The abnormalities of retinal vessels such as retinal arteriolar narrowing, arteriovenous nicking, micro-aneurysms, retinal hemorrhages, and cotton wool spot are closely related to systemic diseases including hypertension, diabetes mellitus, cardiovascular disorders, stroke and renal diseases. The modern retinal vessels examination technology has features of quick noninvasive, quantitative standardized and intelligent analysis. Taking advantage of these to fully discover the retinal vascular abnormalities and get deeper understanding of the relationship between its' mechanism and systemic vascular diseases is not only helpful to better diagnose and treat retinal vascular diseases, but also contributes to predicting the risk and prognosis of systemic diseases. We suggest emphasizing on the study of correlation between retinal vascular abnormalities and systemic vascular diseases using modern retinal vessels examination technology. It will provide the preventive clue of diseases of circulatory system by finding out the retinopathy. Meanwhile, correctly treating systemic diseases would get a better prognosis of the retinopathy. They exist side by side and play a part together for providing a better prognosis, which would be a new direction for the doctors and scientists in the new era.
ObjectiveTo study the changes of bacterial flora after a series of preoperative oral disinfection and the postoperative recovery of patients with craniovertebral junction disorders who were treated with transoral approach operations. And to provide a theoretical basis for the prevention of postoperative complications such as infection.MethodsThe clinical data of 20 cases with craniovertebral junction disorders and treated with transoral approach operations between October 2009 and May 2010 were analyzed. There were 8 males and 12 females, aged 2-66 years (median, 34.5 years). According to the classification of American Spinal Injury Association (ASIA), there were 4 cases of grade B, 8 of grade C, 6 of grade D, and 2 of grade E. The Japanese Orthopedic Association (JOA) score was 10.3±3.0. The mucosa samples of the posterior pharyngeal wall were sent for bacteria culture. These samples were collected by sterile cotton swabs at four crucial points including 3 days before operation/before gargling (T1), 3 days after continuous gargling by chlorhexidine acetate/after anesthesia intubation on the day of operation (T2), after intraoperative cleaning and washing of the mouth (T3), and after intraoperative iodophor immersion for 5-10 minutes (T4). The microflora was stained by means of smear and further counted after an investigation by microscope. The ASIA classification and the JOA scores were applied to evaluate the postoperative nerve function of the patients. A regular reexamination of cervical vertebra with X-ray film, CT, and MRI was conducted after operation to evaluate the reduction of atlantoaxial dislocation, internal fixation position, bone graft fusion, inflammatory lesion, and tumor resection in the craniovertebral junction.ResultsAfter a series of oral disinfection, the mucosa of the posterior pharyngeal wall of all the patients was in a sterile state, which was considered as type Ⅰ incision. All these 20 patients were treated with successful operations, without any intraoperative injury in vertebral artery and spinal cord, or any postoperative complications such as plate loosening, incision infection, or intracranial infection. All the patients were followed up 3-23 months, with an average of 5.15 months. The symptoms such as neck pain, limb numbness and weakness, neural symptoms, etc. were improved to different degrees after operation. The JOA score was improved to 13.4±1.9 at 3 months after operation, showing significant difference when compared with preoperative score (t=8.677, P=0.000); and the atlantoaxial joints had been fused. At last follow-up, the ASIA grades were improved when compared with those before operation. ConclusionIt is safe and effective to cut the posterior pharyngeal muscle layer and implant internal fixation by means of transoral approach in the treatment of craniovertebral junction disorders.
ObjectiveTo establish an appropriate diabetic retinopathy (DR) risk assessment model for patients with type 2 diabetes mellitus (T2DM).MethodsA retrospective clinical analysis. From January 2016 to December 2017, 753 T2DM patients in the Third Affiliated Hospital of Southern Medical University were analyzed retrospectively. Digital fundus photography was taken in all patients. Fasting plasma glucose (FPG), HbA1c, total bilirubin (TB), blood platelet, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), apolipoprotein-A (apoA), apolipoprotein-B (apoB), serum creatinine, blood urea nitrogen (BUN), blood uric acid, fibrinogen (Fg), estimated glomerular filtration (eGFR) were collected. The patients were randomly assigned to model group and testify group, each had 702 patients and 51 patients respectively. Logistic regression was used to screen risk factors of DR and develop an assessment scale that can be used to predict DR. Goodness of fit was examined using the Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve.ResultsAmong 702 patients in the model group, 483 patients were DR, 219 patients were NDR. The scores for DR risk were duration of diabetes ≥4.5 years, 4 points; total bilirubin ＜6.65 mol/L, 2 points; apoA≥1.18 g/L, 2 points; blood urea≥6.46 mmol/L, 1 points; HbA1c ≥7.75%, 2 points; HDL-c＜1.38 mmol/L, 2 points; diabetic nephropathy, 3 points; fibrinogen, 1 point. The area under the receiver operating characteristic curve was 0.787. The logistic regression analysis showed that the risk factors independently associated with DR were duration of diabetes (β=1.272, OR=3.569, 95%CI 2.283−5.578, P＜0.001), TB (β=0.744, OR=2.104, 95%CI 1.404−3.152, P＜0.001, BUN (β=0.401, OR=1.494, 95%CI 0.996−2.240, P=0.052), HbA1c (β=0.545, OR=1.724, 95%CI 1.165−2.55, P=0.006), HDL-c (β=0.666, OR=1.986, 95%CI 1.149−3.298, P=0.013), diabetic nephropathy (β=1.151, OR=3.162, 95%CI 2.080−4.806, P=0.013), Fg (β=0.333, OR=1.396, 95%CI 0.945−2.061, P=0.094). The risk model was P=1/[1+exp−(−3.799+1.272X1+0.744X2+0.769X3+0.401X4+0.545X5+0.666X6+1.151X7+0.333X8)]. X1= duration of diabetes, X2=TB, X3=apoA, X4=BUN, X5=HbA1c, X6=HDL-c, X7=diabetic nephropathy, X8=Fg. The area under the ROC curve was 0.787 and the Hosmer-Lemeshow test suggested excellent agreement (χ2=10.125, df=8, P=0.256) in model group. The area under the ROC curve was 0.869 and the Hosmer-Lemeshow test suggested excellent agreement (χ2=5.345, df=7, P=0.618) in model group.ConclusionThe area under the ROC curve for DR was 0.787. The duration of diabetes, TB, BUN, HbA1c, HDL-c, diabetic nephropathy, apoA, Fg are the risk factors of DR in T2DM patients.
COPD 和肺癌均为最常见的吸烟相关呼吸道疾病。吸入性糖皮质激素( ICS) 近年来被推荐用于重度COPD 的治疗, 同时也被发现在肺癌的化学预防中起重要作用。本文通过综述ICS、COPD 和肺癌之间的关系, 特别是吸入糖皮质激素在肺癌中的化学预防作用, 以期进一步明确ICS 在COPD和肺癌中的作用。
Objective To investigate the inhibitory effects of 15-lipoxygenase-1 (15-LOX-1) gene transfer on oxygen-induced retinal neovascularization in mice. Methods Ninety-six 7-day-old C57BL/6J mice were randomly divided into normal control group, oxygeninduced retinopathy (OIR) model group, gene treated group and empty vector group. The mice with their mothers were kept in (75plusmn;2) % 02 environment for 5 days and then returned to normoxia for 5 days to establish the OIR model. At postnatal day 12, the gene treated group received intravitreous injection of recombinant adenovirus (Ad) vector containing both enhanced green fluorescent protein (EGFP) and mouse 15-LOX-1 genes (Ad-15-LOX-1-EGFP) at 1 l, while the empty vector group received the same volume of recombinant Ad vector containing EGFP (Ad-EGFP). The expression of EGFP was observed on flat-mounted retina by fluorescence microscopy 2 days after intravitreous injection of Ad-15-LOX-1-EGFP. At postnatal day 17, the efficacy of 15-LOX-1 gene transfer on retinal tissue was detected by immunofluorescence staining, real-time polymerase chain reaction and Western blot. The changes of retinal vessels, relative retinal non-perfusion and neovascularization areas were evaluated by fluorescein isothiocyanate-dextran fluorescein angiography on flatmounted retina. The number of endothelium cell nuclei breaking through the inner limiting membrane (ILM) was counted on hematoxylin and eosin-stained retinal section. Results Two days after intravitreous injection of Ad-15-LOX-1-EGFP, the expression of EGFP had been seen by fluorescence microscopy on Flat-mounted retina. Immunofluorescence staining of retinal section revealed that 15-LOX-1 expression was primarily in the outer plexiform layer, inner nuclear layer and ganglion cell layer of retina. The 15-LOX-1 protein and mRNA expression levels were higher in gene treated group than those in OIR model group and empty vector group (tprotein=22.74 and 24.13 respectively.tmRNA=12.51 and 13.40 respectively; P＜0.01). The relative retinal non-perfusion and neovascularization areas were significantly smaller in gene treated group than those in OIR model group and empty vector group (tnon-perfusion=16.22 and 14.31 respectively.tneovascularization=9.97 and 9.07 respectively; P＜0.01), and the number of endothelium cell nuclei breaking through the ILM in gene treated group was obviously lower than the other two groups (t=14.25 and 11.62 respectively，P＜0.01). Conclusion 15-LOX-1 gene transfer can decrease the oxygen-induced retinal non-perfusion areas and inhibit the retinal neovascularization in mice.
Objective To summarize the related risk factors and preventive measures of acute pancreatitis (AP) combined with portal vein system thrombosis (PVST). Method The literatures on the general clinical characteristics, pathogenesis, risk factors and prevention prognosis of AP with PVST in recent years at home and abroad were reviewed. Results The incidence of AP combined with PVST was increasing, and the pathogenesis was complex, primarily related to pancreatitis and direct venous compression, which caused blood flow stagnation and hemodynamic disturbance, followed by induced venous thrombosis. Pancreatic necrosis, peripancreatic fluid volume accumulation and the severity of pancreatitis were the main risk factors for the onset of pancreatitis. Other local and systemic factors such as coagulation dysfunction, malnutrition, esophageal and gastric varices had also been reported in the literatures. At present, the prevention methods reported in relevant studies include anticoagulation treatment, pancreatic surgery debridement and drainage, nutritional support, systemic and local inflammation intervention, and early fluid resuscitation, etc. Conclusions The risk factors and pathogenesis of AP combined with PVST are complex and diverse, which requires early identification by clinical workers, early intervention and treatment to avoid or reduce the occurrence of PVST as much as possible to improve the prognosis of patients. However, some preventive measures still need further research to verify their safety and effectiveness.
摘要:目的: 探讨传染病医院工作人员对甲型H1N1流感医院感染控制知识的认知程度。 方法 :选择救治甲型H1N1流感期间传染病医院不同岗位工作人员进行无记名自填式调查问卷。 结果 :全院对甲型H1N1流感医院感染控制认知总体情况良好,认知的薄弱环节是对防护措施,尤其是一级防护和三级防护的认知;不同工作岗位的工作人员对甲型H1N1流感医院感染控制认知程度不同,与甲型H1N1流感有接触的工作人员认知度高于其他工作人员,中高级职称、高年龄段(35岁以上)的医务人员认知度高于初级职称及低年龄段(35岁以下)的医务人员。 结论 :针对薄弱环节,进一步加强全员医院感染控制知识、技能的培训考核。Abstract: Objective: To explore the knowledge about the Influenza A (H1N1) of Chengdu Hospital for Infectious Diseases ‘s staff. Methods : Different medical staff of the infectious Disease Hospital during the influenza A (H1N1) treatment in Chinese mainland was selected to fill in anonymous questionnaire. Results : The awareness of the hospital is well about the hospital infection control to Influenza A (H1N1). Preventive measure is weak, especially about the primary barriers and the third barriers. The different position awareness is different. The staff who is in touch with Influenza A (H1N1) is more awareness than the others, the senior and intermediate title is more awareness than the Junior Title, the high ages group(over 35 ages) is more awareness than the low ages group (under 35 ages). Conclusion : For the weak link, further strengthens the entire hospital infection control knowledge, skills training and examination.
In 2022, the National Cancer Center (NCC) of China reported the nationwide statistics of 2016 using population-based cancer registry data from all available cancer registries in China, which was mainly about the cancer incidence and mortality. Cancer remains a major health problem currently in our country and requires long term cooperation to deal with. This article provided a key point interpretation and analysis of cancer prevalence data in China, and provided an analysis of several main risk factors for cancer, which was conducive to the development of cancer prevention and control programs in different regions.
ObjectiveTo observe the effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival (DSS) for advanced retinoblastoma (RB). MethodsForty-one patients with advanced RB who received enucleation were enrolled in this study. There were 26 males and 15 females, age at diagnosis was ranged from 2 to 72 months, with a mean of 23.08 months. There were 16 bilateral patients and 25 unilateral patients; 13 group D eyes and 28 group E eyes. 16 patients received enucleation as the primary treatment (operation group), 25 eyes received chemotherapy before enucleation (chemotherapy group). There was no significant statistical difference between two groups for the gender, unilateral and bilateral, international staging or diagnostic age (P>0.05). The histopathology report was performed to assess the risk of postoperative tumor-node-metastasis staging (pTNM) in each patient, and the extent of tumor invasion in the optic nerve, choroid and anterior chamber was divided into 3 levels of low risk, medium risk and high risk. Five deaths were all in the group E with chemotherapy before enucleation. Using R software survival analysis software package survfit function, the application of Kaplan-Meier estimation method, DSS of RB children was calculated from the time of diagnosis, up to the date of the death of patient. DSS differences between chemotherapy, operation group and eye removal time (more than 3 months, less than 3 months) in group E RB children were analyzed. ResultsThe proportion of high risk pTNM stage in chemotherapy group was significantly lower than the operation group. But there was no significant difference between the two groups in the overall risk classification (χ2=3.130,P=0.077). For group D eyes, the overall risk classification in chemotherapy group was significantly lower than the operation group (χ2=5.870,P=0.015). There was no significant difference between the two groups in the overall risk of group E eyes (χ2=0.020,P=0.889). The DSS in chemotherapy group and operation group were 0.71 and 1.00, respectively; the difference was significant (χ2=3.700,P=0.05). The DSS in children whose enucleation delayed for more than 3 months and children whose enucleation performed within 3 months were 0.64 and 1.00, respectively; the difference was significant (χ2=4.800,P=0.028). ConclusionSystemic chemotherapy did not reduce the risk of tumor invasion and metastasis in patients with advanced RB. Instead, it will reduce the DSS in group E eyes of RB.
ObjectiveTo investigate the inhibitory effects of 5-lipoxygenase (5-LOX) on oxygen-induced retinal neovascularization in mice and to explore its possible mechanisms. Methods7-day-old C57BL/6J mice were randomly divided into normal group, oxygen induced retinopathy (OIR) model group, large-dose group, small-dose group and control group with 12 mice in each group. The mice with their mothers were kept in (75±2)% of oxygen environment for 5 days and then returned to normoxia for 5 days to establish the OIR model except for normal group. From postnatal day 12 to 17, the large-dose group and small-dose group received intravitreous injection of 5-LOX at dose of 100 mg/kg and 50 mg/kg respectively, while the control group received the same volume of 1% dimethyl sulfoxide. The mice in the OIR group received no treatment. The number of endothelium cell nuclei breaking through the inner limiting membrane (ILM) was counted on hematoxylin and eosin-stained retinal section. The mRNA expression of 5-LOX, vascular endothelial growth factor (VEGF)-a, VEGF receptor 2 (VEGFR-2) on retinal tissue were detected by reverse transcription polymerase chain reaction (RT-PCR). The protein expression of 5-LOX, VEGF-a, VEGFR-2 and phosphorylation extracellular signal-regulated kinase (P-ERK) 1/2 on retinal tissue were detected by Western blot. ResultsThe number of vascular cell nuclei breaking through the ILM in the large-dose group and small-dose group decreased significantly compared with the OIR group and control group (F=73.390, P < 0.05). The mRNA expression and protein expression of 5-LOX, VEGFa, VEGFR-2 on retinal tissue were decreased significantly in the large-dose group and small-dose group as compared with the OIR group and control group (F=92.668, P < 0.05). The difference of VEGFR-2 protein expression between large-dose group and small-dose group was not significant (F=2.118, P > 0.05). The differences of 5-LOX, VEGF-a, P-ERK 1/2 protein expression between large-dose group and small-dose group were significant (F=86.490, 165.128, 139.424; P < 0.05). ConclusionHypoxia may induce 5-LOX expression in the retina. Retinal neovascularization was significantly inhibited by selective inhibition of 5-LOX.