Efficacy of Watchman occlusion of the left atrial appendage in patients ≥85 years with atrial fibrillation / 中华老年医学杂志

Objective:To analyze the safety and efficacy of left atrial appendage closure(LAAC)with Watchman in patients ≥85 years with atrial fibrillation(AF).Methods:515 elderly patients with atrial fibrillation, including 73 patients aged 85 years or older(85~91), who had undergone Watchman LAAC at Zhoupu Hospital affiliated to Shanghai Health Medical College from August 2016 to December 2020, were retrospectively analyzed.Of those ≥85 years, 44(60.3%)with transesophageal echocardiography records were assigned to the elderly group.Fifty-three patients aged 60 to 65 were selected as the control group.Differences in baseline data, intraoperative conditions, antithrombotic treatment plans and 1-year follow-up prognosis were compared between the two groups.Results:Compared with the control group, there was no difference in AF types, history of ischemic stroke/transient ischaemic attack(all P>0.05), but there were higher incidences of coronary heart disease and renal insufficiency, more severe heart failure, higher CHA 2DS 2-VASC(6.0±1.5 vs.3.6±1.5), HAS-BLED(3.2±1.2 vs.2.3±1.3)scores( t values were 7.682 and 3.871, respectively, P<0.05), and a lower one-stop surgery rate(6 cases or 13.6% vs. 27 cases or 50.9%, χ2=10.517, P<0.05)in the advanced age group.There was no difference in the diameter of the Watchman device, rate of device replacement, compression percentage and residual flow between the two groups during the perioperative period.The incidences of device-related thrombosis were 4.5%(2/44)and 3.8%(2/53)for the advanced age group and the control group, respectively, but the difference was not statistically significant( P>0.05). During the 12-month follow-up, there were no cases of ischemic stroke or intracerebral hemorrhage.Three died of heart failure and 1 died of cancer. Conclusions:LAAC with Watchman is safe and effective for patients over 85 years with AF, but the decision on the procedure should be based on careful assessment of patients' cardiac and renal function and general health.

Promoting effects of Difrarel ? on retinal function following panretinal photocoagulation in diabetic retinopathy / 中华实验眼科杂志

Objective:To investigate the promoting effect of Difrarel ? on retinal function following panretinal photocoagulation (PRP) in the eyes with diabetic retinopathy. Methods:A non-randomized controlled study was performed.A total of 108 eyes of 108 patients with non-proliferative diabetic retinopathy (NPDR) were enrolled in Tongren Ophthalmology Center and Beijing Daxing District People's Hospital from December 2014 to February 2020.The patients were divided into PRP group and PRP+ Difrarel ? group according to different therapies under patients' selection.Difrarel ? was orally administered after PRP in 56 patients of PRP+ Difrarel ? group, and only PRP was given in 52 patients of PRP group.The visual acuity, 30°~60° circular visual field and multifocal electroretinogram were examined before and 1 day, 1 month, 3 months, 6 months, 12 months after PRP.The central macular thickness (CMT) was measured by optical coherence tomography, and fundus neovascularization was observed by fluorescein fundus angiography at 6 and 12 months after PRP.The study protocol was approved by an Ethics Committee of Beijing Daxing District People's Hospital (No.2021-F4). Results:Visual improvement rate was 57.14% (32/56) and 32.69% (17/52) in PRP+ Difrarel ? group and PRP group at the end of following-up, respectively, showing a significant difference between two groups ( χ2=3.56, P<0.05). The visual field mean sensitivity was significantly different at different time points in two groups ( Fgroup=4.77, P<0.05; Ftime=6.51, P<0.05), and was lower after PRP than those before treatment in both groups (both at P<0.05), and was significantly higher in PRP+ Difrarel ? group than PRP group at 3, 6, 12 months after PRP (all at P<0.05). The P1 amplitude density in 3 to 5 rings in PRP+ Difrarel ? group were higher than those in PRP group, and the differences were statistically significant (all at P<0.05). There was no significant difference in CMT between the two groups at different time points ( Fgroup=3.57, P>0.05; Ftime=1.23, P>0.05). No new blood vessels and non-perfusion area were found in both groups. Conclusions:Oral Difrarel ? can improve retinal function after PRP in the eyes with NPDR.

Clinical analysis of severe/critical 2019 novel coronavirus Omicron variant infection combined with atrial fibrillation / 中华危重病急救医学

Objective:To investigate the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients with Omicron variant combined with atrial fibrillation (AF).Methods:From March 23, 2022 to May 15, 2022, 2 675 aged ≥ 50 years old COVID-19 patients with AF were admitted to Zhoupu Hospital, the designated hospital for COVID-19 in Shanghai. Patients were divided into mild symptoms group, normal group, and serious/critical group according to the symptoms. The clinical data, imaging examination and laboratory results and prognosis of the three group patients were compared.Results:The median age of 2 675 COVID-19 patients was 69.0 (60.0, 81.0) years old, the incidence of AF was 5.05% (135/2 675), the age range of AF patients were from 55 to 101 years old, with a median age of 84.0 (74.0, 89.0), and the number of mild symptoms, normal, serious/critical patients were 68, 30, 37, respectively, including 9 of serious and 28 of critical patients. In the serious/critical patients, aged 55-75 years old accounted for 43.2%, the rate of 2019 novel coronavirus vaccination was 32.4%. The identified new-onset AF was the highest among the three groups, but the rate of persistent AF was the highest in the mild symptoms group (58.8%). The severe/critical group complicated with fever (29.7%), hepatic insufficiency (13.5%), renal insufficiency (46.0%), type 2 diabetes (46.0%), and heart failure were higher in NYHA classification [compared with the mild symptoms and normal group (score): 1.8±1.1 vs. 1.1±0.8, 1.2±0.7, respectively, all P < 0.05]. In term of laboratory examinations, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were significantly higher in serious/critical patients compared to the mild symptoms and normal groups [CRP (mg/L): 27.2 (6.0, 60.8) vs. 7.6 (3.1, 19.3), 12.8 (4.9, 26.3), ALT (U/L): 31.3±15.4 vs. 15.4±9.3, 19.3±11.7, AST (U/L): 78.0±21.7 vs. 34.7±15.6, 38.1±24.4, all P < 0.05]. The hemoglobin (Hb) and albumin (ALB) levels were significantly lower than those in the mild symptoms and normal groups [Hb (g/L): 105.3±22.5 vs. 125.8±25.4, 123.0±20.4, ALB (g/L): 33.7±6.0 vs. 39.0±5.5 and 39.6±13.1, all P < 0.05]. In addition, MB isoenzyme of creatine kinase (CK-MB) was significantly higher in the serious/critical group than that in the mild symptoms group [μg/L: 2.5 (1.5, 3.4) vs. 2.2 (1.2, 2.8), P < 0.05]. In terms of the treatment, the percentage of antiplatelet agents and low-molecular heparin ratio compared among the three groups were statistically significant, with the serious/critical group using the lowest percentage of antiplatelet agents (27.0%) and a higher percentage of low-molecular heparin usage than that in mild symptoms group [81.1% (30/37) vs. 51.5% (35/68), P < 0.05]. In terms of prognosis, the mortality of patients with AF was 18.5% (25/135), all of whom were critical ill, including 32.0% (8/25) with cerebral embolism, pulmonary embolism and cerebral hemorrhage. Among them, 40.0% (10/25) died of multiple organ failure (40.0% combined with gastrointestinal hemorrhage), 20.0% (5/25) died of heart failure, and 12.0% (3/25) died of respiratory failure; while there were no death cases recorded in the mild symptoms, normal group and 9 serious patients. Conclusions:The serious/critical patients infected with COVID-19 Omicron variant with AF, have a worse prognosis and high mortality. Multiple organ failure, heart failure, sudden cardiac death, respiratory failure and embolic disease are the major causes of death.

Safety and efficacy of left atrial appendage closure combined with patent foramen ovale closure for atrial fibrillation patients with patent foramen ovale / 中华心血管病杂志

Objective: To analyze the safety and efficacy of combined left atrial appendage (LAA) and patent foramen ovale (PFO) closure in adult atrial fibrillation (AF) patients complicating with PFO. Methods: This study is a retrospective and cross-sectional study. Seven patients with AF complicated with PFO diagnosed by transesophageal echocardiography (TEE) in Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences from June 2017 to October 2020 were selected. Basic data such as age, gender and medical history were collected. The atrial septal defect or PFO occluder and LAA occluder were selected according to the size of PFO, the ostia width and depth of LAA. Four patients underwent left atrial appendage closure(LAAC) and PFO closure at the same time. PFO closure was performed during a one-stop procedure of cryoablation combined with LAAC in 2 patients. One patient underwent PFO closure at 10 weeks after one-stop procedure because of recurrent transient ischemic attack (TIA). All patients continued to take oral anticoagulants. TEE was repeated 8-12 weeks after intervention. In case of device related thrombus(DRT), TEE shall be rechecked 6 months after adjusting anticoagulant and antiplatelet drug treatment. Patients were follow-up at 1, 3, 6, 12, 24 months by telephone call, and the occurrence of cardio-cerebrovascular events was recorded. Results: Among the 7 patients with AF, 2 were male, aged (68.0±9.4) years, and 3 had a history of recurrent cerebral infarction and TIA. Average PFO diameter was (3.5±0.8)mm. Three patients were implanted with Watchman LAA occluder (30, 30, 33 mm) and atrial septal defect occluder (8, 9, 16 mm). 2 patients were implanted with LAmbre LAA occluder (34/38, 18/32 mm) and PFO occluder (PF1825, PF2525). 2 patients were implanted with LACbes LAA occluder (24, 28 mm) and PFO occluder (PF2525, PF1825) respectively. The patients were followed up for 12 (11, 24) months after operation. TEE reexamination showed that the position of LAA occluder and atrial septal defect occluder or PFO occluder was normal in all patients. DRT was detected in 1 patient, and anticoagulant therapy was adjusted in this patient. 6 months later, TEE showed that DRT disappeared. No cardiovascular and cerebrovascular events occurred in all patients with AF during follow-up. Conclusions: In AF patients complicated with PFO, LAAC combined with PFO closure may have good safety and effectiveness.

Effect of wavelength in the efficacy for treatment of non-proliferative diabetic retinopathy / 中华眼底病杂志

Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study.A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients,20 eyes) and the 532 nm group (12 patients,21 eyes).577 nm group and 532 nm group received 3-4 times PRP with single-point mode.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Before treatment and 1 day,1,3,6 and 12 months after treatment,the changes of best corrected visual acuity (BCVA),average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field,and fundus fluorescein angiography (FFA) were compared between two groups.Results The response rate was 85.0％ and 23.8％,respectively in the 577 nm and 532 nm group,the difference was statistically significant (x2 =15.43,P ＜ 0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b wave amplitude of F-ERG and the 30°-60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group,the difference were statistically significant (F =8.68,7.57,4.52;P＜0.05).The average threshold sensitivity (t=2.41,3.48,1.23),a/b wave amplitude (a wave:t=5.82,4.45,7.83;b wave:t=5.40,3.23,4.67) of F-ERG were different between 577 nm and 532 nm group at 3,6 and 12 months after treatment (P＜0.05).There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment.The average laser power were (436.25 ±54.65) and (446.43 ± 35.61) mW,number of laser spots were (1952.95 ± 299.09) and (2119.05 ± 302.69) spots,energy density were (7.60±1.30) and (7.60±3.00) mW× ms/μm2 in the 577 nm group and 532 nm group,respectively.There was no difference in average laser power (t=1.35),number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P＞0.05).Conclusion Compared with the 532 nm laser,577 nm laser treatment has better visual outcomes for NPDR patients.

Comparison of the efficacy of multi-point or single-point mode of 577 nm laser in the treatment of diabetic retinopathy / 中华眼底病杂志

Objective To compare the therapeutic effects of 577 nm laser panretinal photocoagulation (PRP) between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study from August 2013 to February 2014.A total of 29 patients (46 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group (12 patients,22 eyes) and the control group (17 patients,224 eyes).The treatment group received one time PRP of multi-point scanning mode,and the control group received 3-4 times of PRP with single-point mode.In order to evaluate its efficacy,the best corrected visual acuity was measured before treatment,and 1 day,1,2,6 and 12 months after treatment.The average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30 °-60 ° visual field,and fundus fluorescein angiography (FFA) of the change were also compared between the 2 groups.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Results The response rate was 86.4％ and 79.2％,respectively in the treatment and control group,the difference was not statistically significant (x2 =0.414,P＞0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b-wave amplitude of F-ERG in the 30 °-60 ° visual field were reduced at 1 day after treatment both in treatment and control group,the differences were statistically significant (P＜0.05).The average threshold sensitivity,a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m,6m and 12m after treatment (P＞0.05).The average laser power,number of laser spots and energy density were (537.50 ± 64.69) mW and (339.09 ± 132.09) mW,(1934.32 ± 426.38) points and (2061.42 ± 375.49) points,(0.35±0.12) mW o ms/μm2 and (1.95 ± 0.86) mW · ms/μm2 in the treatment group and the control group,respectively.The average laser power and energy density was statistically different between the 2 groups (P＜0.05),while the number of laser spots was no difference (P＞0.05).Conclusions 577 nm multi-point scanning laser can complete the PRP at one time,and achieve the same therapeutic outcomes with the single-point mode which need several times to complete the PRP in the eyes with severe NPDR,and have lower energy density,and thus relative minor function damage.

Effect of compound anisodine on retinal function repair in diabetic retinopathy after panretinal photocoagulation / 中华实验眼科杂志

Background Panretinal photocoagulation (PRP) is an effective method for diabetic retinopathy (DR).However,PRP causes macular edema and visual impairment.The application of compound anisodine,a vascular dynamic drug can alleviate the adverse effect of PRP,but its effectiveness is not verified yet.Objective This study aimed to investigate the clinical therapeutic effect of compound anisodine on retinal functional damage following PRP in the eyes with non-proliferative diabetic retinopathy (NPDR).Methods A prospective cohort study was carried out from August 2013 to February 2014 in Beijing Tongren Hospital.One hundred and ten eyes with NPDR were included and PRP were performed.The operative eyes were randomized into the compound anisodine group (64 eyes) and control group (46 eyes).Compound anisodine solution of 2 ml was injected via temporal subcutaneous tissue since the second day after photocoagulation,and the injection was performed once per day for 4 courses in 3-day interval between each course (1 course for 14 days) in the compound anisodine group,and no any drug was used in the control group.The visual acuity,30° to 60° ring visual field and flash electroretinaogram (F-ERG) were examined before photocoagulation and 1 day,1 month and 2 months after photocoagulation to compare the retinal function between the two groups.ResultsThe vision acuity improved in 55 eyes in the compound anisodine group with the rate 85.94％,and that in the control group was 11 eyes with the rate 23.91％,showing a significant difference between the two groups (x2 =15.425,P =0.000).The mean sensitivities of visual field were (4.15 ± 1.42),(3.94 ± 1.40) and (4.81 ± 1.41) dB in 1 day,1 month and 2 months after photocoagulation in the compound anisodine group,which were significantly higher than (3.76± 1.52),(3.53± 1.55) and (3.64 ± 1.50) dB of the control group (t =1.39,1.44,1.15,all at P＜0.05).The amplitudes of a-wave and b-wave of F-ERG were all higher in the compound anisodine group than those in the control group in various time points after photocoagulation (all at P＜0.05).Conclusions The injection of compound anisodine via temporal subcutaneous tissue can relieve visual functional damage caused by PRP in NPDR eyes.

Effects of intraocular pressure drop for two kinds of aqueous humor drainage implant devices / 医用生物力学

Objective To observe and compare the effects of intraocular pressure (IOP) drop on using two kinds of aqueous drainage device implantation. Methods Forty healthy New Zealand white rabbits were chosen for the experiments. According to different implant devices, they were divided into NADI (new aqueous drainage implant) group and Ahmed group respectively, with 20 rabbits in each. Results Neither group appeared shallow anterior chamber after operation. At 8th week after operation, the postoperative IOP of NADI group and Ahmed group was decreased by 19.4% and 15.7%, respectively, as compared to the preoperative IOP. Statistical comparison showed that there were significant differences in IOP between two groups within 8 weeks (P＜0.05), and the IOP of NADI group was decreased more significantly than that of Ahmed group. Conclusions The IOP in NADI group was reduced more than that in Ahmed group, and such IOP drop was maintained for a longer period in NADI group, which means that NADI has an obvious IOP drop effect and good prospect in clinical application.

Visual function and morphological changes in the macular area of patients with type 2 diabetes mellitus after intensive insulin therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intensive insulin therapy has been found to lessen the progress of diabetic retinopathy (DR) to some extent, while it has also been implicated to be responsible for decrease of DR. We investigated visual function and morphological changes in the macular area in short-term follow-up of patients with type 2 diabetes mellitus after intensive insulin therapy.</p><p><b>METHODS</b>This was a prospective clinical study of nonproliferative DR patients (102 eyes, 120 patients) undergoing intensive insulin therapy. The Contrast Glare Tester (Takagi CGT-1000) was used to examine contrast sensitivity (CS) and Heidelberg Retina Tomograph (HRT) II and Stratus Model 3000 OCT were used to observe the changes of morphology in the macular area. Follow-up times were pre-intensive therapy, 3 and 6 months post-intensive therapy.</p><p><b>RESULTS</b>CS at low and middle frequencies was higher at 3 and 6 months post-therapy compared with pre-therapy (P < 0.05). Significant differences in CS at low frequency were found between 6 and 3 months post-therapy (P < 0.05). Macular edema index was lower in the first, second, and third rings of the macular area after intensive therapy compared with pre-therapy (P < 0.05). Compared with 3 months post-therapy, the macular edema index was lower in the first, second, and third rings of the macular area at 6 months post-therapy (P > 0.05). No significant differences in the thickness of the first, second, and third rings of the macular area were detected between 3 and 6 months post-therapy and pre-therapy (P > 0.05).</p><p><b>CONCLUSION</b>CS and macular edema indexes were significantly improved in nonproliferative diabetic retinopathy patients after intensive insulin therapy, but thickness of the macular area was unchanged.</p>

Observation and management of retinal changes related to diving in professional divers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is very common for professional divers to have damage on the retinas. Severe retinal lesions can profoundly affect athletes' training efficacy and their daily lives. At present, it is not clear if there is effective preventive action. Thus, in our study, we continuously tracked the ocular changes in athletes and closely monitored the risk factors associated with retinal detachment. Also, we analyzed possible interventions, their associated factors, and efficacies for timely preventions to protect the retina from damage in professional divers.</p><p><b>METHODS</b>Between 2009 and 2012, a total of 39 professional divers enrolled in follow-up management. The conducted examinations included ocular examination, record screening on retinal lesion, monitoring best-corrected visual acuity, and checking intraocular pressure (IOP) and the scope of retinal lesion. The management included optimizing training methods, taking customized follow-up based on different retinal lesions, laser treatments for definite cases of retinal tear, retinal degeneration caused by retinal layer thinning or vitreous traction, and observing the changes in the scope of retinopathy.</p><p><b>RESULTS</b>Every year, the percentage of divers who have various degrees of retinal lesions is between 43.3% and 56.2%. During the 4 years, there were no statistically significant differences in divers' best-corrected visual acuity and retinal lesions. There were also no statistically significant differences between male and female athletes. However, there were statistically significant differences in IOP during these years. Moreover there were statistically significant differences in IOP and the scope of retinal lesions between platform divers and springboard divers.</p><p><b>CONCLUSIONS</b>Our management of retinal lesions could be effective to prevent severe retinopathy in professional divers. At the same time, platform divers are more likely to have retinal lesions than springboard divers.</p>

Non-infectious endophthalmitis after vitrectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Non-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrectomy in the same two operation rooms during the same period to estimate the risk factors for non-infectious endophthalmitis after vitrectomy.</p><p><b>METHODS</b>Medical records of patients who presented with severe non-infectious endophthalmitis following vitrectomy between May 13 and June 8, 2011, were reviewed. The presenting symptoms and signs were collected, including visual acuity, intraocular pressure, cornea and anterior chamber activity. The treatments and results of microbiology examination were also recorded and analyzed.</p><p><b>RESULTS</b>Ten patients were identified with severe non-infectious endophthalmitis, presenting 1 day after pars plana vitrectomy. Three eyes (30%) had previous intraocular surgeries, four (40%) had proliferative diabetic retinopathy, and one (10%) got pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation. All the patients were initially treated with topical and/or oral steroids. Only two patients had intravenous antibiotics because of the atypical presentation. One eye had paracentesis because of high intraocular pressure and the aqueous sample was sent for microbiological examination. The culture of the aqueous, air in the operation room, the swab from hand of surgeons, infusion fluid, and vitrectomy effluent were all negative for bacteria and fungi. The inflammation regressed rapidly after the initial treatment.</p><p><b>CONCLUSIONS</b>Intraocular surgery history, poor general health status, longer operation time, and more surgical procedures are the risk factors for non-infectious endophthalmitis after vitrectomy. It responds well to steroids.</p>

Effects of aqueous humor drainage to different parts of rabbit eye on intraocular pressure drop / 医用生物力学

Objective To observe and compare the effects of intraocular pressure (IOP) drop when the aqueous humor was drained to limbus, ambitus and posterior segment of rabbit eye by implanting medical silicone tube. Methods Forty-five healthy New Zealand white rabbits were chosen for the experimental group, each with the medical silicone tube implanted in one eye. According to different implanting ways, the rabbits were divided into the limbus group, ambitus group and posterior segment group respectively, with 15 rabbits in each group. Results According to statistical comparison of preoperative and postoperative IOP values among the 3 groups within 4 weeks, the IOP of the posterior segment group was decreased most by 26.6%, and that of the ambitus group and limbal group was decreased by 16.2% and 1.2%, respectively. The differences between the preoperative and postoperative IOP in first, second and fourth week were statistically significant (P<0.01) for all three groups. The IOP of the posterior segment group after 4 weeks was decreased most, and there were significant differences in IOP values among three groups (P<0.01). Conclusions The greatest IOP drop occurred when the aqueous humor was drained to the posterior segment of the rabbit eye, and this result could provide some reference for the clinical surgery.

A new rat model of glaucoma induced by intracameral injection of silicone oil and electrocoagulation of limbal vessels / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A satisfied glaucoma model is absent now. The aim of this study was to evaluate the effect of a combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins in the rats to establish glaucoma model.</p><p><b>METHODS</b>Operation was performed in each of the left eyes of 90 adult male rats. Right eyes were used as controls. Measurement of intraocular pressure (IOP) was performed with an applanation tonometer (Tono-Pen). Retinal ganglion cells (RGCs) were retrogradely labeled by applying FluoroGold onto the bilateral superior colliculus.</p><p><b>RESULTS</b>During the follow-up (24 weeks), the IOP of the study eyes was significantly higher (P < 0.05) than the control eyes (at final examination, IOP of control eyes was (13.4 ± 1.0) mmHg and IOP of study eyes was (16.1 ± 1.8) mmHg). Correspondingly, at 24 weeks after operation, the RGCs density of the study eyes (2286.11 ± 290.45/mm(2)) was significantly lower than the control eyes (2626.46 ± 164.85/mm(2), P < 0.01). In the operated eyes, histological examination showed excavation of optic disc and increased neuroglial cells in the optic nerve, reduced thickness of retina and diminution of retinal ganglion cells, and atrophy of ciliary body and iris. Notably, the anterior chamber angle of the operated eye remained open.</p><p><b>CONCLUSIONS</b>A combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins may establish a reliable glaucoma model for further research.</p>

Effect of ocular hypertension on the function of retina of glaucoma / 医用生物力学

Objective To explore the effect of elevated intraocular pressure (IOP) on retina's function of rat. Method Chronic glaucoma rat models were built and IOP were measured persistently. Flash electroretinogram (F ERG) and histological status were measured before and after surgery. ResultsThe maximal IOP in rats without anesthesia is (3.07±1.10) kPa in 1 day after surgery. From 1 w to 6 w after surgery, the model eye IOPs are （2.84±0.90） kPa，（2.86±0.54） kPa，（2.76±0.52） kPa，（2.70±0.51） kPa，（2.39±0.27） kPa and（2.09±0.39） kPa, respectively, which are significant higher than that of the fellow eye. A series of main parameters including the amplitudes of a wave, b wave and oscillatory potentials(OPs) all dramatically decreased in model eyes at 6 weeks and 3 weeks postoperatively . No obvious changes were observed by routine HE staining among the eyes before and after surgery. Conclusions The chronic high intraocular pressure could induce the retinal dysfunction before any morphological change occurred, and what's more, the damage showed itself a progressive one.

Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hematopoietic stem cells (HSCs) can be used to deliver functionally active angiostatic molecules to the retinal vasculature by targeting active astrocytes and may be useful in targeting pre-angiogenic retinal lesions. We sought to determine whether HSC mobilization can ameliorate early diabetic retinopathy in mice.</p><p><b>METHODS</b>Mice were devided into four groups: normal mice control group, normal mice HSC-mobilized group, diabetic mice control group and diabetic mice HSC mobilized group. Murine stem cell growth factor (murine SCF) and recombined human granulocyte colony stimulating factor (rhG-csf) were administered to the mice with diabetes and without diabetes for continuous 5 days to induce autologous HSCs mobilization, and subcutaneous injection of physiological saline was used as control. Immunohistochemical double staining was conducted with anti-mouse rat CD31 monoclonal antibody and anti-BrdU rat antibody.</p><p><b>RESULTS</b>Marked HSCs clearly increased after SCF plus G-csf-mobilization. Non-mobilized diabetic mice showed more HSCs than normal mice (P=0.032), and peripheral blood significantly increased in both diabetic and normal mice (P=0.000). Diabetic mice showed more CD31 positive capillary vessels (P=0.000) and accelerated endothelial cell regeneration. Only diabetic HSC-mobilized mice expressed both BrdU and CD31 antigens in the endothelial cells of new capillaries.</p><p><b>CONCLUSION</b>Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice.</p>

Study on protein extraction methods for Streptococcus mutans / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To establish an efficient and stable method for protein extraction of Streptococcus mutans.</p><p><b>METHODS</b>The collected bacteria were treated by freeze-thaw and ultrasonic (method 1), ultrasonic (method 2), boiling (method 3), boiling and ultrasonic (method 4), respectively. The index such as state of bacteria broken, concentration of extracted protein and SDS-PAGE of protein were employed to evaluate the effects of above four methods.</p><p><b>RESULTS</b>Beside the method 3, the other three methods could break the bacteria effectively, of which ultrasonic was the key factor. The pattern of SDS-PAGE which treated by method 1, method 2 and method 4 was almost same, but method 1 resulted in the best abundance. There was significantly difference among the four protein concentration extracted by four methods (P < 0.05). All methods exhibited good stability and reproducibility.</p><p><b>CONCLUSION</b>Method of freeze-thaw and ultrasonic resulted in an efficient proteins extraction of Streptococcus mutans which demonstrated good stability and reproducibility and easy to handle.</p>

Comparison of coronary plaque composition between patients with acute coronary syndrome and stable coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>The purpose of the present study was to compare the plaque composition between patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histological analysis.</p><p><b>METHODS</b>Two hundred and ten patients were divided into ACS group (n = 131, 188 diseased vessels) and SCAD group (n = 79, 158 diseased vessels). A total of 346 de novo lesions with > 50% stenosis in native coronary arteries with diameters > 2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software.</p><p><b>RESULTS</b>There were no significant differences in overall lesions for fibrous (51.2% +/- 12.5% vs. 52.6% +/- 9.6%), fibrolipidic (11.3% +/- 10.6% vs. 12.9% +/- 9.4%), calcium (15.1% +/- 8.9% vs. 20.5% +/- 12.5%) or necrotic core (23.1% +/- 9.8% vs. 20.4% +/- 6.8%, all P > 0.05) components between ACS and SCAD patients. Culprit lesions for fibrous (49.1% +/- 11.2% vs. 50.3% +/- 9.7%), fibrolipidic (10.2% +/- 9.5% vs. 12.7% +/- 9.5%), calcium (15.4% +/- 8.9% vs. 17.4% +/- 24.8%), or necrotic core (24.0% +/- 11.5% vs. 19.7% +/- 5.3%, all P > 0.05) components were also similar between ACS and SCAD patients. High density lipoprotein-cholesterol (HDL) levels > 1.04 mmol/L was associated with more fibrolipidic (15.6% +/- 9.6% vs. 7.4% +/- 5.9%) and less necrotic core (19.4% +/- 8.6% vs. 28.6% +/- 11.2%, all P < 0.05 vs. patients with HDL < or = 1.04 mmol/L) components in ACS patients.</p><p><b>CONCLUSION</b>Coronary plaque composition was similar between ACS and SCAD patients.</p>

Comparison of coronary plaque composition among patients with acute coronary syndrome and stable coronary artery disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The identification of vulnerable plaques before rupture is an important clinical goal. The purpose of the present study was to assess the difference in plaque composition among patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histologic analysis.</p><p><b>METHODS</b>One hundred and thirty-nine patients were divided into ACS group and SCAD group according to clinical presentation. A total of 229 de novo lesions with >50% stenosis in native coronary arteries with diameters >2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software.</p><p><b>RESULTS</b>There were no significant differences in overall lesions for fibrous ((52.0+/-11.9)% vs (54.3+/-8.5)%, P>0.05), fibrolipidic ((12.3+/-10.1)% vs (13.8+/-9.5)%, P > 0.05), calcium ((14.0+/-9.1)% vs (19.3+/-13.1)%, P>0.05), or necrotic core ((22.0+/-11.1)% vs (19.7 +/- 5.4)%, P > 0.05) percentages in ACS and SCAD patients, respectively. There were also no significant differences in culprit lesions for fibrous ((46.4+/-12.0)% vs (53.6+/-8.8)%, P>0.05), fibrolipidic ((9.1+/-9.0)% vs (12.9+/-9.7)%, P>0.05), calcium ((16.6+/-9.7)% vs (21.8+/-26.3)%, P>0.05), or necrotic core ((28.0+/-12.6)% vs (20.6+/-5.2)%, P>0.05) percentages in ACS and SCAD patients, respectively. High density lipoprotein-cholesterol levels >1.04 mmol/L were associated with more fibrolipidic ((14.5+/-10.4)% vs (7.1+/-6.5)%, P<0.05) and less necrotic core ((20.6+/-9.7)% vs (27.9+/-12.6)%, P<0.05) percentages in the cohort with ACS.</p><p><b>CONCLUSIONS</b>In this study, coronary plaque composition assessed by intravascular ultrasound virtual histologic analysis was not significantly different between ACS and SCAD patients. The anatomic relationship of the specific plaque components to the lumen of the vessel was more important than the quantitative information of plaque composition for plaque stability.</p>

Application value of scanning laser angiography with a wide-field contact lens system in choroidal melanoma / 中华眼底病杂志

Objective To evaluate the application value of scanning laser angiography with a wide-field contact lens system in the diagnosis of choroidal melanoma. Methods Twenty-four patients with choroidal melanoma were randomly divided into two groups, who underwent fundus fluorescein angiography and indocyanine green angiography scanning with the wide-field contact and non-contact lens system respectively in order to acquire the 150? wide-field and 30? view image data. The quality of the images was comprehensively evaluated. Results Satisfying images were acquired from all of the 24 patients. Wide-field contact lens system indicated the accurate adjacent relation between the lesion position and the other dissection mechanisms, and also provided the general information about the size of the tumor and the perfusion of fluorescien or indocyanine green in the blood vessels. At the same time, it enlarged the view scope 3-5 times, which make for the screening of the peripheral lesions. Conclusions Scanning laser angiography with a wide-field contact lens system has important application value in the diagnosis of choroidal melanoma.

Comparative investigation of intravitrous levels of hepatocyte growth factor in diabetic neovascular glaucoma / 眼科

Objective To examine the concentrations of hepatocyte growth factor(HGF)and vascular endothelial growth factor (VEGF)in the patients with diabetic neovascular glaucoma(NVG),proliferative retinopathy without neovascularization of the iris(PDR) and idiopathic macular role(IMH),and to determine the relationship between HGF and VEGF.Design Prospective case series. Participants 14 patients(14 eyes)with NVG,22 patients(22 eyes)with non-NVI PDR,19 patients(19 eyes)with IMH.Methods The double-antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to measure the intravitreous level of HGF and VEGF.Main Outcome Measures The concentrations of HGF and VEGF in the same specimens.Results The concentrations of HGF (mean?SD)in vitreous of NVG group,PDR group and IMH group were(12908.42?2946.46)、(9770.86?3802.99)、(4160.54?2044.80)pg/ ml,respectively(Kruskal-Walls test,X~2=32.36,P=0.000).In addition,significant differences were observed between groups of the concentrations of HGF(P＜0.01,respectively).The intravitreous concentrations of VEGF(mean?SD)in three groups were(823.50?718.58)、(821.82?786.27)、(22.73?3.20)pg/ml(X~2=28.30,P=0.O00),respectively(Kruskal-Walls test,X~2=32.36,P=0.000).There was no significant correlation between the concentrations of HGF and those of VEGF in the same specimens from each group(P＞0.05, respectively).Conclusions The intravitreous concentrations of HGF in the patients with diabetic NVG are obviously higher than those with IMH and non-NVI PDR,suggesting that HGF appears to be associated with mediating the neovascularization of retina and iris in NVG.However,it is not found there is any relationship between the intravitreous levels of HGF and VEGF.