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Objective:To observe the efficacy of optical coherence tomography angiography (OCTA) guided half-dose photodynamic therapy (PDT) in the treatment of acute central serous chorioretinopathy (CSC).Methods:A prospective randomized controlled trial. A total of 72 patients (72 eyes) with acute CSC in Peking University People's Hospital from April 2019 to April 2020 were included in the study. They were randomly divided into OCTA group (OCTA-guided PDT, 31 eyes of 31 patients) and indocyanine green angiography (ICGA) group (ICGA-guided PDT, 33 eyes of 33 patients). All patients underwent best corrected visual acuity (BCVA), fundus color photography, OCTA and ICGA examinations. International standard visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity. In OCTA group, the hyper-reflective area on en face OCTA image at choriocapillaris level was identified as treating area. In ICGA group, the area of choroidal vascular hyperpermeability on ICGA which was related to the leakage on fundus fluorescein angiography (FFA) was identified as treating area. The area corresponding to the treating area on FFA or ICGA was outlined on the color fundus photograph to guide PDT laser spot. The complete subretinal fluid (SRF) resolution, BCVA, central retinal thickness (CRT) at 1, 3, 6 months and SRF recurrent rate at 3, 6 months were observed. Continuous variables between the two groups were compared by t-test or Wilcoxon rank sum test. The χ2 test was used to compare the categorical variables. Results:At 1, 3 and 6 months after treatment, the SRF absorption rate in OCTA group and ICGA group was 74.2% (23/31), 63.6% (21/33), 87.1% (27/31) and 84.8% (28/33), 96.8% (30/31), 91.9% (31/33), respectively. OCTA-guided PDT was demonstrated noninferior to ICGA-guided PDT for complete SRF resolution at 1, 3, 6 months [95% confidence interval ( CI) -11.9%-33.1%, P=0.402; 95% CI -14.7%-19.3%, P=0.107; 95% CI-6.3%-16.1%, P=0.226]. There was no significant difference in the recurrence rate of SRF between the two groups at 3 and 6 months after treatment ( χ2=0.009, 0.047; P=0.925, 0.828). The difference of CRT was statistically significant at 6 months ( t=2.017, P=0.047). There was no significant difference in logMAR BCVA at 1, 3 and 6 months after treatment ( t=0.529, 0.762, 1.017; P=0.581, 0.403, 0.243). Conclusions:During 6 months follow-up, OCTA-guided PDT was demonstrated noninferior to ICGA-guided PDT for the SRF absorption rate in patients with acute CSC.
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Objective:To investigate the effect of withdrawal time on postpartum liver function in pregnant women receiving tenofovir disoproxil fumarate (TDF) therapy for blocking mother-to-child transmission of HBV.Methods:A prospective study was conducted in Hangzhou First People’s Hospital from June 2016 to August 2018. A total of 84 pregnant women with HBsAg and HBeAg positive were enrolled and divided into two groups according to simple randomized grouping method with 42 cases in each group. In group A TDF was withdrawn immediately after delivery and in group B TDF was withdrawn 12 weeks after delivery. Finally, 66 patients completed the follow-up for 24 weeks postpartum, 35 cases in group A and 31 cases in group B. All patients were administered TDF from week 24-28 of pregnancy. HBV DNA loads and ALT levels were regularly measured and compared. Multivariate logistic regression was used to explore the risk factors of postpartum ALT flare. SPSS 26.0 statistical software was used for statistical processing.Results:Compared with the baseline levels, the HBV DNA loads at 16 weeks postpartum had no significant changes in both groups( Z=-0.742 and -1.891, both P>0.05). Postpartum ALT flare was observed in 21 of the 66 patients, 9 cases (25.71%, 9/35) in group A, and 12 cases (38.71%, 12/31) in group B ( χ2=1.280, P>0.05); and there was no significant difference in the severity of postpartum ALT flare between the two groups ( χ2=0.527, P>0.05). Binary logistic regression analysis showed that increased ALT level during pregnancy was an independent risk factor of postpartum ALT flare ( OR=13.75, 95% CI 1.49-126.85, P<0.05). Conclusions:When TDF was used for preventing mother-to-child HBV transmission, withdrawal at different times after delivery had no effect on postpartum liver function. ALT flare during pregnancy is a risk factor for postpartum ALT flare, so TDF should be discontinued carefully and liver function should be closely monitored postpartum for such patients.
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Objective: To discuss the clinical characteristics, diagnosis, treatment experience and prognosis of mature cystic teratoma complicated with primary ovarian carcinoid, and to summarize its general charateriseics and to enhance the knowledge of clinician. Methods: Three female patients presented unilateral ovarian tumor in physical examination and were admitted to hospital. The tumor markers of three patients were normal. The preoperative diagnosis was ovarian tumor. Unilateral salpingo-oophorectomy was conducted in two patients. The resection of ovarian tumor was conducted in one patient. Results: The three patients underwent operation successfully. The postoperative pathological diagnosis was mature cystic teratoma complicated with primary ovarian carcinoid. The patients recovered well, who accepted 15-month follow-up with normal life and stable condition, and had no recurrence and metastasis. Conclusion: Mature cystic teratoma complicated with primary ovarian carcinoid is easy to be misdiagnosed before operation. Salpingo-oophorectomy is commonly used as the treatment method of mature cystic teratoma complicated with primary ovarian carcinoid and it can result in good effectiveness and better prognosis.
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Objective:To discuss the clinical characteristics,diagnosis,treatment experience and prognosis of mature cystic teratoma complicated with primary ovarian carcinoid,and to summarize its general charateriseics and to enhance the knowledge of clinician.Methods:Three female patients presented unilateral ovarian tumor in physical examination and were admitted to hospital.The tumor markers of three patients were normal. The preoperative diagnosis was ovarian tumor.Unilateral salpingo-oophorectomy was conducted in two patients.The resection of ovarian tumor was conducted in one patient.Results:The three patients underwent operation successfully.The postoperative pathological diagnosis was mature cystic teratoma complicated with primary ovarian carcinoid.The patients recovered well,who accepted 15-month follow-up with normal life and stable condition,and had no recurrence and metastasis.Conclusion:Mature cystic teratoma complicated with primary ovarian carcinoid is easy to be misdiagnosed before operation.Salpingo-oophorectomy is commonly used as the treatment method of mature cystic teratoma complicated with primary ovarian carcinoid and it can result in good effectiveness and better prognosis.
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Chronic hepatitis B (CHB) is still a global public health problem, resulting in the high risk of decompensated cirrhosis and hepatocellular carcinoma.At present, there are no single available medications that can induce both potent HBV DNA suppression, and high rates of HBeAg and HBsAg clearance.Therefore, there is great interest in developing combination therapies for patients with chronic HBV infection, which can achieve sustained viral suppression and HBsAg negative inversion after a finite course of treatment leading to clinical cure.This article reviews the current status and advances of combination therapy for CHB.
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Objective To evaluate the influence of ultrasound-mediated contrast agent microbubbles carrying kallidinogenase targeted therapy on neurogenesis and angiogenesis after experimental acute cerebral infarction.Methods Kallidinogenase-loaded microbubbles were prepared using mechanical shaking method.Middle cerebral artery occlusion (MCAO) model was established in male Wistar rats by sutureoccluded method.MCAO rats (n =120) were randomly divided into 5 groups:ultrasound-mediated kallidinogenase-loaded microbubbles group (group 1),ultrasound-mediated microbubbles group (group 2),ultrasound-mediated saline group (group 3),kallidinogenase group (group 4),saline group (group 5).Medication was given through tail vein daily for 2-6 consecutive days starting 24 h after MCAO.Ultrasound groups (groups 1,2 and 3) were given 2 MHz pulse ultrasonic irradiation on the ischemia lateral skull for 10 min after injection.Cell proliferation was examined using 5'-bromo-2'-deoxyuridine (BrdU,50 mg/kg).Infarction volume and neurological function were evaluated on the 3rd,7th day after MCAO respectively.Doublecortin (DCX) + cells in the subventricular zone and laminin + in the peri-infarction region were observed at the same time.Results The number of DCX + cells in the subventricular zone (under 20 × ocular) of groups 1-5 was 251.8 ± 13.1,125.7 ± 11.6,130.2 ± 13.7,234.5 ± 12.4 and 123.7 ± 10.0 respectively.The percentage of laminin + cells in the peri-infarction region (× 10 objective) of groups 1-5 was 10.0％ ± 0.8％,5.2％ ± 0.7％,5.0％ ± 1.0％,8.0％ ± 1.8％ and 5.0％ ± 0.9％ respectively.The number of DCX + cells in the subventricular zone and laminin + cells in the peri-infarction region of the group 1 and the group 4 was significantly more on the 7th day after MCAO compared with those of the other three groups (DCX:t values of group 1 vs groups 2,3,5 were 17.88,17.17 and 18.16,all P ＜ 0.01 ; t values of group 4 vs groups 2,3,5 were 15.42,14.78 and 15.70,all P ＜0.01.Laminin:t values of group 1 vs groups 2,3,5 were 7.01,6.71 and 7.11,all P ＜ 0.01 ; t values of group 4 vs groups 2,3,5 were 4.23,3.94 and 4.33,all P ＜0.01).Moreover,the number of DCX+ cells in the subventricular zone (t =2.46,P ＜ 0.05) and laminin + cells in the peri-infarction region (t =2.78,P ＜ 0.05) of the group 1 was much more than those of the group 4.Neurologic scores on the 7th day of groups 1-5 were 1.00 (0.75,1.25),2.0 (2.00,3.00),2.0 (1.00,2.00),1.5 (0.75,2.00),2.0 (2.00,2.50).Compared with other four groups,group 1 showed better functional improvement after stroke (U values of group 1 vs groups 2-5 were 2.0,4.0,7.5 and 2.5,all P ＜ 0.05).While there was no significant difference in infarction volume among five groups at all the time points after MCAO.Conclusions Our study demonstrates ultrasound-mediated kallidinogenase-loaded contrast agent microbubbles targeted therapy promotes neuroblasts proliferation and vascular regeneration compared with mediated and non-medicine-loaded microbubbles therapy,which attributes to functional improvement after MCAO.Therefore,ultrasound-mediated ultrasound contrast agent microbubbles carrying drugs targeted therapy may have a perspective on ischemic stroke.
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Taking global minimum essential requirements(GMER)as standard,school of basic medical science in Wuhan University paid more attention to the cultivation of students' professional skills, innovation ability and communication ability. ‘Response to injury’integrated course was carried out. Based on the immunology,this course involves pathology and pathophysiology and explores the mecha-nism of the diseases' diagnosis and treatment. It took small classes,bilingual education,literature read-ing ,experiments and discussions in various forms . This reform aimed to improve the immunology , pathology and pathophysiology teaching and make our medical education meet the process of globalization.
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It is necessary to determine the position of break points in order to study the structure rearrangement of chromosomes and gene mapping. Therefore it is indispensable to set up region, banded idiogram and nomenclature system. Nesbitt and Franke reported an idiogram and a nomenclature system for band patterns of mouse chromosomes which thereafter was accepted by the Committee on Standardized Genetic Nomenclture. Nevertheless, there are few data of systematical contrast studies in this domain. There are still difficulties for distinguishing between some chromosomes because they are similar and variability. In this paper, we compared our G-banding karyotypes with the banding patterns of Nesbitt's idiogram. Our 400 karyotypes come from bone marrow cells and fibroblasts of several normal inbred and outbred mice. Each banding obtained from each well banded chromosomes of different cells were contrasted to that of Nesbitt's idiogram. The results are as follows: 1. we have not found so many bands in one metaphase chromosome banded with trypsin-Giemsa technique as reported by Nesbitt. 2. The banding numbers and positions on each well banding chromosome picked out from different metaphase plates were consistent with those of Nesbitt's idiogrom. But some bands such as 1E1 and 1E2; 2E5-2F5; 4A3-4A5; 5C1-5C3 can't usually be distinguished in our data. 3. We observed that the major banding structure of each karyotype remains stability, but the minor banding structure appears to be variablitity in inbred mice. In addition, 6 variant pictures and region idiograms in the G-banding structure of each chromosome were showed and some notices for correct analysis of mouse karyotype were discussed.