody chip 55 may be related to the expression of cytokinesResults1. Computer-aided graphic ROP Clinical application of reporting system1). The preparatory work before the examination: Premature children need to use the five compound tropicamide eye drops, we can achieve the ideal state. ROP screening to require hospital ophthalmology, neonatal and maternal and child health in cooperation neonatology.2). Computer aided graphic ROP Analysis Reporting SystemOur results show that: "computer-assisted imaging technique of binocular indirect ophthalmoscope," to be sure to let us answer retinopathy of premature children the existence of important indicators:the presence of peripheral retinal avascular zone; vascular area and no vascular area clear dividing line between the existence of; boundaries have uplift; bump whether vascular proliferation and vascular fibrous proliferation. Therefore, we can safely diagnose whether the ROP in the premature child patients.3). While identification with other diseases (morning glory syndrome, retinoblastoma, retinal hemorrhage in preterm children, the normal peripheral retina gray), the system can provide conclusive evidence to support a permanent diagnosis.4). By studying the binocular indirect ophthalmoscope fundus imaging examination obtained video images of typical retinopathy review of work carried out in the ROP in the teaching of medical staff training. 2. Premature children with ROP normal serum cytokines in the vascular group found that 14 significantly different protein expression, premature children with ROP and normal a week after the serological examination revealed 14 differentially expressed proteins. Of which:1):Preterm children compared with normal and preoperative,1 week after laser photocoagulation for ROP in children with FGF basic, IGFBP-3 expression increased to normal from the abnormal expression of these cytokines demonstrated the pathophysiological process in the ROP an important role:retinal cell apoptosis and expression of a large number of serum IGFBP-3 may be relevant, bFGF may be the existence of further damage to retinal ganglion cells have a preventive effect? This suggests that we are in the ROP in neural development, taking into account the mutual influence and angiogenesis, considering the formation of the nervous system associated with the ROP.2):Part of the inflammatory response associated factor Amphiregulin, GMCSF, MMP-8 expression levels decreased to normal from the abnormal, and the expression of IL-1βto the slightly elevated from normal, indicating that ROP patients had a postoperative inflammatory response, but not the severity of adverse effects on children.3):PIGF can reduce pathological angiogenesis but does not affect the normal physiological angiogenesis, Vaschibin the only effect of a negative feedback mechanism for the regulation of angiogenesis protein. PIGF and Vaschibin from preoperative patients with low expression into a normal expression. Tip PIGF, Vasohibin may become an effective means of treatment of ROPConclutions1. Collate a complete set of graphic ROP diagnosis system; 2. Ciliary nerve long after the ROP screening is important to observe the anatomy;3. Application of angiogenesis-related cytokines in chip technology to obtain normal preterm children, ROP week before and after surgery in children with serum marker protein expression profiles of the experimental method is stable and feasible;4. ADAMTS-1 may be passed into histogranin, Endothelin-1β-defensin into direct and indirect, through its participation in angiogenesis effect, IGFBP-3 by stimulating the differentiation of monocytes and activation of retinal neovascularization;5. Make the nervous system may be stimulated by neuropeptide secretion of monocyte differentiation and activation of angiogenesis in the body, affecting the development of ROP. ROP nervous system involved in the proposed physiological and pathological processes point of view.6. Our results show that students in the ROP of serum cytokines in neurotransmitter-related with a large number of up-regulated expression of cytokines. This suggests that we considered in the study follow-up ROP neurotransmitter is early by participating in the development of ROP and its possible application in the clinical setting.7. ROP pathophysiology is a complex process of angiogenesis cytokines in the process of mutual adjustment.Innovation point1. Constructed graphic diagnosis of ROP effective reporting system;2. The first time the nervous system may be stimulated by neuropeptide secretion of monocyte differentiation and activation of angiogenesis in the body, affecting the development of ROP. ROP nervous system involved in the proposed physiological and pathological processes point of view3. Proposed PIGF, Vasohibin may become a new target for treatment of ROP...