Prevalence and risk factors of refractive error: a cross-sectional Study in Han and Yi adults in Yunnan, China.

BACKGROUND: Few studies have investigated the prevalence of refractive error (RE) in older adults in China, and most have focused on East China. Our study determined the prevalence and risk factors of RE in Han and Yi adults aged 40-80 years in rural and urban areas in Yunnan Province, Southwest China. METHODS: Our cross-sectional study is part of the China National Health Survey (CNHS). The age-adjusted prevalence rates of RE in Han and Yi adults aged 40-80 years in Yunnan were compared. We used a multivariate logistic regression model to identify risk factors for myopia and hyperopia. RESULTS: Among 1626 participants, the age-adjusted prevalence rates of myopia, hyperopia, high myopia and astigmatism were 26.35% (95%CI 24.01-28.70%), 19.89% (95%CI 18.16-21.61%), 2.64% (95%CI 1.75-3.53%), and 56.82% (95%CI 54.31-59.34%). Compared to the Yi population, the Han population had higher prevalence of myopia (31.50% vs 16.80%, p < 0.0001), high myopia (3.34% vs 1.31%, p = 0.049) and astigmatism (60.07% vs 50.67%, p = 0.026) but lower prevalence of hyperopia (16.58% vs 27.37%, p < 0.0001). In the multivariate logistic regression, individuals aged 45-49 (p < 0.001), 50-54 (p < 0.001), 55-59 (p = 0.014), and 60-64 years (p = 0.005) had a lower myopia risk than those aged 40-44 years, and individuals aged 50-54 (p = 0.002), 55-59, 60-64 and 65 years and older (all p < 0.001) had a higher hyperopia risk than those aged 40-44 years. Myopia was also associated with height (p = 0.035), time spent in rural areas (p = 0.014), undergraduate/graduate education level (p = 0.001, compared with primary school or lower education level) and diabetes (p = 0.008). The Yi population had a higher risk of hyperopia than the Han population (p = 0.025). Moreover, hyperopia was related to time spent in rural areas (p < 0.001) and pterygium (p = 0.019). CONCLUSIONS: Our study investigated the overall prevalence of RE in older adults in rural and urban areas of Southwest China. Compared to the Yi population, the Han population had a higher prevalence of myopia, high myopia and astigmatism but a lower risk of hyperopia. The prevalence of myopia in the Han population in underdeveloped Southwest China was similar to that of residents in East China or of Chinese Singaporeans under urban or rural settings.

Parameters for Contrast-Enhanced Ultrasound (CEUS) of Enlarged Superficial Lymph Nodes for the Evaluation of Therapeutic Response in Lymphoma: A Preliminary Study.

BACKGROUND The aims of this preliminary study were to evaluate contrast-enhanced ultrasound (CEUS) imaging and the therapeutic response of enlarged superficial lymph nodes in patients with lymphoma before and after chemotherapy and to determine the most useful CEUS response parameters. MATERIAL AND METHODS Forty-three patients with lymphoma, with 43 enlarged superficial lymph nodes, underwent CEUS and conventional ultrasound (US), before treatment and after the first three cycles of chemotherapy. Clinical responses included overall response (OR) and no response (NR). Imaging parameters by time-intensity curve (TIC) included basic intensity (B), wash-out slope and/or decent slope (K), wash-in slope or rise slope (C), time to peak (TTP), area under the gamma curve (Area), arrive time(ATM), peak intensity (PI), change of peak intensity (I) were compared. And receiver operating characteristic (ROC) curve analysis was operated. RESULTS Quantitative parameters of CEUS before and after the first three cycles of chemotherapy showed a significant difference in the AreaΔ, PID, and IΔ in the OR group compared with NR group (P<0.05). There was a significant difference in the Cpre, Areain, PIin, Iin, AreaΔ, PIΔ, and IΔ in the OR group compared with NR group (P<0.05). The effectiveness of the therapeutic response was predicted by the CEUS parameters of IΔ (P<0.05). And ΔArea has the highest diagnostic performance of ineffectiveness. CONCLUSIONS The findings of this study have shown that quantitative analysis by CEUS may be a useful, and objective, imaging method for the evaluation of the therapeutic response of enlarged superficial lymph nodes in lymphoma before and after chemotherapy.

Clinical value of color Doppler ultrasound combined with serum tumor markers for the diagnosis of medullary thyroid carcinoma.

The present study aimed to explore the clinical value of color Doppler ultrasound combined with serum tumor markers, including calcitonin (CT) and carcinoembryonic antigen (CEA), for the diagnosis of medullary thyroid carcinoma (MTC). A total of 39 patients with MTC (MTC group), 50 patients with papillary thyroid carcinoma (PTC) (PTC group) and 30 patients with thyroid adenoma (benign control group) were enrolled in the present study. The patients were hospitalized at the Affiliated Hospital of Qingdao University from January 2012 to December 2018 and were diagnosed through surgical procedures and pathology laboratory results. The ultrasound results, as well as serum CT and CEA results, were collected and analyzed. A significant difference was observed between the MTC and PTC groups in regards to morphology, margin, aspect ratio, calcification, internal blood flow and lymph node metastasis (all P<0.01). There was also a significant difference between the MTC and benign control group in regards to internal echo, calcification, internal blood flow and lymph node metastasis (all P<0.01). In addition, the levels of serum CT and CEA in the MTC group were significantly higher than those in the PTC and the benign control groups (both P<0.01). For patients with MTC, the levels of serum CT and CEA were significantly associated with maximum tumor diameter, lymph node metastasis and the patient state after treatment (all P<0.01). Furthermore, the sensitivities of ultrasound, serum CT and CEA for the diagnosis of MTC were 76.92, 74.36 and 68.23%, respectively. The value for the combination of the three markers (94.87%) was significantly higher compared with the sensitivity value of each separate marker (all P<0.05). In conclusion, color Doppler ultrasound combined with detecting the levels of serum tumor markers (CT and CEA) significantly improved the diagnostic efficiency for MTC, which could be useful for the clinical diagnosis and treatment of MTC.

Comparison of digital subtraction angiography and contrast-enhanced ultrasound in assessment of carotid stenosis.

INTRODUCTION: The performances of contrast-enhanced ultrasound (CEUS) and digital subtraction angiography (DSA) were used to establish an efficient as well as non-invasive clinical technique for the diagnosis of extra-cranial internal carotid artery (ICA) stenosis. MATERIALS AND METHODS: Thirty-six successive patients (11 women and 25 men, mean age: 65.0 ± 9.2, range: 43-78 years) with internal carotid artery (ICA) stenosis were tested by CEUS and DSA. These tests were carried out by means of Hitachi Preirus ultrasound machine for CEUS and Allura Xper FD20 system (Philips Medical Systems, Nederland B.V.) for DSA. 1.2 ml SonoVue (Bracco, Switzerland) was used a s contrast agent. RESULTS: The results clearly indicated that there were no noteworthy variations among the distributions recorded by CEUS as well as DSA for the four tested groups. The percentage of diameter stenosis calculated by CEUS was clearly in accordance with the DSA images. CEUS showed accurate results with good specificity and sensitivity at 50%, 70%, and 100%. Also, CEUS performance was relatively better than DSA in the diagnosis of ICA and suitability of CEA. CONCLUSION: CEUS proved to be a precise non-invasive testing method for the diagnosis of carotid artery stenosis which is more feasible and well-tolerated in patients with various stages of carotid stenosis.

Soluble uric acid induces inflammation via TLR4/NLRP3 pathway in intestinal epithelial cells.

OBJECTIVES: Hyperuricemia is a risk for cardiovascular and metabolic diseases, but the mechanism is ambiguous. Increased intestinal permeability is correlated with metabolic syndrome risk factors. Intestinal epithelial cells play a pivotal role in maintaining intestinal permeability. Uric acid is directly eliminated into intestinal lumen, however, the mechanism and effect of uric acid on intestinal epithelial cells is poorly explored. Here we carried out an analysis to identify the effect and mechanism of uric acid on intestinal epithelial cells. MATERIALS AND METHODS: IEC-6 was exposed to different concentrations of uric acid to simulate the effect of uric acid on intestinal epithelial cells. Cell viability was determined by MTS assay. Protein content and mRNA were assessed using Western blotting and Q-PCR, respectively. Intracellular ROS was determined using flow-cytometry and fluorescence microscopy. Mitochondrial membrane potential was detected by immunofluorescence using a mitochondrial membrane potential assay kit with JC-1. Small interfering RNA transfection was used to suppress the expression of TLR4. RESULTS: We found soluble uric acid alone increased the release of ROS, depolarized the mitochondrial membrane potential, up-regulated TSPO, increased the expression of TLR4 and NLRP3, and then activated NLRP3 inflammasome and NF-κB signaling, which further resulted in lower expression of tight junction protein and exerted adverse effects on intestinal epithelial cells. Furthermore, the elevated IL-1ß could be restored by silencing of TLR4, indicating soluble uric acid induces inflammation via the TLR4/NLRP3 pathway. CONCLUSION: Soluble uric acid exerted detrimental effect on intestinal epithelial cells through the TLR4/NLRP3 pathway.