Research status of correlation between myopia and accommodative function / 国际眼科杂志(Guoji Yanke Zazhi)

Ocular accommodation refers to the process by which the ciliary muscle creates a clear image of the object in the retina by changing the refractive power of the lens. When the accommodation ability of the eye is insufficient, the imaging focus falls on the region behind the retina and hyperopic defocus is easily formed, resulting in axial growth and leading to the development of myopia, and it is found that most myopic patients usually have some accommodation dysfunction. Myopia has become a public health problem in China, and the prevalence of adolescents has increased dramatically. How to prevent and stop the occurrence and development of myopia is a major challenge. Previous studies have found that ocular accommodation dysfunction is associated with the occurrence and development of myopia, and the measurement of parameters related to accommodation function has certain guiding significance for the prevention and control of myopia. The purpose of this paper is to review the correlation between myopia and ocular accommodation function, with a view to providing new ideas for the prevention, control and treatment of myopia.

Informe de caso de miocardiopatía no compactada en una mujer de 34 años / Case report of left ventricular noncompaction cardiomyopathy in a 34-year-old woman

Introducción: la miocardiopatía no compactada (MCNC) es una miocardiopatía no clasificada por la Organización Mundial de la Salud. Se describe como una enfermedad congénita muy rara, donde se observan trabeculaciones endomiocárdicas que aumentan en número y prominencia. Esta miocardiopatía conlleva un alto riesgo de arritmias malignas, fenómeno tromboembólico y disfunción ventricular izquierda. Objetivo: reportar el caso de una mujer de 34 años, diagnosticada previamente con obesidad mórbida, que acudió a consulta externa para una evaluación cardiovascular prequirúrgica. El electrocardiograma mostró el ventrículo izquierdo (VI) ligeramente dilatado y llamativa trabeculación del mismo. Resultados: se confirma el diagnóstico de MCNC a través de una imagen de resonancia magnética. Se autoriza su cirugía y se recomiendan cambios en su estilo de vida y cambio de medicación para riesgos de fallo cardíaco. En el último ecocardiograma, los diámetros del VI muestran mejoría con respecto al primero. Conclusiones: la presencia de trabeculaciones en el VI debe considerarse un dato clínico de sospecha de MCNC. Se deben realizar más investigaciones sobre las causas de esta miocardiopatía no clasificada para desarrollar mejores formas terapéuticas, sin embargo, ha sido probada la eficacia de los bloqueadores de los receptores de la angiotensina II en el manejo farmacoterapéutico de esta condición

Introduction: Left ventricular non-compaction cardiomyopathy (LVNC) is a cardiomyopathy not classified by the World Health Organization. It is described as a very rare congenital disease where endomyocardial trabeculations that increase in number and prominence are observed. This cardiomyopathy carries a high risk of malignant arrhythmias, thromboembolic events and left ventricular dysfunction. Objective: To report the case of a 34-year-old woman, previously diagnosed with morbid obesity, who came to the outpatient clinic for a preoperative cardiovascular evaluation. The electrocardiogram showed a slightly dilated left ventricle (LV) and striking trabeculation. Results: The diagnosis of LVNC was confirmed by magnetic resonance imaging. Surgery was authorized and lifestyle changes and change of medication for heart failure risks were recommended. On the last echocardiogram, LV diameters show improvement from the first. Conclusions: The presence of trabeculations in the LV should be considered as clinical data of suspected LVNC. Further investigations on the causes of this unclassified cardiomyopathy should be performed to develop better therapeutic ways, however, the efficacy of angiotensin II receptor blockers in the pharmacotherapeutic management of this condition has been proven

Xiao Xianxiongtang Regulates Ca2+ Load and Inhibits Epithelial-mesenchymal Transition， Invasion， and Migration of MGC-803 Cells： Based on Wnt5a/ Ca2+/NFAT Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the effect of Xiao Xianxiongtang （XXXT） on the transforming growth factor （TGF）-β1-induced invasion， metastasis， and epithelial-mesenchymal transition （EMT） of gastric cancer MGC-803 cells and the underlying mechanism. MethodThe molecular docking between XXXT and nuclear factor of activated T cells （NFAT） was performed by CB-DOCK （http：//clab.labshare.cn/cb-dock/）. The invasion and metastasis model of MGC-803 cells was established with 10 μg·L-1 TGF-β1. MGC-803 cells were classified into blank group， model group， 0.1 g·L-1 XXXT group， 0.2 g·L-1 XXXT group， and 0.4 g·L-1 XXXT group. For further clarifying the key role of Wnt5a/Ca2+/NFAT signaling pathway in the inhibition of XXXT on gastric cancer， MGC-803 cells were transfected with Wnt5a overexpression plasmid， and then the cells were classified into blank plasmid group， Wnt5a-OE group， blank plasmid + XXXT （0.4 g·L-1） group， and Wnt5a-OE + XXXT （0.4 g·L-1） group. Cell viability was determined by cell counting kit-8 （CCK-8） assay， cell invasion and migration ability by Transwell invasion assay and wound healing assay， expression of EMT-related proteins （E-cadherin， N-cadherin， Vimentin， Snail） and Wnt5a/Ca2+/NFAT signaling pathway-related key proteins ［Wnt5a， calcineurin （CaN）， NFAT1， and p-NFAT1］ by Western blot， and changes in intracellular Ca2+ concentration by immunofluorescence assay. ResultMolecular docking suggested that XXXT acted on Wnt5a/Ca2+/NFAT signaling pathway. XXXT （0.1， 0.2， 0.4 g·L-1） significantly promoted the loss of MGC-803 cell viability （P<0.05，P<0.01）. It inhibited cells from invading the transwell lower chamber and slowed down the healing of cell wounds in a dose-dependent manner （P<0.05， P<0.01）. Moreover， it promoted the expression of E-cadherin while suppressed the expression of N-cadherin， Vimentin， and Snail （P<0.05， P<0.01）. Further experiments showed that XXXT could inhibit the expression of Wnt5a， CaN， NFAT1， and p-NFAT1， and reduce the nuclear expression of NFAT1 and the transcription activity mediated by NFAT1， so as to reduce the cellular Ca2+ concentration （P<0.05， P<0.01）. XXXT can reverse the effect of Wnt5a （P<0.05， P<0.01）. ConclusionXXXT can attenuate the invasion， metastasis， and EMT of MGC-803 cells via the Wnt5a/Ca2+/NFAT pathway， thereby weakening the tumor-promoting effect of TGF-β1. In summary， XXXT may exert therapeutic effect on gastric cancer by regulating the invasion， metastasis， and EMT of gastric cancer cells.

Comparison of calculated and gradient AC/A ratios among normal, exophoria and esophoria / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the clinical application of calculated and gradient accommodative convergence/accommodation ratio(AC/A)in different eye positions.<p>METHODS: A total of 127 myopes in ophthalmology were included. The calculated AC/A was obtained by near/distance phoria and the gradient AC/A was obtained by near addition +1.00D. The differences of eye positions of the calculated and gradient AC/A were compared. <p>RESULTS:The calculated AC/A value was higher than the near +1.00D gradient AC/C(<i>P</i><0.01); Comparing the same method in different eye positions revealed that the calculated AC/A and gradient AC/A were significantly different, which has the highest AC/A in the esophoria group and the lowest AC/A in the exophoria group; Comparing the two methods in the same group revealed that the calculated AC/A in the esophoria group and the normal group was higher than the gradient AC/A(<i>P</i><0.01), and there was no significant difference in the AC/A measured by the two methods in the exophoria group(<i>P</i>>0.05).<p>CONCLUSION: The calculated AC/A is higher than the gradient AC/A, especially in patients with esophoria and emmetropia, it is easy to obtain high AC/A values by using the calculation method, resulting in erroneous diagnosis. The gradient method is more recommended.

La diabetes mellitus como factor de riesgo cardiovascular / Mellitus diabetes as a cardiovascular risk factor

RESUMEN Introducción: La diabetes se relaciona con las enfermedades cardiocirculatorias, es considerada, un importante factor de riesgo cardiovascular, que lo incrementa, así como a la muerte prematura. Objetivo: Revisar algunos estudios, sobre la diabetes como enfermedad y como factor de riesgo para el desarrollo de las enfermedades cardiovasculares. Métodos: Se realizó una revisión de la literatura, sobre la diabetes y su papel en el desarrollo de las enfermedades cardiovasculares, en el periodo 2007 hasta 2021, en las bases de datos SciELO, EBSCO, LILACS, así como, otras fuentes y recursos de información disponibles en Internet. En la estrategia de búsqueda, se utilizó el vocabulario controlado Descriptores en Ciencias de la Salud y se combinaron con operadores booleanos para limitar o ampliar la recuperación de información sobre el tema, periodo e idiomas deseados. Se incluyeron 19 publicaciones atendiendo a su pertinencia y relevancia. Resultados: Se revisaron estudios sobre la diabetes y su relación con el desarrollo de las afecciones cardiovasculares. Se recuperaron 19 publicaciones, que evidencian ese nexo. Conclusiones: Se mostró la relación entre la diabetes y la aparición de enfermedades cardiovasculares. Se evidenciaron la dieta malsana, el sobrepeso, la obesidad y la inactividad física en la génesis de la diabetes. Se impone el trabajo sistemático en la prevención y su pesquisa activa en las personas con riesgo. La diabetes y las enfermedades cardiovasculares, tienen peso en el cuadro de mortalidad en el mundo, la prevención y control de la diabetes, influirá de manera favorable sobre la morbimortalidad por las enfermedades cardiovasculares.

ABSTRACT Introduction: Diabetes is related to cardiovascular diseases, it is considered an important cardiovascular risk factor, which increases it, as well as premature death. Objective: To review some studies on diabetes as a disease and as a risk factor for the development of cardiovascular diseases. Methods: A literature review was carried out on diabetes and its role in the development of cardiovascular diseases, in the period 2007 to 2021, in the databases Scielo, EBSCO, LILACS, as well as other sources and resources of information available on the Internet. The controlled vocabulary Descriptors in Health Sciences was used. Results: Studies on diabetes and its relationship with the development of cardiovascular diseases were reviewed. 18 publications were recovered, which show this link. Conclusions: The relationship between diabetes and the appearance of cardiovascular diseases was shown. Unhealthy diet, overweight, obesity and physical inactivity are evidenced in the genesis of diabetes. Systematic work on prevention and its active investigation in people at risk is imposed. With its prevention and control, it will favorably influence morbidity and mortality from cardiovascular diseases.

Study on the function of regulating aggregation in children with different types of intermittent exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the binocular accommodative amplitude(AMP)and accommodative facility(AF), near point of convergence(NPC), accommodative convergence/accomodation ratio(AC/A), positive relative convergence(PRC)of intermittent exotropia(IXT)children, according to the convergence insufficiency type, basic type, divergence excess type, and to compare with the normal children, investigating the differences of regulation and collection function.<p>METHODS: Totally 40 IXT children were divided into three groups according to the different types of the IXT patients, the convergence insufficiency group(12 children), the basic group(18 children)and the divergence excess group(10 children). And the 20 non-exotropia children were set up as the control group. AMP was measured with improved push-up test, and AF was measured with turning over convex and concave lens test. NPC was measured with push-up test. AC/A ratio were measured with the lens gradient method. PRC was measured with BO prism. The binocular accommodative and convergence function of four groups were compared.<p>RESULTS: The difference of AMP, AF, NPC, AC/A ratio and PRC among four groups was significant difference(<i>P</i><0.05), and we did the further pair wise comparisons. AMP of the IXT group was less than the control group, and AMP of the convergence insufficiency group was the least; AF of the convergence insufficiency group was less than the basic group and the control group; NPC of the convergence insufficiency group was the largest; AC/A ratio of the convergence insufficiency group and the basic group was lower than the other two groups; PRC of the IXT group was less than the control group when fixating at near target of 33cm, and the mean of the convergence insufficiency group was the least; PRC of the IXT group was less than the control group when fixating at far target of 6mo(<i>P</i><0.05).<p>CONCLUSION: There are differences in the ocular function of accommodation and convergence in different types of IXT children, and the function of the convergence insufficiency IXT is the worst. The binocular accommodative and convergence function of IXT children is worse than non-exotropia children.

Extract from Modified Xiao Xianxiongtang Inhibits Epithelial-mesenchymal Transition and Invasion and Migration Mediated by TGF-β1 of Human Gastric Cancer MGC-803 Cells via Wnt5a/Ca2+/NFAT Signaling Pathway / 中国实验方剂学杂志

Objective:This studu aims to investigate the effect of aqueous extract of modified Xiao Xianxiongtang on the epithelial mesenchymal transition（EMT） and the change of its invasion and migration ability of human gastric cancer MGC-803 cells mediated by transforming growth factor-<italic>β</italic>₁（TGF-<italic>β</italic>₁），and to explore the mechanism of regulating Wnt5a/Ca²⁺/ activated T-cell nuclear factor（NFAT） signaling pathway to inhibit EMT and invasion and metastasis of MGC-803 cells. Method:TGF-<italic>β</italic>₁（10 μg·L^-1）was used to induce EMT and the invasion and metastasis model of human gastric cancer MGC-803 cells. Transwell chamber experiment， scratchhealing experiment， Western blot and immunofluorescence assay were used to detect cell invasion and migration ability， expression of EMT marker protein and key protein expression of Wnt5a/Ca²⁺/NFAT signaling pathway， and intracellular Ca²⁺ concentration. Result:Compared with the blank group， TGF-<italic>β</italic>₁ could significantly enhance the invasion and migration ability of MGC-803 cells（<italic>P</italic><0.01）， down-regulate the level of E-cadherin（<italic>P</italic><0.01）， up-regulate protein expressions of N-cadherin， Snail and Vimentin（<italic>P</italic><0.01）， and induce cell Wnt5a， calcineurin （CaN）， total protein of activated T-cell nuclear factor 1（NFAT1）， up-regulation of phosphorylated proteins p-NFAT1 and NFAT1 nucleoprotein and intracellular accumulation of Ca²⁺（<italic>P</italic><0.01）. Compared with the TGF-<italic>β</italic>₁ group， modified Xiao Xianxiongtang （10， 20， 40 mg·L^-1） could significantly inhibit this phenomenon，and 40 mg·L^-1 had the best effect（<italic>P</italic><0.05，<italic>P</italic><0.01）.The specific inhibitors of Wnt5a/Ca²⁺/NFAT signaling pathway （<italic>R</italic>）-（+）-Bay-K-8644 and modified Xiao Xianxiongtang （40 mg·L^-1） could significantly inhibit theinvasion and migration of MGC-803 cells mediated by TGF-<italic>β</italic>₁， up-regulate the level of E-cadherin， and down-regulate expressions of N-cadherin， Snail， Vimentin， Wnt5a， CaN and NFAT1 proteins and reduce the intracellular accumulation of Ca²⁺（<italic>P</italic><0.05，<italic>P</italic><0.01）.Moreover， （<italic>R</italic>）-（+）-Bay-K-8644 combined with modified Xiao Xianxiongtang （40 mg·L^-1） had stronger inhibitory effect（<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:These results suggest that modified Xiao Xianxiongtang can inhibit the EMT mediated by TGF-<italic>β</italic>₁ via Wnt5a/Ca²⁺/NFAT signaling pathway，thereby reducing the invasion and migration ability of MGC-803 cells.

Cardiotoxicidade por cocaína e disfunção ventricular em paciente jovem / Cocaine cardiotoxicity and ventricular disfunction in a young patient

RESUMO: O uso de substâncias psicoativas pode induzir complicações cardiovasculares. O objetivo deste relato é descrever o caso de um paciente jovem com cardiomiopatia dilatada secundária ao uso de cocaína. Paciente com dispneia há seis meses, com piora progressiva, dispneia paroxística noturna, ortopneia e edema de membros inferiores. Ao exame físico apresentava taquicardia (110 bpm), com demais sinais vitais sem alterações, presença de estertores crepitantes em bases e campos médios, ascite de moderado volume e edema importante de membros inferiores. No eletrocardiogra-ma, apresentava ritmo sinusal com sobrecarga de câmaras esquerdas; na radiografia de tórax, apenas cardiomegalia acentuada. O ecocardiograma evidenciou fração de ejeção (FE) do ventrículo esquerdo (VE) reduzida (7%), aumento de átrio esquerdo e ventrículo direito (VD), com hipertrofia excêntrica e disfunção sistólica acentuada do VE, com disfunção moderada do VD e hipertensão pulmonar (39 mmHg). Na ressonância, apresentou dilatação discreta do átrio direito, VD com dilatação importante, disfunção sistólica biventricular importante, com hipocinesia difusa (FE 8% de VD), além de fibrose miocárdica de padrão não coronariano inferosseptal. O caso relatado evidencia um diagnóstico cujo mecanismo fisiopatológico da cardiomiopatia dilatada não está claro. A associação mais coerente da cardiomiopatia dilatada apre-sentada pelo paciente está relacionada ao uso abusivo de cocaína, devido ao estímulo recorrente e de longa duração que o excesso de catecolaminas provocou no miocárdio. Tendo em vista o espectro de cardiomiopatia, infarto e arritmias que potencialmente podem ocorrer associados ao uso de cocaína, deve-se considerar a hipótese de cardiotoxicidade na avaliação de paciente com história de abuso de cocaína. (AU)

ABSTRACT: The use of psychoactive substances can induce cardiovascular complications. The purpose of this report is to describe the case of a young patient with dilated cardiomyopathy secondary to cocaine use. Patient with dyspnea for six months, with progressive worsening, paroxysmal nocturnal dyspnea, orthopnea, and lower limb edema. Physical examination showed tachycardia (110 bpm), with other vital signs without alterations, presence of crackling rales in the bases and middle fields, moderate volume ascites, and significant lower limb edema. Electrocardiogram showed sinus rhythm with left chamber overload; chest X-ray only marked cardiomegaly. The echocardiogram showed reduced left ventricular (LV) ejection fraction (7%), enlarged left atrium, and right ventricle (RV), with eccentric hypertrophy and severe left ventricular systolic dysfunction, with moderate RV dysfunction and pulmonary hyper-tension (39 mmHg). Resonance presented mild right atrial dilatation, RV with significant dilatation, significant biven-tricular systolic dysfunction, with diffuse hypokinesia, and myocardial fibrosis of non-coronary pattern. The reported case shows a diagnosis whose pathophysiological mechanism of dilated cardiomyopathy is not clear. The most coher-ent association of dilated cardiomyopathy presented by the patient is related to cocaine abuse, due to the long-term recurrent stimulus that excess catecholamines caused in the myocardium. Given the spectrum of cardiomyopathy, infarction, and arrhythmias that may potentially occur associated with cocaine use, the hypothesis of cardiotoxicity should be considered in the evaluation of a patient with a history of cocaine abuse. (AU)

Efficacy of vision therapy in impaired stereoscopic depth with intermittent exotropia (true divergence excess) with unilateral amblyopia: a case report

Divergence excess (DE) can be described clinically as exotropia at far greater than the near deviation by at least 10 prism dioptres (PD). We are reporting a rare case of 25-year-old female visited in the eye department for a routine eye check-up with a history of decreased vision in one eye. On examination, it was detected as a case of unilateral amblyopia with intermittent exotropia of true divergence excess with high accommodative-convergence over accommodation (AC/A) ratio. The patient was asymptomatic from exo-deviation due to the presence of binocular vision and good fusional reserve. The patient was started on active conventional vision therapy along with occlusion therapy. Post 16 weeks of constant therapy, a vision assessment with complete squint assessment along with binocular vision tests were performed. The result interprets to support the use of active conventional vision therapy as an integral part of the clinical treatment of amblyopia and intermittent exotropia. The rate of recovery of several monocular functions monitored during the vision therapy period provides the evidence of neural plasticity at multiple sites in the visual pathway in this adult amblyope. Therefore, if an ordered plan is being followed for the management of the patient of unilateral amblyopia and divergence excess, it can yield long-lasting improvement in visual acuity and binocular functions of any age.

An anatomic study of superficial temporal artery to anterior cerebral artery bypass using ipsilateral parietal branch of superficial temporal artery as graft / 中华显微外科杂志

Objective Revascularization of the distal segment of the anterior cerebral artery (ACA) using extracranial donors requires long interposition grafts.A novel bypass procedure which uses the two main branches of the superficial temporal artery (STA) to reach the A3 segment of the anterior cerebral artery with a single skin incision was designed.Methods Ten cadaveric specimens were dissected through a single skin incision to harvest the frontal and parietal branches of the STA from June,2017 to September,2017.An anterior interhemispheric approach provided access to the middle internal frontal artery (MIFA).The parietal STA was used as an interposition graft between the frontal STA and MIFA.Lengths and calibers of the distal branches of STA and MIFA were measured at the anastomotic sites.All data was statistical analysis by t-test.Results The average caliber of MIFA was (1.4±0.2) mm,which matched the caliber of both frontal and parietal branches of STA.The mean distance for an end-to-side bypass from STA to MIFA was (144.5±7.4) mm and the average harvested donor-graft complex length was (203.1±27.9) mm.This bypass construct provided around 140％ donor graft length.Conclusion Using the parietal branch of the STA as an interposition graft enabled a successful tension-free STA-MIFA bypass.The advantages of this technique over existing approaches include sufficient graft length,caliber match and relative technical ease.

Conhecimento da equipe de enfermagem sobre ressuscitação cardiopulmonar / Nursing team knowledge on cardiopulmonary resuscitation

Objetivou-se identificar o conhecimento teórico da equipe de enfermagem sobre as manobras de ressuscitação cardiopulmonar em suporte básico de vida, associando tal conhecimento às variáveis sociodemográficas, econômicas e de formação profissional. Trata-se de estudo transversal, descritivo e quantitativo, cujos dados foram obtidos de questionários aplicados a 351 funcionários de uma equipe de enfermagem de um serviço de emergência e de unidades de terapia intensiva. Houve declínio do conhecimento dos sujeitos sobre ressuscitação e parada cardiopulmonar com o passar do tempo. Fatores socioeconômicos e profissionais estiveram associados ao conhecimento dos profissionais de enfermagem. Sugere-se que treinamentos com menores intervalos aumentem o grau de retenção e o conhecimento da equipe de enfermagem.

The objective of this study was to identify the theoretical knowledge of the nursing team on the cardiopulmonary resuscitation manoeuvres in basic life support, associating such knowledge to sociodemographic, economic and professional training variables. This is a cross-sectional, descriptive and quantitative study, in which the data were obtained from questionnaires applied to 351 employees of a nursing team of an emergency service and intensive care units. There was a decline in the subjects' knowledge about resuscitation and cardiopulmonary arrest over time. Socio-economic and professional factors were associated with the knowledge of nursing professionals. It is suggested that training with shorter intervals would increase the degree of retention and knowledge of the nursing team.

A Clinical Study On Topographical Analysis Of Vascular Territories In Stroke With Clinical And Etiopathogenesis

Stroke incidence is currently increasing in India, compared to Western countries. Mostly it’s attributed to risk factors like hypertension, diabetes, smoking, and dyslipidemia and alcohol consumption. Risk factors are poorly controlled with insufficient infrastructure and inadequate public awareness, poor rehabilitation services contributes for increasing prevalence of the stroke with disability. This clinical study focussed on topographical analysis of vascular territories involved in stroke with clinical and etipathogeneis contributing stroke.

The clinical research about early diagnosis of small cell lung cancer through mad2 de-tection / 中国肿瘤临床

Objective:To explore combined detection of mad2 with anti-nuclear mitotic spindle apparatus antibody(MSA)and anti-centromere antibody(ACA)and their clinical value for the diagnosis of small cell lung cancer(SCLC).Methods:One hundred and twen-ty SCLC patients,110 non-small cell lung cancer(NSCLC)patients,and 115 pulmonary nodule(PN)patients were enrolled in this study. The expression of mad2 was analyzed by qt-PCR.MSA and ACA were detected by indirect immunofluorescence(IIF)staining.Results:mad2 was overexpressed in SCLC and NSCLC samples(P<0.05).There were significant differences between the results obtained for SCLC and NSCLC samples by qt-PCR(P<0.05).AUC in ROC curve for mad2 expression was 0.799 with an intermediate diagnostic value. In the correlative analysis,the odds ratio of MSA and ACA was 6.94 and 5.60,respectively.In the correlation analysis,Kappa value of mad2 with MSA was 0.49,and Kappa value of mad2 with ACA was 0.42.In the parallel analysis,the sensitivity and specificity was 83.31% and 79.34%,respectively,while the Youden Index was 0.62.Moreover,in the serial analysis,the sensitivity and specificity was 65.32% and 93.35%,respectively,and the Youden Index was 0.59.Conclusions:In comparison with the NSCLC and PN samples,mad2 was overexpressed in SCLC samples.Therefore,mad2 ought to play a critical role in the pathology of SCLC.The combined expression of mad2 with MSA and ACA may contribute to enhancing the sensitivity and specificity of detection;this expression may allow early diag-nosis and clinical diagnosis of SLCC and may be a promising treatment for SCLC.

Changes and analysis of AC/A after excimer laser in situ keratomileusis / 国际眼科杂志(Guoji Yanke Zazhi)

Excimer laser in situ keratomileusis (LASIK) is a typical surgical technique which precisely cutting cornea to rectify refractive error with excimer laser.Since the safety,stability,predictable postoperative vision affirmed,it has been accepted by multiple myopia patients in recent years.AC/A is a significant composition of visual function.Nowadays,numerous scholars have pay close attention to its transformation after LASIK,and this paper reviewed the variation trend of AC/A,the influencing factors and its possible mechanisms.

Experience of Professor Li Shuping in Treating the Recurrent Spontaneous Abortion Caused by Prethrombotic State / 浙江中医药大学学报

Objective]To introduce professor Li Shuping's clinical experience by invigorating kidney and activating blood in treating recurrent spontaneous abortion prethrombotic state.[Method]By following professor Li Shuping's clinical diagnosis and treatment and organizing related cases ,to sum up professor Li Shuping's academic thoughts and clinical experience on the recurrent spontaneous abortion prethrombotic state ,and for proven cases.[Result] Professor Li Shuping thinks the disease of traditional Chinese medicine dialectical belongs to kidney deficiency and blood stasis ,so the basic principle of treatment is to invigorate kidney and activate blood.Professor Li Shuping is good at using invigorating kidney and promoting blood circulation to remove blood stasis,invigorating kidney and activating blood and tonifying qi,invigorating kidney and spleen,invigorating kidney and promoting blood circulation to remove heat.According to the pathogenesis treatment and flexible adjustment,the clinical curative effect is very good. And it is attached test cases of Shoutai Pills with the combination of Angelica Peony Powder treatment of kidney deficiency and blood stasis type recurrent spontaneous abortion. [Conclusion] Professor Li Shuping has unique clinical experience ,her clinical thought of invigorate kidney and activate blood is worthy our deep experiencing and study.

Bilateral stroke: unpaired anterior cerebral artery infarct rare presentation.

ACA territory is an uncommon site for occlusive vascular strokes. Small degree of asymmetry of anterior arteries is present in 80% of patients. Common variants of anterior cerebral arteries include aplasia or hypoplasia of A1 segment. Hypoplasia is found in 10% and aplasia in 1-2% of postmortem examinations. Of all ischemic strokes ACA territory strokes constitutes only 0.6 to 3%. Bilateral ischemic stroke in unpaired ACA is rare entity. We report a case of unpaired ACA due to hypoplasia of right ACA, presenting as stuttering hemiplegia with bilateral focal neurological deficit.

Celiac crisis and hemorrhagic diathesisin an adult / Crise celíaca e diátese hemorrágica em um adulto

Aims: Case-report of a patient with a rare presentation of celiac disease.Case description: A 49 year-old woman, with a long-standing course of diarrhea and weight loss of 35 kg in a three-year period, presented tothe emergency department complaining of an increase in diarrheal depositions, hematemesis, melena, lethargy, anasarca and syncope episodes.After clinical evaluation, upper gastrointestinal endoscopy and laboratorial exams, a rare illness known as celiac crisis was diagnosed. This isa rare presentation of celiac disease, associated with profuse diarrhea and severe metabolic/electrolyte disturbances, more frequent in childrenunder two years, and rarely described in adults.Conclusions: Celiac disease usually manifests itself through chronic diarrhea, abdominal pain and weight loss, but celiac crisis and hemorrhagicdiathesis, although rarely, may also occur.

Objetivos: Relatar o caso de uma paciente com apresentação rara de doença celíaca.Descrição do caso: Apresentamos o caso de uma mulher de 49 anos, com diarreia e emagrecimento de 35 kg em um período de três anos,trazida à emergência por anasarca, aumento nas eliminações diarreicas, vômitos com sangue, melena e episódios de síncope. Além de sintomasneurológicos, apresentava também distúrbios hidroeletrolíticos e perda de função renal. Após investigação clínica com exames endoscópicose laboratoriais foi diagnosticada uma rara enfermidade conhecida com crise celíaca. Esta é uma apresentação rara da doença celíaca, cursandocom diarreia profusa e distúrbios metabólicos/eletrolíticos severos, mais frequente em crianças de menos de dois anos e pouco descrita emadultos.Conclusões: A doença celíaca manifesta-se classicamente por diarreia crônica, dor abdominal e perda de peso, embora apresentações maisraras, como crise celíaca e diátese hemorrágica, possam ocorrer.

Modificación de la relación acomodación por convergencia acomodativa (AC/A), en respuesta adiferentes lentes estímulo / Modification of the accommodative-convergence over accommodation

La cantidad de acomodación que es modificada por acción de la convergencia se denomina la relación AC/A y puede influir en la magnitud de la desviación ocular, en el diagnóstico del estado sensorial y motor, y en el plan de tratamiento del paciente; existen discrepancias en si la medida del AC/A gradiente es igual con otras respuestas acomodativas. Objetivo: determinar si la relación AC/A gradiente estímulo presentaba una respuesta similar al emplear diferentes lentes estímulos. Materiales y métodos: fueron evaluados 132 sujetos a los cuales se midió la heteroforia habitual e inducida con lentes estímulo de +3,00, +2,00, +1,00, -1,00, -2,00 y -3,00 dioptrías, usando la técnica de Thorington, con una carta modificada de forias (para 0,33 m). Resultados: el promedio del AC/A gradiente para el lente estímulo fue de +3,00 (1,39), +2,00 (1,67), +1,00 (1,84), -1,00(1,42), -2,00 (1,48), -1,00 (1,42), y el AC/A pendiente (AC/Ap 1,49); la comparación del AC/A nomostró diferencias significativas (ANOVA, p = 0,0132), pero sí una mayor variabilidad en los resultadoscon los lentes de +/- 1,00D (COA ±2,98 y ±2,56). Conclusiones: el AC/A gradiente estímulo en promedio fue similar cuando se calculó con los diferentes lentes, pero la variabilidad en los datos indica que debería ser medido y calculado con base en varios estímulos de acomodación.

The amount of accommodation modified by convergence is called the AC/A ratio and it can affect the magnitude of ocular deviation in the sensory and motor state diagnosis, as well as in the patient’s treatment plan. There are some disagreements on whether the measurement of the AC/A gradient is the same with other accommodative responses. Objective: To determine if the gradient stimulus AC/A ratio had a similar response when using different stimulus lenses. Materials and methods: One hundred and thirty-two (132) individuals were evaluated, who had regular and induced heterophoria with +3.00, +2.00, +1.00, -1.00, -2.00 and -3.00 dioptry stimulus lenses measured through the Thorington technique, with a modified phoria card (for 0.33 m). Results:The mean gradient AC/A for the stimulus lens was +3.00 (1.39), +2.00 (1.67), +1.00 (1.84), -1.00(1.42), -2.00 (1.48), -1.00 (1.42), and the slope AC/A ratio (AC/Ap1.49). The comparison of the AC/A did not show any significant differences (ANOVA p=0.0132), but a higher variability in the results with the +/-1.00D (COA ±2.98 and ±2.56) lenses. Conclusions: The mean gradient stimulus AC/A was similar when calculated with the different lenses, but the variability of the information indicates that it should be measured and calculated with several accommodation stimuli.

Sobre migrações e transferências / On migrations and transferences / Acerca de migraciones y transferencias

O artigo se propõe a pensar a clínica psicanalítica da perspectiva da contemporaneidade, isto é, enfatizando que é somente no aqui e agora histórico que ela se dá. Uma análise que vem sendo feita há três anos, na maioria das vezes via Skype, serve de ancoragem para questionamentos a respeito do que é o aqui e agora transferencial. Dela também emerge aquilo que o autor vem a denominar de função testemunho do analista.

By emphasizing that the psychoanalytical clinic occurs always in the historical here and now, this paper approaches it from a contemporary perspective. An experience of a three-year analysis, mainly via Skype, is used to bring about the questioning of what is the transferential here and now. This experience is also the starting point of an elaboration of the concept of witness function.

El artículo se propone considerar la clínica psicoanalítica desde la perspectiva contemporánea, es decir, haciendo hincapié en que es sólo en el aquí y ahora que la historia tiene lugar. Un análisis que se ha venido realizando durante tres años, la mayoría de las veces a través de Skype, sirve como base para que interrogantes acerca de lo que es el aquí y ahora de transferencia. Del mismo también emerge aquello que el autor denomina la función de testimonio del analista.

Cambios en la relación acomodación convergencia AC/A en el valor de las forias después de cirugía refractiva Lasik / Changes of the convergence accomodation relation (A/CA) and the forias in patiens before and after refractive surgery Lasik

Objetivo: determinar cambios significativos de la relación acomodación convergencia (AC/A) y las forias en pacientes antes y después de cirugía refractiva con técnica Lasik. Metodología: se realizó un estudio prospectivo para una muestra poblacional de veinte pacientes (cuarenta ojos) sometidos a cirugía refractiva, evaluados ortópticamente en Optiláser en Bogotá. Se determinó como criterio de inclusión haber sido valorado ortópticamente antes y después de la cirugía refractiva. Se evaluaron condiciones motoras, sensoriales, signos, síntomas, agudeza visual, AC/A, forias con cover test y con varilla de maddox. Resultados: en la medida de las forias se observa qué tanto para Cover Test como para Varilla de Maddox no se presentan cambios estadísticamente significativos entre el pre y el posquirúrgico. La relación AC/A calculada con el método de la Heteroforia tuvo valores similares antes y después de la cirugía refractiva; estadísticamente, no se observan cambios significativos, pues se mantuvieron los valores normales en un promedio de 55 por ciento (once pacientes) y 65 por ciento (trece), respectivamente. En cuanto a los pacientes con ACA bajo, se observó que antes de la cirugía había 45 por ciento (nueve pacientes) y después de la cirugía 65 por ciento (seis pacientes). Cabe resaltar que un paciente (5 por ciento) que presentaba foria antes de la cirugía se descompensó en el posquirúrgico, lo que generó tropia en visión próxima y, por ende, imposibilidad en la realización de la valoración de ACA. Conclusiones: la relación acomodación convergencia en pacientes sometidos a cirugía refractiva no presenta cambios significativos, con respecto a su condición inicial. El cover test y la varilla de Maddox reportan diferencias, encontrándose mayor alteración en los valores de las forias en la varilla de Maddox; es decir, que con el método disociante se evidenció un mayor valor de ésta y se encontró una variación significativa con respecto al valor encontrado con el método habitual.

The objetive of the study was to determine significant changes of the convergence accomodation relation (A/CA) and the forias in patiens before and after refractive surgery. Methodos: 40 eyes was submitted to refractive surgery, evaluated by ortoptic in a refractive center OPTILASER. Conditions such as motored, sensorial, signs, symptoms, visual a harpness, AC/A, binocular vision were evaluated with cover test and with maddox rod. Results: in the measures of forias, it is observed that so much for cover test as for maddox rod, there are not significant statistically changes between the pre and the postsurgical pursuit.The relation AC/A calculated with the method of the heteroforia, had similar values before and after the refractive surgery, statistically there are not significant changes observed; therefore the normal values were maintained in an average of 55 percent (11 patients) and 65 percent (13) respectively. As for the patiens with ACA is observed that before the surgery there was 45 percent ( 9 patients) and after the surgery 65 percent (6 patients). It fits to stand out that 1 patient (5 percent) that presented foria before the surgery, is descompensated in the postsurgical treatment generating strabismus in near vision and therefore impossibility in the execution of the appraisal of ACA. Conclusions: the convergence accomodation (AC/A) relation in patients submitted to refractive surgery does not present significant changes, with respect to its initial condition. The cover test and the Maddox rod report differences finding greater alteration in the values of the forias in the maddox rod; that is to say that withthe dissociate method was shown a greater value of the same one, finding a significant variation with respectto the value found with the habitual method.