Quantitative analysis of macular microcirculation changes in diabetic retinopathy patients by optical coherence tomography angiography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the macular microcirculation changes in patients with diabetic retinopathy(DR)by optical coherence tomography angiography(OCTA), and correlate the risk factors that may affect the macular microcirculation, so as to provide a clinical basis for early screening, diagnosis and therapeutic intervention for DR.METHODS: Retrospective study. A total of 75 patients(75 eyes)with type 2 diabetes mellitus(DM)who came to the ophthalmology outpatient clinic and ward of Xi'an Central Hospital from May to October 2022 were collected, and the DM patients were further divided into non-DR(NDR)group, non-proliferative DR(NPDR)group and proliferative DR(PDR)group, with 28 eyes, 25 eyes and 22 eyes in each group respectively. OCTA was applied to perform a 3mm×3mm blood flow imaging scan of the macular retina to automatically obtain the vascular density(VD)of the superficial retinal macular foveal, the parafoveal(1～3mm), as well as the macular 3mm×3mm and the area of macular foveal avascular zone(FAZ). Furthermore, the alteration of these parameters in patients with different degrees of DR was analyzed.RESULTS: Compared with the NDR group, the VD of the 3mm×3mm superficial retinal capillary(SCP)in the macular region was decreased in both PDR and NPDR group(all P<0.017), and the VD of the parafoveal was decreased in each quadrant(P<0.017), with the most significant decrease in the PDR group. The FAZ area of patients in the PDR and NPDR groups was significantly larger than that in the NDR group(P<0.017). Age, homocysteine, best corrected visual acuity(LogMAR), axial length and glycosylated hemoglobin(HbA1c)of patients with DR were negatively correlated with VD in the macular foveal(P<0.05), while homocysteine, best corrected visual acuity(LogMAR), axial length, and the duration of diabetes were negatively correlated with VD in the macular 3mm×3mm(P<0.05). Triglycerides, best corrected visual acuity(LogMAR), and HbA1c were negatively correlated with VD in the parafoveal(P<0.05), while total cholesterol and central macular thickness had no significant correlation with VD(P>0.05).CONCLUSION: The microcirculation changes in the macular area of DR patients can be monitored by OCTA, and the systemic condition of DR patients is closely related to their macular microcirculation.

Differences and causes of myopia among students in different stages in the same region in Xi'an / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To gather baseline data on visual acuity by screening students from different stages in the same administrative district of Xi'an, as well as to analyze and investigate disparities in myopia rates among students from different stages in this area.METHODS: A total of 13 707 students from 21 elementary schools, 3 middle schools, 3 general high schools and 1 vocational high school were randomly selected for uncorrected distance visual acuity and computerized refraction testing in 28 schools with a random sampling approach.RESULTS: The detection rate of myopia in elementary, middle, high and vocational high schools in the same region of Xi'an were 32.27%, 72.07%, 81.22% and 65.12%, respectively; The total myopia rate of students was 47.81%; The myopia rate of girls was higher than that of boys in all grades; The myopia rates of elementary and middle schools increased with the growth of grades; The percentage of high myopia increased from 2.40% in elementary schools to 16.51% in high schools with the growth of grades.CONCLUSION: The myopia rate in different stages of the same region is different, and it tends to rise with the gronth of grades; Girls have a higher myopia rate than boys; Compared to the results of the national survey on myopia in different grades of children and adolescents in 2018, the myopia rate in the same region has decreased significantly in 2021 of the elementary school level, although myopia rate of middle school and high school stage do not rise, the decline is not obvious.

Observation of the curative effect of conbercept in the treatment of different types of diabetic macular edema / 中华眼底病杂志

Objective:To observe the efficacy of conbercept in the treatment of different types of diabetic macular edema (DME).Methods:A retrospective clinical study. From March 2019 to March 2021, 136 eyes of 136 patients with DME diagnosed in Department of Ophthalmology of Xi'an No.3 Hospital were included in the study. Among them, there were 65 males and 71 females; the average age was 56.65±8.65 years. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography (OCT) examination, and glycosylated hemoglobin level (HbA1c) examination. Early Treatment Diabetic Retinopathy Study visual acuity chart was used for BCVA examination, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. An OCT instrument was used to measure the central retinal thickness (CRT) of the macula. According to the characteristics of OCT, DME was divided into diffuse retinal thickening (DRT) type, cystoid macular edema (CME) type, serous retinal detachment (SRD) type, mixed type, and grouped accordingly, respectively, about 30, 38, 33, 35 eyes. There was no significant difference in age ( F=1.189), sex ratio ( χ2=1.331), and HbA1c level ( F=3.164) of the four groups of patients ( P>0.05). All eyes were treated with intravitreal injection of 10 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg) once a month for 3 consecutive times, and then treated as needed after evaluation. BCVA and OCT examinations were performed 1, 3, and 6 months after treatment with the same equipment and methods as before treatment. The changes of BCVA and CRT before and after treatment were compared and observed. For measurement data subject to normal distribution, one-way analysis of variance was performed for comparison between groups; χ2 test was performed for comparison of count data. Results:Before treatment, the logMAR BCVA of the eyes in the DRT group, CME group, SRD group, and mixed group were 0.68±0.11, 0.69±0.15, 0.71±0.12, 0.73±0.14, and CRT was 631.4±50.7, 640.6±55.7, 652.3±63.4, 660.4±61.8 μm. Compared with before treatment, 1, 3, 6 months after treatment, DRT group (BCVA: t=8.139, 11.552, 11.672; CRT: t=16.163, 21.653, 25.855), CME group (BCVA: t=8.923, 9.995, 13.842; CRT: t=16.163, 21.653, 25.855), SRD type group (BCVA: t=5.171, 7.315, 6.051; CRT: t=9.099, 13.731, 21.306), mixed type group (BCVA: t=5.072, 6.939, 7.142; CRT: t=6.920, 15.352, 17.538) The BCVA of the affected eyes was significantly increased, and the CRT was significantly decreased, and the difference was statistically significant ( P<0.05). At 6 months after treatment, the differences in logMAR BCVA and CRT of the 4 groups of eyes were statistically significant ( χ2=58.478, 64.228; P<0.05). The average number of injections in the eyes of the DRT group, CME group, SRD group, and mixed group were 3.37±1.35, 3.68±1.38, 4.18±1.40, 4.13±1.50 times, respectively. Compared with the average number of injections in the eye, the difference was statistically significant ( χ2=9.139, P=0.028). Conclusions:Conbercept can effectively reduce CRT and increase BCVA in eyes with different types of DME. Compared with SRD type and mixed type, DRT and CME type eye are more effective in improving vision, CRT reduction degree is greater, and the number of injections is less.

The role of liver sinusoidal endothelial cells in the progression of nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) is a clinical metabolic syndrome characterized by hepatic steatosis, inflammation, and fibrosis and has become a common chronic liver disease with great impact on public health. Liver sinusoidal endothelial cells (LSECs) are specialized vascular endothelium of liver tissue, and as an important vascular barrier, LSECs play an important role in regulating the absorption and metabolism of nutrients and substances from the blood of the intestines in hepatocytes. This article reviews the research advances in LSEC capillarization, vascular dysfunction, and its involvement in the regulation of liver inflammation, angiogenesis, and liver fibrosis during the development and progression of NAFLD.

Relationship between obstructive sleep apnea syndrome and central serous chorioretinopathy / 中华眼底病杂志

Objective:To observe the correlation between obstructive sleep apnea syndrome (OSAS) and central serous chorioretinopathy (CSC).Methods:From October 2016 to December 2018, 50 cases of CSC patients (CSC group) and 50 healthy people (control group) matched by age and sex who were diagnosed in the ophthalmological examination of Xi’an No.3 Hospital were included in the study. According to the course of the disease, CSC was divided into acute phase and chronic phase, with 20 and 30 cases respectively. The average age ( Z=1.125) and body mass index (BMI) ( Z=0.937) of the two groups were compared, and the difference was not statistically significant ( P>0.05); the age of patients with different courses of CSC ( Z=1.525) and gender composition ratio ( χ2=0.397) and BMI ( Z=1.781) were compared, the difference was not statistically significant ( P>0.05). The Berlin questionnaire was used to assess the OSAS risk of subjects in the CSC group and the control group; polysomnography was used to monitor the apnea-hypopnea index (AHI) and minimum blood oxygen saturation (MOS) during night sleep. OSAS diagnostic criteria: typical sleep snoring, daytime sleepiness, AHI (times/h) value ≥ 5. The severity of OSAS was classified as mild OSAS: 5≤AHI<15; moderate OSAS: 15≤AHI <30; severe OSAS: AHI≥30. Non-normally distributed measurement data were compared by rank sum test; count data were compared by χ2 test. Spearman correlation analysis was performed on the correlation between OSAS and CSC. Results:The AHI data in the CSC group and the control group were 17.46±3.18 and 15.72±4.48 times/h, respectively; the MOS were (83.48±4.68)% and (87.40±3.82)%, respectively; those diagnosed with OSAS were respectively 36 (72.00%, 36/50) and 13 (26.00%, 13/50) cases. AHI ( Z=0.312), MOS ( Z=0.145), and OSAS incidence ( χ2=21.17) were compared between the two groups of subjects, and the differences were statistically significant ( P=0.028, 0.001,<0.001). The AHI of acute and chronic CSC patients were 15.95±3.02 and 18.47±2.92 times/h; the MOS were (86.10±11.07)% and (81.73±4.58)%, respectively. There were statistically significant differences in AHI ( Z=0.134) and MOS ( Z=0.112) in patients with different course of disease ( P=0.005, 0.001). The results of Spearman correlation analysis showed that OSAS and CSC were positively correlated ( r=0.312, P=0.031). Conclusion:OSAS may be a risk factor for the onset of CSC.

Analysis of multimodel imagings for choroidal osteoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the multimodal imaging features of choroidal osteoma.<p>METHODS:Retrospectively observational case series. Nine patients(15 eyes)with choroidal osteoma presented to Xi'an No.3 hospital from October 2015 to August 2019 were included in the study. Among them, there were 2 males and 7 females. All patients received the best corrected visual acuity, fundus color photography, short wavelength fundus autofluorescence(SW-AF), infrared fundus autofluorescence(IR-AF), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), optical coherence tomography(OCT)and orbital X-ray computed tomography(CT). <p>RESULTS: In 15 affected eyes, lesions were involved in macula and optic disc in 5 eyes(33%), lesions were located in macula in 8 eyes(53%), peripapillar lesions in 2 eyes(13%). Choroidal osteomas presented as orange-red or yellow-white lesions with pigmentation on the surface in fundus color photographies. SW-AF images showed that choroidal osteomas presenting with mottled hypofluorescence and hyperfluorescence in 15 eyes(100%), while IR-AF images showed that all of the choroidal osteomas presenting punctate and patchy hypofluorescence and hyperfluorescence. FFA showed that 15 eyes(100%)of choroidal osteoma had gradually enhanced brightness, of which 6 eyes(40%)had severe leakage of fluorescence from sub-retinal neovascularization(SRNV). ICGA images revealed SRNV in 9 eyes(60%), all corresponding area of choroidal osteomas showed low fluorescence in the early stage of angiography, and the brightness of tumors increased during angiography gradually. OCT images showed that choroidal osteomas with inhomogeneous reflection in 10 eyes(67%); choroidal osteomas presented with hypo-reflectivity in 5 eyess(33%). All of the choroidal osteomas(100%)presented as high density bone mass on CT images.<p>CONCLUSION: Choroidal osteoma is orange-red or yellow-white, and expressed as bone mass on CT images, which is an important basis for diagnosis of choroidal osteoma. Damaged RPE leads to appearance of strong and weak mottled SW-AF and IR-AF in the location of choroidal osteomas. FFA and ICGA are helpful to clarify the abnormal circulation in the lesion area. The intensity of cross-sectional reflection in choroidal osteomas are different on OCT images, meanwhile, OCT was helpful to observe the condition of subretinal effusion and neovascularization.

Correlation between obstructive sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy / 中华眼底病杂志

Objective To determine the correlation between obstructive sleep apnea syndrome (OSAS)and nonarteritic ischemic optic neuropathy (NAION).Methods It was a perspective study.A total of 41 consecutive patients with NAION (NAION group) and 41 age-and sex-matched physical examination subjects (control group) in Xi'an No.3 Hospital from December 2016 to December 2018 were enrolled in this study.The apnea hypopnea index (AHI,the number of sleep apneas per hour) was monitored using a polysomnography for patients in NAION group and control group.At the same time,the blood oxygen saturation was continuously recorded.The OSAS can be diagnosed if the AHI value was ≥ 5.OSAS severity was graded as mild:5≤AHI＜ 15;moderate:15≤AHI＜30;severe:AHI ≥30.The grading of OSAS severity between two groups was compared by Fisher's exact test.The AHI and minimum blood oxygen saturation were compared between NAION group and control group using the Mann-Whitney U test.Spearman correlation analysis was performed on the correlation between OSAS and NAION.Results Among the patients in the NAION group,31 patients (75.61％) were diagnosed with OSAS.Among them,6 patients (14.63％) were mild,9 patients (21.95％) were moderate,and 16 patients (39.03％) were severe.In the control group,19 patients (46.34％) were diagnosed with OSAS.Among them,10 patients (24.39％) were mild,5 patients (12.20％) were moderate,and 4 patients (9.75％) were severe.The difference of OSAS patients of mild,moderate and severe between two groups were statistically significant (Z=0.235,0.245,0.312;P=0.012,0.014,0.032).The average AHI of patients in the NAION group was 20.25 ± 7.74,and the mean minimum oxygen saturation at night was (87.38± 5.53)％.The average AHI of the control group was 18.67 ± 11.67,and the mean minimum oxygen saturation at night was (85.06+4.25)％.The differences of the mean AHI and mean minimum oxygen saturation between two groups were statistically significant (Z=1.124,2.317,P=0.003,0.020).There was a positive correlation between OSAS and NAION (Spearman correlation coefficient=0.229,P=0.030).Conclusion There is a positive correlation between OSAS and NAION.

Correlation between Chromosomal Abnormality and Cell Morphology with Myelodysplastic Syndrome Patients / 现代检验医学杂志

Objective To investigate the correlation between morphological abnormalities and abnormal myelodysplastic syn-dromes(MDS)cloning.Methods 82 cases of MDS were collected with complete FISH and morphological abnormalities. The relationship between MDS cell morphology and chromosome abnormality was investigated.Results 45 cases of chromo-somal abnormalities were found,and +8 were the most frequent chromosomal abnormalities.8 cases were +8,-5 and 5q-were 6,20q-were 7,-7 and 7q-were 5,complex karyotypes(>3 abnormalities)were 6.There were statistically significant differences in the proportion of primordial cells,megakaryocyte dysplasia,megakaryocyte abnormalities between karyotype abnormal group and karyotype normal group(P<0.05).There were statistically significant differences in the proportion of abnormal karyotype among high risk group and low risk group,the low risk group and medium risk group(P<0.05).Con-clusion The chromosomal abnormalities of MDS patients would be related to morphological changes.

Clinical study on the relationship between the displaced fracture of the inferior ramus of pubis and the posterior pelvic ring injury / 中国骨伤

<p><b>OBJECTIVE</b>To investigate relation between displaced inferior ramus fractures and posterior pelvic ring injury.</p><p><b>METHODS</b>From August 2012 to August 2015, 51 patients of pubic ramus fractures with complete record were retrospective reviewed including 27 males and 24 females with an average age of(49.1±19.0) years old ranging from 9 to 90 years old. The time from injury to treatment ranged from 0.3 to 48 hours with an average of 10.1 hours. According to Tile classification of pelvic fractures, 28 cases were type A, 17 cases were type B, 6 cases were type C. Pelvic radiographs and computed tomography scans were detailed and evaluated for whether there were posterior pelvic ring injury, meanwhile pubic rami fractures were divided into 4 groups as follow: displaced inferior ramus fractures group, undisplaced inferior ramus fractures group, displaced superior ramus fractures group, undisplaced superior ramus fractures group;the incidence rate of association of posterior pelvic ring injury was determined and compared.</p><p><b>RESULTS</b>Twenty-six patients had displaced inferior ramus fractures, all of them (100%) were combined with posterior pelvic ring injury. Twenty patients had undisplaced inferior ramus fractures, 6 of them(30%)were combined with posterior pelvic ring injury. Twenty-eight patients had displaced superior ramus fractures, 22 of them(78.5%) were combined with posterior pelvic ring injury. Twelve patients had displaced superior ramus fractures, 5 of them(41.6%) were combined with posterior pelvic ring injury. Compared with undisplaced inferior ramus fractures group, there was statistic difference(=0.028 8<0.05) on the incidence rate of posterior pelvic ring injury, there were no statistic difference(=0.055 8>0.05;=0.168 3>0.05) while compared with other undisplaced superior ramus fractures group and displaced superior ramus fractures group, but the incidence rate of association with posterior pelvic ring injury much higher than both of two groups (100% vs 41.6%, 78.5%).</p><p><b>CONCLUSIONS</b>Displaced inferior pubic ramus fractures have the highest incidence rate of association with posterior pelvic ring injury, frequently prompted injury to the posterior pelvis. Displaced inferior ramus fractures were an indirect evidence of posterior pelvic injury.</p>

The validation study of Chinese version of Sunnybrook of the facial nerve grading system / 中国神经精神疾病杂志

Objective We have revised the Sunnybrook facial nerve grading system which has been widely recog?nized in the world to a Chinese version and verified its credibility and validity. Methods First we translated and edited the Sunnybrook facial nerve grading system using Chinese.Nine doctors, who were selected from different hospitals, then scored twice on the same video of 90 patients with facial nerve palsy using the Chinese version of the Sunnybrook facial nerve grading system and grading standard separately at one month interval. The consistency and the repeatability of the Chinese version of the Sunnybrook facial nerve grading system were evaluated. Results The Cronbach 's alpha value was 0.92 and the average coefficient of repeatability (CR) was 12.72, indicating that the Chinese version of the Sunny?brook facial nerve grading system had a high degree of internal consistency and repeatability. The ICC values on the as?sessment and evaluation for the internal measurement were 0.97 and 0.98, respectively. The scored results were compara?ble between doctors who were not familiar with this disease and those who were very familiar with the disease. The aver?age ICC was 0.97(95%CI:0.95~0.99). Conclusions The Sunnybrook facial nerve grading system has good reliability and consistency and hereby recommend Chinese doctors to use it.

Comparison of magnetic resonance elastography and diffusion-weighted imaging for staging hepatic fibrosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To compare the diagnostic values of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) in staging hepatic fibrosis (HF) in an animal model.</p><p><b>METHODS</b>This study consisted of 44 rabbits served as HF group and 9 normal rabbits. HF group was divided into two subgroups: Group A (n = 32) and Group B (n = 12). Rabbits in Group B were served as a complementary group when rabbits in Group A suddenly died during the study. Rabbits from control and Group A underwent abdominal MR imaging (MRI), MRE, and DWI. In Group A, random eight rabbits underwent MRI examinations at 4, 5, 6, 10 weeks after carbon tetrachloride oil subcutaneous injection. Liver stiffness (LS) and apparent diffusion coefficient (ADC) values of liver parenchyma were measured. The diagnostic performance of MRE and DWI for staging HF was compared using the receiver operating characteristic curve analysis on the basis of the histopathological analysis of HF.</p><p><b>RESULTS</b>Significant differences of LS and DWI values were present among HF stages (P < 0.005). The LS values measured on MRE (r = 0.838, P < 0.001) were more strongly correlated with the HF stages than with ADC values (r = -0.527, P < 0.001). The area under the receiver operating characteristic curve values of LS were significantly larger than those of DWI were for discriminating two stages of HF (0.979 vs. 0.712 for ≥ S1, 0.922 vs. 0.699 for ≥ S2). MRE showed higher specificity for predicting all stages of HF compared to DWI.</p><p><b>CONCLUSIONS</b>MRE more strongly correlated with the HF stages than DWI and is more specific in predicting all HF stages.</p>

An abnormal deeper lateral femoral notch is an indirect evidence for anterior cruciate ligament tear / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the relationship between degree of abnormal deeper lateral femoral notch between anterior cruciate ligament tear.</p><p><b>METHODS</b>The radiograph and MRI image material of 16 patients with anterior cruciate ligament injury from January 2013 to November 2013 were reviewed including 14 males and 2 females with an average age of 28.3 years old ranging from 18 to 52 years. Eleven cases was on right side and 5 on left. Survey tool of PASC imaging system was used to measure the depth of lateral femoral notch in patients with abnormal indicated by lateral X-ray view or sagittal view of MRI in knee joint,while clinical data,physical examination,image material in arthroscopy of these patients were retrospective researched.</p><p><b>RESULTS</b>Four patients had an abnormal lateral femoral notch with the depth of 2 mm on lateral X-ray and sagittal MRI, while positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI, and completed tears were comfirmed on the operation of arthroscopy. Two patients without abnomal lateral femoral notch on lateral view of X-ray while with the depth of 1 mm on sagittal view of MRI were also coupled with positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI, and one of them were comfirmed completed anterior cruciate ligament tears on the arthroscopy operation and completed tear could not comfirmed on another one because of disagreed with arthroscopy operation.</p><p><b>CONCLUSION</b>There appears to be an association between abnormal lateral femoral notch on lateral view of knee with anterior cruciate ligament tears. An abnormal deeper lateral femoral notch is an indirect evidence for anterior cruciate ligament tears.</p>

The role of glucagon-like peptide-1 and its receptor in the mechanism of metabolic surgery / 中华胃肠外科杂志

At present, surgery has become one of the treatments for type 2 diabetes, but it is still unclear about the therapeutic mechanism. Many experiments has proved that the anatomical and physiological structure has been altered leading to significant changes related to the secretion of gastrointestinal hormones and neuropeptides. These molecular are related to the metabolism of glucose, functions of islet cells and sensitivity of insulin. Intensive studies of glucagon-like peptide-1 (GLP-1) play an important role in the surgical treatment of diabetes and now it has gained increasing recognition. However, GLP-1 must be combined with GLP-1 receptor (GLP-1R) to execute its function. In this paper we reviewed the role of GLP-1 and its receptor in the mechanism of metabolic surgery.

The therapeutic effects of neuromuscular electric stimulation on patients with swallowing disorders after stroke / 中华物理医学与康复杂志

Objective To investigate the clinical therapeutic effects of neuromuscular electric stimulation (NMES) on patients with swallowing disorders after stroke. MethodsA total of 98 patients with a swallowing disorder after stroke were randomly divided into an NMES group (38 cases),a rehabilitation group (30 cases) and a control group (30 cases).In the control group the patients were treated with medication only; the in rehabilitation group they were treated with medication and swallowing rehabilitation training; in the NMES group they were treated with medication and NMES.The treatments lasted for 3 weeks in all groups.The swallowing function of patients in each group were observed and assessed with dysphagia scoring pre-and post-treatment.Complications of the swallowing disorders,side effects of treatment and the stomach tube leaving rate were observed. ResultsAfter treatment,the dysphagia scores of patients in the NMES and rehabilitation groups both increased,but the average scores in the NMES group were significantly higher than in the rehabilitation and control groups.The difference in therapeutic effect between the three groups was statistically significant.After treatment,the incidence of aspiration pneumonia in the NMES group was significantly lower than that in the control and rehabilitation groups.The average stomach tube leaving rate in the NMES group was significantly lower than that in the control group,but there was no significant difference in stomach tube leaving rates between the rehabilitation group and the NMES group.There was no significant difference among the three groups in malnutrition.No side effect was observed in any group.Conclusions NMES could alleviate post-stroke dysphagia and decrease the incidence of aspiration.The short-term therapeutic effect of NMES was better than that of swallowing rehabilitation training,but the long-term therapeutic effects were about the same in the two groups.

Duodenojejunal bypass in treatment for 7 cases with non-severe obese type 2 diabetes mellitus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and feasibility of duodenojejunal bypass(DJB)on non-severe obese patients with type 2 diabetes mellitus(T2DM).</p><p><b>METHODS</b>The body mass index (BMI), fasting plasma glucose(FPG), 2h-postprandial plasma glucose(2hPG), fasting insulin(F-ins), fasting c-peptide(F-CP), glycated hemoglobin and hypoglycemic agents dose changes were tested in 7 patients with non-severe obese T2DM undergoing DJB, preoperatively and within 24 weeks after surgery during the follow-up. Data were collected and the clinical outcomes of T2DM were analyzed.</p><p><b>RESULTS</b>In 7 cases of non-obese T2DM who underwent DJB, one patient was weaned off hypoglycemic agents with normal FPG, 2hPG and HbA1c postoperatively. Five required significantly lower dosage. No significant improvement in 1 case. Complete remission rate of hyperglycemia was 1/7, effective rate was 6/7, and effective rate of HbA1c was 5/7. No significant changes in BMI were observed between the preoperative and postoperative phases.</p><p><b>CONCLUSION</b>Plasma glucose level can be markedly reduced by duodenojejunal bypass in non-obese T2DM, independent of weight loss, and the mechanism remains unclear.</p>

Observation of clinical efficacy of acupuncture for cerebral vasospasm after embolization of ruptured aneurysms / 中国针灸

<p><b>OBJECTIVE</b>To observe the improvement of acupuncture in cerebral vasospasm (CVS) after embolization of ruptured aneurysms.</p><p><b>METHODS</b>Sixty cases were randomly divided into two groups, an acupuncture-medication group and a conventional treatment group, 30 cases in each one. The cases of CVS in conventional treatment group were treated with Nimodipine. In acupuncture-medication group, on the basis of the treatment as conventional treatment group, Baihui (GV 20) and Fengchi (GB 20) were selected as the main acupoints in the treatment of CVS. The treatment lasted for 3 weeks. Hunt-Hess scale for the standard assessment was adopted to determine the severity of disease before and after treatment and compare the efficacy between two groups. The transcranial Doppler (TCD) was conducted on the 1st, 4th, 7th, 10th, 14th and 21st days successively after operation, and the average flow velocity of 3 pairs of vessels (ACA, MCA, and PCA) was recorded. CT perfusion (CTP) was taken to test cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) on the 1st, 7th, 14th and 21st days successively.</p><p><b>RESULTS</b>The improvement of Hunt-Hess scale in acupuncture-medication group was superior to that in conventional treatment group (P < 0.05). The analysis of variance (ANOVA) was adopted in the comparison of ACA, MCA, PCA, CBF, CBV and MTT between two groups. The results showed that the therapy in either group achieved the effect on CVS (all P < 0.05). But, the improvements in the above mentioned indices in acupuncture-medication group were superior to those in conventional treatment group (all P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture at Baihui (GV 20) and Fengchi (GB 20) down-regulates the peak values or upregulates the valley values. It releases the peak of CVS effectively, improves the clinical prognosis significantly and is the effective therapy for CVS after subarachnoid hemorrhage.</p>

Laparoscopic total mesorectal excision combined with intersphincteric resection for ultra-low rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate clinical outcomes after laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) for ultra-low rectal tumors.</p><p><b>METHODS</b>Clinical data of 36 patients with ultra-low rectal tumor undergoing laparoscopic TME combined with ISR were analyzed retrospectively.</p><p><b>RESULTS</b>The median distance from the inferior margin of the tumor to the anal verge was 3.4 (2.0-5.0) cm. There were 33 cases of well/moderately differentiated adenocarcinoma and 3 rectal malignant villous adenoma. There were 16 patients with stage I disease, 15 with stage II A, 3 with stage III A, and 1 with III B. Postoperatively, one patient developed stenosis at the end ileostomy and 3 anastomotic leakage. After a median follow-up of 16(4-49) months, one patient developed local recurrence at the anastomosis and one case died of liver metastasis. In the 19 patients who had a minimum follow-up of one year, the bowel movements frequency ranged from 1-4 times per day, and these patients were able to withhold defecation for more than 5 minutes.</p><p><b>CONCLUSIONS</b>Laparoscopic TME combined with ISR can achieve oncologic clearance, sphincter preservation, and minimal invasiveness for ultra-lower rectal cancer. However, patients selection should be cautious.</p>

Preliminary Result of Olfactory Ensheathing Cell Transplantation in Intractable Neuropathic Pain Following Spinal Cord Injury: 17 Cases Report / 中国康复理论与实践

@#ObjectiveTo explore the feasibility and potential benefit of olfactory ensheathing cell (OEC) intraspinal transplantation in the treatment of intractable chronic neuropathic pain after spinal cord injury (SCI).Methods17 patients, 15 male and 2 female, with intractable chronic neuropathic pain after spinal cord injury was treated by OEC implant from November, 2004 to November, 2007. The age ranged from 18 to 68 (mean 40.4) years. The etiology of cord impairment included car accidents, falls, radiation damage, machine extrusion, gun-shot, and diving. The patients suffered severe persistent pain for 6 to 309 (mean 102.2) months, and the time points when cell therapy were administrated in the patients ranged from 6 to 312 (mean 105.9 months) after their injuries. Olfactory bulbs were harvested and trypsinized down to single fetal OECs. They were cultured for 12～14 days before implant. The fetal OECs were transplanted by injection into spinal cord at opposing ends of the injury site. The degree of pain was assessed and compared before operation and long-term follow-up according to the International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS), i.e., 0 point means extreme pain, uncontrolled; 1 point, severe pain, narcotics required; 2 points, mild pain, ordinary pain killer effective; 3 points, no pain.ResultsThe follow-up and pain reevaluation were performed at 0.5 to 88 months with an average of 17.5 months after cell transplantation. The mean score of pain amelioration is 1.2 points.ConclusionThe OEC intraspinal transplantation appears to have a promising role in treatment of intractable chronic neuropathic pain after SCI.

Factors influencing the long-term survival in pancreatic carcinoma patients after radical resection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the factors influencing the long-term survival of pancreatic carcinoma patients after radical resection.</p><p><b>METHODS</b>The data of 184 pancreatic carcinoma patients with radical resection were analyzed retrospectively. Analysis of the prognostic factors influencing the long-term survival was performed using Cox proportional hazard regression model.</p><p><b>RESULTS</b>The overall 1-, 3- and 5-year survival rates in this group were 61.7%, 29.0% and 14.3%, respectively. They were 78.0%, 38.4% and 25.7%, respectively, for the patients with a tumor < 3 cm in diameter, significantly better than those with a tumor >or= 3 cm (52.8%, 22.7% and 7.2%, respectively, P < 0.05). Moreover, the 1-, 3- and 5-year survival rates were 67.6%, 30.5% and 17.4%, respectively, in the patients without lymph node involvement, much longer than that in those with lymph node metastasis (37.1%, 20.6% and 0, respectively, P < 0.05). Multivariate analysis by Cox proportional hazard regression model revealed that the tumor size (P < 0.05) and lymph node metastasis (P < 0.01) significantly influenced the long-term survival of the patients.</p><p><b>CONCLUSION</b>Tumor size and lymph node metastasis are significant factors influencing the long-term survival of pancreatic carcinoma patients with radical resection. Therefore, early diagnosis and radical resection are the key points to improve treatment outcome.</p>

Increased expression of Ets-1 in the diabetic retina of streptozotocin-induced rat model / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the involvement of Ets-1 in the pathological progress of the experimental diabetic retina. METHODS: Diabetes was induced by intraperitoneal injection of STZ. Total RNA and Total proteins were isolated from retinas of experimental and control eyes at 4 weeks after STZ-injection and were assessed by Northern blot analysis and Western blot analysis, respectively.RESULTS: Expression of both Ets-1 mRNA and Ets-1 protein was significantly increased in the experimental diabetic rat's retina after STZ-injection compared with the control group (P＜0.001).CONCLUSION: Our results indicated that Ets-1 was involved in the pathological progress of experimental diabetic retina.Further studies should be conducted to focus on the relationship between Ets-1 and VEGF in the diabetic retina.