Effects of soluble glycoprotein 130 on expression of p-STAT3 and vascular endothelial growth factor-A in retina of mice with diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the effect of soluble glycoprotein 130(sgp130)on expression of p-STAT3 and vascular endothelial growth factor(VEGF)-A in retina of mice with diabetes mellitus(DM), and explore the possibility of sgp130 in interfering with inflammatory damage of diabetic retinopathy(DR).METHODS: A total of 45 mice were randomly divided into normal group, DM group and sgp130 group. DM models were made in DM group and sgp130 group with streptozotocin. No special intervention was given to normal group and DM group, but sgp130 group was given intravitreal injection of 1.5mg/mL sgp130 2μL at the 1 and 5wk. After 10wk, all the mice were sacrificed to assess the protein expression of interleukin 6(IL-6), p-STAT3 and VEGF-A in the retina.RESULTS: The expressions of IL-6, p-STAT3 and VEGF-A in retina of DM group were higher than those of normal group at 10wk(all P<0.01). The expression of p-STAT3 and VEGF-A in sgp130 group were lower than those in DM group(all P<0.01).CONCLUSION: The sgp130 can selectively antagonize the trans signal transduction pathway of IL-6, down-regulate the expression of downstream inflammatory factors VEGF-A, and it may be used in the intervention of retinal inflammatory damage related with IL-6 in DM.

A decision tree model to predict successful endovascular recanalization of non-acute internal carotid artery occlusion / 国际脑血管病杂志

Objective:To investigate predictive factors for successful endovascular recanalization in patients with non-acute symptomatic internal carotid artery occlusion (SICAO), to develop a decision tree model using the Classification and Regression Tree (CART) algorithm, and to evaluate the predictive performance of the model.Methods:Patients with non-acute SICAO received endovascular therapy at 8 comprehensive stroke centers in China were included retrospectively. They were randomly assigned to a training set and a validation set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen important variables, and a decision tree prediction model was constructed based on CART algorithm. The model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and confusion matrix in the validation set.Results:A total of 511 patients with non-acute SICAO were included. They were randomly divided into a training set ( n=357) and a validation set ( n=154) in a 7:3 ratio. The successful recanalization rates after endovascular therapy were 58.8% and 58.4%, respectively. There was no statistically significant difference ( χ2=0.007, P=0.936). A CART decision tree model consisting of 5 variables, 5 layers and 9 classification rules was constructed using the six non-zero-coefficient variables selected by LASSO regression. The predictive factors for successful recanalization included fewer occluded segments, proximal tapered stump, ASITN/SIR collateral grading of 1-2, ischemic stroke, and a recent event to endovascular therapy time of 1-30 d. ROC analysis showed that the area under curve of the decision tree model in the training set was 0.810 (95% confidence interval 0.764-0.857), and the optimal cut-off value for predicting successful recanalization was 0.71. The area under curve in the validation set was 0.763 (95% confidence interval 0.687-0.839). The accuracy was 70.1%, precision was 81.4%, sensitivity was 63.3%, and specificity was 79.7%. The Hosmer-Lemeshow test in both groups showed P>0.05. Conclusion:Based on the type of ischemic event, the time from the latest event to endovascular therapy, proximal stump morphology, the number of occluded segments, and the ASITN/SIR collateral grading constructed the decision tree model can effectively predict successful recanalization after non-acute SICAO endovascular therapy.

Endovascular recanalization treatment of non-acute symptomatic internal carotid artery occlusion: a single center retrospective case series study / 国际脑血管病杂志

Objective:To investigate the influencing factors, periprocedural complications, and long-term outcomes of successful recanalization after endovascular treatment in patients with non-acute symptomatic internal carotid artery occlusion.Methods:Patients with non-acute internal carotid artery occlusion received endovascular treatment in the Nanjing Stroke Registration System between January 2010 and December 2021 were retrospectively enrolled. Clinical endpoint events were defined as successful vascular recanalization, periprocedural complications (symptomatic embolism and symptomatic intracranial hemorrhage), neurological function improvement, and recurrence of ipsilateral ischemic events. Multivariate logistic regression analysis was used to investigate the independent influencing factors of successful vascular recanalization. Cox proportional hazards regression analysis was used to investigate the correlation between endovascular treatment outcomes and neurological function improvement, as well as ipsilateral ischemic cerebrovascular events. Results:A total of 296 patients were included, of which 190 (64.2%) were successfully recanalized. Multivariate logistic regression analysis showed that symptoms manifest as ischemic stroke (odds ratio [ OR] 3.353, 95% confidence interval [ CI] 1.399-8.038; P=0.007), the time from the most recent symptom onset to endovascular therapy within 1 to 30 d ( OR 2.327, 95% CI 1.271-4.261; P=0.006), proximal conical residual cavity ( OR 2.853, 95% CI 1.242-6.552; P=0.013) and focal occlusion (C1-C2: OR 3.255, 95% CI 1.296-8.027, P=0.012; C6/C7: OR 5.079, 95% CI 1.334-19.334; P=0.017) were the independent influencing factors for successful vascular recanalization. Successful recanalization did not increase the risk of symptomatic intracranial hemorrhage within 7 d after procedure (3.2% vs. 0.9%; P=0.428). The median follow-up time after procedure was 38 months. Cox proportional hazards regression analysis showed that after adjusting for confounding factors, successful recanalization was significantly associated with postprocedural neurological improvement (hazard ratio 1.608, 95% CI 1.091-2.371; P=0.017), and significantly reduced the risk of recurrence of long-term ischemic events (hazard ratio 0.351, 95% CI 0.162-0.773; P=0.010). Conclusion:In patients with non-acute internal carotid artery occlusion, successful endovascular recanalization can effectively reduce the risk of long-term ischemic events without increasing the risk of symptomatic intracranial hemorrhage.

Comparison of long-term macular morphology after laser retinal photocoagulation and anti-VEGF therapy and their effects on vision prognosis for type 1 ROP / 中华实验眼科杂志

Objective:To evaluate and compare the foveal microvascular morphology and central foveal thickness (CFT) after laser retinal photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (VEGF) in patients with retinopathy of prematurity (ROP), and to explore the factors affecting the prognosis of vision.Methods:A cohort study was conducted.Forty children (40 eyes) aged 4-6 years, who had been treated in Peking University People's Hospital for type 1 ROP from January 2019 to December 2020, were enrolled.Optical coherence tomography angiography (OCTA), best corrected visual acuity (BCVA) and refractive status of the patients were examined.The patients were divided into laser retinal photocoagulation group and anti-VEGF group according to they received a single laser retinal photocoagulation therapy or a single intravitreal injection of anti-VEGF drugs (conbercept or ranibizumab 0.25 mg/0.025 mL) after birth.Twenty age-matched full-term healthy children (20 eyes) were enrolled as the normal control group.The FAZ area, superficial and deep foveal vessel density (VD) and CFT of the affected eyes were measured by OCTA at 4-6 years after treatment to investigate the influence of gestational age, birth weight, morphological characteristics of foveal microvessels and CFT on the prognosis of BCVA.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Peking University People's Hospital (No.2017PHB179-01). Written informed consent was obtained from the guardians prior to any medical examination.Results:There were statistically significant differences in FAZ area, superficial foveal VD and deep foveal VD among the three groups ( F=12.321, 8.436, 5.497; all at P<0.05). The FAZ area was smaller, and the superficial and deep foveal VD of the laser photocoagulation group and the anti-VEGF group were greater than those in the normal control group, and the difference was statistically significant (all at P<0.05). The CFT of the laser photocoagulation group was (267.6±11.8)μm, greater than (259.5±12.9)μm of the anti-VEGF group and (242.4±12.3)μm of normal control group, and the CFT value of the anti-VEGF group was greater than that of the normal control group, and the differences were statistically significant (all at P<0.05). There was a strong negative correlation between the superficial foveal VD and FAZ area ( r=-0.713, P<0.05), a moderate negative correlation between the deep foveal VD and FAZ area ( r=-0.565, P<0.05), and a moderate positive correlation between gestational age and FAZ area ( r=0.485, P<0.05). Pearson correlation analysis results showed that gestational age, FAZ, superficial foveal VD, deep foveal VD, CFT were all correlated with BCVA (all at P<0.05). The effects of gestational age and FAZ on BCVA were both statistically significant ( R2=0.615, both at P<0.05). Conclusions:The morphology of microvessels in macular fovea and the prognosis of BCVA in the affected eye is similar at 4-6 years after laser retinal photocoagulation and intravitreal injection of anti-VEGF drugs for type 1 ROP.The CFT of the affected eye after anti-VEGF drug therapy is better than those after laser retinal photocoagulation.Gestational age and FAZ are the influencing factors of visual acuity after treatment in children with type 1 ROP.

Analysis of the pedigree of a child with interstitial lung disease caused by a novel mutation of p. K114N in SFTPC gene / 中国小儿急救医学

Objective:To analyze the clinical and chest CT features in a family with interstitial lung disease(ILD), and assess the probable causative gene mutations for the family.Methods:In order to identify the etiology of the proband′s ILD, the pedigree was investigated.The clinical data of five proband′s pedigree members were collected, and the chest HRCT examination was performed on four proband′s pedigree members with respiratory symptoms.The human whole exon sequencing was performed on the proband′s blood samples, then its deleterious effects were assessed.Subsequently, the strong pathogenic mutation was validated by Sanger sequencing.Results:According to the family survey, there were five patients with ILD in the family, including three males and two females.One of them died.The surfactant protein C(SFTPC)gene(exon4, c.342G>T, p.K114N)was found in all four surviving patients.The mutation was considered to be originated from the father of the proband, and the pathogenic mutation was considered, which was not included in the databases and was a noval mutation.In addition, the clinical manifestations of different patients in the family were significantly different.Conclusion:The novel mutation of p. k114n in SFTPC gene can lead to ILD in children, and the mutation has incomplete exons in family members.Chest CT and whole exon sequencing play an important role in the diagnosis of ILD in children.

Analysis of the disease spectrum of the patients in the pediatric emergency department of the grade A of level Ⅲ women and children′s hospital in Guangzhou area / 中国小儿急救医学

Objective:Based on 108, 591 cases of pediatric emergency visits in a Level Ⅲ Grade A women and children′s hospital in Guangzhou area, we analyze the disease spectrum and epidemiological characteristics, and summarize the characteristics of patient flow changes.These investigations will provide an basis for scientific decision-making for manpower and material resource management of pediatric emergency and hospital workflow design.Methods:The children admitted to the Pediatric Emergency Department of the Zhujiang New Town District of Guangzhou Women and Children′s Medical Center from October 2016 to September 2018, including night emergency and inpatient observations, were analyzed according to the admission date, admission time, gender, age, initial diagnosis and etc.Results:There were more boys than girls in the emergency department, whose ratio was 1.46∶1 (64 480∶44 111 cases). The age of children ranged from 0 to 17 years old, with a median of 11 (23, 48) months.The age distribution was mainly under 5 years old, accounting for 84.14% (91 336/108 591). During the whole year, the number of children in July was the most, accounting for 10.53% (11 433/108 591), and the children in February were the least, accounting for 6.04% (6 555/108 591). The highest visit time of the whole day was 22-23 pm, accounting for 18.83% (20 443/108 591). The most of the diagnosis was respiratory disease, accounting for 53.83% (66 522/123 576). A total of 1 057 critically ill children were received, accounting for 0.97% (1 057/108 591). A total of 911 accidental injuries were received, accounting for 0.84% (911/108 591). Acute upper respiratory tract infection was the most among all diagnoses, accounting for 34.47% (42 541/123 576).Conclusion:Children in the pediatric emergency department of Guangzhou Women and Children′s Medical Center are mainly under 5 years old, and the number of children is the most in July of the year.The main disease is respiratory diseases.Medical staff can be trained according to the actual situation, and the disease spectrum can be updated in time to provide convenience for emergency rescue and improve service level.

The prediction value of Field Assessment Stroke Triage for Emergency Destination score in acute large vessel occlusion stroke / 中华神经科杂志

Objective:To validate the predictive function of Field Assessment Stroke Triage for Emergency Destination (FAST-ED) score on large vessel occlusion (LVO) in Chinese population.Methods:The information about the patients who had the disease onset within 24 hours, were treated in the Emergency Department of Jinling Hospital, and diagnosed as ‘acute ischemic stroke’ was collected. Via the emergent brain computed tomography angiography or digital subtraction angiography, the patients were divided into LVO group and non-LVO group. The scores of FAST-ED were calculated according to the National Institutes of Health Stroke Scale (NIHSS) scores and compared with Rapid Arterial oCclusion Evaluation (RACE), 3-item Stroke Scale (3I-SS), Cincinnati Stroke Triage Assessment Tool (C-STAT), and Prehospital Acute Stroke Scale (PASS) scores. Moreover, the patients were further divided into anterior and posterior circulation lesion groups to explore whether the FAST-ED scale can differ the anterior or posterior circulation effectively.Results:Three hundred and eighty-one patients were eventually included, among whom 284 were diagnosed as LVO, and 97 were diagnosed as non-LVO. Receiver operating characteristic curves showed that cut-off value of 4 optimized the scale (sensitivity: 0.76, specificity: 0.69, area under the curve: 0.78). The area under the curve of FAST-ED score(0.78) showed no statistically significant difference with NIHSS (0.79), RACE (0.77), 3I-SS (0.78) and C-STAT scores (0.75), and exhibited statistically significant difference with PASS score (0.74; 95% CI 0.69-0.78, P=0.01). FAST-ED score showed no statistically significant difference in predicting anterior and posterior circulation lesions. Conclusions:FAST-ED score can predict LVO in a rather accurate manner. It can predict anterior and posterior circulation lesions with similar effectiveness. So FAST-ED is able to be a prehospital screening tool and make assistance to the prehospital treatment.

Value of amplitude-integrated electroencephalogram combined with quantitative indices of cranial magnetic resonance imaging in predicting short-term neurodevelopment in moderately and late preterm infants: a prospective study / 中国当代儿科杂志

OBJECTIVES@#To study the association of amplitude-integrated electroencephalogram (aEEG) and the quantitative indices biparietal width (BPW) and interhemispheric distance (IHD) of cranial magnetic resonance imaging (cMRI) with short-term neurodevelopment in moderately and late preterm infants.@*METHODS@#A total of 104 moderately and late preterm infants who were admitted to the neonatal intensive care unit from September 2018 to April 2020 were selected as the subjects for this prospective study. The Naqeeb method and sleep-wake cycling (SWC) were used for aEEG assessment within 72 hours after birth. cMRI was performed at the corrected gestational age of 37 weeks. BPW and IHD were measured at the T2 coronal position. At the corrected age of 6 months, the Developmental Screening Test for Child Under Six (DST) was used to follow up neurodevelopment. According to developmental quotient (DQ), the infants were divided into a normal DST group (78 infants with DQ≥85) and an abnormal DST group (26 infants with DQ<85). Related indices were compared between the two groups. The association between aEEG and cMRI was evaluated.@*RESULTS@#Compared with the normal DST group, the abnormal DST group had significantly lower aEEG normal rate and SWC maturation rate (@*CONCLUSIONS@#For moderately and late preterm infants, aEEG within 72 hours after birth and the quantitative indices BPW and IHD of cMRI at the corrected gestational age of 37 weeks may affect their neurodevelopmental outcome at the corrected age of 6 months.

Preliminary evaluation of carotid artery thrombosis by optical coherence tomography / 中华神经科杂志

Objective:To identify the morphological features and clinical significance of intra-vascular thrombus in carotid stenosis using optical coherence tomography (OCT).Methods:Twelve patients with carotid artery thrombosis detected by OCT assessment in Jinling Hospital between January 2017 and January 2020 were included. Serial area measurements within the athero-thrombotic target lesion were performed to evaluate the OCT-thrombus score, length, area and volume. The clinical data and plaque morphological features were also assessed.Results:Among the 12 patients demonstrating thrombus on OCT, eight patients presented with white thrombus, two patients presented with red thrombus, and another two patients displayed both white thrombus and red thrombus. OCT-thrombus scores were 1-32. The OCT-thrombus score was correlated to the OCT-thrombus volume ( ρ=0.739, P=0.006) and the thrombus length ( ρ=0.932, P<0.001). All lesions were presented with fibrous cap disruption, and 10 lesions were presented with thin-cap fibroatheroma. In view of the OCT findings, all patients received carotid balloon angioplasty and stent implantation. During an average follow-up of 14.2 months, none of the 12 patients had fatal stroke or recurrent ischemic stroke. Conclusions:OCT can be used to assess intra-carotid thrombus and its more detailed morphological characteristics, offering more possibilities in quantitative analysis of thrombus burden.

A study on the relationship between cognitive impairment and nonalcoholic fatty liver disease in old population / 中华内分泌代谢杂志

Objective:To explore the correlation of cognitive function with iron load, atherosclerosis, hippocampal tissue structure, and neuron metabolism in elderly patients with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 100 elderly inpatients with NAFLD were enrolled. According to the mild cognitive impairment(MCI)diagnostic criteria, patients were divided into MCI group and Non-MCI group. The data of medical history and biochemical indexes were collected. Proton MR spectroscopy( 1H-MRS)was performed in the hippocampus of the patients. The total genomic DNA was extracted from the peripheral blood of 48 patients, and DNA sequencing was used to detect the 2616C/T polymorphism of the iron regulatory protein-2 gene(IRP2). T test, ANOVA, χ2 test, and binary logistic regression were used to analyze the data of two groups. Results:Compared with Non-MCI group, MCI group were with older age, lower levels of hemoglobin and soluble transferrin receptor(sTfR), higher hypersensitive C-reactive protein, reduced ankle-brachial index, increased carotid intima-media thickness and choline/creatine in right hippocampal head, and higher proportion of carotid plaque( P<0.05 or P<0.01). sTfR was associated with cognitive impairment in elderly patients with NAFLD( P<0.01). T allele genotype and T allele frequencies in MCI group were higher than those in Non-MCI group( P<0.05). Montreal cognitive assessment scale(MoCA) scores of C/T genotype and T/T genotype group were significantly lower than that of C/C genotype group( P<0.05). Conclusion:Iron metabolism abnormality may be a risk factor of cognitive impairment in elderly patients with NAFLD.

Evaluation of endovascular optical coherence tomography in carotid atherosclerotic stenosis: comparison between symptomatic and asymptomatic patients / 国际脑血管病杂志

Objective:To explore the value of intravascular optical coherence tomography (OCT) in evaluating carotid atherosclerotic stenosis, and compare the morphological characteristics of symptomatic and asymptomatic carotid atherosclerotic plaques.Methods:Patients diagnosed as carotid atherosclerotic stenosis and performed OCT in the Department of Neurology, Jinling Hospital, Medical School of Nanjing University from January 2017 to November 2019 were enrolled retrospectively. Digital subtraction angiography (DSA) and OCT were used to determine the degree of stenosis of the diseased vessels, and the plaque characteristics observed by OCT were recorded. Symptomatic carotid atherosclerotic stenosis is defined as a history of transient ischemic attack, amaurosis fugax, or stroke related to the blood supply area of the diseased vessel within 6 months before the carotid artery examination. The baseline clinical and imaging data of the symptomatic group and the asymptomatic group were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for symptomatic carotid atherosclerotic stenosis. Results:A total of 56 patients were enrolled. DSA and OCT had good consistency in carotid artery diameter measurement ( r=0.93, P<0.001). When the OCT technique was used to evaluate the plaque properties, the consistency of inter-observer ( κ=0.96, P<0.001) and intra-observer ( κ=0.96, P<0.001) was higher. The proportions of patients with type Ⅵ plaque (66.7% vs. 34.5%; P=0.016) and macrophage infiltration (51.9% vs. 24.1%; P=0.032) in the symptomatic group were significantly higher than those in the asymptomatic group, while the proportion of patients with fibrotic plaque was significantly lower than that in the asymptomatic group (40.7% vs. 69.0%; P=0.034). Multivariate logistic regression analysis suggested that type Ⅵ plaques (odds ratio 13.798, 95% confidence interval 1.38-137.675; P=0.025) and macrophage infiltration (odds ratio 5.856, 95% confidence interval 1.405-24.406; P=0.015) were the independent risk factors for symptomatic carotid atherosclerotic stenosis. Conclusions:OCT can be used to evaluate the degree of vascular stenosis and plaque characteristics in patients with carotid atherosclerotic stenosis. The detection rate of complex plaques in patients with symptomatic carotid atherosclerotic stenosis is significantly higher. Type Ⅵ plaque and macrophage infiltration are the independent risk factors for symptomatic carotid atherosclerotic stenosis.

Prehospital stroke scale for identifying large vessel occlusive stroke / 国际脑血管病杂志

The morbidity and mortality of stroke caused by large vessel occlusion are high,and its outcome is closely associated with emergency treatment.In order to receive treatment within the time window,the effective prehospital assessment is very important.The prehospital stroke scale simplifies emergency screening and assessment of such patients.Although the predictive value is good,its role remains controversial.This article reviews some of the prehospital stroke scales used to identify large vessel occlusions and analyzed the characteristics of different scales.

Cognitive function observation and clinical features of 100 cases of elderly patients with non-alcoholic fatty liver disease / 中华消化杂志

Objective To observe the changes of cognitive function,clinical characteristics and hippocampal structure in elderly patients with non-alcoholic fatty liver disease (NAFLD).Methods From December 2014 to June 2016,at Department of Geriatrics,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,169 elderly hospitalized patients who underwent health checkups were enrolled and divided into NAFLD group and non-NAFLD group.The clinical data of two groups were collected,and the Montreal cognitive assessment scale (MoCA) was used for cognitive function assessment.The serum level of soluble transferrin receptor (sTfR) was detected,the liver-spleen ratio was measured and hippocampal proton magnetic resonance spectroscopy (1H-MRS) was performed.T test and linear regression analysis were used for statistical analysis.Results Among the 169 elderly patients,100 were NAFLD and 69 were non-NAFLD.The body mass index(BMI) and waist-to-hip ratio(WHR) of patients in NAFLD group were (25.9 ± 3.4) kg/m2 and 1.03 ± 0.13,respectively,which were higher than those in non-NAFLD group ((24.2 ± 3.7) kg/m2 and 0.95 ± 0.06),and the differences were statistically significant (t =-2.714 and-3.605,both P ＜0.01).MoCA score of the patients in NAFLD group was 20.1 ± 5.8,which was lower than that in non-NAFLD group (22.1 ± 4.4),and the difference was statistically significant(t =2.154,P =0.033).The serum sTfR level and liver-spleen computed tomography(CT) ratio of NAFLD group were (8.78 ± 4.31) mg/L and 0.97 ± 0.12,respectively,which were lower than those of non-NAFLD group ((12.66 ± 3.93) mg/L and 1.19 ± 0.15),and the differences were statistically significant(t =3.765 and 6.142,both P ＜ 0.01).The CT ratio of liver to spleen (β=7.597,95％ confidence interval(CI):2.938 to 12.935) and sTfR (β =0.552,95％ CI:0.304 to 0.787) were positively correlated with cognitive function in elderly patients (both P ＜ 0.01).The height of right hippocampus of NAFLD group was (0.410 ± 0.074) mm,which was lower than that of non-NAFLD group ((0.453 ± 0.086) ram),and the difference was statistically significant (t =2.078,P =0.042).Conclusion Cognitive impairment in elderly NAFLD patients is closely related to iron load and liver fat.

Association of iron metabolism with cognitive function in elderly patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To investigate the association of iron overload with metabolic changes in hippocampal tissues, and to explore the relationship between iron metabolism abnormality and cognitive function in elderly patients with type 2 diabetes mellitus( T2DM) . Methods A total of 97 elderly inpatients with T2DM were enrolled. According to the Mini-mental state examination ( MMSE) score, the type 2 diabetic patients were divided into mild cognitive impairment ( MCI) and non-mild cognitive impairment ( Non-MCI) groups. A retrospective analysis was performed for their clinical data and laboratory parameters, including serum ferritin, MMSE, Montreal cognitive assessment ( MoCA) , carotid intima-media thickness, ankle brachial index, and the ELISA method was used to detect soluble transferring receptor ( sTfR ) . Proton MR spectroscopy ( 1 H-MRS ) was performed in the hippocampus of 26 patients. Results Compared with Non-MCI group, MCI group revealed higher age(P<0.01), higher incidence of carotid plaque (P<0.01), decreased sTfR(P=0.049) and left hippocampal height(P=0.034). Age, sTfR, and carotid plaque were independent risk factors for MCI in elderly patients with T2DM. Conclusion The abnormal iron metabolism may contribute to the occurrence of MCI in the elderly patients with T2DM.

The Preparation and In Vitro Studies of Phytantriol-Based Cubosomes Containing Oridonin / 中国药学杂志

OBJECTIVE: To prepare oridonin-loaded cubosomes, and encapsulate oridonin(ORI) for the purpose of enhancing the solubility and prolonging the action time. METHODS: Phytantriol (PYT) was firstly used to cooperate with Poloxamer 407-propylene glycol-water system to improve the solubility of ORI for developing ORI-loaded cubosomes. Polarizing microscope, small angel X-ray scattering (SAXS) and cryogenic transmission electron microscopy(cryo-TEM) were used to study the characters of cubosomes. RESULTS: Under homogenization conditions of 1 200 bar for 9 cycles, the obtained PYT-based cubosomes had narrow particle size distribution with a mean particle size of (225.9 ± 5.6) nm. The internal structures of cubosomes were revealed by small-angle X-ray scattering as a bicontinuous cubic liquid crystalline phase with Pn3m geometry. The encapsulation efficiency and drug loading determined by ultrafiltration centrifugation were (86.6 ± 1.5)% and (3.69 ± 0.06) mg•g-1, the solubility of ORI had been increased by 5.20 times. CONCLUSION: The optimized formulas of cubosomes show obvious 24 h-sustained release, and the in vitro release profiles fitt the Higuchi release model well, implying diffusion-control as main release mechanism.

Application of remote screening system for diabetic retinopathy in Beijing Desheng Community / 中华实验眼科杂志

Objective To develop a remote diabetic retinopathy (DR) screening system and to evaluate the effectiveness of the screening system in community.Methods A cross-sectional study was carried out under the informed consent of subjects in Peking University People's Hospital and Beijing Xicheng District Desheng Community Health Service Center from June 2015 to December 2016.A remote DR screening system was established in Peking University People's Hospital and Beijing Xicheng District Desheng Community Health Service Center during June 2015 to December 2016.Based on non-mydriatic digital eye fundus camera photography and the internet transmission technology,anterior ocular segment and fundus images of 2 473 eyes from 1 355 community subjects with type 2 diabetes mellitus were transmitted from Beijing Xicheng District Desheng Community Health Service Center to the reading center of Peking University People's Hospital,and the results were provided to the subjects after analysis,including visual examination,diagnosis and follow-up rate of the subjects,the agreement between remote screening system and conventional screening method was analyzed and compared.Results The visual acuities of the 2 473 eyes of 1 355 subjects were obtained by trained community physician,and the visual acuity was ≤0.05 in 103 eyes (4.2％),＞0.05-0.3 in 780 eyes (31.5％),＞0.3 in 1 590 eyes (64.3％).A good consistency was found in the diagnosis and grading of DR (Kappa value =0.895) and in diagnosis of macular disorder (Kappa value =0.763)between the remote screening system and conventional screening method.In addition,the diagnosis results of retinal photocoagulation were consistent between the two methods (Kappa value =1.000).The mean duration of the remote screening system for one subject was 10 minutes,which was shorter than 23 minutes of conventional screening method.The follow-up rate of remote screening system was 75.2％.Conclusions There is a high consistency in the DR diagnosis and evaluation between the remote non-mydriatic screening system and conventional screening method.The screening program with follow-up requests has a satisfying follow-up rate,which could meet the demand of DR screening.

Application of optical coherence tomography in the cerebral angiography / 中华神经科杂志

As an emerging intravascular imaging technology, intravascular optical coherence tomography (OCT) has been recognized for its clinical application value in the continuous exploration of the past decade. With its high resolution, OCT can clearly display the subtle morphological features of arterial stenosis lesions, help select treatment options, guide stent placement, and evaluate stent-vessel relationship and neo-intimal coverage after stent implantation for timely detecting early and late complications after stent placement. In recent years, a series of studies have also explored the value of OCT in the evaluation of cerebral angiography and intracranial and extracranial artery stent placement. We made a review of this topic.

Nursing experience in shortening course of treatment of postoperative Hirschsprung′s disease / 中国实用护理杂志

Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.

Clinical applications of optical coherence tomography angiography / 中华眼底病杂志

Optic coherence tomography (OCT) is one of the most rapid developing technologies in ophthalmology. OCT angiography (OCTA) has been made possible by the development of even faster scanning and sampling techniques, which is the next milestone after stratus OCT and spectral domain OCT. Without the need of injection of the contrast agent, OCTA is capable of providing a three-dimensional reconstruction of the perfused microvasculature within the retina and choroid by detecting the motion of scattering particles such as erythrocytes within sequential OCT cross-sectional scans performed repeatedly at the same location of the eye with different analysis algorithms. Comparing to fundus fluorescein angiography and indocyanine green angiography, with improved OCT technology and understanding, OCTA has showed certain advantages to diagnose retinal and choroidal diseases, especially macular vascular diseases. It is important to establish the contributions that OCTA can make to diagnosing, managing and understanding of ocular fundus diseases.

Metabolomic analysis of the changes of pathways in immunosuppressive mechanism caused by cyclophosphamide in mice / 中国实验动物学报

Objective To investigate the changes of metabolic pathways in the process of immunesuppression in mice caused by cyclophosphamide by metabolomic analysis. Methods Flow cytometry was used to detect the changes of immune cells, and the results were analyzed using partial least squares model. The potential biomarkers were screened by variable importance in projection ( VIP) parameters in the partial least squares model, and the differential metabolites were determined by statistical analysis. The differential metabolites were identified using the metabolomics rapid identification and analysis software. Nine kinds of metabolites were identified by searching and calculation, and result of pathway enrich-ment showed three differential metabolic pathways. Results Cyclophosphamide had a significant effect on the biosynthesis of unsaturated fatty acids, metabolism of mitochondrial fatty acids, metabolism of glycophospholipid, biosynthesis of steroid hormones, metabolism of arachidonic acid, metabolism of fatty acids, and the biosynthesis of pyrimidine. Conclusions The most important metabolic pathways affected by cyclophosphamide in the normal body are the metabolism of arachidonic acid, glycophospholipid and pyrimidine.