?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

A total of 115 patients with Hoshimoto thyroiditis were classified under 2 groups: one group being treated with selenium and L-throxine (L-T4) and other group with L-T4 alone.All patients were followed up for 3 months.In the selenium treated group thyroid peroxidase antibody level was decreased in 33 patients (56%) and thyroglobulin antibody level was decreased in cases.

Objective To elucidate the relationship between serum uric acid (SUA) and cardiovascular risk factors in Shandong coastal inhabitants. Methods A random, stratified cluster sampling method was conducted. A population.based cross-sectional survey for hyperuricemia was performed and 4 988 dwellers of Shandong coast were investigated. Fasting SUA,lipid profiles,insulin concentrations,etc.,were determined by automatic biochemical analysis device and electrochemiluminescence analyzer.The investigation of general,healthy and nutritional conditions was carried out by questionnaire. Results In male and female subjects, the cardiovascular risk factors such as systolic blood pressure,diastolic blood pressure, selum ereatinine,total cholesterol.triglvceride,waist circumference and body mass index all increased with rising SUA,and the level of senlm high densitv lipoprotein fell accordingly.Homeostasis model assessment insulin resistance index (HOMA- IR) in female subjects increased by the quartile group,not in male subjects.Compared with SUA<280 μmol/L group.odds ratio(OR) values of hypertension in SUA 280-319,320-349,≥350 μmol/L groups were 1.54,1.88 and 2.70 respectively in female,and 2.29,4.15 and 4.96 for metabolic syndrome (MS).As for male,compared with SUA<280 μmol/L group OR value of hypertension in SUA ≥420 μmol/L group was 1.52,and OR values of MS of 1.41,1.87 and 3.27 occurred in SUA 320～379,380～419,≥420 μmol/L groups.After being adjusted for confounding factors,logistic stepwise regression revealed that elevated SUA was an independent risk factor for hypertension in both genders.Conclusion Elevated SUA level is closely related to the incidence and development of cardiovascular diseases,and should not be ignored in clinical practice.

Objective To observe the effects of fluvastatin on proliferation and apoptosis of HL-60 cells,and to offer the theoretical evidence for tumor treatment.Methods HL-60 cells were divided into:fluvastatin groups(0.5,5.0,10.0 and 20.0 ?mol?L-1),HL-60 control group,positive control group(treated with 10.0 ?mol?L-1ATRA).The live cell number was counted for cell proliferation assay.The growth inhibitory rate of HL-60 cells was detected using CCK-8 kit.The cell cycle distribution and apoptotic rate were measured using flow cytometry assay.Results Compared with control group,after HL-60 cells were treated with 0.5,5.0,10.0 and 20.0 ?mol?L-1of fluvastatin for 1-4 d,the number of live cells decreased in different level(P

Objective:To analyze the clinical features, imaging findings and gene test of patients with type Ⅱ Alexander disease.Methods:All the clinical data of three cases with type Ⅱ Alexander disease from August 2018 to June 2020 in the Department of Neurology, Qilu Hospital of Shandong University (Qingdao) and Qilu Hospital of Shandong University were collected, and their clinical and imaging findings were analyzed retrospectively.Results:All the three patients were middle aged and old men with a chronic progressive course, beginning with weakness of one or both lower limbs, followed by dizziness, dysarthria, dysphagia, sphincteral disturbances, constipation and orthostatic hypotension. Three patients all experienced misdiagnosis (hydrarthrosis, cerebral vascular disease, alcoholism, respectively) at early stage of the disease. Cranial magnetic resonance imaging (MRI) showed mild supratentorial periventricular leukodystrophy, which was not specific. Sagittal cranial MRI demonstrated medulla oblongata and upper cervical cord atrophy called “tadpole atrophy”, which had high suggestive value. The results of gene analysis showed heterozygous mutation of glial fibrillary acidic protein gene, which had been reported as pathogenic gene; c.1091C>T (p.A364V) in exon 6, c.722C>T (p.R258C) in exon 4 and c.197G>A (p.R66Q) in exon 1, respectively.Conclusions:Type Ⅱ Alexander disease is an autosomal dominant disease, most with point mutations, rarely with deletion mutations. Type Ⅱ Alexander disease should be suspected when a patient had signs of lower brainstem involvement such as dizziness, ataxia, pyramidal sign, autonomic dysfunction, especially when cranial MRI showed mild supratentorial leukodystrophy, and medulla oblongata and upper cervical cord atrophy.

Objective To explore the most suitable equation in accessing renal function for the elderly type 2 diabetic patients, and its clinical utility in combination with hypersensitive C-reactive protein (hsCRP). Methods The new Cystatin C-based equations for estimated glomerular filtration rate (Cys-eGFR) and conventional predictive equations were compared with isotopic GFR (iGFR) by linear regression analysis, paired t-test, Bland and Altman procedures and non-parametric receiver operating characteristic (ROC) curves. The new Cys-eGFR equation and hsCRP were also incorporated for detecting renal disease in this population. Results The new Cys-eGFR equation had a better relativity with iGFR (r= 0.767, P＜0.001), a less bias (bias: 0.0007, P＞0.05), a higher conformance (2SD: 21.56), higher sensitivity (90.7%) and specificity (88.6%) for diagnosing moderate decrease in renal function. There was a negative relationship between the new Cys-eGFR and hsCRP (r=-0.655, P＜0.01). When the new Cys-eGFR was 67.06 ml· min-1 ·1.73 m-2 and hsCRP was 5.65 mg/L, the combination of Cys-eGFR and hsCRP was better than the combination of serum creatinine and urine albumin/creatinine ratio in screening stage 3 chronic kidney disease (95%vs.46%). Conclusions The combination of new Cys-eGFR equation and hsCRP may screen an early decrease of moderate GFR.

Objective To reveal the geographical distribution regularity of the normal reference value of old female’s hemoglobin in China,and provide scientific basis for making its unified standards.Methods The normal reference values of 15 690 examples of old female’s hematocrit by the method of hemoglobin cyanide(HiCN)and five geographical factors in 157 areas in China,its distribution regularity and the complex relationship characteristic between geography environment elements were analyzed with the methods of factor analysis,spatial analysis of GIS and correlation analysis.Results By the method of factor analysis,the five factors of geography environment were combined into two common factors F1and F2;the original data was replaced with its scores to infer the regression equation :y^=127.9-0.01009F1-0.01543F2?8.8.And this equation was used to figure out the reference value of 1 288 observation points in China.With support of the model of spatial analysis of GIS,the distribution regulation of old female’s hemoglobin reference value in China and its distribution regularity was west-higher,east-lower,north-higher and south-lower.Conclusion If some area’s altitude(X1),sunshine hours yearly(X2),mean relative humidity yearly(X3),mean temperature yearly(X4),precipitation yearly(X5) are known,this place’s reference value of hemoglobin can be calculated out by using this equation.The reference value of hemoglobin in any areas in China can be gotten from the trend distribution regularity map.

OBJECTIVE:To study the improvement effect of lanthanum hydroxide on chronic renal failure (CRF) hyperphos-phatemia in rats. METHODS:CRF hyperphosphatemia rat model were induced and then randomly divided into model group,lan-thanum carbonate group [0.3 g/(kg·d)],calcium carbonate group [4.2 g/(kg·d)] and lanthanum hydroxide high-dose,medium-dose and low-dose groups [1.5,1,0.5 g/(kg·d)] with 10 rats in each group. They were given adenine 0.2 g/(kg·d)intragastrically in the morning,and then given relevant medicine intragastrically in the afternoon;a week later,they stopped taking adenine but con-tinued to take relevant medicine for 22 d. 10 normal rats were selected as normal control group. General examination was conduct-ed,and renal coefficient,serum contents of calcium,phosphorus,PTH,creatinine(Scr)and usea nitrogen(BUN)were detected after last medication as well as renal pathological change. RESULTS:Compared with normal control group,model group showed CRF sign,renal coefficient,the contents of phosphorus,PTH,Scr and BUN were increased,while the content of calcium was de-creased(P<0.01);renal section showed obvious pathological characteristics. Compared with model group,CRF sign of rats were improved in lanthanum carbonate group,calcium carbonate group and lanthanum hydroxide groups. The renal coefficient (except for lanthanum hydroxide high-dose group),serum contents of phosphorus(except for calcium carbonate group),PTH(except for lanthanum hydroxide low-dose group and calcium carbonate group),Scr(except for lanthanum hydroxide low-dose group and calci-um carbonate group)and BUN were all decreased,while serum content of calcium and calcium-phosphorucs product(only in calci-um carbonate group)was increased(P<0.05 or P<0.01). There was no statistical significance in other difference. The renal sec-tion pathological characteristics were improved. CONCLUSIONS:Lanthanum hydroxide can improve renal function and reduce the level of serum phosphorus in CRF hyperphosphatemia model rats.

Objective To investigate the computed tomography (CT) features of autoimmune pancreatitis (AIP).Methods The CT imaging data of 33 patients with AIP confirmed by pathology and/or steroid therapy were retrospectively analyzed.Image analysis including the shape of pancreas, density of lesion, contrast enhancement, the changes of pancreatic duct and biliary duct, peripancreatic appearances and adjacent organ involvement.T test was performed for statistical analysis.Results Among 33 patients with AIP, 23 cases (70%) with pancreatic parenchyma diffuse enlargement, eight cases (24%) with partial enlargement and two cases (6%) with normal pancreas.The lesions appeared hypoattenuating or isoattenuating on plain CT scan.After contrast-enhanced scan, the average CT values of lesions were (75.7±17.0) Hu at arterial phase, which was lower than that of venous phase (90.7±12.0) Hu, and the difference was statistically significant (t=3.378,P=0.002).The lesions demonstrated as progressive enhancement at venous phase.Among 33 patients, the main pancreatic duct was visible in six patients (18%).Sixteen patients (48%) presented with intrahepatic and extrahepatic biliary tract dilatation caused by intrapancreatic common bile duct stenosis.Thickened envelope-like structure around the lesions, presenting as capsule sign was seen in 14 patients (42%).Extra-pancreatic organ involvement was found in seven patients including three cases of kidney involvement.After treated with steroid, seven patients repeated CT which showed different degrees of improvement.Conclusion The main CT findings of AIP are diffuse and partial enlargement of pancreas with progressive enhancement at venous phase, envelope-like structure around pancreas, and stenosis of intrapancreatic common bile duct, which are important in the diagnosis and differential diagnosis of AIP.

Aim To investigate the effects of metformin on phospho-signal transducers and activators of transcription 3(p-STAT3) expression in the spinal dorsal horn in rats with bone cancer pain(BCP).Methods Healthy female SD rats weighing 200~220 g were randomly divided into four groups(n=12 each): Sham+NS, Sham+Metformin, BCP+NS, BCP+Metformin groups.Normal saline or metformin(200 mg·kg-1) was given intraperitoneally once a day at 7~14 day after surgery in four groups.Mechanical withdrawal threshold(MWT) was measured on-1, 3, 5, 7, 10, 12, 14 day after BCP.The L4-6 segments of spinal cords were used to detect the expression of p-STAT3 by Western blot and immunohistochemical staining technique after the behavioral test was completed on day 14.Results Intraperitoneal injection of metformin reversed hyperalgesia and suppressed the expression of p-STAT3 in BCP rats.Conclusion Metformin can attenuate BCP by inhibiting the expression of p-STAT3 in the spinal dorsal horn.