Assessments of the ocular surface and meibomian gland morphology in patients with treatment-naive acne vulgaris / Avaliação da superfície ocular e da morfologia das glândulas meibomianas em pacientes com acne vulgar virgens de tratamento

ABSTRACT Purpose: To investigate ocular surface and meibomian glands in patients with treatment-naive acne vulgaris. Methods: The Ocular Surface Disease Index (OSDI) questionnaire, invasive tear film breakup time, fluorescein staining of the ocular surface, and Schirmer II test were performed for all subjects. Total eyelid and meibomian gland secretion scores were assessed. Non-contact meibography was performed with the Sirius corneal topographic device. Results: The right eyes of 35 patients with acne vulgaris and 35 healthy volunteers were included the study. While the OSDI and staining scores were significantly higher in the acne group than in the control group (p=0.01 and p=0.003, respectively), the invasive tear film breakup time and Schirmer measurements were significantly lower in the acne group (p=0.000 and p=0.003, respectively). The total eyelid and meibomian gland secretion scores were also higher in the acne group than in the control group (p=0.003 and p=0.000, respectively). On the morphological evaluation of the meibomian glands, the thickening, thinning, tortuosity, and presence of ghost areas were statistically significantly more common in the acne vulgaris group than in the control group (p=0.000, p=0.001, p=0.05, and p=0.006, respectively). The percentage of the meibomian gland loss area was significantly high in the acne vulgaris group on both upper and lower meibography. The meibomian gland loss area positively correlated with total eyelid and meibomian gland secretion scores. Conclusion: Acne vulgaris may have a predisposition to meibomian gland dysfunction and ocular surface damage. Early recognition of meibomian gland and ocular surface alterations seems important, especially in acne vulgaris cases for which oral isotretinoin treatment is planned.

RESUMO Objetivo: Todos os indivíduos responderam ao questionário Ocular Surface Disease Index (OSDI) e tiveram avaliados o tempo de ruptura do filme lacrimal pelo método invasivo, a coloração da superfície ocular com fluoresceína e o teste de Schirmer II. Foram ainda avaliados o escore palpebral total e o de secreção das glândulas meibomianas. Foi realizada meibografia sem contato com um dispositivo topográfico corneano Sirius. Métodos: Todos os indivíduos responderam ao questionário Ocular Surface Disease Index (OSDI) e tiveram avaliados o tempo de ruptura do filme lacrimal pelo método invasivo, a coloração da superfície ocular com fluoresceína e o teste de Schirmer II. Foram ainda avaliados o escore palpebral total e o de secreção das glândulas meibomianas. Foi realizada meibografia sem contato com um dispositivo topográfico corneano Sirius. Resultados: Foram incluídos no estudo os olhos direitos de 35 voluntários com acne vulgar e 35 saudáveis. Os escores do Ocular Surface Disease Index e da coloração foram significativamente maiores no grupo com acne em comparação com o grupo controle (p=0,01 e p=0,003, respectivamente), mas o tempo de ruptura do filme lacrimal pelo método invasivo e as medidas do teste de Schirmer II foram significativamente menores (p=0,000 e p=0,003, respectivamente). O escore palpebral total e o escore de secreção das glândulas meibomianas também foram maiores no grupo com acne que no grupo controle (p=0,003 e p=0,000). Na avaliação morfológica das glândulas meibomianas, o espessamento, o afinamento, a tortuosidade e a presença de áreas fantasmas nas glândulas foram mais comuns no grupo acne vulgar que no grupo controle, com significância estatística (p=0,000, p=0,001, p=0,05 e p=0,006 respectivamente). A porcentagem da área de perdas das glândulas meibomianas foi significativamente mais alta no grupo com acne vulgar, tanto na meibografia superior quanto na inferior. A área de perda das glândulas meibomianas demonstrou uma correlação positiva com o escore palpebral total e com o escore de secreção das glândulas meibomianas. Conclusão: A acne vulgar pode levar a uma predisposição para a disfunção das glândulas meibomianas e para danos na superfície ocular. Parece ser importante reconhecer precocemente as alterações das glândulas meibomianas e da superfície ocular, especialmente nos casos de acne vulgar para os quais se planeja o tratamento oral com isotretinoína.

Clinical diagnostic techniques for rare genetic diseases in children: current status, advances, and thoughts / 中国当代儿科杂志

Rare diseases refer to a group of single diseases with low incidence rates, complex pathogeneses, severe disease conditions, and rapid progression. Most rare diseases have a genetic background and may occur in childhood. Paying attention to the rare genetic diseases in children and performing early diagnosis and treatment can effectively delay the course of disease and improve the quality of life of children. Many rare diseases can be diagnosed with the help of various experimental techniques, but the diagnosis of rare diseases is still not widely understood. This article summarizes the laboratory diagnostic techniques currently used for rare genetic diseases in children, so as to provide clues for the diagnosis and treatment of such diseases and help to enhance the theoretical understanding and precise medical treatment of rare genetic diseases in children.

Comparing the vision quality using double-pass technique in eyes with corrected refractive errors and emmetropic eyes / Comparação da qualidade óptica usando a técnica de dupla passagem em olhos com erros de refração corrigidos e olhos emetrópicos

ABSTRACT Purpose: To evaluate the vision quality by measuring the objective light scatter index and objective optical quality parameters (Strehl Ratio and Modulation Transfer Function) in patients with emmetropia and ametropia. Methods: This prospective, cross-sectional study included 408 eyes. The ametropic group comprised of eyes with best-corrected visual acuity of 0.0 logMAR or better and present at least a refractive error of ≥0.25 D. Patients underwent slit lamp examination, visual acuity, refraction, and vision quality using the HD Analyzer. Results: The mean objective light scatter indices were 0.62 ± 0.63, 0.77 ± 0.70, 0.74 ± 0.30, 0.93 ± 0.55, and 0.85 ± 0.61, and mean Strehl Ratio and Modulation Transfer Function scores were 38.17 ± 10.4, 37.37 ± 10.06, 29.84 ± 9.71, 33.2 ± 12.11, and 33.13 ± 10.09 in emmetropes, myopia, hyperopia, spherical equivalent of ≥0, and spherical equivalent of <0, respectively. Differences in all variables were significant between emmetropic and corrected hyperopic and between spherical equivalent of ≥0, and spherical equivalent of <0 eyes (p<0.05). Conclusion: In spectacle-corrected conditions (with trial frames), emmetropic and simple myopic eyes had significantly better vision quality compared to hyperopic and astigmatic eyes. The clinical significance of these results should be investigated in further studies.

RESUMO Objetivo: Avaliar a qualidade óptica medindo o índice de dispersão objetiva de luz e os parâmetros de qualidade óptica objetiva (Razão de Strehl e Função de Transferência de Modulação) em indivíduos com emetropia e ametropia. Métodos: Estudo prospectivo, transversal, incluindo 408 olhos. O grupo ametrópico era de olhos com melhor acuidade visual corrigida de 0,0 logMAR ou melhor e apresentando, pelo menos, um erro refrativo de 0,25 D ou mais. Os pacientes foram submetidos a exame com lâmpada de fenda, acuidade visual, refração e qualidade óptica com o HD Analyzer. Resultados: O índice de dispersão objetiva de luz médio foi de 0,62 ± 0,63, 0,77 ± 0,70, 0,74 ± 0,30, 0,93 ± 0,55, 0,85 ± 0,61 e a média da Razão de Strehl e de Função de Transferência de Modulação foram 38,17 ± 10,4, 37,37 ± 10,06, 29,84 ± 9,71, 33,2 ± 12,11 e 33,13 ± 10,09 em olhos emetrópicos, míopes, hipermétropes, equivalente esférico ≥0 e equivalente esférico <0 respectivamente. Foram encontradas diferenças significativas em todas as variáveis entre olhos emetrópicos e com hipermetropia corrigida, equivalente esférico ≥ 0 e equivalente esférico <0 (p<0,05). Conclusão: Em condições com lentes corrigidas (com armações de prova), os olhos emetrópicos e com miopia simples apresentaram qualidade óptica significativamente melhor em comparação com os olhos hipermétropes e astigmáticos. O significado clínico destes resultados deve ser estudado posteriormente.

Research progress on the diagnostic techniques of early keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

@#Diagnosis of early keratoconus(KC)contributes to identifying potential patients before typical clinical symptoms. It also contributes to timely intervention of the progress of disease and improvement of long-term prognosis. Hence, it is crucial to prevent iatrogenic corneal ectasia and reduce the burden of keratoplasty. There are diverse kinds of early KC diagnosis techniques, including corneal topography, corneal aberrations, epithelial and corneal thickness measurement, corneal confocal microscopy, corneal biomechanics, and genetic examination. Since it is often difficult to ensure sufficient sensitivity and specificity with single technique, multiple techniques are beneficial to evaluate the cornea comprehensively, which may become the development tendency of early KC diagnosis in the future.

Molecular characterization of nontuberculous Mycobacteria in a tuberculosis and HIV reference unit in the State of Amazonas, Brazil

ABSTRACT Background: In recent years, the prevalence of nontuberculous mycobacterial (NTM) infections has increased in different regions of the world. The American Thoracic Society (ATS) recommends standardized identification criteria, reinforcing the need for faster and less complicated clinical and laboratory techniques. Methods: In this retrospective study, NTM species isolated from pulmonary, extrapulmonary, and disseminated samples from patients treated at a TB/HIV reference unit in the State of Amazonas from 2011 to 2014 were identified through a combination of molecular techniques. Results: To identify the molecular technique, 50 cryopreserved NTM cultures were recovered and subcultivated in culture medium. The potentially pathogenic NTM species identified were M. avium, M. intracellulare, M. kansasii, M. chelonae, M. abscessus, M. fortuitum, and M. peregrinum. Results of GenoType® showed moderate agreement with those of genomic sequencing (kappa = 0.60), whereas the results obtained by the PRA-hsp65 technique disagreed with the results obtained by sequencing (kappa = 0.49). Conclusions: Our findings highlight that GenoType CM is a good method for the identification of NTM, as well as the need for the application of standardized criteria, such as those set forth by the ATS.

Presentación y manejo de las cardiopatías congénitas en el primer año de edad / Presentation and management of congenital heart disease in the first year of age

Resumen Las cardiopatías congénitas (CC) se definen como una anomalía estructural del corazón o de los grandes vasos intratorácicos. Constituyen la malformación congénita más frecuente al nacimiento. Al menos un tercio de los pacientes requieren algún tipo de intervención antes del año de edad. Las manifestaciones clínicas de las cardiopatías en la etapa neonatal se presentan con un amplio contexto clínico y se pueden confundir con problemas a nivel pulmonar o infeccioso, lo que dificulta su diagnóstico y con ello contribuyendo de forma importante a la mortalidad y morbilidad de estos pacientes, ya que se retrasa el diagnóstico y manejo oportuno. El monitoreo por oximetría de pulso en el periodo neonatal se utiliza actualmente como método diagnóstico para la detección de cardiopatías congénitas críticas; a pesar de que las detecta en forma temprana, en muchos países aún no se lleva a cabo. El objetivo de este artículo es ofrecer un panorama general de la presentación clínica, aspectos diagnósticos y manejo inicial de las CC en el primer año de edad que pueda ser de utilidad a los médicos de primer contacto para mejorar la atención en este grupo de pacientes.

Abstract Congenital heart disease (CHD) is defined as a structural abnormality of the heart or large intrathoracic vessels. They constitute the most frequent congenital malformation at birth. At least one third of patients require some type of intervention before the year of age. The clinical manifestations of heart disease in the neonatal stage are presented with a wide clinical context and can be confused with problems at the pulmonary or infectious level making difficult to diagnose them and thereby contributing significantly to the mortality and morbility of these patients since the diagnosis is delayed and timely handling. Pulse oximetry monitoring in the neonatal period is currently used as a diagnostic method for the detection of critical congenital heart disease. Although it detects them early, in many countries it is not yet carried out. The objective of this article is to offer an overview of the clinical presentation, diagnostic aspect and initial management of CHD in the first year of age that may be useful to first contact physicians to improve the management of this group of patients.

Peripheral retinal fluorescence features of ultra-wide fundus fluorescein angiography in normal fundus eyes / 中华实验眼科杂志

Objective:To analyze the peripheral retinal fluorescence characteristics of normal fundus on ultra-wide field fluorescein angiography (UWFA) images.Methods:A cross-sectional study was conducted.Ninety-five patients (190 eyes) who underwent normal UWFA in Renmin Hospital of Wuhan University from July 2016 to January 2019 were enrolled.There were 94 (49.47%) male eyes and 96 (50.53%) female eyes.Among them, there were 72 (37.89%) mild cataract eyes, 60 (31.58%) moderate and low myopia eyes and 58 (30.53%) subjective blurred vision eyes.The peripheral retinal fluorescence characteristics were divided into vascular-associated feature or non-vascular feature according to whether the retinal vessel involved or not.The subjects were divided into ≤40 years old group and >40 years old group, and the differences in various features between the two groups were compared and analyzed.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2019-K037). Written informed consent was obtained from each patient prior to any examination.Results:Four non-vascular and five vascular-associated fluorescence features were found in normal peripheral retina.Non-vascular features contained glass hyperfluorescence in 158 (83.16%) eyes, far peripheral retina with mottled florescent band in 82 (43.16%) eyes, granular ground hyperfluorescence in 24 (12.63%) eyes and local mottled fluorescence in 21 (11.05%) eyes.Vascular-associated fluorescence features included peripheral avascular area in 92 (48.42%) eyes, vessels passing through the ora serrata in 66 (34.74%) eyes, microaneurysm in 60 (31.58%) eyes, slight leakage within 10 minutes after angiography in 56 (29.47%) eyes and angiotelectasis in 30 (15.79%) eyes.There were 19.61% (20/102) of eyes with peripheral retinal vessels passing through the ora serrata and 43.10% (44/102) of eyes with microaneurysm and 19.61% (20/102) of eyes with angiotelectasis in >40 years old group, and there were 52.27% (46/88), 18.23% (16/88) and 11.36% (10/88) correspondingly in ≤40 years old group, and the differences were statistically significant ( χ2=22.235, 10.451, 9.259; all at P<0.01). Conclusions:UWFA reveals four non-vascular and five vascular-associated fluorescence characteristics of normal fundus and age might be associated with the distribution of microaneurysm and angiotelectasis.

Biopsia endobiliar con pinza por acceso percutáneo: primera experiencia en Uruguay / Biopsy of biliary ducts via percutaneous catheterization: first experience in Uruguay / Biópsia endobiliária com pinça de acesso percutâneo: primeira experiência no Uruguai

Resumen: Presentamos la primera experiencia en Uruguay de una biopsia endobiliar con pinza por acceso percutáneo que realizáramos en una paciente con estenosis biliar hiliar de probable causa neoplásica. Hasta nuestro conocimiento, no existen reportes de esta técnica en Uruguay. La difusión de la disponibilidad de esta técnica en nuestro medio es de gran importancia, ya que permite al equipo médico tratante disponer de una nueva herramienta para el manejo diagnóstico de las estenosis biliares.

Abstract: The study presents the first experience in Uruguay of a forceps biopsy of biliary ducts via percutaneous catheterization performed in a patient with hilar biliary strictures probably caused by a tumor. As far as we know, no reports on this technique have been published in our country. It is important to spread the availability of this technique in our country since it provides the medical team with a new tool for the diagnostic handling of biliary strictures.

Resumo: Apresentamos a primeira experiência no Uruguai de uma biópsia endobiliária com pinça de acesso percutânea realizada em um paciente com estenose biliar hilar de provável causa neoplásica. Para nosso conhecimento, não há relatos dessa técnica no Uruguai. A difusão da disponibilidade dessa técnica em nosso ambiente é de grande importância, pois permite à equipe médica responsável o tratamento ter uma nova ferramenta para o manejo diagnóstico da estenose biliar.

Research status of virus-related corneal endotheliitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#The virus-related corneal endotheliitis has diverse inducement, complex etiology, unclear pathogenesis, diverse clinical manifestations. There is no unified classification at present. Auxiliary diagnosis technology is improving constantly, loop-mediated isothermal amplification and all kinds of PCR have a certain auxiliary role in the diagnosis of this disease. But the diagnosis also mainly relys on history and clinical manifestation in clinic. Anti-viral drug and glucocorticoid are the main treatment. Virus-related corneal endotheliitis has high recurrence rate, so there is an urgent need to research new drugs and new treatment. Experiment researches of genetic engineering drugs, such as vaccines, unwinding-primers enzyme inhibitors, and chemokine receptors, bring hope to the treatment of virus-related corneal endotheliitis. The purpose of this article is to review the related research of virus-related corneal endotheliitis.

Recent application and outlooks of fluorescent diagnostic techniques in clinic / 医疗卫生装备

Current problems and demands of intraoperative diagnosis were presented. Basic theories and classification of fluorescent diagnostic techniques were introduced, and the advantages compared with traditional pathology were also analyzed.Current research and application status of fluorescent diagnostic techniques were summarized and analyzed in two aspects:spectroscopy analysis and image analysis,and it was indicated that fluorescent diagnosis was important for research and clinical application.Furthermore,future development directions of fluorescent diagnostic techniques were analyzed,and improving accuracy and combining diagnosis with clinical treatment were growing trends in fluorescent diagnostic techniques.

Ultrasound-Guided Percutaneous Core Needle Biopsy of Abdominal Viscera: Tips to Ensure Safe and Effective Biopsy

Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications.

Riesgo cardiovascular en lupus eritematoso sistémico / Cardiovascular risk in systemic lupus erythematosus

Antecedentes: Los pacientes con lupus eritematoso sistémico (LES) tienen mayor frecuencia de factores de riesgo cardiovascular (RCV) tradicionales, esto sumado a la presencia de factores de RCV no tradicionales, aumenta la probabilidad de eventos cardiacos hasta 5 veces. Objetivo: Determinar la frecuencia de los factores de RCV en una población de pacientes con LES. Materiales y métodos: Se realizó un estudio descriptivo, transversal, observacional, en 51 pacientes con diagnóstico de LES. Resultados: Se reportó el patrón lúpico de dislipoproteinemia ya que el 52,9% presentó hipoal-falipoproteinemia, 49% hipercolesterolemia, 35,3% hipertrigliceridemia y 19,6% elevación de c-LDL. Con respecto a las comorbilidades el 31,4% presentó obesidad, 27,5% hipertensión arterial y 6% diabetes mellitus. Los factores de RCV no tradicionales que predominaron fueron los asociados con la actividad de la enfermedad, el 90,1% tomaba glucocorticoides, 70,6% presentó niveles bajos de C3, 66,7% tuvo PCR > 2 mg/l, 56,9% tenía más de 4 puntos de SLEDAI-2 K, 41,2% presentó niveles bajos de C4, 29,4% tenía más de 10 arios de duración de la enfermedad, 25,5% tenía nefritis lúpica. Con lo que respecta a la presencia de anticuerpos asociados a RCV el 58,8, 9,8, 74,8 y el 3,9% presentaron anti-Smith, anticoagulante lúpico, anti-beta 2 glicoproteína I, anticardiolipinas positivas, respectivamente. Conclusiones: Los pacientes con LES presentan un estado proinflamatorio y aterogénico, aumentando el riesgo de desarrollar enfermedades cardiovasculares tanto por mayor incidencia de los factores de riesgo tradicionales, como por la presencia de factores que promueven una inflamación crónica.

Background: Patients with systemic lupus erythematosus (SLE) have a higher frequency of traditional cardiovascular risk factors (CVR). This, combined with the presence of nontraditional cardiovascular risk factors, increases the probability of cardiac events by five times. Objective: To determine the prevalence of CVR factors in a population of patients with SLE. Material and methods: A descriptive, cross-sectional, observational study in 51 patients with the diagnosis of SLE. Results: A lupus dyslipoproteinaemia pattern was reported, of which 52.9% had hypo-alphalipoproteinaemia, 49% hypercholesterolaemia, 35.3% hypertriglyceridaemia, and 19.6% with an elevated c-LDL. The comorbidities found were, 31.4% with obesity, 27.5% with high blood pressure, and 6% suffered from diabetes mellitus. Predominant non-traditional CVR factors were associated with disease activity, with 90.1% taking glucocorticoids, 70.6% had low levels of complement C3, 41.2% had low levels of complement C4, 66.7% had a CRP > 2 mg/l, 56.9% had a SLEDAI-2 K score greater than 4 points, 29.4% had more than 10 years of disease duration, and 25.5% had lupus nephritis. As regards the presence of antibodies associated with CVR, 58.8, 9.8, 74.8 and 3.9% had anti-Smith antibodies, lupus anticoagulant, antibeta2glycoprotein I, and positive anticardiolipin, respectively. Conclusions: Patients with SLE have a pro-inflammatory and atherogenic state, increasing the risk of developing cardiovascular diseases, and therefore a higher incidence of traditional risk factors, such as the presence of factors that promote chronic inflammation.

Modified low cost SNP genotyping technique using cycle threshold (Ct) & melting temperature (Tm) values in allele specific real-time PCR.

Background & objectives: Genotyping has now become one of the major diagnostic means for almost all diseases. Among the advanced techniques that are used to study single nucleotide polymorphisms (SNPs), only a few are applicable for routine disease diagnosis. Their applicability mainly depends on three factors: cost, time, and accuracy. The primary objective of this study was to propose allele-specific real-time PCR as a rapid, low cost and simple genotyping method for routine diagnostics. Methods: Two SNPs, rs3014866 and rs2149356 were analysed using allele-specific real-time PCR. The polymerase chain reaction was carried out using RealQ PCR master mix containing SYBR Green DNA I dye followed by melt curve analysis. The results were validated by agarose gel electrophoresis and DNA sequencing. Results: The allelic discrimination and zygosity of the two SNPs were assessed by combined cycle threshold (Ct) and melting temperature (Tm) values. Variations in Ct and Tm values among the two alleles were observed in both rs3014866 (Ct: C allele - 24±1, T allele - 27±1; Tm: C allele - 82.5±0.3, T allele - 86.3±0.2) and rs2149356 (Ct: C allele - 24±1, A allele - 26±1; Tm: C allele - 79.4±0.2, A allele - 80.4±0.3). Based on the variations, homozygous and heterozygous alleles were detected. Agarose gel electrophoresis and DNA sequencing also confirmed the allelic variation and zygosity observed in real-time PCR. Interpretation & conclusions: In diagnostic settings where a large number of samples are analysed daily, allele-specific real-time PCR assay may serve as a simple, low cost and efficient method of genotyping

Diode laser-assisted transcanalicular dacryocystorhinostomy: the effect of age on the results / Dacriocistorrinostomia transcanalicular auxiliada por laser de diodo: o efeito da idade sobre os resultados

ABSTRACT Purpose: The aim of this study was to explore the effect of age on the success of transcanalicular diode laser-assisted dacryocystorhinostomy (TCDCR). Methods: Seventy patients (70 eyes) who underwent transcanalicular diode laser-assisted dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction as a primary surgery were included in this retrospective, nonrandomized study. The patients were divided into two groups according to age. Mean ages were 21.3 ± 3.3 in group 1 and 60.3 ± 7.3 in group 2. The records of the 3-, 6-, and 12-month follow-up examinations were evaluated, and the anatomical and functional outcomes were noted. Functional success was defined as the absence of epiphora as indicated by the patient. Anatomical success was determined as patency of the neo-ostium with irrigation. Results: At the 3-month follow-up, 67% cases in group 1 showed anatomical success and 52% showed functional success; in group 2, the rates were 100% and 92%, respectively. Functional and anatomical success rates were the same for both the 6- and 12-month visits; 46% in group 1 and 76% in group 2. The results in group 2 were significantly better at all three follow-up visits (p<0.05). Conclusions: This study clearly showed that the older patients experienced better transcanalicular diode laser-assisted dacryocystorhinostomy results than the younger patients. The diminished inflammatory response in the older population may be a possible contributing factor to these results. .

RESUMO Objetivo: O objetivo deste estudo foi explorar o efeito da idade sobre o sucesso de dacriocistorrinostomia transcanalicular auxiliada por laser de diodo (TCDCR). Método: Setenta olhos de setenta pacientes submetidos dacriocistorrinostomia transcanalicular auxiliada por laser de diodo para o tratamento da obstrução nasolacrimal como cirurgia primária foram incluídos neste estudo retrospectivo, não randomizado. Os pacientes foram divididos em dois grupos segundo a idade. As idades médias foram 21,3 ± 3,3 no grupo 1 e 60,3 ± 7,3 no grupo 2. Os registros do acompanhamento pós-operatório aos três, seis e 12 meses, foram avaliados, observando resultados anatômicos e funcionais. Sucesso funcional foi definido como a ausência de lacrimejamento, conforme informado pelo paciente. Sucesso anatômico foi determinado como a permeabilidade do novo óstio à irrigação. Resultados: Nos três meses de acompanhamento, 67% dos casos no grupo 1 apresentou sucesso anatômico, e 52% mostraram sucesso funcional. No grupo 2, as taxas foram de 100% e 92%, respectivamente. Taxas de sucesso funcionais e anatômicas foram as mesmas para ambos os seis e 12 meses de visitas: 46% no grupo 1 e 76% no grupo 2. Os resultados do grupo 2 foram significativamente melhores em todas as três visitas pós-operatorias (p<0,05). Conclusões: Este estudo mostra claramente que os pacientes mais idosos apresentam melhores resultados à dacriocistorrinostomia transcanalicular auxiliada por laser de diodo comparados aos mais jovens. A resposta inflamatória diminuída na população mais velha é um possível fator que contribuiu para estes resultados. .

Clinical Research Guidelines for the Treatment of Eczema with New Uyghur Medicine ;(Draft) / 中国中医药信息杂志

Retrospective multi-center study on medical records of Uyghur medicine diagnosis and treatment program of eczema was done. Demography, diagnostics, therapeutics, efficacy evaluation and nursing data and other information were collated and analyzed. With analysis and summary of the primary and the secondary symptoms, eczema was divided into four types:blood corruption type (Ofunetlengen Kan Tiplik), blue colored yellow bile type (Zenggereng Sapra Tiplik), abnormal black bile type (Hayri Tabii Savda Hilitlik), and salty phlegm type (Shor Belgem Hilitlik). Uyghur Medicine syndrome differentiation and efficacy evaluation criteria were established. Skin itching, lesion shape, and lesion area integral of patients were scored before and after the treatment, respectively. According to the improvement in symptoms of Uyghur medicine syndrome and life quality of patients, and the internal environment change, evaluation criteria for the efficacy of disease symptom combination were established. On this basis, in accordance with the technical requirements of the national new medicine assessment technology, the study developed clinical research guidelines for the treatment of eczema with new Uyghur medicine.

Guideline of Clinical Research of New Drugs of Traditional Uygur Medicine for Treatment of Psoriasis Vulgaris (Draft) / 中国中医药信息杂志

The multi-central clinical records retrospective survey for psoriasis vulgaris was carried out by collecting related information such as demographic, diagnostics, therapeutics, efficacy evaluation, nursing data, and so on. The Uygur medical differentiation classification standard about psoriasis vulgaris was established and it was divided into four types:abnormal Khan Hilit type, abnormal Sapra Hilit type, abnormal saltness Balgham Hilit type, and abnormal Sawda Hilit type, according to main symptom and secondary symptom feature. The disease efficacy evaluation standard was established based on score of surface area and severity of skin injury combining with the changes of main symptom and secondary symptoms. On the basis, guidelines for clinical research of new drugs of Uygur medicine used in the treatment of psoriasis vulgaris were formulated in accordance with the technical requirements and procedure of national center for drug evaluation.

Progression in application of optical coherence tomography in ocular anterior segment examination / 中华实验眼科杂志

Optical coherence tomography (OCT) is a technology that imaging the ocular structure by the interference of light.OCT is invented and applied in the examine and measure of the retina and choroid.However,the development of spectrum domain make the study of ocular anterior segment structure possible.Anterior segment OCT (AS-OCT) can image the tissue structures of the cornea,anterior chamber,pupil,iris,etc.on the same picture.Also,AS-OCT can be used to measure the corneal surface and curvature after excimer laser in situ keratomileusis,the examination of the angle,iris,ciliary body in glaumatous eyes,the observation of dynamic alteration of the filtering bleb following antiglaucoma surgery and the evaluation of ocular anterior segment tissue after eye trauma.AS-OCT examined at a non-contact,non-invasive way with higher resolution and higher speed.In addition,AS-OCT offers the quantitative analysis of the ocular anterior segment.The clinical application,advantages and disadvantages,prospect of AS-OCT in ophthalmology were reviewed in this paper.

Clinical analysis for 51 cases of primary hyperparathyroidism / 中华全科医师杂志

Objective To study clinical characteristics,causes of misdignosis and diagnostic and therapeutic methods for primary hyperparathyroidism (PHPT).Methods Retrospective analysis was done for 51 patients of PHPT,47 confirmed by biopsy after surgical operation and 4 without operation diagnosed based on their serum levels of calcium,alkaline phosphatase ( ALP),intact parathyroid hormone ( iPTH ),and computed tomography (CT) or 99mtechnetium sestamibi (99mTcMIB1) imaging at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou during June 1997 to November 2010.Results Bone-related complications were the most common clinical manifestation,accounting for 51％ (26/51 ) of the cases,and adenoma,a benign,enlarged and hyperactive parathyroid gland,in 34 of 47 cases ( 72％ ).In orthotopic lesions,the right inferior was affected in 19 of 46 cases (41％),followed by the left inferior in 13 cases (28％),while 5 of 51 cases (10％) with ectopic parathyroid gland.PHPT was easily misdiagnosed as urolithiasis,rheumatic disease,primary osteoporosis,etc,accounting for 92％ of the cases in our study.Preoperative serum levels of calcium,ALP and iPTH in the patients varied with their clinical type and pathological classification,the highest in patients with urolithiasis-bone-related complications [ (3.22 ±0.35) mmol/L,(1455 ± 1091 ) U/L and (1669 ± 515 ) ng/L,respectively ] and in patients with parathyroid carcinoma [ (3.46 ± 0.40) mmol/L,( 1410 ± 426) U/L and ( 1861 ± 768) ng/L,respectively ].Sensibility of preoperative localization diagnosis using ultrasonography,CT and 99mTcMIBI was 88％ (35/40),97％ (30/31) and 97％ (31/32),respectively.Conclusions PHPT is frequently misdiagnosed as other diseases.Measurement of serum calcium should be included in routine physical examinations,supplemented with measurement of serum ALP and iPTH,as well as medical imaging,which can help avoid misdiagnosis.CT combined with 99mTcMIBI imaging can improve accuracy of preoperative localization diagnosis.

Study of ocular aberrations with age / Estudo das aberrações oculares e idade

INTRODUCTION: Aging has various effects on visual system. Vision deteriorate, contrast sensitivity decreases and ocular aberrations apparently make the optical quality worse across the years. PURPOSE: To prospective evaluate ocular aberrations along the ages. METHODS: Three hundred and fifteen patients were examined, 155 were male (39.36 percent) and 160 were female (60.63 percent). Ages ranged from 5 to 64 year-old, the study was performed from February to November, 2004. Patients were divided into 4 age-groups according to IBGE (Instituto Brasileiro de Geografia e Estatística) classification: 68 patients from 5 to 14 year-old, 55 patients from 15 to 24 year-old, 116 from 25 to 44 year-old and 76 from 45 to 67 year-old. All patients had the following characteristics: best corrected visual acuity > 20/25, emmetropia or spherical equivalent < 3.50 SD, refractive astigmatism < 1.75 CD on cycloplegic refraction, normal ophthalmologic exam and no previous ocular surgeries. This protocol was approved by Federal University of São Paulo Institutional Review Board. Total optical aberrations were measured by H-S sensor LadarWave® Custom Cornea Wavefront System (Alcon Laboratories Inc, Orlando, FLA, USA) and were statistically analysed. Corneal aberrations were calculated using CT-View software Version 6.89 (Sarver and Associates, Celebration, FL, USA). Lens aberrations were calculated by subtraction. RESULTS: High-order (0.32 e 0.48 µm) and ocular spherical aberrations (0.02 e 0.26 µm) increased respectively in child and middle age groups. High order (0.27 µm) and corneal spherical aberrations (0.05 µm) did not show changes with age. Lens showed a statistically significant spherical aberration increase (from -0.02 to 0.22 µm). Vertical (from 0.10 to -0.07 µm) and horizontal coma (from 0.01 to -0.12 µm) presented progressively negative values with aging. CONCLUSION: High-order and spherical aberrations increased with age due to lens contribution. ...

INTRODUÇÃO: A idade afeta o sistema visual. A qualidade da visão se deteriora progressivamente com a idade, a sensibilidade ao contraste diminui e as aberrações oculares aumentam contribuindo para a piora da qualidade visual. OBJETIVO: Estudar prospectivamente as aberrações oculares entre as idades de 5 a 64 anos. MÉTODOS: Foram examinados 315 pacientes, 155 homens (39,36 por cento) e 160 mulheres (60,63 por cento) com idades entre 5 a 64 anos. O estudo foi realizado entre fevereiro a novembro de 2004. Os pacientes foram divididos em quatro grupos etários de acordo com a classificação do IBGE (Instituto Brasileiro de Geografia e Estatística): 68 pacientes entre 5 a 14 anos, 55 pacientes entre 15 a 24 anos, 116 pacientes entre 25 a 44 anos e 76 pacientes entre 45 a 67 anos de idade. Todos apresentavam acuidade visual corrigida para longe >20/25, emetropia ou equivalente esférico <3,5 DE, astigmatismo <1,75 DC ao exame sob cicloplegia, exame oftalmológico normal e sem cirurgia oftalmológica prévia. O Comitê de Ética da Universidade Federal de São Paulo aprovou esse protocolo. As aberrações foram medidas usando o sensor H-S (Hartmann-Shack) LadarWave® (Alcon Laboratories Inc, Orlando, FL, USA) e foram analisados estatisticamente. As aberrações da córnea foram calculadas usando o programa CT-View Versão 6.89 (Sarver and Associates, Celebration, FL, USA). As aberrações do cristalino foram calculadas por subtração. RESULTADOS: Encontramos um aumento das aberrações de alta ordem (0,32 e 0,48 µm) e da aberração esférica do olho (0,02 e 0,26 µm) respectivamente nas faixas etárias correspondentes às crianças e meia-idade. As aberrações de alta ordem (0,27 µm) e a aberração esférica da córnea (0,05 µm) não se modificaram com a idade. A aberração esférica do cristalino aumentou (de 0,02 a 0,22 µm). O coma vertical e horizontal apresentaram valores negativos progressivamente com a idade. CONCLUSÃO: As aberrações de alta ordem e a aberração esférica ...

The value of esomeprazole test in diagnosing gastroesophageal reflux disease:A randomized multi-center controlled trial / 中华消化杂志

Objective To evaluate the diagnostic value of esomeprazole test in patients with gastroesophageal reflux disease.Methods Consecutive patients with heartburn and/or acid regurgitation in three medical centers were enrolled in a prospective,randomized,double-blind study with a placebo-control design.After upper endoscopy examination,patients were divided into non-erosive reflux diseases and erosive esophagitis.All patients underwent 24-hour ambulatory esophageal pH monitoring.Those who were diagnosed as gastroesophageal reflux diseases had either esophagitis under endoscopy or abnormal esophageal acid exposure in 24-hour ambulatory esophageal pH monitoring.The patients were randomly divided into treatment group and control group.The patients in treatment group were received 40 mg of esomeprazole daily while the patients in control group were given placebo once daily for 14 days.The severity and frequency of heartburn were recorded both by doctors and patients before and during treatment.Results Two hundred and seventeen patients were completed the study(105 patients in treatment group and 112 patients in control group).If the symptom of heartburn which disappeared in the sixth and seventh day of the first week,it was defined as positive for esomeprazole test,the sensitivity and specificity in treatment group were 87.7% and 42.5%,respectively If the symptom of heartburn disap peared in the second week,it was defined as positive for esomeprazole test.The corresponding sensitivity and specificity in treatment group were 84.6% and 45%,respectively.The Youden index was 0.362 and 0.296 for criteria of one and two weeks,respectively.If the heartburn score improved by more than 50%,75% or 100% from the baseline score after treatment,it was defined as positive for esomeprazole test,the sensitivity and specificity were 95.4% and 32.5%,87.7% and 32.5%,84.6% and 45%,respectively.Conclusions The esomeprazole test has high value in diagnosis of GERD with sensitivity of 87.7% and specificity of 42.5%.Positive definition of heartburn disappeared in the sixth and seventh day is superior in cost-effective.