Endolymphatic sac tumor with intralabyrinthine hemorrhage: a case report / 临床耳鼻咽喉头颈外科杂志

A 27-year-old female patient suffering endolymphatic sac tumor with intralabyrinthine hemorrhage was reported. The patient had hearing loss in the left ear with continuous tinnitus, and MRI showed the soft tissue shadow of endolymphatic sac. Considering that the tumor involved semicircular canal and vestibule,endolymphatic cyst tumor resection was performed by labyrinth route. After surgery, there was no cerebrospinal fluid leakage and facial nerve function was normal. More importantly, enhanced MRI of temporal bone showed no tumor recurrence 1 year after surgery.

Clinical analysis and curative effect of reactivation of retinopathy of prematurity after intravitreous injection of ranibizumab / 中华眼底病杂志

Objective:To observe the clinical characteristics and therapeutic effect of reactivation of retinopathy of prematurity (ROP) patients after intravitreal injection of ranibizumab (IVR).Methods:A retrospective case series study. Eleven children with ROP (21 eyes) who were reactivated after IVR in Shenzhen Eye Hospital from January 2019 to October 2021 were included in the study. Among them, there were 6 males (11 eyes) and 5 females (10 eyes), with the gestational age of (27.6±2.2) weeks and birth weight of (1 034.6±306.5) g. At the first IVR treatment, 14 eyes (63.7%, 14/22) had acute ROP (AROP), 8 eyes (36.3%, 8/22) had threshold lesions. Post-reactivation treatments include IVR, retinal laser photocoagulation (LP), or minimally invasive vitrectomy (MIVS). The follow-up time after treatment was 12 to 18 months. Birth gestational age, birth weight, treatment method, corrected gestational age at treatment, lesion stage before and after treatment, lesion reactivation and regression time were recorded. The clinical characteristics and efficacy were observed and analyzed.Results:The time from initial IVR treatment to reactivation was (8.2±3.5) weeks. The corrected gestational age of the child was (43.62±4.08) weeks. In 21 eyes, AROP, threshold lesion, prethreshold lesion, and stage 4 lesion were in 2, 4, 12, and 3 eyes, respectively. The patients were treated with IVR, LP, IVR+LP, IVR+MIVS in 2, 13, 4 and 2 eyes, respectively. After the first reactivation treatment, the time of regression and stability was (8.4±4.9) weeks after treatment. There were 5 eyes with secondary reactivation of the lesion, and the lesion stages were stage 3, stage 4a and stage 5 in 2, 1 and 2 eyes, respectively. The mean reactivation time was (19.3±6.0) weeks after the last treatment. The patients in stage 3, stage 4a and stage 5 were treated with LP, LP+MIVS and IVR, respecitively, and the lesions subsided steadily during follow-up. At the last follow-up, 19 out of 21 eyes showed complete regression of the lesions, stable photocoagulation, regression of crista-like lesions, no additional lesions, and retinal leveling. All retinal detachment was "funnel-shaped" in 2 eyes.Conclusions:The lesion reactivation of AROP after IVR treatment is more common. The early reactivation rate is higher after treatment. There is a possibility of reactivation twice after re-treatment.

Antagonistic effect of SC79 on high glucose-induced apoptosis of RPE cells and its regulatory mechanism on AKT-XIAP signaling pathway / 中华实验眼科杂志

Objective:To investigate the antagonistic effect and potential mechanism of specific AKT activator SC79 on the apoptosis of human retinal pigment epithelial (ARPE)-19 cells induced by high glucose in vitro. Methods:The ARPE-19 cells were cultured in high glucose medium (containing 30 mmol/L glucose) plus 5, 10 or 20 μg/ml SC79, respectively.After 6-, 12- and 24-hour culture, the optimal experimental concentration and timing were determined according to cell proliferation rate.Then ARPE-19 cells were divided into four groups, normal control group cultured in normal medium containing 5.6 mmol/L glucose for 48 hours, mannitol group cultured in medium containing 5.6 mmol/L glucose and 24.4 mmol/L mannitol for 48 hours, high glucose group cultured in high glucose medium for 48 hours, and high glucose+ SC79 group cultured in normal medium containing 10 μg/ml SC79 for 12 hours plus in high glucose medium for 36 hours.The proliferation rate of APRE-19 cells was detected by MTS assay.The apoptosis rate was measured by flow cytometry.The relative expression levels of phosphorylated protein kinase B (p-Akt), X-linked inhibitor of apoptosis protein (XIAP), caspase-9, caspase-3 and its active fragments (active-caspase-3) were assayed by Western blot.The ARPE-19 cells were divided into Neg-shRNA group, AKT shRNA group and blank control group and were treated with the corresponding transfection complex and serum-free medium.The AKT mRNA expression was detected by real-time PCR.The transfected ARPE-19 cells were divided into Neg-shRNA+ SC79 group and AKT shRNA+ SC79 group and were cultured according to the culturing method of high-glucose+ SC79 group.The apoptosis rate of the two groups was tested by flow cytometry.Results:Among different concentrations of SC79 and treatment times, the proliferation rate of cells treated with 10 μg/ml SC79 for 12 hours was the highest.The proliferation rate of ARPE-19 cells in high-glucose group was significantly lower than that in normal control group, mannitol group and high-glucose+ SC79 group, and the differences were statistically significant (all at P<0.01). The apoptosis rate of cells in the high-glucose group was (52.27±3.21)%, which was significantly higher than (3.90±0.71)% in normal control group and (20.70±3.62)% in high-glucose+ SC79 group (both at P<0.01). The relative expression levels of p-Akt, XIAP, caspase-9 and caspase-3 were significantly lower and the relative expression level of active-caspase-3 was significantly higher in high glucose group than those in normal control group and high-glucose+ SC79 group (all at P<0.05). The relative expression level of AKT mRNA in normal control group, Neg-shRNA group and AKT shRNA group was 0.60±0.07, 0.59±0.03 and 0.11±0.10, respectively, showing a statistically significant difference among the groups ( F=30.44, P<0.01). The apoptosis rate of cells in the AKT shRNA+ SC79 group was significantly higher than that in high-glucose+ SC79 group and Neg-shRNA+ SC79 group (both at P<0.001). Conclusions:SC79 can partially antagonize the apoptosis of ARPE-19 cells induced by high glucose, which is related to the activation of AKT/XIAP pathway and the inhibition of the caspase family.

Effect of anti-VEGF intravitreal injections on the development of nervous system in retinopathy of prematurity / 中华实验眼科杂志

Retinopathy of prematurity (ROP) is a blinding eye disease characterized by abnormal proliferation of retinal blood vessels in children.Vascular endothelial growth factor (VEGF) can specifically stimulate retinal vascular endothelial cell proliferation and neovascularization.Retinal ischemia and hypoxia in preterm infants promote the compensatory increase of intraocular VEGF expression, and then induce the pathological growth of retinal vessels.The intravitreal injection of anti-VEGF drugs provides a new therapeutic way for ROP by inhibiting the biological activity of VEGF and delaying retinal neovascularization.However, the blood-retina barrier of children with ROP is likely to be destructed, which can cause the imbalanced homeostasis of the retinal microenvironment.The anti-VEGF drugs can cause irreversible damage to nerve cells through the blood-retina barrier and blood-brain barrier, which affects the development of the nervous system in children with ROP.At present, whether anti-VEGF drugs result in the abnormal development and functional changes of nervous system in premature infants remains unknown and attracts much attention.In this paper, the role of VEGF in the pathogenesis of ROP and neurodevelopment, as well as the effects of anti-VEGF drug intravitreal injections on the neurological development of children with ROP were reviewed to provide the clinical basis for the rational and safe application of anti-VEGF drugs.

Comparison of the thickness of macular ganglion cell inner plexiform layer in patients with a history of laser photocoagulation versus intravitreal injection of ranibizumab for retinopathy of prematurity / 中华眼底病杂志

Objective:To compare the thickness of the macular ganglion cell inner plexiform layer (mGCIPL) in patients with a history of laser photocoagulation (LP) versus intravitreal injection of ranibizumab (IVR) for retinopathy of prematurity (ROP).Methods:A retrospective clinical study. From June 2020 to January 2021, 70 eyes of 35 children with a history of surgery for ROP in Shenzhen Eye Hospital were included in the study. Among them, 18 males had 36 eyes, and 17 females had 34 eyes. The average age was 5.54±1.04 years. There were 18 patients (36 eyes) in LP group and 17 patients (34 eyes) in IVR group. There was no significant difference in age ( t=-1.956), sexual composition ratio ( χ2=0.030), birth gestational age ( t=-1.316) and birth weight ( t=-1.060) between the two groups ( P=0.059, 0.862, 0.197, 0.297). All the eyes underwent the examination of optical coherence tomography (OCT). An elliptical region of 14.13 mm 2 centered on macular fovea was scanned according to the macular cube 512×128 model of the Cirrus HD-OCT 5000. The software was used to automatically divide macular fovea into six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum thickness of mGCIPL. t test was used to compared mGCIPL thickness between two groups using independent samples. Pearson correlation analysis was used to evaluate the correlation between mGCIPL thickness and age, birth gestational age, birth weight. Results:Patients in IVR group had significantly decreased mGCIPL thickness than that in LP group in the six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum ( t=6.484, 6.719, 7.682, 7.697, 5.151, 5.008, 7.148, 6.581; P<0.05). The thickness of mGCIPL was not significantly correlated with age, birth gestational age, birth weight ( P>0.05). Conclusion:The thickness of mGCIPL in patients with IVR treatment history is thinner than that in LP treatment.

Pay attention to the effect of anti-vascular endothelial growth factor drugs on neurodevelopment in children with retinopathy of prematurity / 中华眼底病杂志

Retinopathy of prematurity (ROP) is one of the leading causes of visual impairment in children. As understanding on the pathogenesis of ROP accumulated, anti-vascular endothelial growth factor (VEGF) drugs and their application have changed the treatment mode. Anti-VEGF therapy, with convenient operation and clear efficacy, has become an important treatment method for ROP. However, due to the dysfunction of organs in children with ROP, anti-VEGF drugs can enter blood circulation after intravitreal injection and then lead to temporarily reduction of the VEGF level in the blood, which may theoretically cause adverse effects on the development of all organs (especially the brain) in children with ROP. Therefore, it's necessary to pay attention to the effect of anti-VEGF drugs on neurodevelopment in children with ROP, strictly grasp the indications, and standardize its clinical application, so as to continuously improve the overall prognosis of ROP.

Analysis of epidemiological characteristics and clinical features of 480 hospitalized patients with dengue fever in Guangdong Province in 2019 / 中华传染病杂志

Objective:To analyze the epidemiological and clinical characteristics of hospitalized patients with dengue fever in Guangdong Province in 2019, so as to provide reference for clinical diagnosis and treatment of dengue fever.Methods:The general data, laboratory examination data, clinical manifestations and prognosis data of 480 inpatients with dengue fever admitted to Eight People′s Hospital Affiliated to Guangzhou Medical University between January 4 and October 31, 2019 were analyzed retrospectively. The clinical and onset characteristics of patients with dengue fever were described.Results:Among 480 dengue patients, 442(92.1%) were dengue fever, 38(7.9%) were severe dengue, and 136(28.3%) had underlying diseases. The peak age of onset was mainly in young adults aged 20 to 49 years old, accounting for 66.0%(317/480) in total. The seasonal peak was mainly in August to October. There were 399(83.1%) local cases and 61(12.7%) imported cases. The most common clinical manifestations were fever (98.1%, 471/480), chills (72.9%, 350/480), headache (58.5%, 281/480) and bone/joint/muscle pain (67.1%, 322/480), followed by digestive tract symptoms and respiratory tract symptoms. Among 446 serum samples, 358 (80.3%) were dengue virus (DENV)-1, 54 (12.1%) were DENV-2, 34 (7.6%) were DENV-3. The main laboratory tests of the patients were leucopenia (65.8%, 316/480), low hematocrit (30.2%, 145/480), thrombocytopenia (48.3%, 232/480), neutropenia (44.8%, 215/480), elevated alanine aminotransferase (ALT) (37.7%, 181/480) and aspartate aminotransferase (AST) (59.4%, 285/480). Treatment mainly adopted symptomatic support treatment and active prevention of complications. The length of stay was (5.8±3.1) days (range 1.0-38.0 days). A total of 461(96.0%) patients were cured or improved.Conclusions:In 2019, the majority of dengue fever patients in Guangdong Province are young adults aged 20 to 49 years old, and the proportion of severe patients is high, with DENV-1 infection as the main type. After symptomatic support treatment and active prevention of complications, most of the dengue fever patients have a good prognosis.

Optical coherence tomography angiography of macula in retinopathy of prematurity children with single treatment history / 中华实验眼科杂志

Objective:To observe the changes of macular morphology and best corrected visual acuity (BCVA) in children with retinopathy of prematurity (ROP) after single treatment of laser photocoagulation or intravitreal injection of ranibizumab (IVR) by optical coherence tomography angiography (OCTA).Methods:A cross sectional study was conducted.Fourteen cases (23 eyes) of ROP children with a treatment history aged 4-10 years were enrolled as the ROP group in Shenzhen Eye Hospital from April to August 2018, with 8 cases (16 eyes) of age-matched full-term children as control group.Among the ROP group, 9 cases (14 eyes) receiving photocoagulation were set as the photocoagulation group and 5 cases (9 eyes) receiving IVR as the injection group.The 3 mm×3 mm scanning mode of OCTA was adopted to measure the area of foveal avascular zone (FAZ), FAZ morphological index, superficial retinal vascular density (VD) and superficial retinal perfusion density (PD), and the B-scan mode was used to determine the central foveal thickness (CFT). BCVA of all children was recorded and analyzed.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shenzhen Eye Hospital (No.b-03). Written informed consent was obtained from guardians prior to any examination.Results:Compared with the control group, there was smaller area of FAZ, more irregular FAZ morphology and thicker CFT in the ROP group.The central fovea of macula in the laser photocoagulation group was shallow and almost indiscernible, and FAZ morphology was irregular.The FAZ area, FAZ morphological index, VD and PD in the ROP group were (0.09±0.08) mm 2, 0.51±0.25, (19.18±2.50)mm/mm 2 and 0.35±0.04, respectively, which were significantly lower than (0.32±0.08)mm 2, 0.68±0.07, (20.94±0.93)mm/mm 2, 0.38±0.02, respectively in the control group ( t=-8.03, -3.14, -3.02, -2.52; all at P<0.05). The CFT in the ROP group was (215.00±21.32) μm, which was significantly thicker than (164.29±20.20) μm in the control group ( t=8.91, P<0.05). There was no statistical difference in BCVA between the two groups ( t=0.16, P=0.87). The CET in the laser photocoagulation group was significantly thicker than that in the injection group ( t=3.50, P=0.01). Conclusions:There are obvious morphology changes of macula in ROP children with single treatment history of laser photocoagulation or IVR, while the BCVA is not significantly affected by the treatment.

Value the standardized treatment of pediatric retinal diseases to improve its treatment level / 中华眼底病杂志

In recent years, with the deepening of understanding of children's retinal diseases and the continuous updating of treatment techniques, the efficacy of children's retinal diseases has also been improved. Due to the particularity of the anatomical structure of the retina of children in the growth and development stage and the pathogenesis, clinical manifestations and outcomes of children's retinal diseases are different from those of adults, the principles of treatment of adult retinal diseases cannot be directly applied to children's retinal diseases. Cryotherapy, laser photocoagulation, intravitreal injection of anti-VEGF drugs, and vitreoretinal surgery are the main treatment methods for children's retinal diseases. However, there are still many problems in the selection of indications, equipment parameters, and treatment of complications. The treatment norms of the disease need to be further improved. Therefore, research on the treatment of children's retinal diseases, and the establishment of surgical standards and norms through expert consensus and other methods are helpful for the treatment of children's retinal diseases.

Clinical observations of micro-incision vitrectomy surgery for retinopathy of prematurity with early intervention failure / 中华眼底病杂志

Objective:To evaluate the safety and efficacy of 27G micro-incision vitrectomy surgery (MIVS) combined with intravitreal injection of ranibizumab (IVR) in the treatment of retinopathy of prematurity (ROP) with early intervention failure.Methods:Retrospective case series was performed. Fourteen eyes (11 infants) with ROP who underwent 27G MIVS combined with IVR were included from March 2016 to January 2018 in Shenzhen Eye Hospital. Among them, there were 5 males with 7 eyes, 6 females with 7 eyes. The average gestational age of the infants was 28.12±0.90 weeks; the average birth weight was 1 023.64±200.96 g. Before the early clinical intervention, 1 infant (2 eyes) had ROP in zone Ⅰ stage 3 with plus disease, 8 infants (10 eyes) had ROP in zone Ⅱ stage 3 with plus disease, and 2 infants had ROP in aggressive posterior ROP. Six eyes underwent laser photocoagulation, while 8 eyes received laser therapy combined with IVR. Six eyes of stage 4A ROP and 8 eyes in stage 4B. Retinal detachment was detected with a mean of 10.44±9.21 weeks. At the time of surgery, the average post-conceptional age was 48.02±8.09 weeks. All the affected eyes were treated with standard sclera with three incisions 27G MIVS. During the operation, only local vitrectomy was performed to release and clear fibroascular proliferation in the optic disc, anterior macular area and pericristal area. After surgery, 10 mg/ml of ranibizumab 0.03 ml was injected into the vitreous cavity. The average follow-up time was 23.36±8.34 months. The primary objectives were the condition of retinal reset, ROP progression control and complications.Results:All patients had uneventful surgeries with an average duration of 32.86±9.35 mins. Of the 14 eyes, 12 eyes (85.71%) were controlled, 8 eyes (57.14%) had a good rearrangement of macular structure, while 4 eyes with macular traction. Two eyes had ROP progression, recurrence of retinal detachment, posterior synechia. Complicated cataract was in 1 eye. Proliferative vitreoretinopathy and retinal detachment was in 1 eye after 7 months the operation.Conclusion:27G MIVS combined with IVR is a safe and effective treatment for ROP with early clinical intervention failure.

Relationship between tumor necrosis factor-α and retinopathy of prematurity / 中华眼底病杂志

The exact pathophysiological mechanisms of retinopathy of prematurity (ROP) remain elusive. The risk factors of ROP include excessive oxygen therapy, malnutrition, infection and inflammation. Among the factors above, the effect of inflammation on ROP has received more attention. TNF-α is a biological active protein which is involved in neovascularization and inflammation. It may play a role in the development of ROP. This review summarized the studies on the association between TNF-α and ROP in recent years, so as to provide a new way to further study the pathogenesis and treatment methods of ROP.

Epidemiology, clinical characteristics and treatment in 278 patients with coronavirus disease 2019 in Guangzhou / 中华内科杂志

Objective:To retrospective analyze the epidemiology, clinical characteristics, treatment and prognosis in patients with coronavirus disease 2019 (COVID-19).Methods:A total of 278 patients with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were selected. The general demographic data, epidemiological data, clinical symptoms, laboratory examinations, lung CT imaging, treatment and prognosis were analyzed.Results:There were 130 male patients (46.8%) and 148 females (53.2%) with age (48.1±17.0) years and 88.8% patients between 20-69 years. Two hundred and thirty-six (84.9%) patients had comorbidities. Two hundred and eleven cases (75.9%) were common type. The in-hospital mortality was 0.4% (1/278). The majority (201, 72.3%) were imported cases mainly from Wuhan (89, 44.3%). The most common clinical manifestations were fever (70.9%) and dry cough (61.5%). In some patients, hemoglobin (10.4%), platelets (12.6%) and albumin (55.4%) were lower than the normal range. Other biochemical tests according to liver and function were normal, while lactic dehydrogenase (LDH) was elevated in 61 patients (21.9%), creatine kinase increased in 26 patients (9.4%). Prolonged activated partial thromboplastin time (APTT) was seen in 52 patients (18.7%), D-dimer higher than normal in 140 patients (50.4%), while 117 patients (42.1%) had elevated high-sensitivity C-reactive protein. Typical CT manifestations included single or multiple ground glass shadows especially in lung periphery in early disease which infiltrated and enlarged during progressive stage. Diffuse consolidation with multiple patchy density in severe/critical cases and even "white lung" presented in a few patients. Two hundred and forty-two patients (87.1%) received one or more antiviral agents, 242 (87.1%) combined with antibacterials, 191 (68.7%) with oxygen therapy. There were 198 patients (71.2%) treated with traditional Chinese medicine.Conclusions:COVID-19 could attack patients in all ages with majority of common type and low mortality rate. Clinical manifestations involve multiple organs or systems. Progression of the disease results in critical status which should be paid much attention.

Clinical characteristics and CT imaging features of patients with different clinical types of coronavirus disease 2019 / 中华危重病急救医学

Objective:To investigate the clinical characteristics and CT imaging features of patients with different clinical types of coronavirus disease 2019 (COVID-19), so as to provide a reference for the treatment and evaluation of COVID-19.Methods:The clinical data of 278 patients with COVID-19 admitted to Guangzhou Eighth People's Hospital from January 20th to February 10th in 2020 were collected. The patients were divided into mild, ordinary, severe and critical types. The differences of clinical symptoms and signs, laboratory examination indexes and CT image features of lung in different clinical types were analyzed and compared, and the relationship between clinical and imaging features and clinical types of diseases were analyzed.Results:Among the 278 patients with COVID-19, 130 were male (46.8%) and 148 were female (53.2%), of whom 88.8% (247/278) were 20 to 69 years old. 238 (85.6%) patients combined one or more basic diseases. The source of cases was mainly imported cases ( n = 201, 72.3%), of whom 89 cases were imported from Wuhan, accounting for 44.3% of all imported cases. With the aggravation of the disease, the male composition ratio, age and the number of basic diseases of patients gradually increased, and the incidences of fever, dry cough, chilly or chills, and fatigue in severe and critical patients were significantly higher than those in the mild and ordinary ones. The white blood cell count (WBC), neutrophil counts (NEU) and proportions (NEU%) of the severe and critical patients were higher than those of the mild and ordinary patients [WBC (×10 9/L): 5.7±3.1, 6.5±2.4 vs. 5.4±1.7, 4.9±1.6; NEU (×10 9/L): 4.4±3.1, 4.9±2.5 vs. 2.8±1.2, 2.9±1.3; NEU%: 0.72±0.13, 0.73±0.14 vs. 0.51±0.12, 0.59±0.11; all P < 0.01], while the lymphocyte count (LYM) and ratio (LYM%), platelet count (PLT) were lower than those in the mild and ordinary patients [LYM (×10 9/L): 1.0±0.4, 1.2±0.8 vs. 2.1±0.9, 1.5±0.6; LYM%: 0.21±0.11, 0.20±0.12 vs. 0.40±0.11, 0.32±0.11; PLT (×10 9/L): 177.1±47.8, 157.7±51.6 vs. 215.3±59.7, 191.8±64.3; all P < 0.05]. The level of albumin (Alb) was the lowest in the critical patients and the level of total bilirubin (TBil) was the highest, which was statistically significant as compared with the mild, ordinary and severe patients [Alb (g/L): 33.0±5.8 vs. 42.8±4.4, 39.6±5.1, 34.4±4.2; TBil (μmol/L): 20.1±12.8 vs. 12.0±8.7, 10.9±6.3, 12.2±8.3; both P < 0.01]. Lactate dehydration (LDH) and cardiac troponin I (cTnI) in the severe and critical patients were significantly higher than those in the mild and ordinary patients [LDH (μmol·s -1·L -1): 5.6±2.2, 5.0±2.9 vs. 2.8±0.9, 3.3±1.2; cTnI (μg/L): 0.010 (0.006, 0.012), 0.010 (0.006, 0.012) vs. 0.005 (0.003, 0.006), 0.005 (0.001, 0.008); both P < 0.05]. C-reactive protein (CRP) level of severe patients were higher than that in the mild, ordinary and critical patients [mg/L: 43.3 (33.2, 72.1) vs. 22.1 (16.2, 25.7), 29.7 (19.8, 43.1), 25.8 (23.0, 36.7), P < 0.01]. The level of procalcitonin (PCT) in the severe and critical patients was higher than that in the mild and ordinary patients [μg/L: 0.17 (0.12, 0.26), 0.13 (0.09, 0.24) vs. 0.06 (0.05, 0.08), 0.05 (0.04, 0.09), P < 0.01]. The typical CT imaging features were as follows: the ordinary type mainly showed the single or multiple ground glass shadows on the chest image; the severe type mainly showed the multiple ground glass shadows, infiltration shadows or solid transformation shadows. Compared with the ordinary patients, the lesions increase, and the scope of the lesion expanded to show double lungs. Critical type was mainly manifested as diffuse consolidation of both lungs with multiple patchy density increase shadows, multiple leafy patchy density increase shadows were seen on each leaf, most of them were ground glass-like density, and some were shown separately lung consolidation. Conclusions:Men, advanced aged, and combining multiple underlying diseases are high-risk populations of COVID-19, and they should pay close attention to the risk of progressing to severe or critical type. CT imaging features could be used as an important supplement when diagnosing severe and critical COVID-19.

Role of adiponectin in retinopathy of prematurity / 中华实验眼科杂志

Retinopathy of prematurity (ROP) is a disease which the retinal vascular system is not mature at birth, leading to cessation of development and abnormal proliferation of blood vessels, in a relatively high oxygen environment.Adiponectin (APN) is an endogenous bioactive protein secreted by adipocytes.It has functions of regulating Glucose and lipid metabolism, inhibiting atherosclerosis and protecting the cardiovascular system.APN can inhibit angiogenesis which may be involved in the occurrence and development of ROP in recent research.APN may be regulating the serum level of tumor necrosis factor α (TNF-α), insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF) A to prevent the development of ROP.The expression of APN is also affected by fibroblast growth factor 21 (FGF-21) and long-chain polyunsaturated fatty acids (ω-3 LCPUFAs) at the same time.Understanding the role of APN in ROP can provide new ideas for further study of the pathogenesis and prevention and treatment of ROP.

Comparative study of left ventricular hemodynamic changes after Revivent surgery by dual‐modality imaging / 中华超声影像学杂志

Objective To investigate the hemodynamic changes before and after Revivent surgery in patients with left ventricular apical aneurysm by cardiac magnetic resonance imaging ( CM R ) and echocardiography . Methods Twenty‐two cases with left ventricular apical aneurysm were examined by two‐dimensional and three‐dimensional transthoracic echocardiography 1 week before operation ,1 month and 12 months after operation ,by CM R 1 week before operation and 12 months after operation .Left ventricular end‐diastolic volume( LVEDV ) ,left ventricular end‐systolic volume ( LVESV ) ,left ventricular end‐diastolic diameter ( LVEDd ) , left ventricular end‐systolic diameter ( LVESd ) , left ventricular ejection fraction ( LVEF) ,stroke volume ( SV ) ,stroke output index ( SVI) ,cardiac output ( CO ) and cardiac output index ( CI) were quantitatively measured and statistical analysis were performed . Results T here were significant differences between preoperation and 1 month after operation for the measurements of LVEDV ,LVESV , LVEDd and LVEF by both CM R and echocardiography ( all P ＜ 0 .05 ) . Compared with preoperation , LVESd decreased significantly 12 months after operation ( P ＜0 .01) . However ,there were no significant differences between preoperation and 1 or 12 months after operation for the measurements of SV ,SVI ,CO and CI ( all P ＞ 0 .05 ) . T he consistency between CM R and echocardiography measurements was good . Conclusions Revivent surgery provides an effective and feasible treatment for patients with left ventricular apical ventricular aneurysm . T he dual‐modality imaging with CM R and echocardiography are reliable technical means to evaluate the changes of left ventricular heamodynamiscs during the perioperative period of Revivent

Comparison of diagnostic values between myocardial perfusion imaging and dual source CT coronary angiography in coronary artery stenosis in patients with diabetes complicated with coronary heart disease / 吉林大学学报(医学版)

Objective:To evaluate and compare the diagnostic values between myocardial perfusion imaging (MPI)and dual source CT coronary angiography(DS-CTCA)in coronary artery stenosis in the diabetic patients with coronary heart disease(CHD),and to elucidate the clinical application values of MPI combined with DS-CTA in the diabetic patients with CHD.Methods:A total of 52 diabetic patients with CHD underwent the examinations of MPI and DS-CTCA were selected.The degrees of coronary artery stenosis of branches of coronary artery were compared between MPI examination and DS-CTCA examination,including left main coronary artery(LM),left anterior descending coronary artery(LAD),left circumflex branch(LCX)and right coronary artery(RCA).Based on the coronary angiography(CAG)regarded as the golden standard,the specificity,sensitivity and accuracy of each imaging examination method were compared;the specificities,sensitivities and accuracies of parallel diagnosis and serial diagnosis of two kinds of methods were also compared.Results:The stenosis degrees of LM and LAD were no different between MPI examination and DS-CTCA examination(P>0.05),but the stenosis degrees of LCX and RCA were different between two imaging examination methods(P<0.05).Compared with MPI examination, the sensitivity of DS-CTCA examination in the diabetic patients with CHD was decreased(71.0%vs 90.1%),and the difference was significant(P=0.035);the specificity of DS-CTCA examination in the diabetic patients with CHD was increased(85.7%vs 58.4%),and the difference was significant(P=0.027);but the accuracies of two examinations in the diabetic patients with CHD were no different(76.4%vs 78.4%)(P=0.062).Compared with parallel diagnosis,the specificity and accuracy of serial diagnosis were increased(93.5% vs 33.8%,P=0.001;94.7%vs 71.2%,P = 0.030);but the sensitivities had no difference(95.4% vs 93.1%,P = 0.074). Conclusion:The diagnostic accuracy of evaluating the degree of coronary artery stenosis in the diabetic patients with CHD is not different between DS-CTCA examination and MPI examination. And the serial diagnosis of two examination methods can improve the diagnostic accuracy.

Effect of retinal hemorrhage on laser photocoagulation in patients with retinopathy of prematurity / 中华眼底病杂志

Objective To observe the effect of retinal hemorrhage on the treatment of retinopathy of prematurity (ROP) by laser photocoagulation.Methods Retrospective case analysis.Screening and diagnosis of 134 eyes in 67 patients with ROP in Zone IⅡ Stage 3+ were included in the study.Among them,32 patients were male and 35 patients were female.The average birth gestational age was 27.80 ± 2.55 weeks.The average birth weight was 1060± 320 g.All children underwent binocular indirect ophthalmoscopy and RetCam Ⅲ.Of the 134 eyes,38 eyes (28％) with anterior,ridge or vitreous hemorrhage (group A);96 eyes (72％) without hemorrhage.Retinal avascular photocoagulation was performed within 72 hours after diagnosis by intravenous sedative combined with ocular surface anesthesia with 810 nm laser.Follow-up was performed at 1,4,8 and 12 weeks after treatment,and then every 6 months thereafter.The same equipment and methods before treatment were used to examine and document the regression and progression of ROP.The number of eyes with lesions after photocoagulation in the two groups was compared by x2 test.The t-test was used to compare the gestational age and birth weight.Results Among 134 eyes,lesions completely resolved in 125 eyes (93.3％),progressed in 9 eyes (6.7％).In group A,7 eyes were progressive (18.4％).In group B,2 eyes were progressive (2.1％).There was a statistically significant difference in the number of eyes with lesions after laser treatment in group A and B (x2=9.14,P=0.003).There was no significant difference in birth gestational age and birth weight (t=0.85,0.25;P=0.40,0.80).Conclusion The laser photocoagulation is safe and effective in the treatment of ROP.The preretinal,ridge or vitreous hemorrhage is related to the progression of the lesion after laser photocoagulation.

Non-epithelial ovarian cancer:CT,MRI findings and corresponding pathological basis / 实用放射学杂志

Objective To study the CT and MRI findings and corresponding pathological basis of non-epithelial ovarian cancer (NEOC).Methods The CT,MRI and clinical data of 74 patients with NEOC proved by surgical pathology were reviewed retrospectively.CT plain scan was performed in 57 cases,and CT enhancement scan was performed in 52 cases;MRI plain scan was performed in 17 cases,and MRI enhancement scan was performed in 11 cases;CT and MRI scans were performed together in 3 cases.Results Among the 74 patients,there were 23 mature teratomas (25 lesions),2 immature teratomas,8 strumas,10 yolk sac tumors,6 dysgerminomas,7 granulosa cell tumors,11 thecomas,5 fibromas and 2 sertoli-leydig cell tumors.97.3% (72/74)of the lesions were unilateral.There were 88.0% (22/25)and 92.0% (23/25)detection rate of calcification and fat in teratomas,respectively.On contrast enhancement,the immature teratoma showed significant enhancement,whereas the mature teratoma showed mild enhancement.On plain CT,strumas presented as multilocular cystic-solid masses,with calcification in 5 cases.After contrast agent administration,the solid portions showed marked enhancement.Tortuous vessels were seen in 7 yolk sac tumors.The linear hypointensity in dysgerminoma on T2WI showed marked enhancement.The granulosa cell tumors were cystic-solid masses,and 4 cases with increased estradiol.Solid mass with mild enhancement were present in thecomas and fibromas,and there were 8 cases with ascites.CT findings of 2 sertoli-leydig cell tumors were cystic-solid masses with significant enhancement of the cystic wall on contrast CT.Conclusion NEOC have some certain CT and MRI characteristics.Teratomas often contain calcification and fat.Strumas:multilocular cystic-solid masses.Yolk sac tumor:tortuous vessels.Dysgerminoma:marked linear enhancement.

MRI findings of superficial siderosis of the central nervous system / 实用放射学杂志

Objective To study the MRI findings of superficial siderosis of the central nervous system(SSCNS)and to improve the understanding of SSCNS imaging features.Methods MRI images of 21 cases were retrospectively reviewed.MRI plain scan (T1WI,T2WI)and diffusion weighted imaging(DWI)were performed in all patients;T2* weighted angiography(SWAN)scan was performed in 8 patients.Results On T1WI of 21 cases,only 4 cases showed infratentorial superficial siderosis which appeared as linear hypointense signal in sulci cerebelli and around brainstem.On T2WI of 21 cases,18 cases presented with linear hypointense signal on cerebral surface.On DWI of 21 cases,20 cases showed linear hypointense signal on cerebral surface,and the other one case showing negative signal on DWI presented hypointense signal on SWAN.On SWAN of 8 cases,more lesions were found in more regions.Conclusion SSCNS has characteristic findings on MRI.SWAN is sensitive to superficial siderosis.MRI is a reliable method for the assessment of SSCNS.

The clinical evaluation of ulinastatin on improvement of renal syndrome hemorrhagic fever with small vas-cular injury / 实用医学杂志

Objective To explore the clinical effect of ulinastatin on capillary injury improvement of renal syndrome hemorrhagic fever and renal leakage. Methods Patients were divided into 2 groups according to the random number table. The experimental group(25 cases)was given with ulinastatin and the control group(25 cases) was given 5% sugar solution as a blank control. All patients were treated with nutritional support ,rehydration , prevention of bleeding and other symptoms. In addition,according to the number of days of fever in the experimental group,the patients were divided into two groups. The experimental group A(9 cases)had fever 1 ~ 4 days;the experimental group B(16 cases)had fever 5 ~ 7 days. All patients were measured in microalbuminuria ,serum creatinine,plasma albumin and other clinical indicators after 7 day treatment. Results Compared with the control group,microalbuminuria of the experimental group was significantly decreased;Creatinine recovery rate was faster than that in the control group;Plasma albumin had significantly increased;The number of symptomatic days of concurrent perfusion of other tissues had also significantly reduced. Compared with the experimental group B , microalbuminuria of the experimental group A was significantly decreased;Creatinine recovery rate was faster than that in the experimental group B;Plasma albumin had significantly increased;The number of symptomatic days of concurrent perfusion of other tissues was also significantly reduced. Conclusion Ulinastatin could effectively treat vascular injury and syndrome due to capillary leakage caused by epidemic hemorrhagic fever virus ,and the best effect occurs in early application in the fever.