Effect of acid sphingomyelinase on nonalcoholic fatty liver disease via PPARα- PGC-1α pathway / 中国药理学通报

Aim To investigate the effects of acid sphingomyelinase(ASMase)on high-fat induced nonalcoholic fatty liver disease in mice and its regulation of PPARα- PGC-1α pathway. Methods ASMase knockout mice based on C57BL/6 background were constructed. Closed group heterozygotes were obtained through hybridized with wild-type mice(ASMase+/-),together with the littermate WT mice were prepared for NAFLD model in this study. The experiment was divided into four groups:WT+Chow:the WT mice were fed with normal diet for 12 weeks; WT+HFD:the WT mice were fed with high-fat diet for 12 weeks; ASMase+/-+Chow:the ASMase+/- mice were fed with normal diet for 12 weeks; ASMase+/- +HFD:the ASMase+/- mice were fed with high fat diet for 12 weeks. Biochemical method was used to detect serum TC,TG and liver TC,TG contents and liver function such as ALT and AST. Oil red staining,HE staining,Masson staining and Sirius red staining were performed to detect liver lipid accumulation,hepatocyte morphology and liver fibrosis. AmplexTM red sphingomyelinase kit was applied to detect ASMase activity. Western blot was performed to detect protein expressions of ASMase,PPARα,PGC-1α and CPT1. Results WT+HFD group displayed hypercholesterolemia and liver dysfunction. Levels of liver triglyceride(TG)were significantly higher than those in WT+Chow group(P<0.05 or P<0.01). Meanwhile,the hepatocytes showed marked steatosis,balloon-like changes,and fibrosis. Protein expression and activity of ASMase in liver increased significantly(P<0.01 or P<0.001),whereas CPT1,PPARα and PGC-1α expressions were not statistically significant compared with matched control group. Heterozygously ASMase-deficient mice reduced the elevated liver TG induced by HFD,as well as improving balloon-like changes and liver fibrosis. Furthermore,the expressions of PPARα,PGC-1α and CPT1 were up-regulated in ASMase+/- +HFD mice compared with WT+Chow group.Conclusions ASMase promotes hepatic steatosis and fibrosis,which may be related to its inhibition of PPARα-PGC-1α pathway.

Current status of surgery for portal hypertension in China: a national multi-center survey analysis / 中华器官移植杂志

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Pregnancy-associated neuromyelitis optical spectrum disorder combined with primary Sjögren's syndrome: A critical illness case report / 北京大学学报(医学版)

Central nervous system involvement in primary Sjögren's syndrome (pSS) is less common and usually presents as white matter lesions, neuromyelitis optica spectrum disorder (NMOSD), or transverse myelitis. NMOSD is an immune-mediated inflammatory demyelinating disease of the central nervous system with a high rate of relapse and significant disability. Studies have shown that patients with pSS combined with NMOSD have more severe symptoms and poorer prognosis. Here, we present a case of critical illness in pregnancy-associated NMOSD combined with Sjögren's syndrome. The patient was a 30-year-old pregnant woman with a history of Sjögren's syndrome who was diagnosed with NMOSD. She received combination therapy with steroids, intravenous immunoglobulin (IVIG), and hydroxychloroquine during pregnancy, resulting in partial resolution of numbness below the waist. However, due to irregular medication adherence outside the hospital setting, she developed weakness in her right lower limb accompanied by inability to move it, while her left lower limb still had some mobility but occasional numbness along with urinary and fecal incontinence. Ten days later, she was admitted to the emergency department where an emergency cesarean section was performed to deliver a healthy baby boy. However, her condition worsened postpartum as she developed high fever accompanied by bilateral lower limb paralysis and weakness along with loss of voluntary control over urination and defecation. The patient underwent ano-ther course of treatment consisting of steroids and IVIG; however there was limited improvement in symptoms observed after this intervention. Following administration of rituximab for the first time, the patient developed urinary tract infection which was successfully managed before continuing regular infusions. In later stages the patient could walk slightly with a limp and regained control over urination and defecation, allowing her to resume normal activities. This case suggests that combination therapy with steroids, IVIG, and hydroxychloroquine should be considered for the patients with pregnancy-associated NMOSD combined with Sjögren's syndrome. Rituximab can significantly improve symptoms such as postpartum paralysis in patients with NMOSD, however, there may be a risk of infection associated with its use.

Intermedin improves renal structure and function and microvascular injury in IgA nephropathy rats / 中国药理学通报

Aim To investigate the hepatotoxicity of rutecarpine(RUT)by using high-content screening technology.Methods HepG2 cells were exposed to different concentrations of RUT for different time, then cell viability was detected by MTT method.Cell count, nucleus injury, mitochondrial membrane potential(MMP), reactive oxygen species(ROS), internal flow of calcium, cell membrane integrity(DIR)were measured by high-content screening technology.The activation of MAPK, NF-κB and JAKs-STATs was assayed by high-content screening technology.The apoptosis was detected by flow cytometry.Results The viability was significantly reduced by 100 μmol·L-1 RUT(P<0.01)after HepG2 cell exposure to RUT for 24 h, the nuclear area decreased and the nuclear morphology was uneven, and after 48 h, the cell count was significantly reduced(P<0.01), the early apoptosis was detected(P<0.01).After HepG2 cell exposure to RUT for 6 h, the levels of ROS and internal flow of calcium significantly increased(P<0.01), and the cell membrane integrity was obviously damaged(P<0.01).After exposure to 100 μmol·L-1 RUT for 24 h, the phosphorylation of ERK, JNK, STAT3 and p38 significantly increased(P<0.01, P<0.05), but there was no significant change in total protein level.The expression of c-Jun and c-Fos was up-regulated at 3 h(P<0.01), and at 3h time point, the phosphorylation of NF-κB p65 significantly increased(P<0.01), but nuclear translocation was not significant.Conclusions Under certain conditions, RUT shows cytotoxicity on HepG2 cells, and its toxic mechanism is mainly related to injury caused by oxidative stress and inflammatory response.

Efficacy analysis of elective nodal irradiation and involved field irradiation combined with chemotherapy in treatment of esophageal cancer / 肿瘤研究与临床

Objective:To explore the efficacy of elective nodal irradiation (ENI) and involved field irradiation (IFI) combined with chemotherapy in treatment of esophageal cancer.Methods:A total of 104 patients with esophageal cancer in Affiliated Hospital of Jiangnan University from May 2018 to May 2020 were selected as subjects for prospective study. All patients were randomly divided into observation group and control group by lottery method with 52 cases in each group. The target volume of observation group was delineated with IFI, and the control group was delineated with ENI. The curative effects, the levels of serum tumor markers [carbohydrate antigen 50 (CA50), squamous cell carcinoma (SCC) and carcinoembryonic antigen (CEA)] before and after treatment, the 1-year overall survival (OS) rate, the incidence of adverse reactions and the scores of various dimensions of health survey summary (SF-36) after treatment were compared between the two groups.Results:The total effective rate in the observation group was 90.38% (47/52), the total effective rate in the control group was 84.62% (44/52), and the difference was not statistically significant ( χ2 = 0.79, P =0.374). There was no statistical difference in CA50, CEA, SCC levels between the two groups before and after treatment (all P > 0.05). After treatment, the CA50, CEA and SCC levels in the two groups were lower than those before treatment, and the differences were statistically significant (all P < 0.05). The 1-year OS rate of the observation group was 94.23%, the control group was 90.38%, and the difference in OS between the two groups was not statistically significant ( χ2 = 0.54, P = 0.462). The incidence of acute radiation esophagitis in the observation group was lower than that in the control group, and the difference was statistically significant ( P < 0.001). There was no statistical difference between the two groups in SF-36 scale scores of physical functioning, role-physical, bodily pain, mental health, vitality, social functioning, role-emotional, and general health after treatment (all P > 0.05). Conclusions:Both ENI and IFI are effective treatments for patients with esophageal cancer. There is no significant difference in the quality of life of patients between the two delineation methods, but the incidence of acute radiation esophagitis is lower in patients with IFI regimen.

N-terminal pro-brain natriuretic peptide levels in patients with anomalous left coronary artery from pulmonary artery.

INTRODUCTION: N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is used as an important biomarker for heart failure in children and adults. Previous researches have shown the value of NT-pro-BNP in various congenital heart defects (CHD). However, the level of NT-pro-BNP in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) has not been determined. MATERIALS AND METHODS: Plasma NT-pro-BNP was measured in 23 patients diagnosed with ALCAPA before operation. Echocardiogram was also recorded for each patient. RESULTS: Patients with NT-pro-BNP above 300 pg/mL showed a statistically significant decrease in LVEF (p < 0.0001) and in age (p < 0.0001) compared to patients with NT-pro-BNP below 300 pg/mL. Age (r = 0.399, p = 0.012) and LVEF (r = 0.403, p = 0.011) showed a statistically significant correlation with NT-pro-BNP in linear regression when NT-pro-BNP more than 300 pg/mL. A negative correlation was shown between NT-pro-BNP and LVEF (r = 0.570, p < 0.0001) in all the patients. No significant correlation was observed between mitral regurgitation (MR) grade and NT-pro-BNP in a Spearman correlation test (r = 0.383; P = 0.071). CONCLUSIONS: In patients with ALCAPA, NT-pro-BNP levels showed a negative correlation with age and LVEF when NT-pro-BNP above 300 pg/mL and no correlation with age and LVEF when NT-pro-BNP under 300 pg/ml. Further studies are needed to determine whether there is a correlation between MR grade and NT-pro-BNP levels.

Blood biochemical indicators, IgM and IgG antibodies in 56 confirmed and suspected COVID-19 cases / 上海预防医学

Objective To provide reliable indicators for effective prevention and control of COVID-19, we examined the biochemical indicators as well as anti-SARS-CoV-2 IgM and IgG antibodies in confirmed and suspected COVID-19 patients. Methods A total of 56 confirmed and suspected COVID-19 cases quarantined during January-March, 2020 in Gansu Provincial People′s Hospital and People′s Hospital of Xigu District, Gansu Province were included.Based on the results of nucleic acid testing and CT scan finding, they were divided into three groups: positive in both nucleic acid testing and CT scan finding; positive in nucleic acid testing but negative in CT scan finding; negative in both nucleic acid testing and CT scan finding.COVID-19 viral nucleic acid was detected and chest CT scan was performed.The following biochemical indicators were examined: total protein, albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyltranspeptidase, creatine kinase and lactate dehydrogenase.SPSS 22.0 statistical software was used to analyze the differences in the biochemical indicators among these three groups, as well as the temporal trend of IgM and IgG antibodies at different points of time. Results There were significant differences in the mean values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase between these three groups (P < 0.05), whereas no significant difference in the mean value of total protein and albumin (P>0.05).ROC curve indicated that aspartate aminotransferase had the largest maximum area under the curve (AUC, 0.834), whereas alanine aminotransferase had the highest sensitivity (1.0) and total bilirubin had the highest specificity (0.927).Thus, aspartate transaminase provided the best prediction for the diagnosis of COVID-19, with sensitivity of 0.786, specificity of 0.854, and the maximum AUC of 0.834.In 12 of 16 confirmed COVID-19 patients tested IgG positive after 10 days of diagnosis, and 10 of 10 confirmed COVID-19 patients tested IgG positive after 14 days of diagnosis. Conclusion Aspartate aminotransferase may be the most useful indicator in the diagnosis of COVID-19.

Relationship between X-ray injury cross-complementary protein 1 gene polymorphism and prognosis of triple-negative breast cancer / 中国医师进修杂志

Objective To investigate the relationship between X-ray injury cross-complementing protein 1 (XRCC1) gene polymorphism and prognosis in patients with triple-negative breast cancer (TNBC). Methods Patients with primary triple-negative breast cancer (TNBC) diagnosed in the Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine from January 2013 to January 2015 were selected. Patients were selected for genotyping (XRCC1 gene Arg280His, Arg399Gln and Arg194Trp) and divided into survival group and death group according to the prognosis of patients. Logistic regression was used to analyze the relationship between XRCC1 genotype and prognosis. Results A total of 130 patients were enrolled in the study, with an average age of (50.4 ± 6.3) years. The mean follow-up time was (45 ± 13) months, including 62 patients with breast cancer-related deaths and 68 patients with survival. The patients in death group was older than those in the survival group [(52.6 ± 6.7) years vs. (48.3 ± 5.2) years, P < 0.01), and and the lymph node metastasis rate was higher [88.7%(55/62) vs.73.5%(50/68), P＝0.028]. The frequency of XRCC1 gene Arg399Gln genotype in the survival and death group was GG: 61.8% vs. 38.7%; GA: 32.4% vs. 41.5%; AA: 5.9% vs. 19.4%, P＝0.011.There were also statistical differences between the two groups in the frequency of allele, and the frequency of A allele was significantly higher in the death group than in the survival group (40.4% vs. 22.0%, P<0.01). For the additive model of the Arg399Gln polymorphism A allele, for each additional copy of the A allele, the risk was 1.443 times that before the increase (95% CI 1.174-1.793, P<0.01). After adjusting for age and lymph node metastasis, the A allele still significantly increased the risk of death ( OR＝1.533, 95% CI 1.254-1.903, P < 0.01). Conclusions The XRCC1 gene Arg399Gln polymorphism is associated with the prognosis of TNBC, and patients with the A allele have a poor prognosis.

Mechanism and safety of triptolide in treatment of rheumatoid arthritis / 中草药

Objective: To explore the mechanism of triptolide in the treatment of rheumatoid arthritis (RA) and analyze its safety. Methods: A total of 60 rats were randomly divided into control group, model group, methotrexate (MTX) group and triptolide (TP) low, medium and high dose groups with 10 rats in each group. In addition to the control group, the rats in the other groups were established type II collagen-induced RA model. After the successful establishment of the model, rats in MTX group were given 0.4 mg/kg MTX by gavage from the 3rd week. Rats in TP high, middle, and low dose groups were given 0.1, 0.2, and 0.4 mg/kg TP by gavage. Rats in control group and model group were given equal volume distilled water once a day for 4 weeks. The paw swelling of rats in each group was compared. The percentage of CD4+CD25+and CD4+Foxp3+ Treg was detected by flow cytometry. The levels of IL-10, IL-17, TNF-α, VEGF, IFN-γ, TGF-β, ALT, and AST in the serum were detected. The pathological morphology of ankle joint was observed under microscope. The expression levels of IL-10, IL-17, TNF-alpha, VEGF, IFN-γ, and TGF-β were detected by immunohistochemistry. Results: Pathological sections showed that synovial cells were proliferated significantly in the ankle joint of rats in the model group, with infiltration of a large number of inflammatory cells such as monocytes and lymphocytes, new capillaries, thinning of bone trabeculae and serious erosion of cartilage surface. The degree of pathological changes in other groups was significantly less than that in model group. After treatment, the degree of joint swelling and arthritis index in MTX and TP groups were significantly decreased compared with those before treatment (P 0.05). There was no significant difference between MTX group and TP high dose group (P > 0.05). Conclusion: TP is effective in treating type II collagen-induced arthritis in rats, which can significantly improve joint swelling. Its mechanism is related to promoting the expression of IL-10 and TGF-β, increasing the proportion of Treg cells, inhibiting the expression of IL-17, TNF-α, VEGF and IFN-γ, and has no obvious hepatotoxicity.

Research Progress on Biopharmaceutics of Active Ingredients in Chinese Materia Medica Under Multi-component System / 中国实验方剂学杂志

The biopharmaceutical properties (solubility, permeability, etc.) of active pharmaceutical ingredients are playing an important role in understanding of disposition of drugs in the body, screening of drugs and evaluation of drug delivery system. The active ingredients of Chinese materia medica (CMM) are various and complex, the research on biopharmaceutics provides a train of thought and practical method for the prediction and research on the process of active ingredients from CMM in vivo. The multi-components system is one of the main differences between CMM and chemical medicine, and the study on biopharmaceutics of active ingredients in CMM under multi-components system has become a hot topic. The progress on biopharmaceutics of active ingredients in CMM under multi-components system was reviewed in this article, which may provide the reference for data integration, theoretical induction and system construction in this field, and provide new train of thought for the research on CMM theories and the development of CMM in the perspective of biopharmaceutics.

Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center / 北京大学学报(医学版)

OBJECTIVE@#To investigate and analyse the features of treatment behavior and standardized therapeutic status of patients with psoriatic arthritis (PsA).@*METHODS@#Out patients diagnosed with PsA in People's Hospital of Peking University, Haidian Hospital, People's Hospital of Jianyang City, Central Hospital of Xinxiang City, Integrated Traditional Chinese and Western Medicine Hospital of Cangzhou City, The Third Hospital of Hebei Medical University from February to June 2018 were enrolled in this investigation. The data including gender, age of onset, course of disease, site of first consulting department, time of the first visit and definite diagnosis, follow-up interval, and use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and biological DMARDs (BioDMARDs) were collected and analyzed.@*RESULTS@#In the cross-sectional study, 133 PsA patients were investigated. The mean age of onset was (47±11) years, the male to female ratio was 1.3:1, and mean disease duration was (16±8) years. Rheumatology department was the most common site of first hospital visit (37.6%, 50/133). Orthopedics department and dermatological department were visited by 24.1% (32/133) and 23.3% (31/133), respectively. Ratio of definite diagnosis was the highest in rheumatology department which was 78% (39/50). The ratio of definite diagnosis of dermatological department was the second highest, which was 19.4% (6/31). The mean definite diagnosed time was 7.6 months since the first visit of PsA patients, and diagnosed time was the shortest in rheumatology department, which had statistical significance. 37% PsA patients were treated appropriately in 3 months, 17.3% PsA patients were treated in 3-6 months and 40.2% patients with PsA visited their doctor more than once a year. 48.8% patients hadn't received standardized treatment before visit, and one third patients never received the therapy of DMARDs. Methotrexate was the most commonly used cDMARDs (58.3%), followed by leflunomide (20.5%) and BioDMARDs (19.7%), and biologicals were tumor necrosis factor antagonists.@*CONCLUSION@#In this multi-center study, the first visit department of PsA patients was widely distributed, and most patients were definitely diagnosed in Rheumatology Department. The time of their first visit and definite diagnosis were delayed due to multi factors. Nearly half of the patients did not receive standardized treatment.

A Swarming Approach to Optimize the One-Hop Delay in Smart Driving Inter-Platoon Communications.

Multi-platooning is an important management strategy for autonomous driving technology. The backbone vehicles in a multi-platoon adopt the IEEE 802.11 distributed coordination function (DCF) mechanism to transmit vehicles' kinematics information through inter-platoon communications, and then forward the information to the member vehicles through intra-platoon communications. In this case, each vehicle in a multi-platoon can acquire the kinematics information of other vehicles. The parameters of DCF, the hidden terminal problem and the number of neighbors may incur a long and unbalanced one-hop delay of inter-platoon communications, which would further prolong end-to-end delay of inter-platoon communications. In this case, some vehicles within a multi-platoon cannot acquire the emergency changes of other vehicles' kinematics within a limited time duration and take prompt action accordingly to keep a multi-platoon formation. Unlike other related works, this paper proposes a swarming approach to optimize the one-hop delay of inter-platoon communications in a multi-platoon scenario. Specifically, the minimum contention window size of each backbone vehicle is adjusted to enable the one-hop delay of each backbone vehicle to get close to the minimum average one-hop delay. The simulation results indicate that, the one-hop delay of the proposed approach is reduced by 12% as compared to the DCF mechanism with the IEEE standard contention window size. Moreover, the end-to-end delay, one-hop throughput, end-to-end throughput and transmission probability have been significantly improved.

Laser absorption spectroscopy data processing method based on co-frequency and dual-wavelength and its application.

In the detection process of atmospheric laser absorption spectroscopy in open space, the transmitted beam is inevitably affected by atmospheric turbulence, resulting in superimposed fluctuation noise in the received optical signal. First, the correction method of atmospheric turbulence is theoretically analyzed. In order to reduce the error influence factors and the error transfer coefficient, a new method of spectral data processing based on co-frequency and dual-wave has been proposed. By modifying scintillation noise and background noise, the influence of atmospheric turbulence noise in open space is reduced. An atmospheric detection system in open space based on co-frequency and dual-wave has been established. The experimental results show that the maximum fluctuation of the spectral signal processed by the method of spectrum data processing based on the co-frequency and dual-wave is reduced from 12.854% to 4.635%, and the single-intensity absorbance is fitted by Voigt with its correlation coefficient of 0.9525. The mean of the standard deviation of the algorithm is 0.1370, while the mean value of the standard deviation of the existing algorithm in a short time is 0.6928. And, through the comparative experiment, the standard deviation of the existing data processing techniques of two-wavelength differential absorption is 0.2974, while the standard deviation of the method of spectrum data processing based on the co-frequency and dual-wave is 0.1038. It can be concluded that the co-frequency and dual-wave method can effectively reduce the influence of atmospheric turbulence noise and laser flashing to improve the stability of concentration measurement, which has practical engineering value.

Comparison of efficacy between Ranibizumab and Conbercept for wet age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy between Ranibizumab and Conbercept for wet age-related macular degeneration. <p>METHODS: Totally 78 cases(78 eyes)of wet age-related macular degeneration treated in our hospital from February 2014 to March 2016 were selected and divided into Group A and Group B, each with 39 cases(39 eyes). Patients in two groups were given ranibizumab and conbercept respectively, and were followed up for 12mo. The various data including visual acuity, the macular foveal retinal thickness, choroidal neovascularization(CNV)leakage and complications were compares between two groups. <p>RESULTS: At 1wk, 1 and 3mo after treatment, the uncorrected vision of Group A was higher than that of Group B, the difference was statistical significance(<i>t</i>=14.05, 12.71, 18.27; <i>P</i><0.05). The macular foveal retinal thickness at different time points in Group A was thinner than that of Group B, the difference held statistical meaning(<i>t</i>=2.504, 2.051, 1.991; <i>P</i><0.05). Two groups' total efficiency at 1 and 3mo after operation had no statistical points(<i>χ²</i>=1.076, 0.253; <i>P</i>>0.05). <p>CONCLUSION: The ranibizumab and conbercept shows identical effect in treating CNV leakage of patients wet age-related macular degeneration without any serious complications occurred, but the comparison of the two shows that the improvements of visual acuity and macular foveal retinal thickness are better in ranibizumab treatment than in conbercept treatment.

Carotid plaque composition and volume evaluated by multi-detector computed tomography angiography / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the differences of plaquecomposition and volume between symptomatic and asymptomatic patients with carotid artery stenosis by multi-detector computed tomography angiography (MDCTA).@*METHODS@#The consecutive patients with internal carotid artery stenosis≥70% diagnosed by digital subtraction angiography (DSA) were retrospectively analyzed from July 2011 to December 2015 in Peking University China-Japan Friendship School of Clinical Medicine. The symptomatic patients were defined as those who experienced nondisabling ischemic stroke or transient cerebralis chemic symptoms, including hemispheric events oramaurosis fugaxin the last 6 months. Otherwise, the patients were considered as a symptomatic. A total of 78 patients were enrolled in the study. Of these patients, there were 35 asymptomatic patients (44.9%) and 43 symptomatic patients (55.1%). All the patients received MDCTA before DSA. According to the plaque analysis of post processing work station, carotid plaques were divided into lipid-rich necrotic coreplaques (HU≤60), fibrous plaques (60 to 130 HU) and calcified plaques (HU≥130) through the different value sthreshold of HU. The plaque volume and proportion were all calculated. The differences between the two groups were compared by statistical methods.@*RESULTS@#The proportion of calcified plaques in asymptomatic patients was significantly higher than in symptomatic patients (t=2.760, P=0.007).And the proportion of LRNC plaqueswas lower than that in symptomatic patients (Z=2.009, P=0.044). There was statistical significance between the asymptomatic and symptomatic patients. Multivariate analysis showed that there was a positive correlation between the proportion of calcified plaques and asymptomatic carotid artery stenosis (OR=0.949; 95%CI: 0.915 to 0.985; P=0.005). The proportion of LRNC plaques showed a negative correlation with asymptomatic carotid artery stenosis (OR=1.068; 95%CI: 1.021 to 1.117; P=0.004). For the symptomatic patients, when the LRNC plaque proportion was greater than 30.3%, the specificity was 94.3%, and the sensitivity was 37.2%. There was no significant difference in plaque volume and fibrous plaque proportion in both groups.@*CONCLUSION@#Compared with symptomatic carotid plaques, the proportion of asymptomatic calcified plaques increased but the proportion of LRNC plaques decreased. Plaque LRNC 30.3% of the total volume may represent a clinically useful cutoff. For the patients with carotid artery stenosis, MDCTA may help noninvasively risk-stratify patients.

Ahmed glaucoma valve implantation treatment of traumatic angle recession glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study the influence of Ahmed glaucoma valve implantation on eyesight, intraocular pressure and corneal endothelial cell density of patients with traumatic angle recession glaucoma. ·METHODS: Totally 33 cases (35 eyes) of patients with traumatic angle recession glaucoma admitted to our hospital since June 2014 to June 2016 were selected and treated with Ahmed glaucoma valve implantation. The clinical data of all patients were retrospectively analyzed, so as to evaluated to success rate of surgery. Non-contact tonometer was applied to surveying intraocular pressure before treatment and at 1wk, 1,3,6mo and 1a post treatment. Specular microscope was adopted to examine and calculate the corneal endothelial cell density before treatment and at 1wk, 1, 3, 6mo and 1a post treatment. All affected eyes were compared for visual acuity before surgery and in 1a after surgery, moreover, patients were followed - up, received the further consultations and the complications were recorded. ·RESULTS: As for 35 affected eyes, the absolute success rate of surgery was 54% , while the relative success rate was 40% , and the total successful rate and failure rate were 94% and 6% respectively. In terms of the number of people who had no light sensation before surgery, or who had light sensation, ≤0. 01, 0. 01-0. 10 or >0. 10-0. 20, there was no significant difference (Z=-0. 132, P=0. 362). The intraocular pressure before treatment was 43. 43 ± 3. 65mmHg, at 1wk after surgery was 13. 50 ± 2. 54mmHg, at 1mo was 15. 93 ± 2. 61mmHg, at 6mo was 16. 00 ± 2. 18mmHg and at 1a was 16. 45 ± 2. 21mmHg, and the difference among different time points had statistical significance (F= 887. 82, P<0. 01). After treatment the intraocular press decreased compared to before treatment (P<0. 05); those after treatment had no difference with each other ( P> 0. 05 ). Before treatment, the corneal endothelial cell density was 2443. 35 ± 343. 12 pieces/mm2, in 1wk after the surgery was 2231.67±334.45 pieces /mm2, in 1mo after the surgery was 2065. 47 ± 336. 45 pieces /mm2, in 3mo after surgery was 2031. 47 ± 345. 76 pieces/mm2, in 6mo was 2001. 72±337. 18 pieces /mm2and in 1a after the surgery was 1979. 65 ± 301. 32 pieces /mm2, and the difference among different time points had statistical significance ( F = 13. 49, P<0. 01 ). After treatment the corneal endothelial cell density decreased compared to before treatment (P<0. 05); those after treatment had no difference with each other (P>0. 05). After surgery, there were 4 cases (4 eyes) of ocular hypotension, 3 cases (3 eyes) of hyphema, 2 cases ( 2 eyes) of drainage tube plugging and 2 cases ( 2 eyes ) of intraocular hypertension, which were all quickly relieved after basic intervention treatment. · CONCLUSION: Treating traumatic angle recession glaucoma with Ahmed glaucoma valve implantation can dramatically optimize the state of intraocular hypertension and protect the retaining visual acuity, and visual acuity can be optimized in some cases. It causes little complication that can be relieved with basic prognosis, but postoperative corneal endothelial cell loss exists in some cases.

Observation of cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole at different stages / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the visual acuity after cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole (IMH) at different stages. ·METHODS: In this study, 75 IMH patients ( 75 eyes ) treated in our hospital from August 2014 to August 2016 were enrolled and underwent cataract extraction, vitrectomy and C3F8gas tamponade. Patients were divided into stage Ⅱ Group ( 18 cases ), stage Ⅲ ( 36 cases) and stageⅣ(21 cases) according to Gass stages, and macular hole closure at 2 and 4wk postoperatively were compared. The routine visual acuity examination before and after surgery were performed, and the visual acuity in each group were compared. The optical coherence tomography ( OCT) was used to measure the macular thickness before and after surgery. ·RESULTS: The closure rate of macular hole in stage Ⅱwas significantly higher than that of stage Ⅲ and IV at the 1mo after operation, that at the stage Ⅲ was significantly higher than that of stageⅣgroup, and the difference was statistically significant (P<0. 05). There was no significant difference in the rate of closure of macular hole between stage Ⅱ and stage Ⅲ at 3mo after operation (P>0. 05). The proportion of eyes with visual acuity of finger counting, 0. 02-0. 08, 0. 10-0. 20, 0. 25-0. 40 and ≥0. 50 was statistically significant different before and after surgery(P<0. 05). The improvement rate of visual acuity was 94% in stage Ⅱ, which was significantly higher than that in stage Ⅲ (83%) and stage Ⅳ (67%). The macular thickness of the stage Ⅱ and Ⅲ was significantly lower after the surgery, but there was no significant difference in the stage Ⅳ before and after surgery (P>0. 05), the decreasing range of the stage Ⅱ and Ⅲ was not statistically significantly different (P>0. 05), which were significantly higher than that of the stage Ⅳ, the difference was statistically significant (P<0. 05). ·CONCLUSION: Cataract extraction, vitrectomy and C3F8 gas tamponade surgery is conducive to the vision recovery after idiopathic macular hole, but the effects with different Gass staging are different, surgery should be performed as early as possible to improve macular hole closure and eyesight recovery.

Combined treatment of Conbercept and panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the efficacy of the combined treatment of Conbercept and panretinal photocoagulation (PRP) for neovascular glaucoma (NVG) with central retinal vein occlusion (CRVO).· METHODS:The clinical data of 100 NVG patients with CRVO treated in our hospital from May 2014 to May 2017 were retrospectively analyzed.In those,50 patients treated with glaucoma filtering surgery combined with PRP were selected as control group,and based on this,50 patients treated with intravitreal injection of conbercept were included in the observation group.The best corrected visual acuity (BCVA) before treatment,and after 7d,1,3,and 6mo treatment were compared.The intraocular pressure IOP of each period with the non-contact tonometer were also compared,the effect of surgery was evaluated by slit-lamp examination of neovascularization combined with intraocular pressure,and then recurrence rate and complication was recorded during 6mo follow-up.· RESULTS:No statistically significant difference was found between preoperative and after surgery at each time point (P＞0.05).The intraocular pressure of the two groups was significantly lower than that of before the surgery,the observation group was significantly lower than that of the control group 7d and 1mo after surgery,and the difference was statistically significant (P＜0.05).There was no statistically significant difference on lOP the 3 and 6mo after surgery between two groups (P＞0.05).The operation success rate was 100％ in the observation group and was 92％ in the control group,the difference was statistically significant (P＜ 0.05).The complete success rate of the observation group was 84％,which was significantly higher than 66％ of the control group,the difference was statistically significant (P＜ 0.05).The hyphema and recurrence rate of the observation group were significantly lower than those of the control group,the difference was statistically significant (P＜0.05).There was no significant difference in the incidence of shallow anterior chamber and low intraocular pressure (P＞0.05).· CONCLUSION:Preoperative intravitreal injection of conbercept combined with panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion make the pressure recovery and neovascularization time shorter with better surgical results,and can control the anterior chamber hemorrhage and reduce the recurrence rate.

Intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy of intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma (NVG). METHODS: The clinical data of 90 patients with NVG treated in our hospital from June 2014 to June 2016 were analyzed retrospectively. There were 42 patients treated with trabeculectomy and panretinal photocoagulation enrolled as the control group. On the basis of this, 48 patients who received intravitreal injection of conbercept 5-7d preoperatively were enrolled as observation group. The best corrected visual acuity (standard logarithmic visual acuity), intraocular pressure and the regression of neovascularization were observed and compared before treatment,and 1wk,1,3,and 6mo post treatment. Then the clinical efficacy and postoperative complications were observed and recorded. RESULTS: The difference of visual acuity of the two groups was significant before and after treatment,and the best corrected visual acuity of observation group was significantly higher than that of the control group at 1mo after the operation (P<0.05), no difference was found at 1wk,3 and 6mo post treatment (P>0.05). The pre- and postoperative intraocular pressure of the two groups showed significant difference, and the intraocular pressure of the observation group was significantly lower than the control group at 1wk, 1, 3 and 6mo post treatment (P<0. 05). The cure rate in the observation group was significantly higher than that in the control group (77% vs 64%), with statistical significance (P<0 05). The incidence of anterior chamber hemorrhage and shallow anterior chamber in the observation group was significantly lower than that of the control group (P<0.05), with no difference in the incidence of macular degeneration(P>0.05). Moreover, the recurrence rate of neovascularization in the observation group was significantly lower than that of the control group at 6mo after operation (P<0.05). CONCLUSION: The intravitreal injection of conbercept 5-7d before panretinal photocoagulation can significantly reduce intraocular pressure,improve the visual acuity for the treatment of NVG, which also has a higher comprehensive cure rate.

Ocular surface changes after combined surgery of glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract. ·METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease,and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time (BUT), corneal fluorescein staining score (FL), tear secretion test (S I t) and conjunctival epithelium goblet cell density(CIC) was compared between two groups before operation and at 1wk,1 and 3mo after operation. · RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group (P > 0. 05). At 1wk, 1mo after operation,data of the observation group was significantly higher than that of the control group and before operation, with statistical significance (P < 0. 05), no significant difference was shown at postoperative 3mo (P>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance (P<0.05). The preoperative FL score of the observation group was significantly higher than that of the control group, while the postoperative FL score of the observation group at 1wk,1 and 3mo had sharp difference with that before operation(P<0.05),all were significantly higher than that of the control group,there was statistical significance(P<0.05). There was no significant difference in S I t score between the observation group and the control group preoperatively ( P > 0. 05), and the postoperative S I t scores of the observation group at 1wk,1 and 3mo postoperatively was evidently lower than that of the control group and before operation (P<0.05). There was no significant difference in CIC density between the two groups preoperatively. While the postoperative data of the observation group at 1wk, 1 and 3mo postoperatively was significantly lower than that of the control group and before operation,with statistical points (P<0.05). · CONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion,impair conjunctival epithelium goblet cell.