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Objective:To observe the clinical characteristics and optical coherence tomography (OCT) features of pseudopapilledema (PPE) combined with peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in children.Methods:A retrospective observational study. From October 2019 to May 2021, total 22 eyes from 12 children diagnosed as PPE combined with PHOMS in the Neuro-ophthalmology Department of The First Hospital of Xi’an (Affiliated of The First Hospital of Northwest University) were recruited. Among the children, 6 were male and 6 were female. The average age was (10.6±2.7) years. The average course from disease onset to diagnosis of PPE combined with PHOMS was (8.0±7.5) months. All patients underwent best corrected visual acuity (BCVA), relative afferent papillary defect (RAPD), Ishihara's test, fundus photography, OCT, fundus autofluorescence (FAF), ocular B-mode ultrasound, visual field and patternvisual evoked potential (P-VEP). The clinical and OCT characteristics of the patients were observed.Results:The anterior segments of the patients were normal. The intraocular pressures and Ishihara's test were all normal. All RAPD were negative. Total 22 eyes, BCVA was 1.0 in 21 eyes and one eye was 0.12. The fundus photography revealed blurred optic discs margin, showing mild to moderate edema-like elevation with more prominent in the nasal parts, presenting as a "C" shape halo. No obvious abnormal fluorescence was observed in FAF. The OCT scan of involvement eyes showed an elevated appearance in vary degrees, and the sharply marginated ovoid hyper-reflective mass-like structures which laterally herniated into the peripapillary region under retinal nerve fiber layer and above the Bruch membrane were detected with consecutive nasal enlargement scanning, corresponding to the nasal parts in the fundus photography. The higher degree of elevation, the larger the volume. Macular retina pigment epithelium layer and ganglion cell thickness were normal. Ocular B-mode ultrasound showed that the head of the optic nerve in the posterior wall of the eyeball (in front of the optic disc) was elevated in all affected eyes, and there was no strong signal echo in it. Visual field examination showed physical blind spot enlargement in 3 eyes and visual field defect in 2 eyes. P-VEP examination showed that the peak was slightly delayed in 3 eyes and the amplitude was slightly reduced in 3 eyes.Conclusions:Enlarged nasal optic disc OCT scan can improve the detection rate of PHOMS. PHOMS were detected bilaterally in the cases with binocular PPE while only in the effected eye in the cases of monocular PPE; the higher degree of PPE, the lager volume of PHOMS. PHOMS were could contribute to the diagnosis of PPE in children.
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Transsynaptic retrograde degeneration of optic neuropathy (TRDON) refers to the degeneration and/or apoptosis of presynaptic neurons (retinal ganglion cells) caused by damage to the lateral geniculate body and post-geniculate visual pathway. At present, the pathogenesis of TRDON is secondary apoptosis of P β-type retinal ganglion cells, resulting in the atrophy of optic tract, thinning of the retinal nerve fiber layer and retinal ganglion cell layer thickness and declining of retinal microvascular density, which are consistent with the visual field defect attributed to the primary disease. Of which, the thinning of the retinal ganglion cell layer thickness is considered as the characteristic of TRDON. Now, there is little understanding and related research on TRDON in China. Clinicians should pay attention to the characteristics and severity, occurrence time and location of the above structural changes in these patients through optical coherence tomography, and monitor the activity and progress of the lesions, so as to determine the cut-off point for drug intervention and the drug targets for developing new treatment methods, and bring benefits for patients in partial visual function recovery and disability reduction.
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Objective:To evaluate the effect of maternal depressed mood at pregnancy and postpartum on the risk of emotional or behavioral disorders of offspring by meta-analysis. Methods:The following Mesh words and free words were searched in 7 online databases, including the PubMed, Embase, Web of Knowledge, PsycINFO, Cochrane, WanFang databases and China National Knowledge Infrastructure from January 1, 2000 to October 31, 2020: " maternal" AND " depression" AND " child OR offspring" AND " neuropsychology" . According to the inclusion and exclusion criteria, case-control and cohort studies reporting the effect of maternal depressed mood during pregnancy or postpartum on the risk of emotional or behavioral disorders of offspring were reviewed. Meta-analysis was performed by RevMan 5.3. Results:Fourteen studies involving 3 914 in the case group and 17 016 in the control group were included.Children whose mother with depressed mood during pregnancy or postpartum had 2.03 times risk of emotional or behavioral disorders than those whose mothers without depressed mood ( OR=2.03, 95% CI: 1.55-2.65). Both depressed mood at pregnancy and postpartum could increase the incidence of emotional or behavioral disorders in children, but there was no significant difference between these two periods ( Z=-0.371, 95% CI: 0.796-1.168). Moreover, the effect of maternal depressed mood on emotional or behavioral disorders in offspring could last to the preschool and school period, and the children in the school period may have higher incidence of emotional or behavioral disorders than those during the preschool period ( Z=-2.340, 95% CI: 0.643-0.962). Conclusions:Maternal depressed mood can increase the incidence of emotional or behavioral disorders in offspring, which are long-lasting and do not decrease with age.
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Objective:To investigate the clinical characteristics of vascular neuro-ophthalmology in patients with central retinal artery occlusion (CRAO).Methods:A single-center, prospective clinical study. From January 2018 to December 2020, 49 eyes of 49 CRAO patients of The Neuro-ophthalmology Department of Xi'an First Hospital were included in the study. Data on patient demographic characteristics, vascular risk factors, disease characteristics, digital subtraction angiography (DSA) imaging characteristics of internal carotid arteries, treatment, treatment-related adverse events, and 1-month follow-up vascular events were collected. All patiens were examined by visual acuity, head CT and or magnetic resonance imaging. At the same time, 35 cases of internal carotid artery vascular DSA were examined; 14 cases of head and neck CT angiography were examined. The anatomical variation of the extracranial segment of the internal carotid artery was divided into tortuous, tortuous, and coiled; the aortic arch was divided into type Ⅰ , type Ⅱ , type Ⅲ, and bovine type. Intravenous thrombolysis, arterial thrombolysis, conservative treatment were performed. The follow-up time was1 month after treatment. Functional vision was defined as vision ≥20/100. Vascular events were strokes, cardiovascular events, deaths and neovascular glaucoma during follow-up.Results:Among 49 eyes of 49 cases, 40 eyes were male (81.6%, 40/49), and 9 eyes were female (18.4%, 9/49); the average age was 60.7±12.9 years. There were 33, 17, and 16 cases with hypertension, type 2 diabetes, and cerebrovascular disease, respectively; 27 and 34 cases had a history of smoking and tooth loss, respectively. Taking antihypertensive, hypoglycemic, antiplatelet aggregation/anticoagulation, and hypolipidemic drugs were 15, 5, 8, and 5 patients, respectively. There were 11 cases of transient amaurosis before the onset, and 17 cases of CRAO after waking up. There were 33 cases (67.3%, 33/49) with infarction of the affected side of the brain tissue. DSA was performed in 35 cases, and the stenosis rate of the internal carotid artery on the affected side was 70%-99% and 100% were 3 (8.6%, 3/35) and 4 (11.4%, 4/35) cases, respectively. The ophthalmic artery on the affected side originated from the external carotid artery in 5 cases (14.3%, 5/35). There were 17 (54.8%, 17/31) and 2 (6.5%, 2/31) cases of tortuousity and kinking in the extracranial segment of the internal carotid artery. There were 15 (42.9%, 15/35), 6(17.1%, 6/35), and 2 (5.7%, 2/35) cases of aortic arch type Ⅱ, type Ⅲ, and bovine type, respectively. Intravenous thrombolysis and arterial thrombolysis were performed in 13 and 29 cases, respectively. Complications occurred in 2 cases during treatment; 3 cases of symptoms fluctuated after treatment, and 10 cases of asymptomatic new infarcts occurred in imaging studies. Forty-eight cases were treated with antiplatelet aggregation/anticoagulation and hypolipidemic treatment. At discharge and 1 month after treatment, the recovery of functional vision was 7 and 17 cases, respectively. One month after treatment, 1 case died because myocardial infarction; 2 cases of neovascular glaucoma occurred.Conclusion:The proportion of CRAO patients with vascular risk factors and internal carotid artery abnormalities on the affected side is relatively high; the prognosis is relatively good after intravenous thrombolysis and/or arterial thrombolysis and secondary stroke prevention.
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Objective:To investigate the risk factors for poor outcome and recurrence at 1 year after first-ever ischemic stroke in non-diabetic patients.Methods:Using Xi'an Stroke Registry Research Database, the clinical data of patients with non-diabetic first-ever ischemic stroke diagnosed in 4 tertiary A hospitals in Xi'an from January to December 2015 were collected. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. Prognosis (functional outcome and recurrence) was followed up at 1 year after diagnosis. Functional outcome was assessed using the modified Rankin scale. 0-2 was defined as good outcome and >2 as poor outcome. Recurrence was defined as new focal neurological dysfunction caused by cerebral infarction or cerebral hemorrhage events during follow-up and confirmed by cranial CT or MRI. Multivariable logistic regression analysis was used to identify the independent influencing factors of clinical outcomes at 1 year. Multivariable Cox proportional hazard model was used to identify the independent influencing factors of recurrence within 1 year. Results:A total of 1 214 non-diabetic patients with first-ever ischemic stroke were included. One year follow-up showed that 210 patients (17.3%) had a poor outcome, 88 (7.2%) of them died, and 47 (3.9%) had recurrence. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.042-1.090; P<0.001), atrial fibrillation ( OR 3.170, 95% CI 1.588-6.327; P=0.001), white blood cell count ( OR 1.106, 95% CI 1.006-1.216; P=0 037), baseline NIHSS score ( OR 1.210, 95% CI 1.147-1.277; P<0.001), and stroke associated-pneumonia (SAP; OR 3.677, 95% CI 1.451-9.316; P=0.006) were independently associated with poor outcomes. Multivariate Cox proportional hazards regression analysis showed that baseline NIHSS score (hazard ratio [ HR] 1.055, 95% CI 1.003-1.109; P=0.036) and SAP ( HR 7.067, 95% CI 3.154-15.836; P<0.001) were independently associated with recurrence. Kaplan-Meier survival curve analysis showed that the 1-year recurrence rate of patients with severe stroke was significantly higher than that of patients with mild to moderate stroke (log-rank test, P<0.001), and the 1-year recurrence rate of patients with SAP was significantly higher than that of patients without SAP (log-rank test, P<0.001). Conclusion:Age, atrial fibrillation, white blood cell count, baseline NIHSS score and SAP are the independent predictors of poor outcomes at 1 year after first-ever ischemic stroke in non-diabetic patients. Baseline NIHSS score and SAP are the independent predictors of recurrence within 1 year after first-ever ischemic stroke in non-diabetic patients.
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Histology teaching requires a combination of theory and experiment for a better understanding of microstructure and related functions of body.On the basis of the comparison and summary of the advantages and limitations of traditional light microscopy tissue slices and the emerging digital slicing,we combined them in the teaching of micromorphology experiments to achieve a better teaching results.Each experimental course (about 3 to 4 hours) was divided into four parts:teaching videos,observation of light microscopy tissue slices and digital slicing,discussion on course content and random quizzes.This teaching method contributed to the improvement of the students' interest and motivation in learning,the teachers' teaching efficiency and the overall teaching quality.
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Objective To study the clinical effects of the Tanreqing injection combined with Danshen-Chuanxiongqin injection for the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effects on plasma NO and endothelin-1 (ET-1) levels. Methods A total of 79 patients with AECOPD in our hospital from May 2014 to January 2017 were enrolled in this study. The subjects were randomly divided into the control group (n=39) and the combined therapy group (n=40). The control group were treated with Tanreqing injection, the combined therapy group were treated with Tanreqing injection combined with Danshen-Chuanxiongqin injection.The two groups were treated for 10 days.The clinical effects of the two groups after treatment were compared. The MPAP, PASP, PADP, PaO2, PaCO2, SaO2, NO and ET-1 of the two groups before and after treatment were compared. Results The total efficacy rate of the combined therapy group was 97.5% (39/40), which was significantly higher than 82.1% (32/39) of the control group (x2=5.178,P=0.023).After treatment,the MPAP(25.19 ± 8.71 mmHg vs.35.28 ± 9.52 mmHg,t=4.917),PASP (44.35 ± 12.26 mmHg vs.57.24 ± 11.17 mmHg,t=4.881),PADP(17.16 ± 4.05 mmHg vs.26.40 ± 3.85 mmHg, t=10.38),PaCO2(42.70 ± 6.31 mmHg vs. 51.44 ± 6.83 mmHg, t=5.910)of the combined therapy group were significantly lower than those of the control group(P<0.05).After treatment,the PaO2(73.95 ± 7.82 mmHg vs. 67.21 ± 7.16 mmHg,t=3.993),SaO2(94.86% ± 5.11% vs.83.63% ± 4.27%,t=10.586)of the combined therapy group were significantly higher than those of the control group (P<0.05). After treatment, the plasma NO (55.82 ± 10.08 μmol/L vs.46.34 ± 8.50 μmol/L,t=4.513)of the combined therapy groupwas significantly higher than the control group(P<0.05)and the plasma ET-1(80.41 ± 8.95 ng/L vs.87.68 ± 9.24 ng/L,t=3.552)of the combined therapy groupwere significantly lower than the control group (P<0.05). Conclusions The Tanreqing injection combined with Danshen-Chuanxiongqin injection showed good efficacy for the patients with AECOPD,and the therapy can reduce the pulmonary arterial hypertension and ET-1, improve the lung tissue oxygen supply and NO release, and improve the cardiopulmonary function.
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Objective To investigate the efficacy of butylphthalide on elderly patients with acute cerebral infarction and its effect on serum uric acid,c-reactive protein,and hemorheology.Methods Elderly patients (86 cases) with acute cerebral infarction in Xi'an No.1 Hospital from January 2015 to December 2015 were randomly divided into two groups.The control group was treated with conventional symptomatic treatment of acute cerebral infarction,observation group added with butylphthalide soft capsules.The NIHSS score and efficacy of the two groups,the serum uric acid,c-reactive protein,and the change of hemorheology before and after treatment were compared.Results The effective rate of observation group was 90.70％,significantly higher than that of control group 72.09％ (P ＜ 0.05);The NIHSS score,serum uric acid and c-reactive protein levels,blood viscosity and platelet aggregation rate of two groups after treatment were significantly lower (P ＜ 0.05),the Barthel index were significantly increased (P ＜ 0.05),and the change of observation group were more significant (P ＜ 0.05).Conclusion Butylphthalide has high curative effect on elderly patients with acute cerebral infarction,can reduce the level of serum uric acid,c-reactive protein and the degree of nerve function defect,improve the hemorheology and life self-care activities ability,which can protect the brain.
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Objective To observe the effect of five-tone music therapy on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.Methods Ninety anxiety and depression in-patients treated with chemotherapy after gastric cancer radical surgery were randomly divided into observation group and control group,45 cases in each group.Patients of the two groups were treated with the same chemotherapy regimen and nursing,and additionally,the observation group was given fivetone musie therapy and the control group was given conventional music therapy.The intervention effects were evaluated by scoring with Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS) and questionnaire for the quality of life of gastric cancer patients (QLQ-STO22) at admission time and when discharging from hospital.Results The SAS and SDS standard scores and the scores of each dimension of QLQ-STO22 in the observation group were markedly decreased after intervention,the differences being statistically significant (P ＜ 0.01 compared with those before intervention).And the SAS and SDS standard scores of the observation group after intervention were lower than those of the control group (P ＜ 0.01).In the aspects of quality of life,the scores of all dimension of QLQ-STO22 except taste,appearance and hair loss in the observation group were lower than those in the control group (P ＜ O.05).Conclusion Five-tone music therapy is effective on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.
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Objective:To evaluate the effect of internal distraction osteogenesis in the treatment of complicated teeth-maxillofacial deformity.Methods:Clinical data of 1 0 cases with complicated teeth-maxillofacial deformity were analyzed retrospectively.In the first stage,the patients were operated by internal distraction osteogenesis.In the second stage,the distractor was removed after 3 to 6 months of consolidation period,followed by other operation for further occlusal reconstruction.Results:All the operations were per-formed as planned.The distraction distance was 7 -70 mm.The distraction process was smooth in all the cases.Occlusion was recon-structed and the deformity was corrected by following operation satisfactorily.Conclusion:Internal distraction osteogenesis is effective in the treatment of complicated teeth-maxillofacial deformity for further occlusal reconstruction and functional repair.
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Discussion teaching mode was carried out in the teaching of histology and embryol-ogy for clinical medical undergraduates in Chongqing Medical University from aspects of proposing questions, group learning, class discussing and summarizing. Classroom tests were accompanied to evaluate the teaching effect. It showed the discussion teaching achieved satisfactory effects. The correct answer rate of 92.36%students was≥60%. Students not only acquired knowledge but also increased their comprehensive abilities. The well-supervised topics, active participation of students and timely summary of teachers at the end of the class were the key factors in the practice of the discussion teaching mode.
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Course examination and evaluation of accomplishment is a very important part in the course of talent cultivation.Examination model combining formative evaluation and summative evaluation was applied in histology and embryology course by teaching and research section of histology and embryology in Chongqing Medical University.Formative evaluation use several indicators including class learning,class testing,homework,web-based learning and comprehensive learning to evaluate learning attitudes,levels and ability of student.More than 90％ students agreed with new examination evaluating system.This examination improvement was recognized by teachers since it strengthen students' ability of open learning and lifelong learning as well as provided teachers with lots of experiences.
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Objective To study the effects and related mechanism of low-dosed methyl-mercury chloride (MMC) on the epithelial apoptosis of fetal mice intestine. Methods Pregnant mice on E12.5 d and E13.5 d were injected with different doses of MMC (0, 1, 2, 4 mg/kg) intraperitoneally. After 48 h, their duodenum and colon were dissected out and sliced into the paraffin sections. Some sections were stained with HE to count the numbers of apoptotic bodies (NAB) with stereological method. The others were stained with the immunohistochemical method to observe the expression of apoptosis-associated proteins Bcl-2, Bax and immediate early gene c-fos. Results ①In all experimental groups, the NAB in the epithelium were higher than that of control groups (P
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Objective: To observe the apoptosis and expression of apoptosis related proteins Bcl-2,Bax and P53 during the developing mouse stomach.Methods: Serial sections of fetal mice aged 11～15 days were made.The density of apoptotic bodies(DAB) in the epithelium was measured with stereological method.The expression of apoptosis related proteins Bcl-2,Bax and P53 in the epithelium were detected with the SABC method of immunocytochemistry,and image analysier was used to detect the products-intensity of each section.Results: ① The peak-expression of DAB in the epithelium was on the 14 th and 15 th day.② The peak-expression of Bcl-2 in the epithelium was on the 11 th and 13 th day,the peak-expression of Bax in the epithelium was on the 14 th day,the peak-expression of P53 were on the 11 th and 14 th day.Conclusion: ① Bcl-2 may have a role in suppressing cell apoptosis in the epithelium of stomach,Bax may have a role in promoting cell apoptosis.P53 do not have close relationship with the control of epithelial cells apoptosis in fetus mouse stomach.
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Objective To study the spatiotemporal distributions of epithelial proliferation and apoptosis,and the correlation of morphogenesis with them in developing stomach.Methods Serial sections of fetal mice aged 11-15.5 days were made.The morphogenesis of stomach was observed under light microscope.The density of mitotic cells(DMC) and apoptotic bodies(DAB) of epithelium in the developing cardia,pylorus,greater curvature,lesser curvature were measured with stereological method.Results The morphological development of stomach took place on the 11~(th) day of mouse embryo development.The fundus,greater curvature and lesser curvature were observed on the 12~(th) day.The peak value of DMC all appeared before the peak value of DAB.In the epithelium of cardia,no obvious peak value of DMC was observed and the peak value of DAB was on the 11.5~(th),12.5~(th),13.5~(th) day.In the epithelium of pylorus,the peak value of DMC was on the 12.5~(th) day,the peak value of DAB was on the 14~(th) day.In the epithelium of greater curvature,the peak value of DMC was on the 11.5~(th) and 12~(th) day,the DAB value was low.In the epithelium of lesser curvature,the peak value of DMC was on the 11.5~(th) day,the peak value of DAB was on the 12.5~(th) day.Conclusion There was very close spatiotemporal relationship between the cell proliferation,cell apoptosis and the morphological development of stomach.