[Analysis of spontaneous nystagmus and the frequency characteristics of affected semicircular canals in patients with vestibular neuritis].

Objective: To investigate the spontaneous nystagmus (SN) and the frequency characteristics of affected semicircular canals in patients with vestibular neuritis (VN). Methods: This is a cross-sectional study. A total of 61 patients with VN admitted to the Department of Neurology of Shanxi Bethune Hospital from June 2020 to October 2021, 39 were male and 22 were female, with a mean age of (46±13) years old and male to female ratio of 1.77∶1. According to SN characteristics, 61 patients were divided into non-nystagmus group(nSN), horizontal nystagmus group(hSN) and horizontal-torsional nystagmus group (htSN). Clinical data were collected, and SN, unilateral weakness (UW), directional preponderance (DP), and video head impulse test (vHIT) gain were used as observation indicators. Statistical analysis by SPSS23.0 software. Normal distributed quantitative data (age, semicircular canal gain, SN intensity) were expressed by x¯±s, non-normal distributed quantitative data (disease course, UW, DP) were expressed by M(Q1,Q3), qualitative data were expressed by rate and composition ratio, difference analysis by one-way ANOVA, rank sum test, Chi-square test or Fisher's exact probability method, considered by P value<0.05. Results: (1)The disease course of nSN, hSN and htSN was 7.0 (4.0, 12.5), 6.0 (3.5, 11.5), and 3.0 (2.0, 6.5) days respectively, and there were statistical differences (χ2=7.31,P=0.026).(2)The horizontal nystagmus intensity of htSN was (16.8±8.6)°/s, which was significantly higher than that of (9.8±4.7)°/s in hSN (t=3.71, P<0.001). There was no significant difference in the positive rate of UW between the three groups (P=0.690), and there was a significant difference in the positive rate of DP in the three groups (χ2=12.23, P=0.002). The horizontal nystagmor intensity in the htSN was positively correlated with the vertical nystagmus intensity (r=0.59, P=0.001).(3)The gain of the affected horizontal canal of the three groups was statistically different (F=8.28, P=0.001), and the gain of the horizontal canal of hSN and htSN was significantly lower than that of nSN (t=2.74, P=0.008; t=4.05, P<0.001); The gain of the affected anterior canal in the three groups was statistically different (F=5.32, P=0.008). The gain of the anterior canal in both nSN and hSN was significantly higher than that in htSN (t=3.09, P=0.003; t=2.15, P=0.036). The horizontal canal gain of htSN is positively correlated with the anterior canal gain (r=0.74, P<0.001).(4)The affected semicircular canals in the two groups with no-vertical-component nystagmus (nSN and hSN) and the htSN were counted. The composition ratio of the affected semicircular canals in the two groups was different (χ2=8.34, P=0.015). Conclusion: The occurrence of SN in patients with VN is related to many factors, such as the disease course, low and high frequencies, and the severity of the condition in the affected semicircular canal.

[Analysis of the correlation between peripapillary retinal nerve fiber layer cross-sectional area and myopia in individuals aged 50 years and above].

Objective: To measure the peripapillary retinal nerve fiber layer (RNFL) cross-sectional area in individuals aged 50 years and above with different refractive errors, and analyze its correlation with axial length and refractive error. Methods: This was a cross-sectional study conducted as part of the "Beijing Eye Study". The study was population-based and longitudinally designed. In 2001, a cohort of individuals aged 40 years and above from five urban communities in Haidian District and three rural communities in Daxing District, Beijing, were surveyed. Follow-up examinations were conducted in 2011. In this study, the follow-up data from 2011 were collected and analyzed. One eye of each participant was randomly selected, and the participants were categorized into four groups based on their spherical equivalent: emmetropia group (-0.50 D≤spherical equivalent≤0.50 D), low myopia group (-3.00 D≤spherical equivalent<-0.50 D), moderate myopia group (-6.00 D≤spherical equivalent<-3.00 D), and high myopia group (spherical equivalent<-6.00 D). Spectral-domain optical coherence tomography (OCT) was used to perform circular scans with a diameter of 12° centered on the optic disc. ImageJ software and Heidelberg Eye Explorer software were used to calculate the RNFL cross-sectional area. One-way analysis of variance was used to compare the differences in RNFL thickness and RNFL cross-sectional area among different groups. Linear regression analysis was performed to analyze the correlation between RNFL thickness and axial length and spherical equivalent, as well as the correlation between RNFL cross-sectional area and axial length and spherical equivalent. Results: A total of 184 participants (184 eyes) were included in the study, including 88 males and 96 females. The median age was 59 (54, 66) years, with 87 right eyes and 97 left eyes. There were 50 participants (50 eyes) in the emmetropia group, low myopia group, and moderate myopia group, and 34 participants (34 eyes) in the high myopia group. There were no significant differences in age, gender, and eye laterality among the groups (all P>0.05). The RNFL cross-sectional areas in the emmetropia, low myopia, moderate myopia, and high myopia groups were (1.115±0.106), (1.122±0.136), (1.105±0.105), and (1.096±0.106) mm2, respectively, with no significant differences observed (F=0.43, P=0.730). The RNFL thickness in the emmetropia, low myopia, moderate myopia, and high myopia groups were (102.5±9.5), (102.5±12.1), (94.2±8.3), and (90.2±8.9) µm, respectively, with a significant difference observed (F=16.42, P<0.001). Univariate linear regression analysis was performed with spherical equivalent as the independent variable and peripapillary RNFL thickness as the dependent variable, yielding the regression equation: peripapillary RNFL thickness=102.651+1.634 × spherical equivalent (R2=0.21, P<0.001). Similarly, when axial length was used as the independent variable and peripapillary RNFL thickness as the dependent variable, the regression equation was: peripapillary RNFL thickness=174.161-3.147 × axial length (R2=0.18, P<0.001). There was no significant correlation between RNFL cross-sectional area and spherical equivalent (P=0.065) or axial length (P=0.846). Conclusions: There were no significant differences in peripapillary RNFL cross-sectional area among individuals aged 50 years and above with different axial lengths or refractive errors.

[Morphological parameters of the posterior pole in a high myopia population aged over 40 years: a 10-year follow-up study].

Objective To study the long-term changes of the morphological parameters of the posterior pole in highly myopic patients over 40 years old in Chinese natural population. Methods A population-based follow-up study. The study included 71 patients (27 males, 44 females; 110 eyes) with high myopia who completed the Beijing Eye Study in 2001 and 2011 and had assessable color fundus photographs. The age of the patients in 2011 was 56.2±9.5 years old. According to the definition of pathological myopia by the meta-analysis of the Pathological Myopia Research Group, the fundus photos in 2001 were interpreted, and 110 eyes were divided into groups of simple high myopia (79 eyes) and pathological myopia (31 eyes). The morphological parameters during the 2 follow-up visits in 2001 and 2011 were measured in the color fundus photos, including optic disc tilt ratio, optic disc rotation degree, ß zone area, disc-fovea distance, disc-outer ß zone border distance, fovea-outer ß zone border distance, and vertical distance between temporal arterial arcades, and compared in all the subjects, patients with simple high myopia and patients with pathological myopia. Correlations between the 10-year changes of these parameters and other parameters were analyzed using multiple linear regression analysis. Results In all subjects, the incidence of optic disc tilt and rotation was 41.1% (44/107) and 63.3% (68/107), respectively. The optic disc tilt ratio in 2001 and 2011 was 1.34±0.31 and 1.34±0.33, respectively. The optic disc rotation degree was 30.4±26.3° and 30.0±25.3 in 2001 and 2011, respectively. The differences in optic disc tilt ratio (Z=-0.317, P>0.05) and optic disc rotation degree (t=0.159, P>0.05) were not statistically significant. The ß zone area [1.34 (0.45,3.73)mm2, Z=-7.295, P<0.05], disc-fovea distance [(5.18±0.54)mm, t=-3.523, P<0.05], and disc-outer ß zone border distance [1.55 (0.24,2.16)mm, Z=-6.825, P<0.05] in 2011 were significantly increased compared to those in 2001 [1.05 (0.23,1.88)mm2, 5.08±0.43, 1.39 (0.77,1.93)mm]. There was no statistically significant difference in the vertical distance between temporal arterial arcades (Z=-1.858, P>0.05). The fovea-outer ß zone border distance in the simple high myopia group in 2011 was significantly shorter than that in 2001 (Z=-3.221, P<0.05), while there was no significant change in this parameter in the pathological myopia group (t=0.655, P<0.05). In multivariate analysis, larger ß zone area was significantly correlated with longer corneal curvature (r=0.462, P<0.05) and longer axial length (P<0.05). Longer disc-fovea distance was significantly correlated with lower best corrected visual acuity (r=0.348, P<0.05) and longer axial length (P<0.05). Similarly, longer disc-outer ß zone border distance was related to lower best corrected visual acuity (r=0.538, P<0.05) and longer axial length (P<0.05). In addition, the progression of myopic maculopathy (Z=-3.425, P<0.05) and the progression from simple high myopia to pathological myopia (Z=-2.911, P<0.05) were both related to enlargement of the ß zone. Conclusion For patients with high myopia aged over 40 years, the optic disc morphology is relatively stable, while the disc-fovea distance and ß zone area will continue to increase with the progression of myopia. This may be due to the elongation of axial length. Enlargement of the ß zone may be a predictor for the progression of myopic maculopathy. (Chin J Ophthalmol, 2021, 57:908-915).

[Integrated management and prognosis analysis of fetus with complete transposition of the great arteries during pregnancy and perinatal period].

Objective: To investigate the prenatal diagnosis, integrated management and prognosis of fetal complete transposition of the great arteries (D-TGA) detected by ultrasonography. Methods: The prenatal diagnosis, integrated management and prognosis of 19 D-TGA fetuses found by ultrasound during pregnancy in Peking University People's Hospital from January 2014 to June 2019 were analyzed retrospectively. Results: The incidence of D-TGA was 0.12% (19/16 028) among fetuses diagnosed by ultrasound during 5 years. Among the 19 cases, there were 7 cases (7/19) of D-TGA alone, 7 cases (7/19) of D-TGA combined with ventricular septal defect (VSD), 5 cases (5/19) of D-TGA combined with other cardiac malformations; 2 cases (2/19) of D-TGA combined with extra cardiac malformations, and 1 case (1/19) of fetal growth restriction. Nuchal translucency (NT) thickening was found in 3 cases (3/19) at the first trimester of pregnancy. Among the 19 D-TGA fetuses found by ultrasound examination, 18 (18/19) had chromosome karyotype analysis of fetuses or newborns, and chromosomal abnormalities were found in 2 cases, all of which were terminated in the second trimester of pregnancy. The integrated management and multidisciplinary diagnosis and treatment of D-TGA fetuses during pregnancy and perinatal period were carried out. Nine cases (9/19) had induction in the second trimester of pregnancy, 10 cases (10/19) were delivered at term, and the gestational week of delivery was (38.3±0.7) weeks, among which 6 cases (6/10) were delivered by caesarean section due to obstetric factors, and 4 cases (4/10) were delivered by vaginal birth. The oxygen saturation was (69.2±11.3)% at birth and (77.8±6.7)% when transferred to the department of pediatrics. Except for one case lost to follow-up, the other 9 newborns received operation. The average operation time was (21.8±22.1) days after birth, 8 cases (8/9) completed one operation and 1 case (1/9) performed two operations. All of the 9 cases treated by surgery were followed up well. Conclusions: Prenatal diagnosis, individualized evaluation and integrated management during pregnancy and perinatal period should be carried out for the patients with fetal D-TGA detected by ultrasound. Fetal D-TGA is not an indication of cesarean section. The open of ductus arteriosus can be maintained with drugs when necessary after birth, and a good prognosis could be obtained through surgery.

[Evaluation of the efficacy and safety of a foldable capsular vitreous body in the treatment of severe retinal detachment].

Objective: To determine the efficacy and safety of vitrectomy combined with implantation of a foldable capsular vitreous body in the treatment of severe retinal detachment with early ocular atrophy in human eyes. Methods: This study was a prospective, multicenter, and one-arm phase Ⅱ clinical trial. Patients with severe retinal detachment and early eyeball atrophy attending Beijing Tongren Eye Center from April 2011 to July 2012 were included. A standard three-port pars plana vitrectomy was performed, and a foldable capsular vitreous body was folded and sent into the vitreous cavity; silicone oil was injected into the capsule. Measurement of visual acuity and intraocular pressure, corneal endothelium count, color fundus photography, optical coherence tomography, and ocular ultrasonography were performed to observe retinal reattachment and adverse reactions after surgery. Wilcoxon signed rank test was performed to compare the baseline and postoperative visual acuity, intraocular pressure and corneal endothelium count. Results: A total of 26 patients were enrolled, including 23 males and 3 females. The age was (37.5±11.5) years, with an average follow-up of 33 months. For each patient, only the left or right eye was included (13 left eyes and 13 right eyes). Retinal reattachment was found in all 24 eyes, and the eyeball atrophy was controlled in all patients. Visual acuity was improved in 4 patients (15.4%) and unchanged in 5 patients (19.2%). The mean intraocular pressure [(14.4±3.9) mmHg(1 mmHg=0.133 kPa)] at the last follow-up was higher than the baseline intraocular pressure [(12.0±6.5) mmHg], but the difference was not statistically significant (Z=-1.859, P=0.063). For the 16 patients with ocular atrophy at baseline, the last follow-up intraocular pressure [(14.6±3.9) mmHg] was significantly higher than the preoperative intraocular pressure [(8.5±2.4) mmHg] (t=-5.326, P<0.001). No obvious adverse reactions were observed. Conclusions: Implantation of a foldable capsular vitreous body is an effective way to treat severe retinal detachment with early eyeball atrophy. It can help to reattach the retina, control eyeball atrophy, maintain the eye shape and intraocular pressure, while visual acuity improvement is limited. (Chin J Ophthalmol, 2019, 55: 259-266).

[Effect of trephination on the cut-edge of cornea].

Corneal buttons were cut from rabbit and human eyes by anterior trephination and scissor completion or by posterior punching. Light microscope was used to measure the inward bevelling of the corneal cut-edge. With anterior trephination, the apparent width of inward bevelling of rabbit corneal buttons was 0.757 +/- 0.232 mm; with posterior punching, the apparent width of inward bevelling was 0.466 +/- 0.161 mm, and the cut-edge was also smooth. The mechanism of cut-edge bevelling was discussed.

[A preliminary study on relationship between Atractylodes lancea and A. chinensis as analyzed by RAPD].

OBJECTIVE: To study the relationship between A. lancea and A. chinensis by RAPD analysis. METHOD: Using 10 random primers, RAPD of seven Atractylodes samples was performed. The result was analyzed by RAPDistance Package Version 1.04. RESULT: A total of 60 polymerphic loci were amplified. It appears that the Atractylodes samples tend to cluster in relation to their habitats, and A. lancea has close phylogenetic relationship with A. japonica. CONCLUSION: A certain correlation among the chemical composition, genetic diversity and geographic distribution has been revealed. It is reasonable to separate A. lancea from A. chinensis according to their habitats.

kappa-Opioid receptor-mediated antinociceptive effects of stereoisomers and derivatives of (+)-matrine in mice.

The antinociceptive effects of seven matrine-type lupin alkaloids were examined using the acetic acid-induced abdominal contraction test (the writhing test) and the tail-flick test in mice. (+)-Allomatrine, the C-6 epimer of (+)-matrine, produced the antinociceptive effect at 1/3 potency of (+)-matrine or pentazocine. It was demonstrated that the antinociceptive effects of (+)-allomatrine were mediated through the activation of kappa-opioid receptors, while the antinociceptive effect of (+)-matrine was mediated by both mu- and kappa-opioid receptors. (-)-Sophoridine, the C-6 epimer of (+)-matrine, (+)-sophoranol, (-)-14 beta-hydroxymatrine and (+)-matrine N-oxide, which possess a hydrophilic group, and (-)-sophocarpine and (-)-sophoramine having a double bond(s) did not show significant antinociceptive activity.