Retinal laser – Protocols and practical tips

Background: Many a young doctors in training find retinal laser photocoagulation a daunting task. However, if correct protocols are followed and checklists are observed, then it is not difficult to have a successful laser sitting with a happy patient. Most of the complications can be avoided with correct settings and techniques. Purpose: To enumerate the basic protocols of retinal laser photocoagulation and provide practical tips including laser settings and checklists for hassle?free laser experience. Synopsis: Laser settings for a pan?retinal photocoagulation (PRP) for proliferative diabetic retinopathy differ from those for a focal laser for macular edema. A fill in PRP is indicated when an active Proliferative diabetic retinopathy (PDR) is seen after the initial PRP is completed. The settings and protocols for laser photocoagulation for lattice degeneration are different, and various techniques of barrage laser are discussed. Practical tips and checklists are given, which will not be found in any textbooks. Highlights: Animated illustrations and fundus photos are used to explain the correct techniques of performing laser photocoagulation in different indications and scenarios. Detailed instructions and checklists are provided, which can be very useful to avoid complications and medicolegal problems. The practical tips and guidelines in an easy?to?understand manner make this video highly educational for the novice retinal surgeons who want to perfect their technique of retinal laser photocoagulation.

Effects of lattice superpulsed CO 2 laser combined with asiaticoside cream ointment on repair of facial depression acne scar / 中华医学美学美容杂志

Objective:To investigate the effect of lattice superpulsed CO 2 laser combined with asiaticoside cream ointment on the repair of facial depression acne scar. Methods:A total of 124 patients with facial acne depression scar who visited the dermatology department of Zhengzhou People's Hospital from January 2019 to December 2020 were selected as subjects, including 60 males and 64 females, aged 16-38 (27.2±4.8) years. According to the random number table, the patients were divided into the control group ( n=62) and observation group ( n=62). The control group were treated with lattice superpulsed CO 2 laser, and the observation group were treated with lattice superpulsed CO 2 laser combined with asiaticoside cream ointment for 6 months. The therapeutic efficacy, Vancouver scar scale (VSS), ECCA score, skin barrier related indicators, pain duration, healing time, delayed duration and adverse reactions were compared between the two groups. Results:The total effective rate in the observation group (91.94%) was significantly higher than that in the control group (77.42%) (χ 2=5.04, P<0.05), pain duration, scab formation time, scab removal time, complete healing time, delay period and the incidence of adverse reactions were significantly lower than those in the control group [(2.76±1.04) h, (2.64±1.03) d, (6.18±1.47) d, (8.87±1.75) d, (7.89±2.16) d, 3.23% vs. (4.11±1.29) h, (3.87±1.14) d, (7.24±1.56) d, (11.05±1.93) d, (10.52±3.01) d, 12.90%, detection value = 6.42, 6.30, 3.90, 6.59, 5.59, 3.92, P<0.05]. After treatment, the VSS scale and ECCA score in the observation group were significantly lower than those in the control group (5.71±1.06, 39.12±10.64 vs. 6.42±1.17, 42.61±11.51, t=3.54, 2.26, P<0.05). After treatment, the water content of cuticle in the observation group was significantly higher than that in the control group [(40.02±14.14) vs. (34.35±11.50) AU, t=2.45, P<0.05], and transepidermal water loss, lactic acid stimulation test score and cuticle protein content were significantly lower than those in the control group [(19.07±5.70) g/(h·m 2), (2.62±1.27) score, (30.12±10.63) μg vs. (21.39±6.51) g/(h·m 2), (3.25±1.89) score, (35.10±11.19) μg, t=2.11, 2.18, 2.54, P<0.05]. Conclusions:Lattice superpulsed CO 2 laser combined with asiaticoside cream ointmentis can effectively treat acne scar and reduce adverse reactions, and the curative effect is better than single laser treatment.

Effects of grid methods on precision and efficiency of specific absorbed fraction calculation in Monte Carlo simulation / 中国辐射卫生

@#<b>Objective</b> To compare the precision and efficiency of computing the specific absorbed fraction (SAF) of a reference human with two grid methods in MCNP6.0. <b>Methods</b> Based on the adult female reference voxel phantom provided by the International Commission on Radiological Protection, assuming the liver as the source organ emitting single-energy photons (0.5 MeV), the SAF of each target organ/tissue was calculated by using the mesh method and repeated structure lattice method with the F4, F6, and *F8 tally cards in MCNP6.0. We compared the methods by assessing the relative deviation of SAF and computing time for 27 organs/tissues. <b>Results</b> Compared with reported data, the absolute values of relative deviations of SAF values for all the organs/tissues were less than 5%, except for the eye lens and skin. By using the repeated structure lattice-based *F8 tally, the relative deviations of SAF values of the organs/tissues were all smallest, but with the longest computing time. The computing time of the mesh-based F4 tally was slightly longer than that of the repeated structure lattice-based F6 tally, which was shortest. <b>Conclusion</b> The *F8 tally simultaneously simulating primary and secondary particle transport showed the highest precision. The mesh tally requireda longer computing time than the lattice tally when using the same tally card.

A method of lung puncture path planning based on multi-level constraint / 生物医学工程学杂志

Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.

Sequential therapy by local injection of triamcinolone acetonide and lattice CO 2 laser for hypertrophic scar / 中华医学美学美容杂志

Objective:To determine the clinical effect of sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser for hypertrophic scar. Methods:A total of 80 hypertrophic scar patients, including 45 male and 35 female, in our clinic were randomly divided into test ( n=40) and control ( n=40) groups from March 2019 to May 2020. Patients aged from 18-42 years with average age 28.1. Patients in test groups were treated with triamcinolone acetonide and lattice CO 2laser sequentially. After final treatments, third-party blind evaluation, Vancouver scar scale, visual analog scale and dermatology life quality index were performed. Results:Test group acquired more satisfied result in third-party blind evaluation (82.5% vs. 52.5%, χ2=8.216, P<0.05). Vancouver scar scale, visual analog scale and dermatology life quality index were not significantly different before treatment for both groups while test group acquired better improvement after treatment ( P<0.05). Conclusions:Sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser is effective for hypertrophic scar and worths wide application in the clinic.

Porous Lattice Structure of Femoral Stem for Total Hip Arthroplasty / Estructura de Diseño Poroso por Latice de Vástago Femoral para Artroplastia Total de Cadera

Abstract Total Hip Arthroplasty (THA) is one of the surgical procedures carried out satisfactorily in procedures for osteoarthritis and trauma lesions. ATC surgery reduces pain and improves the quality of life of young patients. Therefore, it is of great importance to improve the properties of hip implants, since current implants do not match their lifespan with the life expectancy of a young patient. This is because the solid prostheses that currently exist have a higher Young's modulus, and therefore are too rigid compared to the bone tissue. On the other hand, the cyclic and continuous loads to which the hip joint is subjected in daily activities, can cause loosening and consequent implant loss The present work proposes an implant manufactured with a porous lattice structure, which aims to reduce stiffness, allow bone growth and a more effective mechanical load transfer. Three computational models subjected to static charges were evaluated and compared: 1) healthy femur, 2) implanted femur with a commercial prosthesis, and 3) implanted femur with a prosthesis with lattice structure. For the computational analysis it was decided to perform a static analysis of a person standing on the left foot; a load equivalent to the body weight was applied on the head of the femur, balancing the reaction forces in the system of forces (contact force, body weight, and abductor muscle).. The results were shown in terms of displacement, compression and deformation. The model implanted with a prosthesis with a lattice design presented a slight decrease in displacement, and a decrease in compression and deformation values, which indicated that the proposed design has a better distribution and transport of the loads through its structure.

Resumen La artroplastia total de cadera (ATC) es uno de los tratamientos quirúrgicos llevados a cabo de manera satisfactoria en procedimientos para la osteoartritis y lesiones de trauma. La ATC reduce el dolor y mejora la calidad de vida de los pacientes. Por lo tanto, es de gran importancia mejorar las propiedades de los implantes de cadera, ya que los implantes actuales tienen un tiempo de vida útil y deben cumplir con las expectativas de rehabilitación para los pacientes. Esto se debe a que las prótesis sólidas que existen actualmente tienen un módulo de Young más elevado, y por lo tanto son demasiado rígidas a comparación del tejido óseo. Por otro lado, las cargas cíclicas y continuas a las que se ve sometida la articulación de la cadera en actividades diarias, pueden ser causa del aflojamiento y consecuente pérdida del implante. El presente trabajo propone un implante fabricado con una estructura porosa tipo látice, el cual tiene como objetivos reducir la rigidez, permitir crecimiento óseo y una transferencia de cargas mecánicas más efectiva. Se evaluaron y compararon tres modelos computacionales sometidos a cargas estáticas: 1) fémur sano, 2) fémur implantado con una prótesis comercial, y 3) fémur implantado con una prótesis con estructura látice. Para el modelo computacional se optó por hacer un análisis estático de una persona parada sobre el pie izquierdo; donde se aplicó una carga equivalente del peso corporal sobre la cabeza del fémur, equilibrando las fuerzas de reacción en el sistema de fuerzas (fuerza de contacto, peso corporal, y músculo abductor). Los resultados fueron mostrados en términos de desplazamiento, compresión y deformación. El modelo implantado con una prótesis con un diseño tipo látice presentó una ligera disminución de desplazamiento, y disminución en los valores de compresión y deformación, lo que indicó que el diseño propuesto posee una mejor distribución y transporte de las cargas a través de su estructura.

Investigation on peripheral retinal degeneration in civil aviation pilots recruitment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the prevalence on peripheral retinal degeneration and to provide theoretical support for the medical examination of civil aviation pilots recruitment. <p>METHODS: Two thousand four hundred and fifty prospective flight students(Four thousand nine hundred eyes)who received medical examination in Civil Aviation General Hospital from February 2018 to May 2019 were divided into three groups according to diopter after fully mydriatic with tropicamide phenylephrine eye drops(Group A: +3.00 to <-0.50D, Group B: -0.50 to <-3.00D, Group C: -3.00 to -4.50D). The prevalence of peripheral retinal degeneration in each eye was examined, and the results were statistically analyzed. <p>RESULTS:There were five hundred and seventy five students with different types of peripheral retinal degeneration in 2 450 checked students, the prevalence was 23.5%. There was statistical difference in the prevalence of peripheral retinal degeneration in different diopter groups(χ2=65.386, <i>P</i><0.01). There was statistical difference in the prevalence of different types of peripheral retinal degeneration(χ2=351.276, <i>P</i><0.01). There was statistical difference in the prevalence of peripheral retinal degeneration in different parts(χ2=563.712, <i>P</i><0.01). <p>CONCLUSION: Peripheral retinal degeneration is not rare in civil aviation recruitment. The prevalence increases with the progression of myopia, and the lesions are mostly in bitamporal quadrant. It is suggested to identify according to different types.

A self-controlled study on corneal nerve invasion phenomenon of Bowman's membrane in patients with ⅢA lattice corneal dystrophy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze and study the corneal nerve invasion phenomenon of Bowman's membrane in patients with IIIA lattice corneal dystrophy by confocal laser scanning microscopy. Quantitative analysis of 10a continuous observation image data was performed, followed by self-control studies.<p>METHODS: A total of 10 patients(13 eyes)with IIIA Lattice corneal dystrophy were continuously examined by confocal laser scanning microscopy. The data were observed and analyzed. <p>RESULTS: The normal corneal nerve of Bowman's membrane(Grade 0)of IIIA LCD patients gradually decreased with the prolongation of observation time. The nerves of grade I to V involved(amyloid-wrapped nerve fibers)gradually increased correspondingly. So suggested that the corneal nerve invasion of Bowman's membrane(amyloid deposits)in patients with IIIA LCD were gradually increasing with time. <p>CONCLUSION: In patients with type ⅢA lattice corneal dystrophy, there is a neurotropic phenomenon in Bowman's membrane, which gradually worsens with the aggravation of the lesion. This lesion can explain the recurrent epithelial damage of the IIIA LCD from some degrees. Continuous observation of patients with type IIIA LCD by corneal laser confocal microscopy can well understand the development of the lesion and explain its clinical manifestations.

A Method for Fluorescent Diffuse Optical Tomography Based on Lattice Boltzmann Forward Model on GPU Parallelization / 中国医疗器械杂志

Fluorescent Diffuse Optical Tomography (FDOT) is an emerging imaging method with great prospects in fields of biology and medicine. However, the current solutions to the forward problem in FDOT are time consuming, which greatly limit the application. We proposed a method for FDOT based on Lattice Boltzmann forward model on GPU to greatly improve the computational efficiency. The Lattice Boltzmann Method (LBM) was used to construct the optical transmission model. This method separated the LBM into collision, streaming and boundary processing processes on GPUs to perform the LBM efficiently, which were local computational and inefficient on CPU. The feasibility of the proposed method was verified by the numerical phantom and the physical phantom experiments. The experimental results showed that the proposed method achieved the best performance of a 118-fold speed up under the precondition of simulation accuracy, comparing to the diffusion equation implemented by Finite Element Method (FEM) on CPU. Thus, the LBM on the GPU may efficiently solve the forward problem in FDOT.

A Fluorescence Diffusion Optical Tomography System Based on Lattice Boltzmann Forward Model / 中国医疗器械杂志

Fluorescence Diffuse Optical Tomography (FDOT) is significant for biomedical applications, such as medical diagnostics, drug research. The fluorescence probe distribution in biological tissues can be quantitatively and non-invasively obtained via FDOT, achieving targets positioning and detection. In order to reduce the cost of FDOT, this study designs a FDOT system based on Lattice Boltzmann forward model. The system is used to realize two functions of light propagation simulation and FDOT reconstruction, and is composed of a parameter module, an algorithm module, a result display module and a data interaction module. In order to verify the effectiveness of the platform, this study carries out the light propagation simulation experiment and the FDOT reconstruction experiment, respectively comparing the Monte Carlo (MC) light propagation simulation results and the real position of the light source to be reconstructed. Experiments show that the proposed FDOT system has good reliability and has a high promotion value.

Chinese electronic medical record named entity recognition based on sentence-level lattice-long short-term memory neural network / 第二军医大学学报

Objective To propose a conditional random field (CRF) model based on the new word segmentation method Re-entity, and to compare with bi-directional long short-term memory neural network (BiLSTM)-CRF and Lattice-long short-term memory neural network (LSTM). Methods After analyzing the existing entity recognition methods, we proposed CRF method based on Re-entity, BiLSTM-CRF and Lattice-LSTM for the China Conference on Knowledge Graph and Semantic Computing in 2018 (CCKS2018) task one: Chinese clinical named entity recognition, and trained character vector sets at different parameter levels based on different corpora. The comparative experiments on model performance were carried out in the different neural network models for each methods. Finally, the comparative study was carried out based on different input lengths such as the sentence level and the text level. Results Re-entity method can improve the performance of CRF model. Lattice-LSTM model based on sentence level achieved a strict F1-measure of 89.75% on this task, which was higher than the highest F1-measure (89.25%) on the task one of CCKS2018. Conclusion The CRF model based on Re-entity can effectively improve the recognition rate of traditional Chinese medicines in electronic medical records by using normalized Chinese clinical drug. Re-entity method can improve the error accumulation caused by word segmentation in data preprocessing. Lattice structure can better combine the latent semantic information of characters and word sequences. At the same time, sentence-level input can effectively improve the recognition accuracy of neural network models.

Preparation and quality evaluation of licorice flavonoids self-microemulsifying drug delivery system / 中草药

Objective: To study the prescription and preparation technology of licorice flavonoids self-microemulsifying drug delivery system (LF-SMEDDS) and evaluate its quality. Methods: The optimal formulation of LF-SMEDDS was screened by test of solubility, compatibility of oil and emulsifier, and pseudo-ternary phase diagram. Simplex lattice method was applied to optimize formulation with average particle size, polydispersity index and drug loading as evaluation indexes, the physicochemical characteristics, in vitro dissolution and stability were also determined. Results: The optimal prescription composition of LF-SMEDDS was 10% of Cinnamomi Cortex oil, 55% of RH-40, and 35% of 1,2-propanediol. The LF-SMEDDS exhibited uniform and transparent appearance, with the average particle size of (16.30 ± 0.22) nm, polydispersity index of 0.155 ± 0.008, Zeta pontential of (-20.11 ± 0.50) mV and drug loading of (86.03 ± 0.37) mg/g. The results of in vitro dissolution test indicated that the accumulative dissolution of LF was 90.65% at 30 min. The stability experiment showed that LF-SMEDDS was affected by high temperature and illumination, indicating that it should be stored at low temperature and protected from light. Conclusion: The LF-SMEDDS is simple in preparation and stable in quality, significantly increasing the solubility of LF and improving its oral bioavailability, which can provide reference for further research and development about the related preparations of the active fraction.

Study of TGFBI gene mutations in the patients with corneal dystrophy in northeast of China / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the mutation type of TGFBI gene in a lattice-like corneal dystrophy(LCD)family in northeast China. <p>METHODS: A basic ophthalmologic examination was performed on the patients and two normal persons in the family. Genomic DNA of three affected, two unaffected family members and 50 normal individuals was extracted from peripheral leukocytes. All exons of TGFBI were amplified by polymerase chain reaction(PCR)methods and direct sequencing was carried out for mutation analysis. <p>RESULTS: A missense mutation(c.370C>T)in exon 4 of TGFBI led to an amino acid substitution R124C in the TGFBI protein in all affected family members, but the mutation was not detected in normal subjects of the family and control individuals. <p>CONCLUSION: We conclude that the novel mutation R124C causes lattice corneal dystrophy type I in the studied family. It was verified that R124C is a hot spot mutation in LCD I.

Outcomes of keratoplasty in lattice corneal dystrophy in a large cohort of Indian eyes

Purpose: The purpose of this study is to evaluate the outcomes of keratoplasty for lattice corneal dystrophy (LCD) performed at a tertiary eye care center. Methods: A retrospective review of medical records of those patients who were clinically diagnosed to have LCD (72 eyes of 57 patients) and underwent either penetrating keratoplasty (PK, 58 eyes of 46 patients) or deep anterior lamellar keratoplasty (DALK, 14 eyes of 13 patients) between the years 1987 and 2014 was performed. The main outcome measures included demographics, clinical features, and outcomes of keratoplasty. Results: The median follow-up after keratoplasty was 3.1 years (interquartile range [IQR], 9 months to 9 years). The median best-corrected visual acuity (BCVA) was 0.18 (IQR, 0.10�48) (Snellen equivalent 20/30 [IQR, 20/25�/60]) at 4 years postoperatively and 0.65 (IQR, 0.18-0.95) (Snellen equivalent 20/89 [IQR, 20/30�/178]) at 10 years following surgery. DALK eyes had a significantly better BCVA than PK eyes at 2 years following keratoplasty. The median overall survival of grafts was 15.8 years. Late complications included recurrence of LCD (14 eyes), graft infiltrate (23 eyes), graft rejection (15 eyes), graft failure (16 eyes), and glaucoma (14 eyes). Conclusion: The outcomes of graft are similar following PK and deep anterior lamellar keratoplasty; however, the latter appears to provide slightly better visual outcome. Recurrence of dystrophy in the graft and graft infiltrates limit the overall graft survival in both the groups.

Hippocampus MRI Parallel Segmentation Using Three Dimensions Lattice Boltzmann Model with Prior Information / 中国医疗器械杂志

Getting volume change of hippocampus by segmenting on brain MRI is an important step in the diagnose of Alzheimer's disease and other brain disease. Three dimensional segmentation can make use of the correlation of image in gray and spatial position, so it has high accuracy. This paper proposes a novel three-dimensional lattice Boltzmann model combined with the surface evolution of deformable model and taking the prior information as an external force term to constrain the evolution of three dimensional surfaces. In order to solve the problem of high computational cost caused by 3D segmentation, the parallelization of the method is programmed on single GPU platform and dual GPU platform. Comparison experiments were set to test the accuracy of segmentation and computational efficiency between the novel LB method and another method by using 20 real AD patient's MRI from ADNI. In ensuring the accuracy of the segmentation, the time can be reduced to 12.76 s on single GPU platform, and 17.32 s on dual GPU platform, contrasting 132.43 s on CPU platform. It fully validates the characteristics of lattice Boltzmann method which can be highly parallelized.

Noninvasive numerical simulation of coronary fractional flow reserve based on lattice Boltzmann method / 生物医学工程学杂志

In order to investigate the application of lattice Boltzmann method (LBM) in the numerical simulation of computed tomography angiography-derived fractional flow reserve (FFR ), an idealized narrowed tube model and two coronary stenosis arterymodels are studied. Based on the open source code library (Palabos), the relative algorithm program in the development environment (Codeblocks) was improved. Through comparing and analyzing the results of FFR which is simulated by LBM and finite element analysis software ANSYS, and the feasibility of the numerical simulation of FFR by LBM was verified . The results show that the relative error between the results of LBM and finite element analysis software ANSYS is about 1%, which vertifies the feasibility of simulating the coronary FFR by LBM. The simulation of this study provides technical support for developing future FFR application software, and lays the foundation for the calculation of clinical FFR .

The application of high-dose grid radiotherapy technique / 中华放射肿瘤学杂志

High dose grid radiotherapy ( GRID ) refers to a single fraction of high-dose radiation ( 10-25 Gy) in which, beams are divided into multiple small beam lets through a grid collimator or MLC, resulting in non-uniform dose distribution of high and low dose area ("peak-to-valley" effect) in the target volume. Recently, as 3D radiotherapy ( 3DRT) technology emerged, the 2D GRID has been reconfigured into 3D dose LATTICE whereby high doses are concentrated at each lattice vertex within the radiation target volume with drastically lower dose between vertices through multiple focused non-coplanar beams with different radiation techniques. Compared with 2D GRID therapy, 3D LATTICE shows significant effect on"peak-to-valley" and minimizes radiation to surrounding tissues. Experimental and clinical data have shown that LATTICE therapies can reduce toxicity to normal tissue while stimulating bystander effects, endothelial cell death and immunogenic abscopal effects leading to enhanced killing of tumor cells and further improve the control of the local and distant disease. The clinic experience with LATTICE, although limited, has demonstrated favorable outcomes, especially for treating bulky tumors and palliative intend. The exact mechanism of the clinical advantages by LATTICE is not explicitly known and a more comprehensive biological study and clinical trials are called should be carried out.

T1ρ magnetic resonance imaging for liver fibrosis detection and staging / 上海交通大学学报（医学版）

Objective· To investigate the value of three-dimensional spin-lattice relaxation (T1ρ) magnetic resonance imaging (MRI) for liver fibrosis detection and staging and compare with two-dimentional real-time shear wave elastography (SWE). Methods · Twenty-nine rabbit models of CCl4-induced liver fibrosis were established and six untreated rabbits served as controls. T1ρ MRI and two-dimentional real-time SWE examinations were performed at 2, 4, 6, 8, 10 and 12 weeks, respectively. T1ρ values and liver stiffness (LS) values were measured. Fibrosis was staged according to the METAVIR scoring system. Correlation test was performed among T1ρ values, LS values and fibrosis staging. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of T1ρ and SWE in detection of fibrosis. Results · There was a moderate positive correlation between fibrosis staging and T1ρ values (r=0.566, P=0.000), and a significantly positive correlation between fibrosis staging and LS values (r=0.726, P=0.003).Areas under ROC were 0.861 for SWE and 0.856 for T1ρ(P=0.940),0.906 for SWE and 0.849 for T1ρ(P=0.414),0.870 for SWE and 0.799 for T1ρ (P=0.422), and 0.846 for SWE and 0.692 for T1ρ (P=0.137), when diagnosing liver fibrosis with ≥?F1, ≥?F2, ≥?F3 and F4 stage, respectively. Conclusion · T1ρ imaging has potential for liver fibrosis detection and staging with good diagnostic capability similar to that of SWE.

Pedigree and clinical characteristics in a Chinese family with lattice corneal dystrophy / 中华实验眼科杂志

Background Lattice corneal dystrophy (LCD) is a progressive disease,whose clinical features are varied in different stages.It is rarely be reported that clinical findings of different stages and factors of promoting the occurrence and development on LCD in a family.Objective The aim of this study was to identify the characteristics of the pedigree and clinical features of different stages in a LCD family,and further to discuss its influence factors.Methods A cross-sectional study was performed in this study.A Chinese family with LCD was enrolled in Shenzhen Eye Hospital from 2015 to 2016.Questionnaires for disease-related history,visual acuity measurement,ocular anterior segment examination and color photography were carried out for all the members of the family.In addition,anterior segment OCT (AS-OCT),laser scanning confocal microscope and corneal endothelium microscope were used to observe the morphology of corneal stroma and changes of corneal endothelial cells.The pedigree chart was drawn by Cyrillic2.1 software and analyzed based on Mendel law.Results This family included 5 generations of 73 members.Patients with LCD were found in each generation with similar morbidity in different gender,which followed the law of autosomal dominant inheritance.Eleven patients were found in 49 members related with Ⅲ1 of this family with the prevalence rate of 22.45％ and onset age at 21-50 years old,and the course of disease was 3-34 years.All of the members had no systemic disease except for two patients (Ⅲ 1 and Ⅲ 5) with hypertension.In the early stage of LCD,some bifurcate striolae appeared in the patients' corneal stroma without symptoms for many years.In the progressive stage,there was corneal irritation symptom accompanying with vision's decrease in the eyes with LCD.The bifurcate striolae were increased,widened and interwoven into lattice lines that the boundaries gradually became fuzzy,then corneal macula was formed because of recurrent corneal infiltration,and eventually resulted in corneal leucoma.High reflection corresponding to the pathologic region was showed by laser scanning confocal microscope and AS-OCT.No significant differences were found in corneal endothelial cell density and the percentage of hexagonal cells between LCD patients and normal phenotype families (t =1.887,P=0.075;t=-0.719,P =0.481).Penetrating keratoplasty was performed in a patient with corneal opacity and serious corneal opacity occurred near the surgical incision one year after the surgery.One patient was diagnosed as LCD 2 years after laser assisted in-situ keratomileusis.One patient was a welder.Conclusions LCD is autosomal dominant inheritance in the family.The clinical manifestations of LCD in the early,progressive and late stage can be seen in the pedigree,which offers a reference for ophthahnologists.Corneal surgery and lesion may induce the onset or aggravation of LCD.

Mutation Analysis of the TGFBI Gene in Consecutive Korean Patients With Corneal Dystrophies

BACKGROUND: Mutations in the transforming growth factor beta-induced gene (TGFBI) are major causes of genetic corneal dystrophies (CDs), which can be grouped into TGFBI CDs. Although a few studies have reported the clinical and genetic features of Korean patients with TGFBI CD, no data are available regarding the frequency and spectrum of TGFBI mutations in a consecutive series of Korean patients with clinically diagnosed CDs. METHODS: Patients with any type of CD, who underwent both ophthalmologic examination and TGFBI gene analysis by Sanger sequencing at a tertiary care hospital in Seoul, Korea from 2006 to 2013, were enrolled in this study. RESULTS: Among a total of 89 patients, 77 (86.5%) were diagnosed as having clinical TGFBI CD. Seventy-three out of 74 patients (98.6%) with granular CD type 2 (GCD2), had the p.R124H mutation. Of particular note, one patient with rapidly progressive CD had the p.R124H mutation as well as a novel nonsense variant with unknown clinical significance (p.A179*). In three patients with lattice CD type 1 (LCD1), one known mutation (p.R124C) and two novel variants (p.L569Q and p.T621P) in the TGFBI gene were identified. CONCLUSIONS: This study provides epidemiological insight into CDs in a Korean population and reaffirms that GCD2 is the most common TGFBI CD phenotype and that p.R124H is the only mutation identified in patients with GCD2. In addition, we broaden the spectrum of TGFBI mutations by identifying two novel missense variants in patients with LCD1.