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Thyroid-associated ophthalmopathy (TAO) is a common orbital disease in the adults, which leads to a series of ocular symptoms and signs, seriously affecting the visual function and life quality of patients.Grasping the disease progression accurately and evaluating the severity and activity of TAO objectively play a crucial role in improving the management and prognosis of TAO patients.Grading and staging methods of TAO have been constantly improved.In the descriptive evaluation of subjective symptoms and signs of TAO, four international grading and staging systems with similarities and different focuses, namely, NOSPECS, CAS, VISA and EUGOGO, have been proposed successively.In recent years, with the rapid development of science and technology, objective evaluation methods such as imaging technology and laboratory examination have played an important role in the grading and staging of TAO.Among them, the application of orbital CT and MRI has made a great breakthrough in quantitative analysis of the disease.Continuous summary of grading and staging methods of TAO can contribute to the guidance for improving diagnosis, treatment and prognosis of TAO.
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Ocular choristoma is composed of ectopic tissues with normal structures. The pathogenesis still remains uncertain. Histopathologically, it is a dense connective tissue mixed with epidermal appendages, smooth muscle cells, mature adipose tissue, lacrimal glands, lymph nodes, skeletal muscle fibers, cartilage and bone. Because of its low incidence, most of published literature are case reports. The clinical manifestations are non-specific and we need to distinguish it from other ocular masses. The choice of surgical resection depends on the ocular symptoms, the effect on appearance, and the need for clinical confirmation. This paper reviews the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and treatment of ocular choristoma.
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BACKGROUND: Adding growth factor to scaffold material can promote the proliferation and osteogenic differentiation of cultured stem cells in vitro and promote bone tissue regeneration. Advanced platelet rich fibrin (A-PRF) contains a variety of growth factors, which can promote the proliferation activity of a variety of cells and the expression of related functional proteins. OBJECTIVE: To observe the effects of the sole and combined usage regarding A-PRF and biphasic calcium phosphate (BCP) on the growth of bone marrow mesenchymal stem cells. METHODS: The third generation of rabbit bone marrow mesenchymal stem cells was cultured in four groups, including basic medium (blank group), A-PRF condition medium (A-PRF group), BCP (BCP group), A-PRF condition medium and BCP (A-PRF+BCP group). Cell proliferation activity was detected by CCK-8 assay. Cell adhesion was observed based on methylrhodamine-phalloidin fluorescence staining. Intracellular alkaline phosphatase expression and mineralized nodules were quantitatively measured. RESULTS AND CONCLUSION: (1) The absorbance value of proliferation of the A-PRF+BCP group was higher than that of the other three groups at 3, 5, 7, 11 and 14 days after culture. The absorbance value of proliferation of cells cultured in the A-PRF group was higher than that of the BCP group and the blank group at 1, 3 and 5 days after culture. The absorbance value of proliferation of BCP group was higher than that of the A-PRF group and the blank group at 7, 11 and 14 days after culture. (2) Methylrhodamine-phalloidin fluorescence staining showed that bone marrow mesenchymal stem cells in the BCP group and the A-PRF+BCP group adhered to the surface of BCP and the number of cells and microfilaments in the A-PRF+BCP group was higher than that in BCP group. (3) The synthesis of mineralized nodules was A-PRF+BCP group > BCP group > A-PRF group > blank group at 1, 21 and 28 days after surgery. (4) The expression of alkaline phosphatase was A-PRF+BCP group > BCP group > A-PRF group > blank group at 5, 7 and 9 days. There was significant difference between the two groups (P < 0.05). (5) The results showed that BCP exerted a weak influence on promoting cell proliferation in the early stage, but its effect of scaffold was apparent. A-PRF had a significant effect on promoting cell proliferation with considerable influence on promoting cell proliferation and differentiation when combined BCP.
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Objective:To summarize the evaluation and management of early enteral nutrition tolerance in a patient with refractory status epilepticus after ketogenic diet.Methods:Nursing essentials were as follows: Individualized enteral nutrition tolerance assessment was given every 4 hours after ketogenic diet, including nausea, vomiting, abdominal distention, diarrhea, gastric retention and upper gastrointestinal bleeding; when patients suffered from intolerance to ketogenic diet, nasointestinal tube was retained to upper jejunum, ketogenic diet was diluted, dietary fiber and trypsin were increased. Intake of preparations and probiotics could reduce the incidence of diarrhea and gastric retention. Blood sugar and ketone levels were monitored every 4 hours to evaluate the therapeutic effect of ketogenic diet by Engel grading. Early active mobility was carried out to reduce the mechanical ventilation time and improve limb muscle strength.Results:After careful treatment and nursing, ketogenic diet progressed smoothly and gastrointestinal intolerance improved significantly. On the 30th day of admission, Engel was grade I. The patient was stable with no functional epileptic attack. On the 66th day after admission, the patient was successfully taken off line and transferred to the general treatment area. During the period of hospitalization, there was no nursing related complications such as pressure ulcer, and the patient recovered and discharged.Conclusion:Individualized assessment and management of enteral nutrition tolerance can effectively reduce the related complications and improve the prognosis of patients with refractory status epilepticus who take ketogenic diet.
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Osteoporosis is a common metabolic bone disease, influenced by genetic and environmental factors, that increases bone fragility and fracture risk and, therefore, has a serious adverse effect on the quality of life of patients. However, epigenetic mechanisms involved in the development of osteoporosis remain unclear. There is accumulating evidence that epigenetic modifications may represent mechanisms underlying the links of genetic and environmental factors with increased risk of osteoporosis and bone fracture. Some RNAs, such as microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs), have been shown to be epigenetic regulators with significant involvement in the control of gene expression, affecting multiple biological processes, including bone metabolism. This review summarizes the results of recent studies on the mechanisms of miRNA-, lncRNA-, and circRNA-mediated osteoporosis associated with osteoblasts and osteoclasts. Deeper insights into the roles of these three classes of RNA in osteoporosis could provide unique opportunities for developing novel diagnostic and therapeutic approaches to this disease.
Subject(s)
Humans , Osteoporosis/genetics , MicroRNAs/genetics , RNA, Long Noncoding/genetics , RNA, Circular/geneticsABSTRACT
Diabetic retinopathy (DR) is a common complication of diabetes,and remains the leading cause of blindness among working-age individuals all over the world.Current treatments for DR mainly focus on the advanced stages of the disease and are associated with significant adverse effects.As the pathogenesis of DR is not thoroughly revealed,the development of more effective therapy of DR is challenging,in which a good DR animal model is essential.At present,these animal models involve mammals,non-mammals and other species.The modeling methods also include chemical injection,high glucose diet,genetic engineering and ex vivo retinal explant cultures.Although most of the models discussed,especially the rodent models,have demonstrated the basic features of NPDR,the key feature of human PDR (pre-retinal neovascularization secondary to diabetes per se) is not recapitulated in any diabetic animal models.Therefore,choosing the appropriate DR animal model according to the purpose of research will be very important in understanding development of the disease and new approaches that prevent or delay the onset of DR.
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Objective To study the effectiveness and safety of abdominal lifting and compression method in patients sufferred from cardiac arrest (CA).Methods According to the inclusion and exclusion criteria,72 patients from Hainan People's Hospital and Zhengzhou People's Hospital were enrolled for study of abdominal lifting and compression (ALC) method from January 2014 to June 2015.The markers of respiratory and circulatory performance of all patients were recorded,and re-collected after CPR with ALC.In addition,the data of demographics and clinical signs of patients were collected.The rates of restoration of spontaneous circulation (ROSC) and successful resuscitation were calculated.Differential analysis of singlegroup design univariate quantitative and qualitative data was carried out.Results A total of 72 patients were included finally.The ROSC rate was 15.3％ (11/72) after using ALC equipment,and there was no statistically significant difference in rate of ROSC (P =0.566) between ALC and pre-test (13.0％).However,compared with NT group resuscitated without using ALC method or with using chest compression method,the rate of ROSC was significantly improved in the ALC group (15.3％ vs.O.1％,P ＜ 0.01).Conclusions Abdominal lifting and compression CPR equipment is stable,portable and safe in practice.Abdominal lifting and compression CPR method has its prominent role in saving patients from respiratory and cardiac arrest,and it is sufficient to overcome the disadvantages of conventional CPR method.
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Objective To explore the effect of the procedural nursing management on nursing quality of hospitalized patients in department of rheumatology. Methods About 267 inpatients were divided into control group (n=125) and experiment group (n=142). The control group received routine medication nursing and the experiment patients were treated with procedural nursing management including implementing medication services and analyzing the factors influencing precise medication and the countermeasures . Result The rate of precise medication in the experiment group was significantly higher than that of the control group ( P<0 . 05 ) . Conclusions The procedural nursing management can promote patient's precise medication so as to ensure the therapeutic effect by medication . It does good for the promotion of medication scientizeation and professionalization .
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Background Insulin-like growth factor-1 (IGF-1) participates in the regulation of the biological activity of cells.Researches showed that the serum IGF-1 level is significantly raised in the patients with Graves diseases.Thyroid associated ophthalmopathy (TAO) is one of Graves diseases,and orbital adipose cells are the target cells of thyroid autoantigens.However,whether IGF-1 is associated with TAO is still unclear.Objective This study was to investigate the expressions of IGF-1 in both circulating blood and orbital adipose tissue in TAO patients.Methods A retrospective cohort study was performed.Eighty-six TAO patients were enrolled in West China Hospital of Sichuan University from August 2009 to February 2014.According to the clinical activity score criteria(CAS) ,the patients were divided into active stage (CAS ≥ 4,35 patients) and inactive stage (CAS ＜4,51 patients).Eighty-six health adult persons were enrolled as the controls.The periphery blood of 3 ml was collected from each subject to detect the serum IGF-1 level by ELISA.Orbital adipose tissues were obtained during the surgery from 35 TAO patients and 35 patients with benign orbital tumor or orbital adipose prolapse from August 2009 to February 2014.The histopathological examination of orbital adipose tissue was carried out to evaluate the pathological characteristics, and the expression of IGF-1 in orbital adipose tissue was assessed by immunochemistry.This study protocol was approved by Ethic Committee of West China Hospital of Sichuan University, and informed consent was obtained from each subject before entering the cohort.Results The mean serum IGF-1 level was (0.862±0.026)ng/ml in the TAO patients,and that in the normal controls was (0.767 ± 0.480) ng/ml, without significant difference between them (P=0.281).The mean serum IGF-1 level was (0.877±0.355) ng/ml and (0.803±0.031) ng/ml in active stage and inactive stage of patients, respectively, and no significant difference was found between them (P =0.834).IGF-1 expression located in cellular membrane and cytoplasm.The expressing intensity of IGF-1 in orbital adipocytes was significantly enhanced in the TAO patients with the positive rate of 74.29% , and that in the controls was 45.46％ ,showing a statistical difference between the two groups (x2=5.289,P=0.021).Conclusions Serum IGF-1 level dose not rise in TAO patients, but the expression of IGF-1 in orbital adipocytes up-regulates, indicating that mature orbital adipocytes of TAO are regulated mainly by IGF-1.
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ObjectiveTo research the current situation at traditional Chinese clinics in urban area of Beijing,and to propagate the importance of re-visiting.Methods500 outpatients were selected randomly from 4 traditional Chinese clinics in urban area of Beijing from April 1st in 2010 to March 31st in 2011.Questionnaires were undertaken by these patients,including 120 first visitors and 380 re-visitors,then SPSS17.0 was used to statistically analyze the re-visiting proportion,influence factors and reasons for re-visiting.Results The highest re-visiting proportion was 56.7％ in 4 clinics and the total was 47.0％; 13.6％ patients who didn't have re-visit choice for their having no significant curative effect,12.6％ for having no time,10.3％ for having been recovered; patients who had curative effect and doctor's advice to re-visit may be the related influence factors of re-visiting; in the investigation of reasons,73.0％ patients made re-visit choice for having curative effect,35.9％ for doctors' good medical ethics,35.9％ for doctors' advice.ConclusionThere was a low re-visiting proportion in these 4 traditional Chinese clinics in urban area of Beijing; the top three non-revisiting reasons were no significant curative effect,having no time and having recovered.Having curative effect and doctor's advice to re-visit may be the related influence factors of re-visiting; the top three re-visiting reasons were curative effect,doctor's good medical ethics and doctor's exhortation.