In the published article, the Author Contributions statement did not mention Jia Yin's contributions. The correct statement is "JY and KP contributed to conception and design of the study. KP supervised the study. SZ, HS, SW, and KP conducted experiments and acquired data; HS and KP wrote the manuscript; LP analyzed data; FM assisted in conducting the experiments; JZ and HG assisted in analyzing data; JL and XW provided the reagents; KP designed research studies and revised the manuscript."In the published article, the Acknowledgements statement was displayed as "We thank Dr. Jia Yin as an advisor for the hypoxia study." The correct statement is "None."The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.
Objective To investigate the reasons for delays in seeking medical care in patients with diabetic retinopathy and associated risk factors. Methods We retrospectively reviewed data for patients with sight-threatening diabetic retinopathy (STDR) who attended a hospital in China. Various forms of STDR were identified, including severe non-proliferative DR, clinically significant macular edema and proliferative DR. Demographic, clinical and socioeconomic information was collected and the associated risk factors were evaluated. Results Of the 127 patients with STDR, 89.2% sought medical care within 1 month of developing symptoms. Those who sought treatment ≥6 months after symptoms developed had significantly lower income and less knowledge of diabetic complications than those who attended earlier. Multivariate logistic regression analysis showed that no or infrequent routine examination for diabetic complications were associated with long delays in seeking medical care (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.05–9.19; and OR 2.91, 95% CI 1.04–8.40, respectively). Conclusions Most patients with STDR sought medical care within 1 month of symptoms developing, but no or infrequent routine examination for diabetic complications was associated with long delays. These results stress the importance of educational programs regarding diabetic complications to encourage timely medical care and prevent poor outcomes.
Transdifferentiation of keratocytes into fibroblasts or further into myofibroblasts, which produced denser and more disorganized extracellular matrix, is the major cause of corneal fibrosis and scarring, leading to corneal blindness. TGF-β1 is the critical cytokine for the myofibroblast’s transdifferentiation and survival. Hypoxia Inducible Factor (HIF) was found to play an important role in promoting fibrosis in lung, kidney, and dermal tissues recently. Our preliminary study demonstrated that topical administration of the acriflavine (ACF), a drug inhibiting HIF dimerization, delayed corneal opacity and neovascularization after the alkali burn. To know whether ACF could prevent corneal fibrosis and improve corneal transparency, we created a mouse mechanical corneal injury model and found that topical administration of ACF significantly inhibited corneal fibrosis at day 14 post-injury. The reduction of myofibroblast marker α-SMA, and fibronectin, one of the disorganized extracellular matrix molecules, in the corneal stroma were confirmed by the examination of immunohistochemistry and real-time PCR. Furthermore, the ACF inhibited the expression of α-SMA and fibronectin in both TGF-β1 stimulated or unstimulated fibroblasts in vitro. This effect was based on the inhibition of HIF signal pathways since the levels of the HIF-1α downstream genes including Slc2a1, Bnip3 and VEGFA were downregulated. To our knowledge, this is the first time to implicate that HIFs might be a new treatment target for controlling corneal fibrosis in mechanical corneal injuries.
Background Diabetic retinopathy (DR) is a common diabetes-associated complication and a primary cause of blindness. One of the critical factors affecting timely and effectual therapy for DR is the delay in treatment after the onset of symptoms. The present study aimed to investigate the reasons for the delay in the treatment of the condition and the risk factors associated with the delay. Methods We retrospectively reviewed data from 127 patients with sight-threatening diabetic retinopathy (STDR) treated at Qilu Hospital of Shandong University in China. Various forms of STDR were identified including severe non-proliferative DR, clinically significant macular edema (CSME) and proliferative DR(PDR). Information concerning demography, clinical, and socioeconomic status of the patients was gathered. Risk factors associated with the delay was evaluated using logistic regression analysis. Results Among 127 patients with STDR, 89.2% sought medical care one month after the onset of symptoms. Patients who sought for treatment 6 months post-symptom onset had significantly lower income and less knowledge about diabetic eye complications than those presenting within 6 months. Multivariate logistic regression analysis showed that never or infrequent routine examination for diabetic complications was associated with a long delay in seeking medical care (odds ratio 3.06, 95% CI 1.05-9.19, p <0.05; odds ratio 2.91, 95% CI 1.04-8.40, p <0.05). Conclusions Most STDR patients sought medical care one month after the onset of symptoms. Never or infrequent routine examination for diabetic complications was associated with a long delay. The results of the present study stress the necessity to implement educational programs on diabetic complications to encourage early medical care and prevent disastrous outcomes.
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