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Objective:To observe the multimodal image features of inflammatory lesions and choroidal neovascularization (CNV) in multifocal choroiditis (MFC).Methods:A retrospective clinical analysis. A total of 90 eyes of 46 patients with MFC diagnosed in the Department of Ophthalmology of Yunnan University Affiliated Hospital from May 2017 to April 2021 were included in the study. Among them, there were 21 males and 25 females; the average age was 38.30±8.97 years old. Twenty-nine cases of MFC were diagnosed in the past, and they visited the doctor again due to new symptoms; 17 cases without a clear past medical history were the first visits. All eyes underwent color fundus photography, fluorescein fundus angiography (FFA), optical coherence tomography (OCT), and OCT angiography (OCTA). With reference to the literature and the results of multimodal fundus imaging examinations, MFC lesions were divided into active CNV lesions, inactive CNV lesions, active inflammatory lesions, and inactive inflammatory lesions, with 31 (34.4%, 31/90), 12 (13.3%, 12/90), 26 (28.9%, 26/90), 90 (100.0%, 90/90) eyes. Nineteen eyes were treated with anti-vascular endothelial growth factor drugs. To summarize and analyze the manifestations of inflammatory lesions and CNV lesions in different imaging examinations. The Wilcoxon rank test was used to compare the detection rate of CNV lesions between FFA and OCTA.Results:In eyes with active inflammatory lesions and active CNV lesions, yellow-white lesions, retinal hemorrhage and exudation were seen on fundus color photography; FFA examination showed fluorescein leakage in the lesions; OCT examination showed retinal pigment epithelium (RPE) layer in the lesions was uplifted, the boundary was unclear, combined with subretinal and intraretinal fluid; OCTA examination showed that there was no blood flow signal in each layer of vascular tissue in active inflammatory lesions, and blood flow signals were seen in active CNV lesions. In the eyes of inactive inflammatory lesions and inactive CNV lesions, the fundus color photography showed that the lesions had clear boundaries without bleeding or exudation; FFA examination, the lesions were fluorescently stained, and there was no fluorescein leakage; OCT examination, inactive CNV lesions manifested as raised lesions with clear boundaries, and inactive inflammation manifested as scars formed by mild RPE hyperplasia or depressions in outer structures formed by atrophy; OCTA examination, inactive inflammatory lesions showed patchy loss of blood flow signal or penetrating blood flow signal below, blood flow signal can be seen in inactive CNV lesions.Conclusion:MFC active inflammatory lesions and active CNV lesions are often accompanied by retinal hemorrhage and exudation; FFA shows fluorescein leakage; OCT shows that the boundary of raised lesions is unclear; OCTA can identify the nature of CNV or inflammatory lesions.
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Objective To evaluate the early diagnostic value of circulating microRNA-1 (miR-1) on acute myocardial infarction (AMI). Methods A prospective cohort study was conducted. The patients with chest pain admitted to the Second People's Hospital of Wuxi from November 2012 to June 2015 were enrolled. According to AMI diagnostic criteria, the patients were divided into AMI group and non-AMI group, and healthy individuals during the same period were served as heath controls. The venous samples of the onset patients were collected within 3 hours after admission. The plasma miR-1 was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the levels of plasma cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were measured by electrochemiluminescence. The correlation between plasma miR-1 and cTnI as well as CK-MB was performed by Spearman analysis. The early diagnostic performance of plasma miR-1, cTnI, and CK-MB for AMI was estimated by receiver operating characteristic (ROC) curve analysis. Results There were 127 patients in AMI group, and 107 in non-AMI group, including 82 patients with angina pectoris, 2 with pulmonary embolism, 3 with aortic dissection, 2 with acute pericarditis, 3 with myocarditis, 13 with acute heart failure, and 2 with peptic ulcer. Ninety volunteers were served as healthy controls. There was no difference in clinical characteristics including gender and hyperlipidemia between AMI group and non-AMI group. The expressions of plasma miR-1, cTnI and CK-MB were significantly increased in AMI patients as compared with those of the healthy controls [miR-1 (2-ΔΔCt): 4.32±2.60 vs. 1.44±0.75 and 0.98±0.18, cTnI (μg/L): 3.23 (0.63, 10.70) vs. 0.02 (0.00, 0.17) and 0.00 (0.00, 0.00), CK-MB (U/L): 32.40 (14.20, 95.40) vs. 14.40 (11.20, 17.10) and 8.90 (8.28, 9.50), all P < 0.01]. The expression of plasma miR-1 had a significantly positive correlation with cTnI and CK-MB in AMI patients (r1 = 0.395, r2 = 0.490, both P < 0.000). It was demonstrated by ROC curve analysis that the area under ROC curve (AUC) for the diagnostic value of miR-1 on AMI was 0.905 [95% confidence interval (95%CI) = 0.860-0.950, P = 0.000], the sensitivity was 86.6%, and the specificity was 95.4%; the AUC for cTnI was 0.908 (95%CI = 0.870-0.946, P = 0.000), the sensitivity was 81.9%, and the specificity was 95.9%; the AUC for CK-MB was 0.795 (95%CI = 0.736-0.854, P = 0.000), the sensitivity was 63.0%, and the specificity was 92.9%. Conclusions Plasma miR-1 has the capacity in early diagnosis of AMI, superior to CK-MB, and equal to cTnI. It can provide additional diagnostic information beyond cTnI. The diagnostic accuracy for early AMI can be improved with the combination of plasma miR-1 and cTnI.
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Objective To investigate changes of serum proteins and related enzymes in patients with schizophrenia and its relationship to metabolic syndrome.Methods Five hundred and three inpatients with schizophrenia and 60 healthy volunteer were selected in this study.The demographic information and medical history data of them were recorded and levels of serum proteins and enzymes were measured,and the metabolic syndrome (MS) was diagnosed according to IDF criteria.Results Serum protein contents of schizophrenic patients (total protein (71.14 ±6.13) g/L,albumin (44.56 ±4.24)g/L,globulin(26.35 ±5.04) g/L,apoprotein A(10.97 ± 0.27) g/L,and apoprotein B (0.69 ± 0.25) g/L) were significantly lower than control group (79.96 ± 6.10) g/L,(49.44 ±5.63) g/L,(30.52 ±4.00) g/L,(10.97 ±0.27) g/L,and(0.69 ±0.25)g/L (P＜0.01).Urea nitrogen ((4.36± 1.36) mmol/L) was lower than control group ((5.22 ± 1.31) mmol/L) and C-reaction protein ((3.17 ± 6.58) mg/L) was higher than control group (1.35 ± 1.83) (P ＜ 0.01).Alanine aminotransferase ((24.28 ± 32.76) IU/L),a-L Fucosidase((17.49 ± 4.83) U/L),adenosine dehydrogenase((17.81 ± 5.67) U/L),and creatine kinase isoenzyme((10.50 ±4.92)IU/L) were higher than control group (18.12 ±9.77)IU/L,(15.98 ± 3.58)U/L,(11.75 ±5.48) U/L,and (9.12 ±3.62)IU/L,P＜0.01),but AST isoenzyme ((5.97 ±4.97) U/L)was lower than control group ((7.05 ± 6.72) U/L).Alanine Aminotransferase,alkaline phosphatase,γ-glutamyl transpeptidase,and a-L Fucosidase,AST isoenzyme and cystatin-c of schizophrenic patients with MS were significantly higher than non-MS patients(P ＜ 0.05).Conclusion There are significant metabolic disorders of proteins and enzymes in patients with schizophrenia,and abnormal changes of many enzymes are significantly associated with metabolic syndrome.
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Objective To investigate the abnormal distribution of lymphocytes in eutopic and ectopic endometrium of patients with endometriosis and its significance. Methods In 43 cases, biopsies of ectopic tissues were taken by laparoscopy and laparotomy from patients with endometriosis and eutopic endometrium by curettage at the same time. In 19 cases, eutopic endometrium was taken from hysterectomy for myomatous uterus. Immunohistochemical techniques were employed to demonstrate the difference in the number and ratio of the lymphocyte subsets between the patients with endometriosis and the controls. Results In the patients with endometriosis, in the proliferative phase, ectopic endometrium contained respectively CD+3、CD+8T cells and CD+68 macrophages (67.2±13.5)/5HP, (45.0±14.0)/5 HP and (37.2±10.6)/5 HP, significanly higher then that in the eutopic endometriun (52.4±11.3)/5HP (P<0.01), (32.5±10.0)/5HP (P<0.05)， and (30.7±10.3)/5HP， and also higher as compared with the control group (52.1±14.9)/5HP (P<0.05)， (28.9±12.7)/5HP (P<0.01), (26.3±9.3)/5HP (P<0.05); in the secretory phade, CD+8/CD+4, and CD+68 content was respectively 3.5±1.2，(40.3±12.2)/5HP, higher than that in the control group, 3.2±0.8 (P<0.05), (28.6±10.6)/5HP (P<0.01). The number of macrophages was also significantly increased. No cyclic changes in the number of lymphocytes in each subpopulation in ectopic endometrium were found. Conclusions In the patients with endometriosis, the changes in T lymphocytes and macrophages are mainly on the endometriotic sites. The infiltration of many lymphocytes and macrophages into the ectopic endometrium formed a chronic inflammatory process. The lymphocytes are not able to clear the ectopic endometrium in the late stages of endometrium，on the contrary, they stimulate the further growth of the endometrium.