Two structural predictors of visual outcome of idiopathic epiretinal membrane surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate two structural predictors of visual outcome of epiretinal membrane surgery.METHODS:Retrospective study for 30 eyes of epiretinal membrane surgery between January 2014 and October 2016.We assessed the related parameters of the optical coherence tomography and recorded the best-corrected visual acuity(BCVA) at baseline and 1,3 and 6mo after surgery.Correlations between the final best-corrected visual acuity and photoreceptor integrity status or photoreceptor outer segment length were investigated.RESULTS:Average best-corrected visual acuity decreased at 1mo postoperatively compared with baseline,but improved at 3 and 6mo.Central macular were more sweller at 1mo postoperatively than baseline,but a significant thickeness reduction was found at 6mo (P＜ 0.05).Photoreceptor outer segment length were shortened at 1 mo compared with preoperation (P＜0.05),gradually approached the baseline level at 3 and 6mo.Multivariate regression the final best-corrected visual acuity associated with photoreceptor integrity and photoreceptor outer segment length (P=0.023,0.004).CONCLUSION:Photoreceptor integrity and photoreceptor outer segment length detected by OCT were significant predictors of the final best-corrected visual acuity(BCVA) after idiopathic epiretinal membrane surgery.

Sciatic nerve regeneration in a rat model of brain injury at different locations / 中国组织工程研究

BACKGROUND:Previous studies have shown that traumatic brain injury can promote the regeneration of peripheral nerve by reducing scar collagen in nerve endings.OBJECTIVE:To investigate the effect of brain injury at different locations on the ipsilateral rat sciatic nerve regeneration.METHODS:Ninety-nine healthy male Sprague-Dawley rats were equivalently randomized into three groups:group A,right sciatic nerve transection;group B,right sciatic nerve transection combined with right brain injury;and group C,right sciatic nerve transection combined with left brain injury.All of transected nerves were sutured under microscope.Classical Feeney method was used to establish a model of traumatic brain injury.At 4,6,8,10 and 12 weeks after modeling,the sciatic functional index (SFI) was calculated by measuring footprint.At 4,8 and 12 weeks after modeling,the bilateral gastrocnemius were harvested for determining wet weight and calculate wet weight ratio,followed by acetylcholinesterase staining at the motor end plate to detect the absorbance values.At 4,8 and 12 weeks after modeling,fluoro-gold retrograde tracing was used to trace L4-5 vertebrae for 1 week,and the number of spinal cord anterior horn motor neurons positive for fluoro-gold was detected and calculated by fluorescence microscope.RESULTS AND CONCLUSION:The SFI value in each group was gradually improved with time.The SFI value was significantly higher in the groups B and C than the group A at 4 and 6 weeks after modeling (P ＜ 0.05),and was further improved in the group B at 8 weeks compared with the groups A and C (P ＜ 0.05).The wet weight ratio of gastrocnemius showed no significant difference among groups at 4 weeks after modeling (P ＞ 0.05),and the group B showed a significantly higher wet weight ratio than the other groups from the 8th week (P ＜ 0.05).Compared with the groups A and C,the absorbance values of motor endplate in group B appeared to be a significant increase at the beginning of the 8th week (P ＜ 0.05).At 4 and 6 weeks after modeling,the number of spinal cord anterior horn motor neurons positive for fluoro-gold was significantly nigher in the groups B and C than in the group A,and the number was significantly higher in the group B than the groups A and C at 12 weeks (all P ＜ 0.05).These finding manifest that brain injury can promote the repair of ipsilateral sciatic nerve injury,thus proving theoretical reference for unveiling the mechanism by which traumatic brain injury promotes peripheral nerve regeneration.

Clinical Profiles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients

BACKGROUND AND PURPOSE: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries. METHODS: This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients. RESULTS: ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded. The most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor deficits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological deficits recorded in a few patients. After a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). CONCLUSIONS: With the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profiles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specific markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fluid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.

Clinical Profiles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients

BACKGROUND AND PURPOSE: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries. METHODS: This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients. RESULTS: ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded. The most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor deficits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological deficits recorded in a few patients. After a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). CONCLUSIONS: With the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profiles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specific markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fluid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.

Neuroprotective effect of donepezil on β-amyloid25～35-induced neurotoxicity / 中华神经医学杂志

Objective To investigate the neuroprotective effect of cholinesterase inhibitor donepezil on β-amyloid25～35 (Aβ25～35)-induced neurotoxicity and its related mechanism.Methods PC12 cells were conventionally cultured.Serial concentrations of Aβ25～35 and donepezil (0,0.5,1,5,10,20 and 50 μmol/L) were added to PC 12 cells and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) staining was then employed to detect their effects on PC12 cell viability; pretreatments with 1,5,10,20 and 50 μmol/L donepezil were given to the PC12 cells 2 h before adding 20 μmol/L Aβ25～35 as pretreatment groups A,B,C,D and E,and normal control group Ⅰ and 20 μmol/L Aβ25-35 treatment group were chosen; MMT assay was again used to detect the PC12 cell viability and level of lactate dehydrogenase (LDH).Pretreatment with 10 μmol/L GF109203X (protein kinase C [PKC] antagonist) given to the PC12 cells 30 min before adding 10 μmol/L donepezil was carried out as pretreatment group F,and normal control group Ⅱ,10 μmol/L GF109203X treatment group and 10 μmol/L donepezil treatment group were chosen; the expressions ofphosphorylation-PKC (P-PKC) and its major substrate phosphorylated myristoylated alanine-rich protein C kinase substrate (P-MARCKS) were measured by Western blotting; the effect of donepezil on PKCα and PKCε isoforms subcellular distribution were detected by immunofluorescence staining.Results Aβ25-35 (5,10,20 and 50 μmol/L) treatment for 24 h could decrease the cell viability in PC12 cells in a dose-dependent manner (P＜0.05); as compared with PC12 cells in the control group,the 20 μmol/L Aβ25 ～35 treatment group enjoyed lower PC12 cell viability and higher release of LDH.As compared with 20 μmol/L Aβ25～35 treatment group,pretreatment groups B,C,D and E enjoyed increased cell viability and decreased LDH release (P＜0.05).Western blotting indicated that 10 μmol/L donepezil treatment can promote PKC and MARCKS phosphorylation as compared with control group,and the expressions of P-PKC and P-MARCKS in the pretreatment group F were significantly lower than those in the donepezil group (P＜0.05).Immunofluorescence staining indicated that PKCα and PKCε isoforms located mainly in the cytoplasm of PC12 control cells,while donepezil could increase the expressions of PKCα and PKCε isoforms in the membrane fraction.Conclusion Donepezil can antagonize Aβ25-35-induced neurotoxicity in PC12 cells and PKC activation may underline the donepezil' s neuroprotective effect.

Atorvastatin combined with clopidogrel in preventing carotid artery atherosclerostic plaques of aged patients with infarction / 中华神经医学杂志

Objective To observe the clinical effects of atorvastatin combined with clopidogrel on the prevention of carotid artery atherosclerostic plaques in aged patients with infarction. Methods Eighty aged patients with infarction, admitted to out hospital from July 2006 to September 2010, were chosen; these patients were randomly divided into observation group (n=40, giving treatment of atorvastatin combined with clopidogrel) and control group (n=40, giving treatment of treatment of Clopidogrel). The levels of triglyceride (TG), total cholesterol (CH), low-density lipoprotein cholesterol (LDL-C) and lactate dehydrogenase (LDH), the blood viscosity and the platelet maximum aggregation rate (MAR) were measured and the plaque scores were evaluated 4, 12 and 24 w after the treatment.Results As compared with those before treatment, the levels of TG, LDL-C and MAR in the control group 24 w after treatment, and the levels of TG and CH in the observation group 12 w after treatment and the levels of TG, CH, LDL-C and MAR in the observation group 24 w after the treatment were significantly decreased (P<0.05). As compared with the control group, the observation group enjoyed significantly lower level of CH 12w after the treatment and lower levels of TG, CH and LDL-C 24 w after the treatment (P<0.05). Lower plaque scores in the observation group were noted as compared with that in the control group 24 w after the treatment (P<0.05). Conclusion Atorvastatin combined with clopidogrel can safely prevent and stabilize the carotid artery atherosclerostic plaques in aged patients with infarction.

Characteristics of prospective memory impairment and event-related potentials changes in Parkinson's disease patients without early treatment / 中华神经医学杂志

Objective To investigate the characteristics of prospective memory impairment and event related potentials(ERPs)changes in Parkinson's disease(PD)patients without early treatment.Methods Event-based prospective memory(EBPM),time-based prospective memory(TBPM)and ERPs were examined in 33 PD patients and 31 healthy controls matched with age,gender,education and occupation.Results The scores of EBPM and TBPM in PD patients were significantly lower than those in normal controls(P＜0.05).The latencies of N2 and P300 were significantly prolonged,and P300amplitude was markedly decreased in PD patients as compared with those in normal controls(P＜0.05).The relative analysis showed that the P300 latency was positively correlated with both EBPM(r=0.628,P=0.000)and TBPM(r=0.582,P=0.000).Conclusion The EBPM and TBPM impairment might exist in PD patients without early treatment; the P300 latency can be used as a predictive electrophysiological marker to assess the severity of EBPM and TBPM impairment in PD patients.

Preliminary molecular epidemiology of the Staphylococcus aureus in lower respiratory tract infections: a multicenter study in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Staphylococcus aureus (S. aureus) remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus in lower respiratory tract infections (LRTIs) have been documented. The aim of this study was to explore the molecular epidemiology of S. aureus in LRTIs in China.</p><p><b>METHODS</b>A multicenter study of the molecular epidemiology of S. aureus in LRTIs was conducted in 21 hospitals in Beijing, Shanghai and twelve other provinces from November 2007 to February 2009. All the collected S. aureus strains were classified as minimum inhibitory concentration (MIC), mecA gene, virulence genes Panton-Valentine Leukocidin (PVL) and γ-hemolysin (hlg), staphylococcal cassette chromosome mec (SCCmec) type, agr type, and Multilocus Sequence Typing (MLST).</p><p><b>RESULTS</b>Totally, nine methicillin-sensitive S. aureus (MSSA) and 29 methicillin-resistant S. aureus (MRSA) strains were isolated after culture from a total of 2829 sputums or bronchoalveolar lavages. The majority of MRSA strains (22/29) had a MIC value of ≥ 512 µg/ml for cefoxitin. The mecA gene acting as the conservative gene was carried by all MRSA strains. PVL genes were detected in only one S. aureus strain (2.63%, 1/38). The hlg gene was detected in almost the all S. aureus (100% in MSSA and 96.56% in MRSA strains). About 75.86% of MRSA strains carried SCCmec III. Agr type 1 was predominant (78.95%) among the identified three agr types (agr types 1, 2, and 3). Totally, ten sequence type (ST) of S. aureus strains were detected. A new sequence type (ST1445) was found besides confirming ST239 as the major sequence type (60.53%). A dendrogram generated from our own MLST database showed all the bootstrap values ≤ 50%.</p><p><b>CONCLUSION</b>Our preliminary epidemiology data show SCCmec III, ST239 and agr type 1 of S. aureus as the predominant strains in LRTIs in Mainland of China.</p>

Drug-resistant genes carried by Acinetobacter baumanii isolated from patients with lower respiratory tract infection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acinetobacter baumanii (A. baumanii ) remains an important microbial pathogen resulting in nosocomial acquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple β-lactamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections (LRTIs).</p><p><b>METHODS</b>Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods.</p><p><b>RESULTS</b>Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanii strains to ampicillin and first- and second-generation cephalosporins (94.87%, 100% and 97.44%, respectively), but also to the third-generation cephalosporins (ceftriaxone at 92.31%, ceftazidine at 51.28%) and imipenem (43.59%) as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-Ia was found in 23 strains, and the aac-6'-Ib gene in 19 strains. aac-3-Ia and aac-6'-Ib genes hibernated in three A. baumanii strains that showed no drug-resistant phenotype.</p><p><b>CONCLUSIONS</b>A. baumanii can carry multiple drug-resistant genes at the same time and result in multi-drug resistance. Aminoglycoside-modifying enzyme genes could be hibernating in aminoglycoside sensitive strains without expressing their phenotype.</p>

Endourological Treatment of Pediatric Urethral Hemangioma with Holmium Laser / 实用儿科临床杂志

Objective To explore the curative effect of endourological treatment of pediatric urethral hemangioma with holmium laser.Methods Two children with urethral hemangioma were enrolled in this study. One urethral hemangioma in the bulbous urethra,another in the posterior urethra. Modalities of diagnosis before operation included B ultrasound,intravenous urogram(IVU) and endoscopy. Two children with urethral hemangioma underwent holmium laser therapy.Results After endourological trearment with holmium laser, two children had been cured.Six months to 4 years follow-up did not find recurrent urethral hemangioma.Conclusions The diagnosis of pediatric urethral hemangioma mainly rely on endoscopy. Endourological treatment with holmium laser is a minimally invasive,safe and effective methods for pediatric urethral hemangiomas.