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Objective To observe the clinical characteristics ofretinoblastoma (RB) in Southwest China.Methods A retrospective clinical study.From January 2010 to December 2017,66 RB patients diagnosed in Ophthalmology Department of West China Hospital of Sichuan University were included in the study.All the patients underwent ocular B-ultrasound,orbital CT or MRI examination.Ten patients underwent RetCam examination at the same time.Twenty-nine patients were diagnosed by histopathological examination,and 37 patients were diagnosed by clinical symptoms and imaging examination.According to whether the tumor invaded the orbit and optic nerve,it could be divided into extraocular stage and intraocular stage.Intraocular tumors were divided into A-E stages according to the international intraocular RB classification.Treatments were performed according to different stages.The general information,age at diagnosis,course of diseases (the time between onset symptoms and diagnosis),causes of visiting a doctor,classification,treatment methods and eyeball preservation rate were retrospectively analyzed.Results Patients all came from Southwest China (56 patients from Sichuan Province,2 patients from Yunnan Province,2 patients from Guizhou Province,and 6 patients from Tibet).The permanent residence were identified in 43 patients,including 27 patients (62.8％) from rural areas.There were 38 males (57.6％);50 unilateral tumors (75.8％) and 16 bilateral tumors (24.2％);51 firstvisiting patients (77.3％) and 15 re-visiting patients (22.7％).The average diagnostic age of first-visiting patients was 20.9 ± 14.4 months,with 23.2 ± 14.7 and 11.2 ± 7.6 months for unilateral and bilateral tumors,respectively.There were 41 patients had definite course and causes,of whom the average course was 90.6± 115.2 days.The most common cause was leucocoria in 32 patients (62.7％),followed by redness and swelling in 4 patients (9.8％),and other causes in 5 patients (12.2％).Among the 15 re-visiting patients,the average diagnostic age was 63.6± 46.8 months,the average course was 32.8 ± 45.5 months.Recurrence was occurred in 5 patients (33.3％),leucocoria in 4 patients (26.7％),postoperative complication in 3 patients (20.0％),protrusion in 2 patients (13.3％) and redness in 1 (6.7％) patient,respectively.Fifty out of 82 eyes were admitted to hospital,including 37 eyes of first-visiting patients and 13 eyes of re-visiting patients.Among 37 first-visiting eyes,there were 5 eyes (13.5％) in stage A-C,26 eyes (70.3％) in stage D-E,6 eyes (16.2％) in extraocular stage.Five eyes in stage A-C were treated with laser photocoagulation and (or) cryotherapy combined with systemic chemotherapy.Four eyes in stage D were treated with intraocular arterial chemotherapy.Nineteen eyes (51.3％) were performed with enucleation,2 eyes (5.4％) with evisceration and 7 eyes (18.9％) abandoned treatment.Among 13 re-visiting eyes,6 eyes (46.2％,with 5 eyes of recurrence) had been enucleated before,4 eyes (30.8％) were in extraocular stage and 3 eyes (23.1％) in stage D-E.Five eyes (38.5％) were treated with evisceration,4 eyes (30.8％) with enucleation,1 eye with oculoplastic surgery and 3 eyes (23.1％) abandoned treatment.The rate of eye preservation was 18.0％,29.0％ for intraocular stage and 0％ for extraocular stage,respectively.Conclusion RB patients in Southwest China have a longer course between onset symptoms and diagnosis,more advanced classification and lower rate of eye preservation.
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Objective To compare the features of OCT angiography (OCTA) between neovascular agerelated macular degeneration (nAMD) and myopic ehoroidal neovascularization (mCNV) patients before and after intravitreal anti-VEGF treatment.Methods A prospective cohort study.Twenty-nine patients (37 eyes) with nAMD (19 males and 10 females,aged 68.20±8.76) and 31 patients (34 eyes) with mCNV (9 males and 22 females,aged 43.10± 11.80,with the mean diopter of-9.71 ± 1.20 D) from Department of Ophthalmology,West China Hospital of Sichuan University during May and December 2017 were included in this study.Ranibizumab or Conbercept (0.5 mg/0.05 ml) was intravitreally injected in all eyes.The patients were follow-up for 3-6 months.The OCTA was conducted before treatment and 1 day,1 week,1 month and 3-6 months after treatment.In order to ensure that the scanning position was the same,the tracking mode was adopted for each scanning.According to the OCTA images,the lesion area,parafoveal superficial vessel density and perfusion area were measured and analyzed contrastively between nAMD and mCNV patients.Results The mean lesion area before and 1 month after treatment in nAMD patients were 0.38± 1.87 mum2 and 0.06±0.12 mm2,while in mCNV patients,those were 0.26± 1.06 mm2 and 0.03 ± 0.05 mm2,respectively.There were statistically significant differences (Z=4.181,4.475;P＜0.001) in CNV lesion area before and 1 month after treatment between nAMD and mCNV patients.Compared with those before treatment,the absolute change (Z=1.853,P=0.064) and the percentage changes (t=2.685,P=0.010) of CNV lesion area l month after treatment in nAMD and mCNV patients show a statistical meaning.There were significantly decreases in both parafoveal superficial vessel density (F=8.997,P=0.003) and perfusion area (F=7.887,P=0.015) 3 months after treatment in nAMD patients,while decreases in parafoveal superficial vessel density (F=11.142,P=0.004) and perfusion area (F=7.662,P=0.013) could be detected 1 day after treatment in mCNV patients,before rising 1 month after treatment.Conclusions There are significantly differences in lesion area before and after the treatment of intravitreal anti-VEGF between nAMD and mCNV patients by OCTA examination.Moreover,the changes of both parafoveal superficial vessel density and perfusion area after anti-VEGF treatment are statistically different in two groups.
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OBJECTIVE@#To investigate the significance of neutrophil/lymphocyte ratio(NLR) and platelet/lymphocyte ratio(PLR) in patients with multiple myeloma (MM).@*METHODS@#Eighty patients with multiple myeloma admitted in our hospital from August 2007 to August 2010 were selected. The clinical data of the patients, including hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), white blood cell(WBC) count, absolute neutrophil count (ANC), platelet count (PC), glomerular filtration rate (GFR), calcium, albumin, β2 microglobulin and so on were collected and analyzed.@*RESULTS@#The optimal threshold of NLR was 2.78 (sensitivity: 83.3%, specificity: 43.1%). The optimal threshold of PLR was 155.58 (sensitivity: 67.7%, specificity: 36.9%). All patients were grouped according to NLR and PLR values, patients with high NLR and PLR had lower albumin levels and higher clinical stages. High NLR patients were mainly men, hemoglobin, GFR values, albumin levels were lower, and the white blood cells count and β2 microglobulin level were higher. High PLR patients showed low albumin level and higher clinical stage. Multivariate analysis showed that β2 microglobulin and NLR were prognostic factors in patients with multiple myeloma (P2.78) associates with poor prognosis in patients with MM, and it may be considered as an independent prognostic factor for MM patients.
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Humans , Male , Blood Platelets , Lymphocytes , Multiple Myeloma , Neutrophils , Prognosis , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the expression of phosphatase and tensin homolog deleted on chromosome ten (PTEN) and B-cell lymphoma/leukemia-2 (BCL-2) in acute myeloid leukemia (AML) and its significance.</p><p><b>METHODS</b>The expression levels of PTEN and BCL-2 mRNA and protein in bone marrow samples from 80 AML patients including 56 de novo patients, 16 patients in remission, 8 relapsed patients and 30 cases of non-hematologic diseases (as control) were detected by real-time PCR and Western blot, respectively, and the relationship between PTEN and BCL-2 expression and clinical pathological parameter was analyzed.</p><p><b>RESULTS</b>The expression levels of both mRNA and protein of PTEN in newly diagnosed AML group and relapse group were significantly lower than those in the control and remission group (P<0.01). The expression levels of both mRNA and protein of BCL-2 in newly diagnosed group and relapse group were significantly higher than those in the control and remission group (P<0.01). The mRNA expression of PTEN and BCL-2 was did not related with the age, sex and white blood count in AML patients. The expression levels of PTEN negatively correlated with expression BCL-2 with AML(r=-0.432, r=-0.569).</p><p><b>CONCLUSION</b>PTEN and BCL-2 participate in the occurrence and development of AML, and may be used as indicators for the evaluation of chemotheraeutic efficacy.</p>
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Objective To examine the expression levels of procalcitonin (PCT),neutrophils apolipoprotein (human neutrophil lipocalin,HNL) and neutrophil CD64 (CD64) in the blood of patients with bacterial infection and investigate their utility in early diagnosis and treatment of bacterial infection.Methods A total of 210 patients with confirmed infection who were treated in hospital from February 2013 to May 2017 were enrolled.The patients were classified into bacterial infection group (105 cases) and viral infection group (105 cases).Additionally,a cohort of 80 healthy subjects were randomly selected from health checkup during the same period as the control group.PCT and HNL were determined on the UPT up-converting phosphor microbial immunity analyzer provided by Beijing Hotgen Biotech Company.BD FACS calibur flow cytometer was used to measure and calculate CD64 percentage.Results The levels of PCT,HNL,CD64 and WBC were compared between bacterial infection group,viral infection group and control group.The between-group difference was statistically significant (P＜0.05).The CD64 and WBC levels were significantly different between viral infection group and control group (P＜0.05),but the PCT and HNL levels were not different significantly between viral infection group and control group (P＞0.05).The area under the ROC curve of PCT,namely AUC PCT,was 0.855,and AUC (HNL) was 0.930,AUC (CD64) 0.928,and AUC (WBC) 0.729.The cutoff value of PCT,HNL and CD64 for diagnosis of bacterial infections was ＞0.79 ng/mL,＞87.43 ng/mL,and ＞9.01％,respectively.Conclusions Bacterial infection is associated with elevated levels of PCT,HNL and CD64,which can be used in early diagnosis of bacterial infections.HNL may provide the highest diagnostic value.
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<p><b>OBJECTIVE</b>To explore the prevalence of vision, mental, audibility, language, psychiatry, extremity, and influence factors in the 0 - 7 year olds.</p><p><b>METHODS</b>A total number of 77,727 0 - 7 year old children living in Shenzhen city were tested with tree phase screening under the Chinese standard of evaluation in disabilities.</p><p><b>RESULTS</b>The prevalence of all disabilities was 5.59 per thousand (adjusted rate was 8.49 per thousand with a false negative of 3.1 per thousand ). The prevalence of mental disease was the highest (1.88 per thousand, with adjusted rate 3.43 per thousand ), the prevalence of language disability was 1.88 per thousand (including retarded language development, with adjusted rate 3.43 per thousand ). The prevalence rates of psychiatry, extremity and audibility disability were 1.59 per thousand, 1.56 per thousand, 1.11 per thousand respectively with of vision the lowest (0.37 per thousand ). The prevalence of all disabilities, audibility, language and mental was on the increase with age. The difference was statistically significant. Among all different age groups regarding psychiatric disease, the highest fell in the 2 - 4 year olds. The prevalence of extremity was not statistically different among age groups. The suspected agents of disease which occurred before or during pregnancy took up 45.7%.</p><p><b>CONCLUSION</b>The prevalence of six kinds disabilities in Shenzhen was about 10 per thousand lower than that of the samples of the nation in 1989, but two times higher than that of similar studies in Japan. The prevalence rates of language and psychiatric disease were higher than that of the nation in 1989. The causation should be further studied.</p>