Quantitative evaluation of retinal microvascular circulation in patients with obstructive sleep apnea-hypopnea using optical coherence tomography angiography.

PURPOSE: To compare capillaries perfusion in macular areas at different layers and peripapillary region in radial peripapillary capillaries (RPC) between healthy subjects and subjects with obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). METHODS: Totally 16 eyes with mild-to-moderate OSA, 14 eyes with severe OSA and 22 control eyes were enrolled in this study. Every subject filled out the Berlin questionnaire and received a comprehensive ocular and physical examination. The clinical characteristics were collected, OCT and OCTA scans using OCTA RT XR Avanti (AngioVue software, Optovue Inc., Fremont, CA, USA) were performed and analyzed. RESULTS: Compared to the control group, the severe group had significantly higher VD in parafovea and perifoveal regions (p = 0.031; p = 0.029) at the level of deep capillary plexus (DCP), whereas the mild-to-moderate group had a significantly lower VD in the peripapillary region on RPC network in disc areas (p = 0.013). CONCLUSIONS: Blood flow changes in macular areas might first appear at the DCP layer in OSA patients. Reduced VD in the peripapillary region at the RPC layer might be associated with OSA and cause subsequent RNFL changes.

Diurnal changes of retinal microvascular circulation and RNFL thickness measured by optical coherence tomography angiography in patients with obstructive sleep apnea-hypopnea.

Purpose: To evaluate capillaries perfusion and retinal nerve fiber layer (RNFL) thickness diurnal changes of macular/optic disc regions among participants with or without obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). Methods: In this study, we enrolled a cohort of 35 participants including 14 patients with mild-to-moderate OSA, 12 patients with severe OSA, and 9 healthy individuals. All participants had Berlin questionnaire filled. At 20:00 and 6:30, right before and after the polysomnography examination, a comprehensive ocular examination was conducted. The systemic and ocular clinical characteristics were collected, and OCTA scans were performed repeatedly. Blood flow and RNFL thickness parameters were then exported using built-in software and analyzed accordingly. Results: After sleep, the overall vessel density (VD) variables, especially macular and choriocapillaris VDs, were relatively comparative and stable. One exception was the RPC vessel density at the inside-disc region with a decreasing trend in the mild-to-moderate group (p=0.023). RNFL changes before and after sleep in the nasal-inferior and peripapillary region were statistically significant (p=0.003; p=0.043) among three groups. And multiple testing correction verified the significant difference in diurnal changes between the mild-to-moderate group and the control group in pairwise comparisons (p=0.006; p=0.02). Conclusions: The changes of imperceptible blood flow and RNFL thickness overnight around optic disc areas could be observed in OSA patients. Despite physiological fluctuations, aberrant diurnal changes might be useful for identifying a decrease in micro-environmental stability associated with the development of various ocular diseases such as glaucoma. Other VD variables, especially macular and choriocapillaris VDs, are relatively stable in eyes of patients having OSA with different severity.

[Effects of Pretreatment on Hydraulic Irreversible Membrane Fouling During Ultrafiltration Short Process: A Pilot Study].

Pilot-scale performances for ultrafiltration of Dongjiang river water without and with micro-coagulation and coagulation-adsorption-sedimentation pretreatments were conducted to investigate the effects of pretreatments on hydraulic irreversible fouling of ultrafiltration short processes. Scanning electron microscope (SEM) imaging, high performance size exclusion chromatography (HPSEC) and fluorescence excitation-emission matrix (EEM) were employed to identify foulants responsible for irreversible fouling during ultrafiltration with and without pretreatments. The results showed that the hydraulic irreversible fouling rate was 0.16 kPa·d-1 with micro-coagulation pretreatment at 10 L·(m2·h)-1, while the rate without pretreatment was 0.32 kPa·d-1 at the same flux. Meanwhile, the fouling rate with coagulation-adsorption-sedimentation pretreatment was almost zero at the same flux. Furthermore, when the flux increased to 17 L·(m2·h)-1, the irreversible fouling was not observable with coagulation-adsorption-sedimentation pretreatment (backwashing every 24 hours). Properties of foulants from external membrane and internal membrane after backwashing showed that the protein-like and fulvic-like substances were responsible for irreversible fouling in Dongjiang river water. Furthermore, structural alteration of cake layer resulted in less cake resistance and higher backwash efficiency after micro-coagulation pretreatment, leading to less irreversible fouling. Coagulation-adsorption-sedimentation pretreatment decreased irreversible fouling with higher removal efficiency of protein-like and fulvic substances, which were the foulants responsible for irreversible fouling during ultrafiltration. Both micro-coagulation and coagulation-adsorption-sedimentation pretreatments decreased irreversible fouling during ultrafiltration short process.

[Clinical observation on ankle-three-needle for treatment of nerve root pain of prolapse of lumbar intervertebral disc].

OBJECTIVE: To observe the analgesic effect of ankle-three-needle on nerve root pain of prolapse of lumbar intervertebral disc. METHODS: Three hundred and eighty cases were randomly divided into an ankle-three-needle group, a routine acupuncture group and a medication group. The ankle-three-needle group were treated with ankle-three-needle therapy, i. e. according to different prolapse segments, points Gentong No. 1, 2 and 3 were selected with lifting-kneading needle insertion method used and the needle was inserted along the skin; the routine acupuncture group were treated with acupuncture at Shenshu (BL 23), Qihaishu (BL 24) and Jiaji (EX-B 2) of the prolapse corresponding segment, and Ciliao (BL 32), etc. with uniform reinforcing-reducing manipulation; the medication group were treated with routine buttock intramuscular injection of aspirin-DL-lysine plus saline. RESULTS: The time inducing analgesia was 6 min in the ankle-three-needle group, 27 min in the routine acupuncture group and 18 min in the medication group. The effect-lasting time was 24.48 h in the ankle-three-needle group, 8.93 h in the routine acupuncture group and 6.36 h in the medication group, with a significant difference as the ankle-three-needle group compared with both the routine acupuncture group and the medication group, but with no significant difference between the routine acupuncture group and the medication group. After treatment, there were very significant differences in change tendency of the analgesic score among the three groups at all the time points (P < 0.01). And there was very significant differences in the changing tendency of straight-leg raising test among the three groups at 0.5 h, 1 h, 24 h and 48 h (P < 0.001). CONCLUSION: Ankle-three-needle has obvious therapeutic effect on nerve root pain induced by prolapse of lumbar intervertebral disc.

[Preliminary study on Professor SUN Liu-he's academic thought].

Professor SUN Liu-he has been engaged in scientific research, clinical and teaching works for tens years and he is a meticulous scholar with great learning, rich clinical experience and great theoretical attainments. In clinical practice of many years, he summarizes and develops Kangai Plaster, Kangai Fushui Plaster, Ai tong Ling Plaster, and so on for acupoint sticking to treat tumors, and establishes Nu-needle hot-reinforcing method and Ti-Yun reducing method, enriching contents of needling methods, and he is good at application of specific points, established points and channel acupoints to treat refractory diseases with good results.

[Observation on therapeutic effect of herbs-partitioned moxibustion on Parkinson disease of 54 cases].

OBJECTIVE: To observe clinical therapeutic effect of herbs-partitioned moxibustion at Shenque (CV 8) on Parkinson disease. METHODS: Ninety cases of Parkinson disease were randomly divided into a treatment group (n=4) and a control group (n=36) in order of visiting. The two groups were treated with routine western medicine for treatment of Parkinson disease, and herbs-partitioned moxibustion at Shenque (CV 8) was added to the treatment group. Their comprehensive therapeutic effects were observed and modified UPDRS cumulative scores were compared. RESULTS: The total effective rate was 83.3% in the treatment group, significantly better than 58.3% in the control group (P < 0.01); the modified UPDRS cumulative score was reduced by 74.1% in the treatment group, significantly better than 16.7% in the control group (P < 0.01). CONCLUSION: Herbs-partitioned moxibustion at Shenque (CV 8) has a certain therapeutic effect on Parkinson disease.

[Clinical study on analgesic effect of Huaisanzhen on the nerve root pain due to prolapse of lumbar intervertebral disc].

OBJECTIVE: To search for an effective therapy for the nerve root pain caused by prolapse of lumbar intervertebral disc. METHODS: One hundred and ninety-two cases were randomly divided into a Huaisanzhen group of 96 cases, a drug control group of 48 cases and an acupuncture control group of 48 cases. The Huaisanzhen group were treated by Huaisanzhen therapy, the drug control group by intramuscular injection of aspirin-DL-lysine and the acupuncture control group by routine acupuncture. RESULTS: The time inducing analgesic effect was shorter, the effect-lasting time was longer, and the analgesic effect and the comprehensive therapeutic effect were better in the treatment group as compared with the two control groups with very significant differences (P < 0.01). CONCLUSION: Huaisanzhen therapy has a better analgesic effect on the nerve root pain due to prolapse of lumbar intervertebral disc.