The characteristics of non-arteritic anterior ischemic optic neuropathy (NAION) include sudden decline of visual acuity, sector-shaped visual field defect connected with the physiological blind spot or hemi-visual field defect, and optic disc edema. Early angiographic abnormalities of optic disc and peripapillary choroidal circulation are important cues for the diagnosis. Angiography combined with visual field test can make the diagnosis more accurate. The pathological mechanism and process of NAION and ischemic cardiovascular/cerebrovascular disease are essentially the same. There are several critical issues in this field we need focus on, including strengthening the cooperation with relevant professional disciplines; improving the ocular ischemia through drugs, intervention and other means; preventing more serious cardiovascular events and intervening in a number of high-risk populations to reduce the incidence of AION.

BACKGROUND:In the clinical treatment of diabetic retinopathy, the therapeutic effects of different filers on the retina and optic nerve after the removal of the vitreous are lack of comprehensive and detailed reports. OBJECTIVE:To observe the changes of retina and optic nerve in patients with diabetic retinopathy after filing cyclic polydimethylsiloxane. METHODS: Totaly 147 patients with diabetic retinopathy undergoing vitreous removal were enroled, including 77 males and 70 females, aged 35to70 years. The vitreous from 74 patients with diabetic retinopathy was filed with cyclic polydimethylsiloxane (test group). The cyclic polydimethylsiloxane was taken out at 3 months post-operation. The vitreous from another 73 patients with diabetic retinopathy was filed with the whole fluorine propane (control group). The changes of retina, optic nerve, intraocular pressure, and the occurrence of vitreous re-hemorrhage and cataract after operation were observed in these two groups. RESULTS AND CONCLUSION: After 7 days of folow-up, the intraocular pressure of patients in the test group was higher than that in the control group (P < 0.05). After 6 months of folow-up, there was no significant difference in the intraocular pressure between these two groups. After 6 months of folow-up, cyclic polydimethylsiloxane was successfuly removed in the test group, retinal blood vessels became thinning with the presence of white sheath, and the number of optic nerves was higher than the control group (P < 0.05). The incidence of vitreous re-hemorrhage and cataract in the test was higher than the control group (P < 0.05). These results demonstrate that after the removal of the vitreous, cyclic polydimethylsiloxane filing can lead to optic atrophy in patients with diabetic retinopathy.

Objective To evaluate the effective method for treatment of premacular hemorrhage. Methods In 36 cases (36 eyes) of premacular hemorrhage (2PD),25 cases were treated with medicine, and 11 cases were treated with laser surgery and medicine. Results In 25 patients treated with medicine, the average time of vision recovery was 24 days and the average time of clearance of vitreous hemorrhage was 40 days; in the other 11 patients treated with laser surgery and medicine,10 were treated successfully, and in these 10 patients, the average time of vision recovery were 5 days and the average time of clearance of premacular hemorrhage were 11 days in 10 cases which were operated successfully with laser in 11 cases. Conclusions Laser surgery of inducing preretinal hemorrhage to vitreous body is an effective method for treatment of premacular hemorrhage to relieve the impaired central vision.

0.05), higher than those in the nighttime (t=3.63,3.16;P

Objective To observe the concentration of plasma endothelin (ET-1) in patients with nonarteritic anterior ischemic optic neuropathy(NAION) and investigate the relationship between ET-1 and NAION. Methods The plasma levels of ET-1 in 41 patients with NAION and 15 age-matched normal control subjects were measured by radioimmuoassay (RIA). The patients with NAION were divided into high papilloedema group, light papilloedema group, and recovery group according to the degree of papilloedema; and were divided into group1 (within 14 days), 2 (within 15-30 days), 3 (within 31-60 days), and 4 (within 61-180 days) according to the disease course. The plasma levels of ET-1 in different groups were detected and compared. Results The plasma level of ET-1 in patients with NAION was significantly higher than that in the normal subjects ( t=5.02,P

Objective To observe the cilioretinal artery and its relationship with central visual loss in central retinal artery occlusion(CRAO) patients.Methods A total of 140 CRAO patients (140 eyes) were enrolled in this study.The patients included 83 males and 57 females.The age was ranged from 42 to 75 years old,with an average of (55.70 ± 22.20) years.All the patients were affected unilaterally,including 79 right eyes and 61 left eyes.The disease duration was from 1 to 10 days,with a mean of (4.7±3.9)hours.Central vision and fluorescence fundus angiography were measured for all patients.The central visual loss was divided into 3 types:mild (≥0.1),moderate (finger counting to 0.08) and severe (no light perception to hand movement).The number,length and location of cilioretinal artery were observed.The correlation between cilioretinal artery and central visual loss was analyzed.Results There were 41 eyes (29.3％) with cilioretinal artery,which including 13 eyes (31.7％) with ≥3 cilioretinal arteries,23 eyes (56.1％) with 2 cilioretinal arteries,5 eyes (12.2％) with 1 cilioretinal arteries.The cilioretinal artery was within 1 disk diameter (DD) in length and not reached the macular area in 37 eyes (90.2％),was more than 1DD in length and reached the macular foveal area in 4 eyes (9.8％).The cilioretinal artery located in the temporal side of optic disk in 29 eyes (70.7％),and in other quadrant in 12 eyes (29.3％).The distribution of central visual loss degree as follow:mild in 15 eyes (10.7％),moderate in 50 eyes (35.7％),severe in 75 eyes (53.6％).The difference of central visual loss in the eyes with or without cilioretinal arteries was not significant (x2=0.16,P＞0.05).Conclusions Cilioretinal artery exists in 29.3％ CRAO eyes.There was no close correlation between cilioretinal artery and central visual loss.

Objective To investigate the effects of Gegenqinlian Decoction on the IL-1β level in the patients with chronic periodontitis.Methods Seventy patients with chronic periodontitis were divided into the observation group and control group,35 cases in each group.The control group was given the periodontal basic treatment.On the basis of the control group,the observation group was given Gegenqinlian Decoction.The probing depth,attachment level and bacterial plaque index level before and after treatment were compared between the two groups.The levels of IL-1β and IL-6 in serum and gingival crevicular fluid were measured before and after treatment in the two groups.Results The total effective rate in the observation group was 94.29%,which was significantly higher than 71.43% in the control group,the difference was statistically significant (χ2=6.437,P<0.05).After treatment,the probing depth,attachment level and bacterial plaque index in the two groups were significantly decreased (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).The levels of IL-1β and IL-6 in serum and gingival crevicular fluid after treatment in the two groups were decreased significantly (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).Conclusion Gegenqinlian decoction can significantly reduce the IL-1β level in the patients with chronic periodontitis,reduces inflammation reaction and improves the therapeutic effect.

Essential hypertension (EH), a complex polygenic disease, is considered to the result of the genetic interaction of multiple gene alterations in concert with environmental factors. Evidences showed that angiotensin-converting enzyme (ACE) gene and G protein beta3 subunit (GNB3) gene are both important susceptibility genes for EH, and that there exists putative biological connection between the two genes in developing hypertension. To investigate whether hypertension was affected by gene-gene interaction between the two genes in the northern Chinese Han population, a case-control association study including 502 hypertensive cases and 490healthy controls was conducted, selecting the ACE gene I/D polymorpinsm and the GNB3 gene C825T polymorphism. Linkage disequilibrium analysis revealed a significant nonrandom distribution only in male hypertensives, indicating that interaction between ACE gene and GNB3 gene may predispose males to the occurrence of hypertension. Multivariate stepwise logistic regression in single locus analysis, with adjustment for common risk factors for hypertension, demonstrated that the OR for DD/ID versus Ⅱ for hypertension among men was significant (OR 1.57; 95% CI, 1.09 ～2.27; P = 0.016) in dominant genetic model. In combination analysis stratified with respect to gender, slightly significant ORs were found after adjustment in males: OR for TT vs CC, 0.11; 95%CI, 0.01 ～0.99; P = 0.049 within ACE DD genotype; OR for DD/ID vs Ⅱ, 1.52; 95% CI, 1.01 ～2.29; P = 0.047 within GNB3 CC+CT genotype. The results suggest that ACE, or a nearby gene, is a male-specific susceptible gene for hypertension, and that there may exist epistatic gene-gene interaction between ACE D allele and GNB3 825C allele.

OBJECTIVETo study the correlation between the expression levels of phagocytic NADPH oxidase p22phox subunit and left ventricular mass index (LVMI) in patients with non-valvular chronic heart failure and explore the role of oxidative stress caused by NADPH oxidase p22phox subunit in left ventricular remodeling.

METHODSSemi-quantitative RT-PCR was used to examine the expression levels of phagocytic NADPH oxidase p22phox in 59 patients with non-valvular chronic heart failure and 20 control subjects. All the subjects underwent ultrasonic cardiography to record their IVST, LVPWT, LVEDd, LVEDs, and EF. Based on the calculated LVMI, the patients were divided into heart failure without LV hypertrophy (LVH) group and heart failure with LVH group.

RESULTSThe patients with heart failure showed significantly higher expression of phagocytic NADPH oxidase p22phox than the control subjects (0.91∓0.37 vs 0.68∓0.33, P=0.039), and the patients with LVH had significantly higher p22phox expression than those without LVH (1.58∓0.20 vs 0.71∓0.24, P=0.026). LVMI showed a positive correlation with the expression of p22phox in these patients (r=0.508, P<0.05).

CONCLUSIONNADPH oxidase p22phox expression level is positively correlated with LVMI and can be indicative of the level of left ventricular remodeling in patients with non-valvular chronic heart failure.

Adult ; Aged ; Case-Control Studies ; Female ; Heart Failure ; metabolism ; physiopathology ; Humans ; Hypertrophy, Left Ventricular ; metabolism ; physiopathology ; Male ; Middle Aged ; NADPH Oxidases ; metabolism ; Ventricular Remodeling

Objective To evaluate the value of ambulatory blood pressure monitoring in evaluating hypertension status and the efficacy of antihypertensive medication in hypertension patients.Methods We retrospectively collected data from 236 elderly hypertensive patients at our hospital from July 2016 to June 2017 and analyzed the blood pressure characteristics of patients under 24 h ambulatory blood pressure monitoring and the effects of different types of antihypertensive medication.Results Of 236 patients with high blood pressure,80.1％ had both higher systolic blood pressure and higher diastolic blood pressure;about 90.0％ had blood pressure load greater than 40.0％;blood pressure in 57.6％ of patients reached its peak both in the morning and in the afternoon;a majority (58.9％)showed a non dipper circadian pattern.After antihypertensive drug treatment,the blood pressure indicators significantly improved(P ＜0.05).Common antihypertensive drugs included calcium antagonists,angiotensin converting enzyme inhibitors (ACEI),angiotensin receptor blockers (ARB),diuretics,beta blockers,and combination drugs.Conclusions 24 h ambulatory blood pressure monitoring can provide comprehensive blood pressure data,help achieve accurate assessment of blood pressure status,and may be used in the evaluation of antihypertensive drug treatment.