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1.
Journal of Stroke ; : 1-11, 2021.
Article in English | WPRIM | ID: wpr-874960

ABSTRACT

Background@#and Purpose The present study aimed to compare the efficacy and tolerability of different blood pressure (BP)-lowering strategies. @*Methods@#Randomized controlled trials that compared various antihypertensive treatments and stroke outcomes were included. Eligible trials were categorized into three scenarios: single or combination antihypertensive agents against placebos; single or combination agents against other agents; and different BP-lowering targets. The primary efficacy outcome was the risk reduction pertaining to strokes. The tolerability outcome was the withdrawal of drugs, owing to drug-related side effects (PROSPERO registration number CRD42018118454 [20/12/2018]). @*Results@#The present study included 93 trials (average follow-up duration, 3.3 years). In the pairwise analysis, angiotensin-converting enzyme inhibitors (ACEis) and beta-blockers (BBs) were inferior to calcium channel blockers (CCBs) (odds ratio [OR], 1.123; 95% confidence interval [CI], 1.008 to 1.252) (OR, 1.261; 95% CI, 1.116 to 1.425) for stroke prevention, BB was inferior to angiotensin II receptor blockers (ARB) (OR, 1.361; 95% CI, 1.142 to 1.622), and diuretics were superior to ACEi (OR, 0.871; 95% CI, 0.771 to 0.984). The combination of ACEi+CCB was superior to ACEi+diuretic (OR, 0.892; 95% CI, 0.823 to 0.966). The network meta-analysis confirmed that diuretics were superior to BB (OR, 1.34; 95% CI, 1.11 to 1.58), ACEi+diuretic (OR, 1.47; 95% CI, 1.02 to 2.08), BB+CCB (OR, 2.05; 95% CI, 1.05 to 3.79), and renin inhibitors (OR, 1.87; 95% CI, 1.25 to 2.75) for stroke prevention. Regarding the tolerability profile, the pairwise analysis revealed that ACEi was inferior to CCB and less tolerable, compared to the other treatments. @*Conclusions@#Monotherapy using diuretics, CCB, or ARB, and their combinations could be employed as first-line treatments for stroke prevention in terms of efficacy and tolerability.

2.
Article in Chinese | WPRIM | ID: wpr-873741

ABSTRACT

Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.

3.
Article in Chinese | WPRIM | ID: wpr-879438

ABSTRACT

OBJECTIVE@#To explore the relationship between lumbar degenerative spondylolisthesis and T2WI high signal in the interspinous ligament in MRI in order to improve the understanding of the signal changes of the interspinous ligament.@*METHODS@#The clinical data of 43 patients with clinically diagnosed lumbar degenerative spondylolisthesis were collected from March 2018 to March 2020, there were 19 males and 24 females, aged 50 to 92 years with an average of 69 years old. Using picture archiving and communication systems (PACS) to access images and record the distribution and incidence of T2WI high signal in the interspinous ligament between the slipped and non-slipped segments. Using Spearman correlation analysis to explore the relationshipbetween the T2WI high signal of the interspinous ligament and the degree of lumbar spondylolisthesis.@*RESULTS@#Except for 8 ligaments that were not included in the statistical results due to poor image quality, 43 patients with a total of 207 lumbar vertebrae and interspinous ligaments were included in the study. According to the Meyerding classification method, 43 patients had a total of 48 segments with spondylolisthesis, 41 segments in grade Ⅰ and 7 segments in grade Ⅱ. There were 30 cases of MRI T2WI high signal in the interspinous ligament corresponding to spondylolisthesis segment, including 3 cases on L@*CONCLUSION@#In patients with degenerative lumbar spondylolisthesis, the MRI T2WI hyperintensity is more common in the interspinous ligament. The occurrence of T2WI high signal is positively correlated with the degree of spondylolisthesis, which should be payed enough attention in imaging diagnosis.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Ligaments, Articular , Lumbar Vertebrae/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Spondylolisthesis/diagnostic imaging
4.
Article in Chinese | WPRIM | ID: wpr-879893

ABSTRACT

OBJECTIVE@#To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants.@*METHODS@#The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP.@*RESULTS@#The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation (@*CONCLUSIONS@#A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.


Subject(s)
Birth Weight , Bone Diseases, Metabolic/etiology , China/epidemiology , Female , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies , Risk Factors
5.
International Eye Science ; (12): 1325-1330, 2020.
Article in Chinese | WPRIM | ID: wpr-822951

ABSTRACT

@#AIM:The dry eye model of rat was induced either by lacrimal gland extirpation or injection of botulinum toxin A into lacrimal gland. The clinical manifestations, pathological features and cytokine changes of these two models were compared, then we discussed their advantages, disadvantages and applicable scope.<p>METHODS:Thirty healthy 8-week-old male Brown Norway rats were randomly assigned into three groups equally. The left eye of group A was blank group, group B was the left lacrimal gland extirpation model, the left tear gland of group C was injected with botulinum toxin A. We compared the data of Schirmer I test, tear break-up time(BUT), and the corneal fluoresceince staining scores at different times(1d before experiment, 3d, 7d, 14d, 28d, and 42d after the surgical process). We observed pathological changes of conjunctiva, cornea and lacrimal gland at 42d, and we used real-time polymerase chain reaction to analyze interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and epithelial growth factor(EGF).<p>RESULTS:At the 3d, compared with group A, the tear secretion of both group B and group C were continuous decrease(<i>P</i><0.05). At the 7d, compared with group A, the BUT of both group B and group C began to decreased(<i>P</i><0.05), and the corneal epithelial staining scores of both group B and group C began to significantly increase(<i>P</i><0.05). There was no statistical difference in the above clinical data between group B and group C(<i>P></i>0.05). The corneal epithelial cells in group A was set as normal morphology, while the corneal epithelial cells in group B and group C showed filamentous separation of surface cells to varying degrees, and the number of conjunctival goblet cells was decreased. The lacrimal gland of group C was obviously atrophic. In conjunctival and corneal tissues, the expression of EGF, TNF-α and IL-6 were significantly increased in group B and group C, which was statistically significant compared with group A(<i>P</i><0.05). The expression of EGF and TNF-α didn't altered significantly between group B and group C(<i>P</i>>0.05), however, the expression of IL-6 in group B was much higher than that in group C(<i>P</i><0.05).<p>CONCLUSION:In this study, we proved that both lacrimal gland extirpation and lacrimal gland injection botulinum toxin A could construct a stable aqueous tear deficiency dry eye rat model. The appropriate animal model should be selected according to the experimental design and research purpose.

6.
Article in Chinese | WPRIM | ID: wpr-821634

ABSTRACT

Objective To investigate the survival period of Yunnan Province-derived smooth-shelled Oncomelania snails bred in laboratory. Methods Oncomelania snails were sampled from Heqing and Yongsheng counties where schistosomiasis is endemic, and uninfected adult snails were collected and bred in laboratory. The survival period of snails sampled from these two counties was compared. Results The 1-, 2-, 3- and 4-year survival rates of laboratory-bred smooth-shelled snails sampled from Yunnan Province were 72.36%, 29.11%, 13.08% and 0.21%, respectively, and were 74.66%, 38.91%, 19.46% and 0.45% for snails derived from Heqing County, and 70.36%, 20.55%, 7.51% and 0 for snails sampled from Yongsheng County, respectively. The mean and median survival period of Yunnan Province-derived adult snails was 20.90 and 20.67 months, and there were significant differences between the snails sampled from Heqing and Yongsheng counties in terms of the mean (22.94 vs. 19.13 months, P < 0.05) and median survival period (21.63 vs. 19.81 months, P < 0.05). Conclusion The mean survival period of Yunnan Province-derived smooth-shelled adult snails is approximately 20 months in laboratory, and the survival varies in geographical areas.

7.
Article in Chinese | WPRIM | ID: wpr-821627

ABSTRACT

Objective To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions. Methods Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis. Results Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum. Conclusion The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.

8.
China Pharmacy ; (12): 1049-1053, 2020.
Article in Chinese | WPRIM | ID: wpr-821492

ABSTRACT

OBJECTIVE:To compare the che mical composition differences of raw and fried processed Glycyrrhiza uralensis , and provide reference for clarifying the regularity of chemical composition change before and after processing and material basis of differential use of raw and fried G. uralensis . METHODS :UPLC-Q-TOF-MS technology was used to detect the composition of raw and fried G. uralensis . By comparing the retention time ,relative molecular weight and other information of the compounds with the databases such as METLIN ,Agilent MassHunter PCDL Manager off-line component identification workstation and references ,the chemical compositions of the compounds were preliminarily identified. Principal component analysis (PCA)method was used to observe the overall distribution trend of samples. Orthogonal partial least square (OPLS-DA)method was used to screen differential compounds [VIP >1.0 and | P(corr)|≥0.5 as criteria] and analyze the content changes of differential compounds. RESULTS :A total of 31 common compounds were preliminarily identified from the raw and fried G. uralensis . PCA analysis showed that raw and fried G. uralensis could be separated well. OPLS-DA analysis result showed that 15 characteristic differential compounds were screened out from raw and fried G. uralensis ,including 13 flavonoids and 2 coumarins;the contents of 8 flavonoids compounds such as licoflavone A ,glycyrrhizin and glabridin and so on in G. uralensis were significantly increased (P<0.05 or P<0.01), while the contents of 5 flavonoids components such as glycyrrhizinol ,glycyrin A and 2 coumarins components such as 2′-4′-trihydroxy-5-methoxy-3-coumarim and hedysarimcoumestan B were significantly decreased (P<0.05) after honey-fried processing. CONCLUSIONS :Before and after processing ,there are obvious differences between some flavonoids and coumarins , which may be the main material basis for differential use of raw and honey-fried G. uralensis .

9.
Article in English | WPRIM | ID: wpr-785344

ABSTRACT

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.


Subject(s)
Adult , Asian Continental Ancestry Group , Biomarkers , China , Consensus , Diagnosis , Diagnosis, Differential , Drug Therapy , Eosinophils , Epidemiology , Epigenomics , Genetics , Humans , Hypersensitivity , Inflammation , International Agencies , Medical Staff , Neck , Phenotype , Precision Medicine
10.
Article in Chinese | WPRIM | ID: wpr-867179

ABSTRACT

Objective:To explore the relationship between the childhood trauma and neruocognition in patients with schizophrenia.Methods:Sixty-two patients with schizophrenic were selected from Anhui mental health center, and sixty-three community health controls were selected. All subjects were assessed with the childhood trauma questionnaire (CTQ), Wisconsin card sorting Test (WCST), attention network test (ANT), verbal fluency test (VFT) and digit span test (DST). SPSS 17.0 was used for statistical analysis. t-test was used to compare the measurement data of normal distribution and Mann-Whitney U test was used to compare the measurement data of non-normal distribution. Spearman correlation analysis was used to analyze the relationship between CTQ score and cognitive function score. Results:Compared with health controls(34.00(30.00, 37.00), 6.00 (5.00, 7.00), 5.00(5.00, 5.00), 5.00(5.00, 5.00), 9.00(6.00, 11.00), 7.00(6.00, 10.00)), the total score of CTQ, subscores of emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect in patients with schizophrenia were significantly increased (48.50(37.75, 57.00), 9.00(6.00, 12.25), 7.00(5.00, 9.25), 5.50(5.00, 7.25), 13.00 (9.00, 16.25), 11.00(8.00, 13.00)) ( Z=-4.781--6.724, all P<0.01). Compared with the control group, the number of WCST classification completed in the patient group was lower, while the number of wrong answers, continuous answers and persistent errors increased ( Z=-5.655--6.060, all P< 0.01). The correct rate of ant decreased, but the reaction time increased ( Z=-5.796, -6.094, all P< 0.01). VFT and DST scores were decreased ( Z=-3.492--8.499, both P< 0.01). In patients with schizophrenia, CTQ sexual abuse subscore were negatively correlated with completed categories scores ( r=-0.384) and positively correlated with total errors ( r=0.360), perseverative responses( r=0.394) and perseverative errors ( r=0.381) on WCST(all P<0.01). CTQ physical neglect scores were negatively correlated with the ANT correct ratio( r=-0.400) and conflict resolution( r=-0.417) (all P<0.01). CTQ emotional neglect scores were negatively correlated with VFT scores( r=-0.345) ( P<0.01). The significant associations remained after controlling for age, education and PANSS scores. Conclusion:Patients with schizophrenia experience more traumatic events in their early years and have extensive cognitive defects. The childhood trauma has negative effects on cognitive flexibility, attention, memory and speech function in patients with schizophrenia.However, the positive correlation between childhood trauma and executive conflict of attention network needs to be further verified and explored.

11.
Article in Chinese | WPRIM | ID: wpr-829583

ABSTRACT

Objective To assess the schistosomiasis transmission risk in Nanjing County, so as to provide the scientific evidence for the development of the schistosomiasis control strategy and consolidation of the control achievements. Methods On May 2019, the Deqiu Village in Deqiu Town and Baiyun Village in Nanjing Town of Yunnan Province, where schistosomiasis were historically relatively highly endemic, were selected to assess the risk of transmission of schistosomiasis by means of a retrospective review of the data pertaining to the historical endemic situation and schistosomiasis control, combined with a cross-sectional survey of snail and wild feces distribution. Results During the period between 2017 and 2018, the mean sero-prevalence rates of Schistosoma japonicum infections were 6.76% (202/2 990) and 2.86% (142/4 971) in humans and 0 (0/1 160) and 10.65% (31/291) in bovines in Deqiu and Baiyun villages of Nanjian County, respectively; however, no egg-positives were identified; in addition, there were 21.06 hm2 snail habitats found, but no S. japonicum infections were detected in snails. In 2019, there was 6.17 hm2 snail habitats detected, with 2.17% (245/11 298) occurrence of frames with snails and a 0.06 snails/0.1 m2 density of living snails; however, no positives for nucleic acid detection were seen in snails; among the 136 wild fecal samples captures from 23 settings, no S. japonicum infections were identified. Conclusions The risk of schistosomiasis transmission remains at a low level in Nanjian County; however, the factors affecting the transmission of schistosomiasis have not been completed eliminated. The integrated schistosomiasis control strategy with an emphasis on the control of the source of S. japonicum infections requires to be reinforced to consolidate the control achievements.

12.
Article in Chinese | WPRIM | ID: wpr-871788

ABSTRACT

Objective:To observe the changes of microperimeter and OCT angiography (OCTA) in idiopathic macular hole (IMH) before and after operation, and to explore the correlation between the changes and visual acuity.Methods:From January 2018 to January 2019, 41 patients (41 eyes) with IMH who underwent pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) flap surgery in Tianjin Eye Hospital were included in this study. Among them, 8 patients (8 eyes) were male and 33 patients (33 eyes) were female. The average age was 64.02±6.46 years. The average course of disease was 7.00±8.85 months. BCVA, microperimeter and OCTA were performed. The retinal mean sensitivity (RMS) at 10 ° and fovea 2 ° fixation rate (P1) and binary contour ellipse area (63% BCEA) were measured by macular integrity assessment instrument. The central retinal thickness (CRT), choroidal blood flow area (CFA), superficial and deep retinal blood flow density (FAVD, FDVD), foveal avascular zone (FAZ) and blood flow densitywithin the width of FAZ 300 μm (FD-300) were measured by OCTA. Twenty one and 19 eyes with or without ILM flap operation were treated with 25G standard three incision PPV. The follow-up time was more than 6 months. Paired t-test was used to compare the indexes before and after operation. Pearson correlation analysis was performed for the correlation between logMAR visual acuity and microperimeter variables and OCTA variables. Nonparametric test was performed for paired comparison between affected eyes and contralateral eyes before and after operation.Results:At 6 months after operation, logMAR visual acuity ( t=-12.33), RMS ( t=7.94), P1 ( t=3.21), 63% BCEA ( t=-3.98), CRT ( t=-9.17), CFA ( t=8.14), FSVD ( t=3.75), FDVD ( t=3.88) were significantly improved compared with those before operation ( P<0.001). The difference of FAZ area ( t=-1.40) and FD-300 ( t=1.95) before and after operation were not statistically significant ( P>0.05). The results of correlation analysis showed that logMAR visual acuity 6 months after surgery was correlated with preoperative logMAR visual acuity, MIN, RMS, P1, 63% BCEA, FSVD, FDVD and FAZ ( r=0.432、0.527、-0.410、-0.383、0.349、-0.406、-0.373、0.407; P<0.05). At 6 months after operation, the indexes of the affected eyes were significantly improved compared with those before operation, but worse than those of the contralateral eyes ( P<0.05). Conclusions:PPV for IMH can effectively improve the visual acuity, retinal function and foveal microvascular circulation. Retinal function and blood circulation changes have a significant impact on postoperative visual acuity.

13.
Article in Chinese | WPRIM | ID: wpr-871700

ABSTRACT

Objective To observe the dynamic characteristics of visual acuity after vitrectomy in different sizes of idiopathic macular hole,and analyze the influencing factors.Methods A retrospective study.From August 2016 to June 2018,302 patients (302 eyes) with monocular idiopathic macular hole who underwent 25G vitrectomy combined with the internal limiting membrane peeling in Tianjin Eye Hospital were included in the study.There were 130 males and 172 females,with the mean age of 63.36 ± 6.91 years.There were 158 left eyes and 144 right eyes.The logMAR BCVA was 1.13 ± 0.45.The minimum diameter (422.92± 211.73 μm) and basal diameter (835.47± 366.42 μm) of macular hole and choroid thickness under fovea (244.84± 60.68 μm)were measured by OCT.According to the minimum diameter,the holes were divided into small hole group (≤ 250 μm),middle hole group (>250 μm and ≤400 μm) and large hole group (>400 μm).The logMAR BCVA at 1,3 and 6 months after surgery in 3 groups were observed.Two-factor repeated measure ANOVA was used to compare the visual acuity of the 3 groups.The generalized estimation equation (GEE) was used to analyze the influencing factors of postoperative visual recovery.Results One month after surgery,all the holes were closed.One,3 and 6 months after surgery,the logMAR BCVA were 0.33 ± 0.25,0.23 ± 0.18,0.16± 0.17 in the small hole group;the logMAR BCVA were 0.46±0.25,0.35±0.26,0.27±0.28 in the middle hole group;the logMAR BCVA were 0.81 ±0.51,0.61 ±0.48,0.53±0.37 in the large hole group.Through repeated measurement variance analysis of two factors,it was found that there was an interaction between different groups and different time nodes (F=23.133,P<0.01).All data were segmented and one-way repeated measure ANOVA was performed.The results showed that there was a statistically significant difference in visual acuity between the small hole group and the middle hole group among preoperative and 1 month after surgery (P<0.05),while there was no statistically significant difference in visual acuity between 1,3 and 6 months after surgery (P>0.05).In the large hole group,among preoperative,1 months after surgery,3 months after surgery,the visual acuity difference was statistically significant (P<0.05),while the visual acuity difference between 3 months after surgery and 6 months after surgery was not statistically significant (P>0.05).The results of GEE analysis showed that hole size (X2=4.17,P=0.04),basal diameter (X2=7.25,P=0.01),disease course (X2=19.26,P=0.00),and choroid thickness (X2=4.19,P=0.04) were the influencing factors of postoperative visual acuity.Conclusions After vitrectomy of macular holes of different sizes,the visual recovery trend is different.The visual recovery of small holes and middle holes is faster and basically restored at 1 month.The large holes requires a slow recovery process and stabilizes vision at 3 months.Hole size,basal diameter,course of disease and choroid thickness are the influencing factors of visual acuity recovery.

14.
Article in Chinese | WPRIM | ID: wpr-870152

ABSTRACT

Sj?gren′s syndrome is a chronic systemic autoimmune disease characterized by lymphocyte proliferation and progressive exocrine gland damage. In China, standardized diagnosis and treatment for Sj?gren′s syndrome lags behind other common rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Based on the evidence and guidelines from China and other countries, Chinese Sj?gren′s Syndrome Collaborative Research Group together with stomatologist and ophthalmologist developed Standardization of diagnosis and treatment of primary Sj?gren′s syndrome. The purposes are: (1) to standardize the detection and interpretation of key indicators for the diagnosis of Sj?gren's syndrome, including serum anti SSA antibody and labial gland pathology; (2) to suggest using widely accepted disease activity index in evaluation of the disease; (3) to standardize rational management for Sj?gren′s syndrome patients with topical and systemic diseases.

15.
Chinese Journal of Urology ; (12): 426-429, 2020.
Article in Chinese | WPRIM | ID: wpr-869686

ABSTRACT

Objective:To investigate the factors related to the prognosis of patients with metastatic renal cell carcinoma after bone metastasectomy and to provide a reference for the clinical treatment of renal cell carcinoma.Methods:The clinical data of 143 patients with metastatic renal cell carcinoma in our center from January 2008 to December 2018 were retrospectively collected. Among 143 patients, 121 were male and 22 were female, with the average age of (54.8±12.5) year-old(from 18 to 85 year-old). The KPS scores of 138 patients were no higher than 80%. According to International Metastatic RCC Database Consortium (IMDC) risk model for metastatic renal cell carcinoma, the patients were divided into intermediate risk group (92 patients) and poor risk group (51 patients). The patients who had received complete resection for both primary lesion and metastatic tumor were regarded as tumor-free (47 patients). Otherwise, the patients with unresectable primary tumor or incomplete resection of the metastatic tumor were defined as the patients surviving conversely bone metastases were the only metastatic site, and the other 57 patients also experienced concomitant metastases comparatively. Sixty-two patients only had solitary bone metastasis lesion and 81 patients had multiple bone metastases. Kaplan-Meier survival analysis was used to calculate the 1-year, 3-year and 5-year survival rate. The impacts of different variables on the prognosis were examined by log-rank test. Univariate analysis and multivariable Cox proportional hazards regression models were used to identify the independent risk factors.Results:The median follow-up time was 49.0 months. The overall survival was 1-115 months, with the median OS was 24.0 months. The 1-year, 3-year and 5-year survival rate were 79.2%, 59.4% and 31.6%, respectively. All the patients underwent bone metastasectomy and 72 of them were treated with targeted therapy. The pathology results of metastasectomy were clear cell carcinoma for 132 patients and non-clear cell carcinoma for the 11 patients. In tumor-free group, the median OS was 30.0 months and in survival with tumor group, the median OS was 19.4 months, with a significant difference between the two groups ( P=0.030). In IMDC intermediate risk group, the prognosis was improved among the patients who received post-surgical targeted therapy after metastasectomy (24.3 months vs. 16.8 months, P=0.027), whereas the difference was not significant for IMDC poor risk group ( P=0.449). Age ≥60 years and multiple bone metastases sites were proved to be the independent risk factors for the prognosis of patients with metastatic renal cell carcinoma after bone metastasectomy. Conclusions:The prognosis of RCC patients with bone metastases was generally poor. Metastasectomy could prolong the OS of the patients who had undergone primary nephrectomy and had solitary bone metastasis. Metastasectomy combined with targeted therapy could significantly improve the prognosis of the IMDC intermediate risk patients. However, the effect of targeted therapy among IMDC poor risk patients remained to be further proved.

16.
Chinese Journal of Endemiology ; (12): 551-556, 2020.
Article in Chinese | WPRIM | ID: wpr-866160

ABSTRACT

Objective:To expound the pathogenesis relationship between Yunnan unexplained sudden death (YUSD) and desmosomal protein gene mutations of arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods:Four YUSD cases families by ARVC pathological diagnosis were selected, to collect heart blood samples of YUSD cases by ARVC pathological diagnosis( n=3), venous blood samples of immediate relatives with genetic relationship (case relatives, n=4) and control population without genetic relationship ( n=7). DNA was extracted for PCR amplification and sequencing of a total of 97 exons of the ARVC desmosomal protein genes plakophilin 2 (PKP2), desmoplakin (DSP), desmoglein 2 (DSG2), desmocollin 2 (DSC2), and junction plakoglobin (JUP), and the mutations of the 5 genes were analyzed in combination with the genetic family. Results:DSP gene mutations were found in all YUSD cases by ARVC pathological diagnosis and case relatives, and PKP2, DSG2, DSC2 and JUP genes mutations were found in 1 person each. The same person carried 1-3 genes mutations. DSP gene existed 4 exon mutation sites, and 1 of which was a newly discovered heterozygous synonymous mutation c.4014 C>A (p.A1338A). PKP2 gene existed 2 exon missense mutation sites in 1 YUSD case by ARVC pathological diagnosis, and 1 of which was a newly discovered heterozygous mutation c.739 G>C (p.G247R). One heterozygous missense mutation site c.799 G>A (p.A267T) of JUP gene was newly discovered, and the predictive value of protein function was 0.963, the possibility of abnormal changes in protein function was high. DSG2 and DSC2 genes each had one mutation site. However, no mutation was found in control population.Conclusions:Both YUSD cases by ARVC pathological diagnosis and case relatives carry ARVC desmosomal protein genes DSP, PKP2, DSG2, DSC2 and JUP mutations. There may be a certain pathogenesis relationship between YUSD and ARVC desmosomal protein gene mutations.

17.
Chinese Journal of Endemiology ; (12): 99-103, 2020.
Article in Chinese | WPRIM | ID: wpr-866077

ABSTRACT

Objective:To analyze the mutations in desmosomal protein genes of arrhythmogenic right ventricular cardiomyopathy (ARVC) in relatives of Yunnan unexplained sudden death (YUSD) cases in Nanjian County, Dali Prefecture, Yunnan Province, and provide a basis for etiological hypothesis and control measures.Methods:The blood samples of YUSD case relatives ( n = 7) and control villagers ( n = 7) were collected, and basic situation investigation and electrocardiography (ECG) examination were performed at the same time. Blood DNA was extracted as a template for PCR amplification, and Sanger method was used to perform plakophilin 2 (PKP2), desmoglein 2 (DSG2), desmocollin 2 (DSC2), desmoplakin (DSP), and junction plakoglobin (JUP) five ARVC desmosomal protein genes sequencing of a total of 97 exons, and comprehensive analysis of gene mutations was carried out. Results:Five of YUSD case relatives carried genetic mutation sites, including DSP gene heterozygous synonymous mutations about exon 20 c.2862 C>T (p.Cys954Cys) and exon 24F c.7122 C>T (p.Thr2374Thr), DSC2 gene heterozygous missense mutation about exon 15 c.2326 A>G (p.Ile776Val), and all the five people were single heterozygous mutation carriers. Among them, two case relatives of the father-son carried the same site mutation of the DSC2 gene; the abnormal ECGs of three YUSD case relatives were ST-T change or clockwise rotation. However, the mutation sites of PKP2, DSG2, DSC2, DSP and JUP genes in control villagers were not detected.Conclusions:YUSD case relatives in Nanjian County carry ARVC desmosomal protein genes DSP and DSC2 mutations. Pathogenic mutation of DSC2 gene c.2326 A>G (p.Ile776Val) is may related to the incidence of some YUSD cases.

18.
Article in Chinese | WPRIM | ID: wpr-864087

ABSTRACT

Drug-induced liver injury (DILI) is a common disease in children with non-infectious liver di-seases, but there is no specific diagnostic method.Genetic-metabolic liver disease is a rare disease with low social recognition and requiring special examination to be diagnosed.The clinical manifestations of the 2 diseases are similar and complex, so it is easy to misdiagnose genetic-metabolic liver disease as DILI.In clinical practice, it is necessary to raise the awareness of excluding genetic-metabolic liver diseases in the diagnosis of DILI, so as to avoid misdiagnosis.

19.
Ultrasonography ; : 221-228, 2020.
Article | WPRIM | ID: wpr-835329

ABSTRACT

The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize liver imaging in patients at high risk for hepatocellular carcinoma (HCC), and it uses a diagnostic algorithm to assign categories that reflect the relative probability of HCC, non-HCC malignancies, or benign focal liver lesions. In addition to major imaging features, ancillary features (AFs) are used by radiologists to refine the categorization of liver nodules. In the present document, we discuss and explain the application of AFs currently defined within the LI-RADS guidelines. We also explore possible additional AFs visible on contrast-enhanced ultrasonography (CEUS). Finally, we summarize the management of CEUS LI-RADS features, including the role of current and potential future AFs.

20.
Ultrasonography ; : 11-21, 2020.
Article | WPRIM | ID: wpr-835322

ABSTRACT

Focal lesions of the adrenal glands are incidentally detected in approximately 5% of cases by modern imaging techniques. Fewer than 5% of these adrenal incidentalomas are malignant and approximately 10% have endocrine activity. Reliable differentiation of malignant versus benign and hormonally active versus nonfunctional adrenal incidentalomas significantly influences therapeutic management and the outcome of affected individuals. Therefore, each adrenal incidentaloma should undergo a standardized diagnostic work-up to exclude malignancy and endocrine activity. This position statement of the World Federation of Ultrasound in Medicine and Biology (WFUMB) summarizes the available evidence on the management of adrenal incidentaloma and describes efficient management strategies with particular reference to the role of ultrasound techniques.

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