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Objective:To develop and verify a predictive model based on CT characteristics for predicting infected walled-off necrosis (IWON) in MSAP and SAP patients.Methods:The clinical and CT data of 1 322 patients diagnosed as MSAP and SAP according to the 2012 Atlanta revised diagnostic criteria in the First Affiliated Hospital of Naval Medical University from January 2015 to December 2020 were continuously collected. Finally, 126 patients who underwent enhanced CT scans within 3 days after admission and percutaneous catheter drainage of WON during hospitalization were enrolled. Among them, there were 63 MSAP and 63 SAP patients. According to the results of the culture from drainage fluid, the patients were divided into sterile walled-off necrosis group (SWON group, n=31) and infected walled-off necrosis group (IWON group, n=95). Patients were divided into training set (18 patients with SWON and 74 patients with IWON from January 2015 to December 2018) and validation set (13 patients with SWON and 21 patients with IWON from January 2019 to December 2020). Univariate and multivariate logistic regression analysis were performed to establish a model for predicting IWON. The model was visualized as a nomogram. The receiver operating characteristic curve (ROC) was drawn. The predictive efficacy of the model was evaluated by the area under the curve (AUC), sensitivity, specificity and accuracy, and the clinical application value was judged by decision curve analysis (DCA). Results:Univariate regression analysis showed that age, etiology, WON with bubble sign and the lowest CT value of WON were significantly associated with IWON. Multivariate logistic regression analysis showed that older age, biliary acute pancreatitis, WON with bubble sign, and the greater minimum CT value of WON were independent predictors for IWON. The formula for the prediction model was 0.12+ 0.01 age-0.75 hyperlipidemia-1.62 alcoholic-2.62 other causes+ 19.18 WON bubble sign+ 0.10 minimum CT value of WON. The AUC, sensitivity, specificity, and accuracy of the model were 0.85 (95% CI 0.76-0.94), 67.57%, 88.89%, and 71.74% in the training set and 0.78(95% CI0.62-0.94), 66.67%, 84.62%, and 73.53% in the validation set, respectively. The decision analysis curve showed that when the nomogram differentiated IWON from SWON at a rate greater than 0.38, using the nomogram could benefit the patients. Conclusions:The prediction model established based on CT characteristics might non-invasively and accurately predict the presence or absence of IWON in MSAP and SAP patients, and provide a basis for guiding treatment and evaluating prognosis.
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Objective:To evaluate the distribution and drug sensitivity of pathogenic bacteria in patients with bacterial keratitis in recent 40 years in China.Methods:A Meta-analysis was conducted.Five databases including PubMed, ScienceDirect, Embase, CNKI and Wanfang Data Knowledge Service Platform were searched.The research was limited to the hospital-based cross-sectional studies published in Chinese and English between 1980 and 2020, without limitations of subject.Two researchers followed the inclusion and exclusion criteria to complete literature retrieval, data extraction and methodological quality evaluation.The literature quality was assessed with reference to a methodological scoring system for rates. Q test and I2 test were used to quantify the degree of heterogeneity of the included literature.According to the heterogeneity, the fixed effects model or random-effects model was used to calculate the combined rates indicators to perform the Meta-analysis. Results:Twenty-seven original studies were incorporated, including 50 046 cases of bacterial keratitis.A random-effects model for the Meta-analysis showed that the positive rate of bacterial culture in bacterial keratitis was 28% (95% CI: 0.24-0.32). Among the culture-positive bacteria, the percentages of gram-positive cocci and gram-negative bacilli were 57% (95% CI: 0.52-0.62) and 32% (95% CI: 0.28-0.37), respectively.The percentages of gram-positive bacilli and gram-negative cocci were 8% (95% CI: 0.06-0.10) and 1% (95% CI: 0.01-0.02), respectively.In the recent 40 years, the proportion of gram-positive cocci isolated from corneas in China was on the rise, and the proportion of gram-negative bacilli was on the decline.Among them, coagulase-negative Staphylococcus accounted for 23% (95% CI: 0.17-0.30), followed by Pseudomonas aeruginosa 18% (95% CI: 0.14-0.23), Streptococcus pneumoniae 8% (95% CI: 0.06-0.12), Staphylococcus aureus 6% (95% CI: 0.04-0.08), Corynebacterium 4% (95% CI: 0.03-0.07), and Escherichia coli 4% (95% CI: 0.02-0.06). The results of the drug sensitivity test showed that gram-positive cocci were highly sensitive to vancomycin, moxifloxacin, levofloxacin and ofloxacin. Pseudomonas aeruginosa was most sensitive to tobramycin, and Escherichia coli was most sensitive to ofloxacin. Conclusions:This Meta-analysis indicates that the proportion of gram-positive cocci isolated from corneas in China has been on the rise, while the proportion of gram-negative bacilli was on the decline during the recent 40 years.Coagulase-negative Staphylococcus and Pseudomonas aeruginosa have become the most common pathogens of bacterial keratitis in China.The sensitivity of various bacteria to commonly used antibiotics shows a downward trend.The sensitive antibiotics should be selected correctly according to the drug sensitivity results.
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Objective:To investigate the clinical features of ocular involvement and the application of Rose criteria in patients with relapsing polychondritis (RP).Methods:The data from RP patients with ocular involvement were collected and analyzed. Patients included must have at least one major criteria of Michet criteria and the application Rose criteria was also investigated. Demographic data of these patients was presented as percentages. The difference between types of disease onset was tested by Mann-Whitney U and comparison among groups was tested by False Discovery Rate. Results:A total of 192 patients were enrolled 98 males and 94 females. The mean age of disease onset was (42±14) (0.5-79) years old, the median disease duration (DD) was 13(0.5, 600) months. The median RP disease activity index (RPDAI) was 39(9-74) and the median RP organ damage index (RPODI) was 2.5(0.1, 108). The median RP damage index (RPDAM) was 3(1-6). The statistical significant difference was identified in median DD between groups of nose and pinna ( Z=10.775, P<0.01), nose and OEH ( Z=9.277, P<0.01), in RPODI between groups of nose and pinna ( Z=7.999, P=0.031), nose and and extra-cranial organs ( Z=8.115, P=0.030) and eye and airway involvement of RPDAM could be seen between groups ( Z=7.683, P=0.037) respectively. Ocular involvement(50.0%), auricular chondritis(21.4%) and airway chondritis(13.5%) were the top three most common symptoms at disease onset. The ocular involvement(100%), airway chondritis (75.0%) and inner ear involvement(69.3%) were the top three most frequent affected organs. All parts of eye could be involved in RP ocular damage. Single-organ involvement was 59.9%; and multi-organ involvement could be seen in 40.1% patients. Diagnostic strength was enhanced by application of Rose criteria in 171 cases fulfilled Michet criteria and 21(10.9%) cases partially fulfilled Michet criteria fulfilled Rose criteria. Active screening for organ (especially inner ear and airway) involvement would improve the rate of early diagnosis. The pinna and airway involvement suggested nose and middle-ear might be involved. Conclusion:Ocular involvement in RP can involve all parts of the eye ball. Examining the inner ear and airway may help to confirm the diagnosis. It is worthy to apply this to clinical practice.
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Objective:To investigate the change regularity and influencing factors of subfoveal choroidal thickness (SFCT) with age among adults.Methods:A cross-sectional study was adopted.A total of 281 Chinese adults, aged between 21 and 90, were selected from working staff and retired staff of an institution who underwent routine physical examinations from June to October 2016 in Beijing Tongren Hospital.One eye of each subject was included in the study according to the random number table method.The subjects were divided into different age groups including 21-30 years group, 31-40 years group, 41-50 years group, 51-60 years group, 61-70 years group, 71-80 years group and 81-90 years group.The SFCT was measured at the fovea and at 500 μm, 1 000 μm and 2 000 μm nasal (N) and temporal (T) to fovea by high definition-optical coherence tomography.Multiple linear regression equation was used to analyze the influence of ages, gender, intraocular pressure (IOP), spherical equivalent (SE) and retinal thickness on SFCT.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2016-012). Written informed consent was obtained from each patient prior to any examination.Results:Mean SFCT of eligible 229 subjects (229 eyes) was (218.73±79.69)μm.Choroid became thinner gradually towards nasal and temporal part.There were significant differences in SFCT, N2 000, N1 000, N500, T500, T1 000 and T2 000 among all age groups ( F=27.05, 22.85, 25.38, 29.11, 32.55, 29.22, 28.70, all at P<0.01). Choroidal thicknesses of all locations showed age-related linear decrease with a steep drop after 50 years old ( R2ranged 0.35-0.47, all at P<0.01). SFCT was associated with SE (β=-10.07, P<0.01) and age (β=-2.43, P<0.01) but not related with gender (β=-19.69, P=0.057), foveal thickness (β=0.02, P=0.897) or IOP (β=-0.86, P=0.466). Conclusions:SFCT shows an age related linear decrease with a steep decline after 50 years old, which was associated with aging and higher SE in myopia, but not related with gender, foveal thickness or IOP within the normal range.
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Three new coumarins, integmarins A-C (1-3), and a new coumarin glycoside, integmaside A (4) were isolated from the leaves and stems of Micromelum integerrimum. Their structures were elucidated on the basis of 1D and 2D NMR and MS data, and their absolute configurations were assigned according to the ECD data of the in situ formed transition metal complexes and comparison of experimental and calculated ECD data. Compounds 1 and 2 are two rare coumarins with butyl and propyl moieties at the C-6 position; compound 3 is a novel coumarin with a highly oxidized prenyl group, and compound 4 is a rare bisdihydrofuranocoumarin glycoside.
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Coumarins/isolation & purification , Glycosides/isolation & purification , Molecular Structure , Plant Leaves/chemistry , Plant Stems/chemistry , Rutaceae/chemistryABSTRACT
Objective:To investigate vision-related quality of life, anxiety and depression in patients with primary angle-closure glaucoma (PACG) and the influencing factors in Baotou, Inner Mongolia.Methods:A cross-sectional study was conducted.One hundred and eighty-two consecutive PACG patients (364 eyes) with intraocular pressure ≤20 mmHg (1 mmHg=0.133 kPa) at 3 random times after treatment were enrolled in Baotou Chaoju Ophthalmic Hospital from September 2018 to January 2020.Gender, age, marital status, education level, monthly income, total treatment cost, glaucoma treatment time, surgery and drug treatment history, best corrected visual acuity (BCVA), Humphrey visual field index (VFI) and scores of the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and Hospital Anxiety and Depression Scale (HADS) of patients were recorded.Pearson correlation analysis was used to analyze the correlation between age and composite VFQ-25 score.Spearman rank correlation analysis was used to analyze the correlation between other statistical data.Stepwise multivariate linear regression was used to analyze the correlation between composite VFQ-25 score, HADS score and statistically significant influencing factors above.This study protocol adhered to the Declaration of Helsinki, and was approved by an Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2015-30). Written informed consent was obtained from each subject.Results:The mean age of subjects was (59.75±8.43) years.The mean composite VFQ-25 score was (68.59±14.43) points.The mean HADS, HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were 16.00 (12.00, 20.00), 8.00 (6.00, 10.00), 8.00 (6.00, 10.00) points, respectively.The proportion of anxious (HADS-A score>10 points) and depressd (HADS-D score >10 points) patients was 18.1% (33/182) and 13.7% (25/182), respectively.Age was positively correlated with BCVA in eyes with better and worse vision ( rs=0.36, 0.29; both at P<0.01), and it was negatively correlated with mean deviation (MD) of Humphrey visual field in the better-MD and worse-MD eyes, VFI of Humphrey visual field in the better-VFI and worse-VFI eyes ( rs=-0.21, -0.23, -0.30, -0.23; all at P<0.01). The composite VFQ-25 score was negatively correlated with age, BCVA in the eyes with better and worse vision ( rs=-0.32, -0.34, -0.48; all at P<0.01), and it was positively correlated with MD in the better-MD and worse-MD eyes, VFI in the better-VFI and worse-VFI eyes ( rs=0.37, 0.45, 0.38, 0.46; all at P<0.01). The HADS-A score was negatively correlated with MD in the better-MD eye ( rs=-0.20, P<0.01). The HADS-D score was positively correlated with BCVA in the eyes with worse vision ( rs=0.26, P<0.01) and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes ( rs=-0.21, -0.22, -0.22; all at P<0.01). The HADS score was positively correlated with BCVA in the eyes with worse vision ( rs=0.22, P<0.01), and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes ( rs=-0.20, -0.20, -0.21; all at P<0.01). The composite VFQ-25 score was negatively correlated with mean HADS-A, HADS-D and HADS scores ( rs=-0.41, -0.41, -0.45; all at P<0.01). According to the multivariate analysis, the composite VFQ-25 score was related to age ( P<0.01), education level ( P<0.01), total treatment cost ( P<0.05), BCVA in the eyes with better vision ( P<0.05) and MD in the worse-MD eyes ( P<0.01). The HADS score was related to gender ( P<0.05) and the composite VFQ-25 score ( P<0.01). Conclusions:The vision-related quality of life and incidence of anxiety and depression are low in patients with PACG in Baotou region, Inner Mongolia.With age increasing, PACG patients suffer from declined visual function, increased visual field damage, reduced vision-related quality of life and raised anxiety and depression.The vision-related quality of life is poorer in patients with lower education level and higher total treatment cost.Female glaucoma patients are more likely to suffer from anxiety and depression.
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Objective:To verify the predictive value of fully-automated 3D volume segmentation of CT images for the overall survival prognosis of resectable pancreatic ductal adenocarcinoma (PDAC).Methods:From July 2018 to March 2019, the clinical data of 198 cases of resectable PDAC were continuously collected in the First Affiliated Hospital of Naval Medical University. According to the level of carbohydrate antigen(CA)19-9 and carcinoembryonic antigen(CEA), the patient were divided into low CA19-9 group(≤210 U/ml ), high CA19-9 group (>210 U/ml ), normal CEA group (<5 ng/ml ) and high CEA group (≥5 ng/ml). Using our fully-automated segmentation tool developed in the early stage, images at the plain phase and portal phase were matched to those at the late artery phase by taking the artery phase as the matching target to establish UNet model; and the PDAC tumor and pancreatic glands were three-dimensionally segmented to estimate the tumor 3D volume. Univariate and multivariate logistic regression analysis were performed to compare the tumor 3D volume with the common preoperative risk factors (tumor 2D long diameter, CA19-9 level, CEA level, etc.) in predicting the patients′ survival. C-index was used to estimate the accuracy for predicting the survival. Receiver operating characteristics curve (ROC) was drawn and AUC was calculated to evaluate the accuracy for predicting the 1-year and 2-year overall survival and the influence of CA19-9 and CEA level on the patients′ overall survival.Results:Univariate logistic analysis showed that age, tumor 3D volume, tumor location, CA19-9 and CEA level were correlated with the patients′ overall survival. Multivariate logistic analysis showed that tumor 3D volume, CA199 and CEA were correlated with the overall survival. Among them, tumor 3D volume was most strongly correlated with the overall survival ( HR=2.25, 95% CI1.49-3.39, P<0.0001). The prognostic C-index of automatic 3D tumor volume, tumor long diameter, serum CEA and CA19-9 was 0.667(95% CI0.617-0.717), 0.637(0.583-0.691), 0.593(0.527-0.659) and 0.585(0.526-0.644), respectively. The AUCs of 3D tumor volume, tumor location, tumor long diameter, serum CEA and CA19-9 for predicting 1-year and 2-year survival were 0.726 and 0.698, 0.562 and 0.562, 0.703 and 0.660, 0.583 and 0.624, 0.602 and 0.609 respectively. C-index and AUC of tumor 3D volume was significantly better than those of the other common preoperative risk factors, and the difference was statistically significant (all P value <0.05). The survival of patients with large tumor 3D volume was greatly poorer than that of patients with small tumor 3D volume in low CA19-9 group, high CA19-9 group, normal CEA group and high CEA group, and the differences were all statistically significant ( HR=2.27, 95% CI 1.39-3.72; HR=2.42, 95% CI1.23-4.74; HR=2.08, 95% CI1.07-4.06; HR=2.67, 95% CI1.63-4.38, all P value <0.01). And the automatic 3D volume was the strongest predictor for the survival in high CA19-9 group. Conclusions:The tumor 3D volume obtained by automatic CT segmentation was an objective and reliable prognostic biomarker, which can supplement the established preoperativel risk factors and was expected to guide the personalized choice of neoadjuvant therapy.
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Objective:To explore the differential diagnosis of pancreatic acinar cell carcinoma (PACC) and pancreatic ductal adenocarcinoma (PDAC) based on multidetector computed tomography (MDCT) features.Methods:The clinical, pathological and MDCT imaging data of 26 patients with pathologically confirmed PACC and 145 patients with pathologically confirmed PDAC who underwent MDCT from November 2013 to April 2021 were retrospectively studied. The differences of MDCT features including tumor location, tumor size, common pancreatic duct and bile duct dilatation, pancreatitis, lymph node metastasis, cyst, pancreatic parenchyma atrophy, duodenal involvement, bile ductal and vascular involvement between the two groups were compared. Univariate analysis and multivariate analysis by logistic regression models were performed to identify the independent predictive factors for PACC.Results:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement were significantly different between PACC group and PDAC group (all P value<0.05). Multivariate analysis revealed that the tumor size ( OR=1.07, 95% CI 1.028-1.15, P=0.001), lymph node metastasis ( OR=0.23, 95% CI 0.065-0.800, P=0.02), pancreatic parenchyma atrophy ( OR=0.15, 95% CI 0.048-0.490, P=0.002) were closely associated with PACC. Conclusions:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement evaluated by MDCT had a certain value in differentiating PACC from PDAC, and the tumor size, lymph node metastasis and pancreatic parenchyma atrophy were independent predictors for the diagnosis of PACC.
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Objective:To analyze the MRI findings of solid pseudopapilloma of the pancreas (SPTs) and nonfunctional pancreatic neuroendocrine tumors (PNETs), and to establish and verify the prediction model of SPTs and PNETs.Methods:The clinical and MRI data of 142 patients with SPTs and 137 patients with PNETs who underwent surgical resection and were confirmed by pathology in the First Affiliated Hospital of Naval Medical University from January 2013 to December 2020 were collected continuously. Age, gender, body mass index (BMI), lesion size, location, shape, boundary, cystic change, T 1WI signal, T 2WI signal, enhancement peak phase, whether the enhancement degree was higher than that of pancreatic parenchyma in the enhancement peak phase, enhancement pattern, whether pancreatic duct and common bile duct were dilated, whether the pancreas shrank, and whether it invaded adjacent organs and vessels were recorded. According to the international consensus on prediction model modeling, patients were divided into training set (106 SPTs and 100 PNETs between January 2013 and December 2018), and validation set (36 SPTs and 37 PNETs between January 2019 and December 2020). The above characteristics of patients in training and validation set were analyzed by univariate and multivariate logistic regression, and a prediction model was established to distinguish SPTs and PNETs, and then visualized as a nomogram. The receiver operating characteristic curve (ROC) of the nomogram of training set and verification set was drawn, and the area under the curve (AUC), sensitivity, specificity and accuracy were calculated to evaluate the prediction efficiency of the model, and the clinical application value of the prediction model was evaluated by decision curve analysis (DCA). Results:Univariate regression analysis showed that there were significant differences on age, gender, lesion size, shape, cystic change, T 1WI signal, peak phase of enhancement, degree of enhancement in peak phase, pattern of enhancement and invasion of adjacent organs between SPTs group and PNETs group (all P value <0.05). Multivariate regression analysis showed that the older age, male patients, the smaller lesion, no high signal on T 1WI, the enhancement peak phase located in arterial phase or venous phase, and the enhancement degree in peak phase higher than that of pancreatic parenchyma were the six independent predictors of PNETs. The prediction model was established by using these six factors and visualized as a nomogram. The formula for predicting PNETs probability was 4.31+ 1.13×age+ 1.31×tumor size-1.29×female-4.18×high T 1WI signal+ 1.28×the enhancement degree higher than that of pancreatic parenchyma -4.69 ×enhancement peak in delay phase. The prediction model was visualized as a nomogram. The AUC values in the training set and validation set were 0.99(95% CI0.977-1.000) and 0.97 (95% CI 0.926-1.000), respectively. The sensitivity, specificity and accuracy in the training set are 98.00%, 94.34% and 96.12% and in the validation set were 86.49%, 97.22% and 91.78% respectively. The results of decision curve analysis show that the prediction model can accurately diagnose SPTs and PNETs. Conclusions:The prediction model established in this study can accurately differentiate SPTs from PNETs, and can provide important information for clinical decision and prognosis.
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Objective:To analyze the value and difference of the optic nerve sheath pulse dynamic deformation index (DI) in normal-tension glaucoma (NTG) and high-pressure primary open angle glaucoma (POAG).Methods:A cross-sectional study was conducted to collect clinical data at the Eye Center of Beijing Tongren Hospital from June 2016 to March 2017, 32 patients with NTG and 35 patients with high-pressure POAG were sampled.For all subjects, their basic information, body mass index (BMI), mean arterial blood pressure (MAP), 24 hours intraocular pressure, and ophthalmologic examinations required for diagnosis were recorded.All subjects underwent transorbital ultrasonography and for each 15 seconds of consecutive ultrasound images were taken.The dynamic post-processing technique was used to calculate the DI.The difference in DI between the two groups and the correlation of DI with other variables were analyzed.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital.Written informed consent was obtained from all subjects prior to their entering the study cohort and receiving the transorbital ultrasound examination.Results:The median level of DI in the NTG group was 0.51 (0.48, 0.54), which was higher than that in the high-pressure POAG group (0.23[0.20, 0.25]), exhibiting a significant difference ( Z=-7.01, P<0.01). The mean BMI in the NTG group was lower than that in the high-pressure POAG group([21.29±4.64]kg/m 2vs. [23.53±3.40]kg/m 2), the mean MAP in the NTG group was lower than that in the high-pressure POAG group([91.44±14.30]mmHg vs. [104.05±13.96] mmHg), the differences between the two groups were statistically significant ( t=-2.30, P<0.05; t=-3.65, P<0.01). There was no statistical association between the two groups of DI and age, MAP, BMI, mean intraocular pressure and maximum intraocular pressure (all at P>0.05). Conclusions:The DI of the NTG patient is higher than that of the POAG patient, which indicates that the optic nerve sheath subarachnoid pressure and optic nerve sheath stiffness in NTG patients are lower than those in POAG patients.Therefore, the DI is a potential indicator of non-invasive intracranial pressure and translaminar cribrosa pressure difference detection in ophthalmology.
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BACKGROUND@#In recent years, visual quality has been extensively investigated in various conditions. In this community-based population study, we analyzed the effects of aging, refraction, and Lens Opacification Classification System III (LOCSIII) score on retinal imaging quality in healthy Chinese adults.@*METHODS@#This cross-sectional study was conducted on sub-group subjects from The Handan Eye Study between October 2012 and January 2013. Healthy subjects over 30-years-old with logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) less than 0 were included. Retinal image quality was measured by optical quality analysis system (OQAS) and recorded as modulation transfer function cutoff frequency (MTFcutoff), OQAS value (OV) 100%, OV20%, OV9%, Strehl ratio (SR), and objective scatter index (OSI). The correlation between age, spherical equivalent refraction (SE), LOCSIII score, and optical quality parameters were investigated by multivariate analysis.@*RESULTS@#Among 1108 verified subjects, 690 subjects (1380 eyes) met the inclusion criteria. Their age ranged from 30 to 76 years, SE ranged from -4.75 to 2.75 D. They were divided into five age groups (30-39, 40-49, 50-59, 60-69, and ≥70 years) for further analysis. After multivariate analysis by mixed-effect linear model, SR (t = -3.03, P = 0.002), OV20% (t = -2.39, P = 0.017), and OV9% (t = -3.16, P = 0.001) significantly decreased with the increasing age, whereas logMAR BCVA (t = 4.42, P < 0.001) and OSI (t = 4.46, P < 0.001) significantly increased with age. As SE increased, SR (t = 2.74, P = 0.01), OV20% (t = 2.31, P = 0.02), and OV9% (t = 2.79, P = 0.005) significantly elevated, and OSI (t = -3.38, P < 0.001) significantly decreased. With the increase in cortical opacity score, all optical quality parameters except for SR significantly decreased, including MTFcutoff (t = -2.78, P = 0.01), OV100% (t = -2.78, P = 0.005), OV20% (t = -2.60, P = 0.009), and OV9% (t = -2.05, P = 0.040). As posterior sub capsular opacity score increased, MTFcutoff (t = -2.40, P = 0.02) and OV100% (t = -2.40, P = 0.01) significantly decreased, while OSI (t = 7.56, P < 0.001) significantly increased.@*CONCLUSIONS@#In healthy Chinese adult population, optical quality-related parameters significantly decrease with the increasing age, and OSI significantly increases with age. In normal BCVA subjects, optical quality is significantly impacted by cortical and posterior sub capsular opacity rather than by nuclear opacity.
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Background@#Handan Eye Study (HES), a large population-based cohort study in rural area of northern China, was one of the few studies focusing on the major eye diseases of rural Chinese population. The aim of this study was to introduce the design, methodology and to assess the data quality of the follow-up phase of HES.@*Methods@#All participants were recruited in Yongnian county of Handan city between 2012 and 2013. Main outcomes were measured by visual quality scales and ocular examinations. We performed the Chi-square test to make comparison of categorical data among groups, One-way analysis of variance and Kruskal-Wallis test was applied to make comparison of continuous data among groups, a post-hoc test was done to make further pairwise comparison. Inter-class correlation coefficients (ICCs) and Kappa coefficients were used to evaluate the consistency between different operators. Logistic regression was used to explore the influence factors of death, odds ratio (OR) and 95% confidence interval (CI) were used to estimate the effect size of each influence factor.@*Results@#The follow-up rate was 85.3%. Subjects were classified into three groups: the follow-up group (n = 5394), the loss to follow-up group (n = 929), and the dead group (n = 507), comparison of their baseline information was done. Compared with the other two groups, age of the dead group (66.52 ± 10.31 years) was the oldest (Z = 651.293, P < 0.001), male proportion was the highest (59.0%) (χ2 = 42.351, P < 0.001), only 65.9% of the dead finished middle school education (Z = 205.354, P < 0.001). The marriage percentage, body mass index (BMI), best-corrected visual acuity (BCVA), and intra-ocular pressure of the dead group was the lowest either. Spherical equivalent error (SER) of the dead group was the highest. Besides, history of smoking, hypertension, diabetes, and heart disease were more common in the dead group. Multivariate analysis showed that age (OR = 1.901, 95% CI: 1.074–1.108), gender (OR = 0.317, 95% CI: 0.224–0.448), and BCVA (OR = 0.282, 95% CI: 0.158–0.503) were associated with death. While between the follow-up group and the loss to follow-up group, there was only difference on age, gender, BMI, systolic blood pressure and SER. The Cronbach coefficients of all scales used in the follow-up were ≥0.63 and the cumulative variances were ≥0.61, indicating good reliability and validity. The ICCs and Kappa coefficients between different operators were ≥0.69.@*Conclusions@#HES has a high follow-up rate and a low risk of loss to follow-up bias. Age, gender, and BCVA are influence factors of death. Specifically, male subjects are at a higher risk of death than female, age is a risk factor of death while BCVA is a protective factor for death.
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BACKGROUND@#Handan Eye Study (HES), a large population-based cohort study in rural area of northern China, was one of the few studies focusing on the major eye diseases of rural Chinese population. The aim of this study was to introduce the design, methodology and to assess the data quality of the follow-up phase of HES.@*METHODS@#All participants were recruited in Yongnian county of Handan city between 2012 and 2013. Main outcomes were measured by visual quality scales and ocular examinations. We performed the Chi-square test to make comparison of categorical data among groups, One-way analysis of variance and Kruskal-Wallis test was applied to make comparison of continuous data among groups, a post-hoc test was done to make further pairwise comparison. Inter-class correlation coefficients (ICCs) and Kappa coefficients were used to evaluate the consistency between different operators. Logistic regression was used to explore the influence factors of death, odds ratio (OR) and 95% confidence interval (CI) were used to estimate the effect size of each influence factor.@*RESULTS@#The follow-up rate was 85.3%. Subjects were classified into three groups: the follow-up group (n = 5394), the loss to follow-up group (n = 929), and the dead group (n = 507), comparison of their baseline information was done. Compared with the other two groups, age of the dead group (66.52 ± 10.31 years) was the oldest (Z = 651.293, P < 0.001), male proportion was the highest (59.0%) (χ = 42.351, P < 0.001), only 65.9% of the dead finished middle school education (Z = 205.354, P < 0.001). The marriage percentage, body mass index (BMI), best-corrected visual acuity (BCVA), and intra-ocular pressure of the dead group was the lowest either. Spherical equivalent error (SER) of the dead group was the highest. Besides, history of smoking, hypertension, diabetes, and heart disease were more common in the dead group. Multivariate analysis showed that age (OR = 1.901, 95% CI: 1.074-1.108), gender (OR = 0.317, 95% CI: 0.224-0.448), and BCVA (OR = 0.282, 95% CI: 0.158-0.503) were associated with death. While between the follow-up group and the loss to follow-up group, there was only difference on age, gender, BMI, systolic blood pressure and SER. The Cronbach coefficients of all scales used in the follow-up were ≥0.63 and the cumulative variances were ≥0.61, indicating good reliability and validity. The ICCs and Kappa coefficients between different operators were ≥0.69.@*CONCLUSIONS@#HES has a high follow-up rate and a low risk of loss to follow-up bias. Age, gender, and BCVA are influence factors of death. Specifically, male subjects are at a higher risk of death than female, age is a risk factor of death while BCVA is a protective factor for death.
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Objective To evaluate the preliminary clinical effect of anterior anatomical reduction plate fixation on the treatment of atlantoaxial dislocation. Methods A retrospective case series study was conducted to analyze the 13 patients with atlantoaxial dislocation admitted to the second affiliated hospital of Xi'an Jiaotong University from January 2016 to December 2017. There were eight males and five females, aged 20-57 years, with an average age of 42 years. All patients received transoropharyngeal reconstruction and atlantoaxial anterior anatomical reduction plate fixation, 12 of which underwent the surgery for the first time but one had the revision surgery. The operation time and intraoperative bleeding were recorded. The angle of the clivus axis was measured, and the reduction of the atlantoaxial spine and the fusion of bone graft were observed. The neurological function was evaluated by Japanese Orthopedic Association ( JOA ) score and the improvement rate of spinal cord function was calculated. The complications were also recorded. Results All patients were followed up for 10-30 months [(14. 2 ± 5. 0)months]. The operation time was 150-285 minutes [(216. 8 ± 36. 7)minutes]. The intraoperative blood loss was 50-130 ml [(80. 5 ± 19. 7)ml]. The slope axis angle was (113. 2 ± 9. 1)° before operation and (145. 8 ± 6. 7)° after operation, with an average increase of 32. 6° (P<0. 01). Anatomical reduction was obtained in nine patients, and partial reduction in four patients. At the last follow-up, the atlantoaxial fusion was obtained in all patients, and the healing time was ( 4. 6 ± 1. 1 ) months. Postoperative neurological symptoms were improved compared with those before operation. The JOA score was improved from preoperative (8. 7 ± 1. 7) points to postoperative (14. 3 ± 1. 2) points, with an average increase of 5. 6 points (P<0. 01). The average improvement rate of spinal cord function was 69％. Except for one patient with cerebrospinal fluid leakage, there were no complications such as spinal cord, nerve, blood vessel injury or wound infection after operation. Conclusions Anterior atlantoaxial anatomical reduction plate fixation can effectively restore the dislocated atlantoaxial joint, restore slope axis angle, improve bone fusion rate, and improve nerve function. It can be used as an alternative or supplement to posterior fixation.
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Objective: To provide reference and suggestions for improving the in-use period information of sterile products after first opening or reconstitution in China. Methods: The package inserts of sterile products in our hospital were investigated. The sterile products needed to be reconstituted before use and with multiple-dose package were selected. The in-use period information of European imported sterile products and domestic sterile products were comparatively analyzed. Results: The presentation rate of in-use period in the package inserts of domestic sterile products was 32. 25% , which was less than 55. 56% of the other imported sterile products, and significantly less than 93. 55% of European imported sterile products. Conclusion: The relevant content of in-use period of sterile products after first opening or reconstitution is supplemented relatively late in China's stability testing guidance for drug substances and products, moreover, the specific technical proposals are absent. It is suggested that the drug administrative department and its techni-cal supportive agencies should improve the relevant guidance and guide pharmaceutical research enterprises and manufacturing enterpri-ses to carry out in-use stability studies, furthermore, gradually improve the relevant in-use period information in package inserts.
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OBJECTIVE:To provide references and suggestions for expiration date management of dismounted drugs in China.METHODS:The main contents about compliance policy for expiration date of repackaged drugs in America were summarized.The current situation and problems of expiration date management of dismounted drugs in China were analyzed to provide suggestions for standardizing expiration date management of dismounted drugs in China.RESULTS & CONCLUSIONS:The compliance policy for expiration date of repackaged drugs in America contain determination principle of expiration date of repackaged drugs,repackaged container standard,etc.In contrast,the expiration date management of dismounted drugs in China is lack of specific standards and requirements;major issues are as follows as the concept of expiration date of dismounted drugs is ambiguous and container management is not standardized.It is suggested that relevant departments can refer to compliance policy for expiration date of repackaged drugs in America,define the method of determining the expiration date of the dismounted drugs,and standardize the standards and management of packaging containers so as to standardize expiration date management of dismounted drugs in China practically.
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The open silica gel, ODS, and Sephadex LH-20 column chromatography, along with the semi-preparative HPLC was used to isolate and purify the chemical constituents from Murraya euchrestifolia. The structures of the isolates were elucidated by their physiochemical properties, NMR, and MS spectroscopic data, as well as comparison with literature data. Eighteen compounds were isolated from the CH2Cl2 fraction of the 95% aqueous EtOH extract of M. euchrestifolia, and their structures were identified as sakuranetin (1), eriodictyol-7,4'-dimethyl ether (2), isosakuranetin (3), 5-hydroxy-7,4'-dimethoxyflavanone (4), eriodictyol-7-methyl ether (5), lichexanthon (6), 5,6,7-trimethoxycoumarin (7), 5-hydroxy-6,8-dimethoxycoumarin (8), 8-hydroxy-6-methoxy-3-n-pentylisocoumarin (9), ethyl caffeate (10), 4-hydroxy-3,5- dimethoxycinnamic acid ethyl ester (11), methyl 3-(5'-hydroxyprenyl)-coumarate (12), (E)-coniferol (13), β-hydroxypropiovanillone (14), 3-hydroxy-7,8-didehydro-β-ionone (15), 3β-hydroxy-5α, 6α-epoxy-7-megastigmen-9-one (16), grasshopper ketone (17), and 4-hydroxy-3,5-dimethoxybenzaldehyde (18). Compounds 1-15 and 18 were first obtained from the plants of Murraya genus, and compounds 16 and 17 were isolated from M. euchrestifolia for the first time.
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Transient receptor potential (TRP) channels are non-selective and cation-permeable channels in the cell membrane, widely distributed in tissues and organs of human body. As biosensors, TRP channels can regulate the functions of vision, hearing, taste, pain, and touch, etc. So far, more than 100 different kinds of natural modulators targeting TRP channels have been identified from 70 species of plants or animals. In this review article, we attempt to summarize the effect of known natural active compounds on TRP channels with focuses on their sources, structures, action features and mechanisms. Hopefully this review can provide some useful information that can facilitate discovery of more specific natural modulators, and development of innovative therapeutic drugs targeting TRP channels.
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Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .
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<p><b>OBJECTIVE</b>To investigate the effect of microRNA-20a(MiR-20a) on osteogenic differentiation of mouse C3H/10T1/2 cells and its regulatory mechanism.</p><p><b>METHODS</b>Osteogenic differentiation of C3H/10T1/2 cells were identified by ALP staining and qRT-PCR. MiR-20a mimics and CKIP-1 siRNA were transfected into C3H/10T1/2 cells respectively with lipo3000. The expression of osteoblast marker genes, miR-20a and CKIP-1 were quantitatively assessed by qRT-PCR.</p><p><b>RESULTS</b>miR-20a expression was up-regulated during osteoblast differentiation of C3H/10T1/2 cells. Overexpression of miR-20a promoted osteogenic differentiation. Furthermore, miR-20a inhibited the expression of bone formation negative regulator CKIP-1. Additionally, CKIP-1 knockdown promoted osteogenic differentiation.</p><p><b>CONCLUSION</b>MiR-20a promotes osteogenic differentiation of C3H/10T1/2 cells possibly through inhibiting the expression of CKIP-1.</p>