To evaluate the automated segmentation algorithm for detection of intra - retinal layers to process images obtained from ultra- high resolution optical coherence tomography ( OCT ) . Graph theory and the shortest path search based on dynamic programming were applied to automatically segment the 8 intra - retinal layers. We experimentally verified the accuracy and reliability of the algorithm. The results showed that the intra-retinal layer boundaries between automated and manual segmentations matched well. The algorithm successfully segmented the intra- retinal layers in glaucoma, high myopia, and retinitis pigmentosa patients. The proposed automatic segmentation for intra-retinal layers provides a promising tool for quantitative analysis in clinical diagnosis and treatment.

OBJECTIVETo observe the effect of Aconite cake-separated moxibustion on primary knee osteoarthritis of liver and kidney deficiency type.

METHODSFifty-six cases of such disease (80 knees) were randomly divided into a cake-separated moxibustion group (41 knees) with Neixiyan (EX-LE 5), Dubi (ST 35), Yinlingquan (SP 9) etc. selected, and a western medicine group (39 knees) were treated with oral administration of Sodium Diclofenate Slow-released Tablet.

RESULTSThe cumulative score for symptoms and signs was (37.41 +/- 6.61) points before treatment and (9.37 +/- 8.15) points after treatment in the cake-separated moxibustion group and (37.64 - 6.00) points before treatment and (12.05 +/- 8.83) points after treatment in the western medicine group, with a very significant difference before and after treatment in the two groups (P < 0.01); two months after treatment, it was (11.71 +/- 8.69) points in the cake-separated moxibustion group and (15.95 +/- 9.96) points in the western medicine group, the former being better than the latter (P < 0.05). After the end of treatment, there was no significant difference in the comprehensive therapeutic effect between the two groups (P > 0.05), the cured and markedly effective rate was 63.4% in the cake-separated moxibustion group and 48.7% in the western medicine group, but two months after treatment, the cured and markedly effective rate of 56.1% in the cake-separated moxibustion group was better than 33.3% in the western medicine group (P < 0.05).

CONCLUSIONAconite cake-separated moxibustion has an ideal therapeutic effect on primary knee osteoarthritis of liver and kidney deficiency type, and the therapeutic effect at anaphase is better than that of Sodium Diclofenate Slow-released Tablet.

Aconitum ; Aged ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Moxibustion ; methods ; Osteoarthritis, Knee ; therapy

OBJECTIVETo study the effect of Chinese herbal compound (CHC) on the expression of hepatocyte cytochrome P450IIE1 in rat model of alcoholic fatty liver (AFL).

METHODSThe AFL rats models were established by administering the drinking water with 40%(v/v) ethanol, and the changes of pathology in liver and hepatocyte P450IIE1 expression, as well as the contents of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), vitamin E (VitE) in liver were detected and compared with those in the control group.

RESULTSFatty degeneration in liver recovered normally in the CHC-treated group. Immunohistochemical and in situ hybridization examination showed that CHC could inhibit the hepatocyte cytochrome P450IIE1 expression markedly, and restore the contents of MDA, SOD, GSH, VitE to nearly normal range.

CONCLUSIONCHC can prevent AFL through inhibiting the hepatocyte cytochrome P450IIE1 expression markedly

Animals ; Cytochrome P-450 CYP2E1 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Fatty Liver, Alcoholic ; pathology ; Gene Expression ; Hepatocytes ; drug effects ; enzymology ; Immunohistochemistry ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effect of T-cell vaccination in murine experimental autoimmune hepatitis (EAH).

METHODSTo induce the EAH model, the syngeneic S-100 antigen emulsified in complete Freud's adjuvant was injected intraperitoneally to C57Bl/6 at day 1 and day 7. For T-cell vaccination, splenocytes were removed from animal 2 weeks after induction of EAH and from control animals, and activated in vitro by mitogen stimulation with Concanavalin A (Con A), then inactivated by mitomycin and injected at 5 10(7) cells per animal as T-cell vaccination at 14 and 7 days before first induction of EAH.

RESULTSThe histological grade and serum ALT level of the mice who received T-cell vaccination were decrease significantly, compared with that of model group (1.44+/-0.88 vs. 2.33+/-0.87, t=2.24, P<0.05; 63.0U/L+/-23.4U/L vs. 115.0U/L1+/-39.6U/L, t=2.37, P<0.01, respectively); there was no significant change in mice who received irrelevant T-cell vaccination.

CONCLUSIONT-cell vaccination with T cells from EAH animals, but not with irrelevant T cells, was able to protect animals from EAH.

Animals ; Hepatitis, Autoimmune ; prevention & control ; Male ; Mice ; Mice, Inbred C57BL ; T-Lymphocytes ; immunology ; Vaccination

Objective To study the long-term trend of injury related deaths, the distribution of causes of injuries as well as disease burden in Macheng city, Hubei province, in 1974-2008.Methods Data was gathered from vital statistics and registration system of Macheng city which was established in 1974. Data related to Cause Eliminated Life Expectancy(CELE), years of potential life lost(YPLL)and proportion of YPLL on total deaths were calculated. Results The injury death rates varied between 62.64/100 000 and 154.97/100 000 during that 35 years. In males and females, injury death rates varied between 69.16/100 000-163.86/100 000 and 55.34/100 000-157.35/100 000,respectively. Death rates on injury in males exceeded those of females. The average infant injury mortality was 770.13/100 000, stayed the highest in all of the age groups. In terms of geographic region, death rate showed the highest in the hilly area(37.03/100 000), followed by mountainous area (33.66/100 000)and the rate was lowest in the plain area(31.43/100 000). In terms of causes of deaths, suicide, drowning, suffocation, traffic accident and fall were the five top causes of injury,accounting for 84.26% of all the injury mortality. The mortality of suicide showed highest in the injury mortality accounting for 48.14% of all the injury mortality. Injury was the main causes of death among children and youths. The mortality of injury was the highest in people aged from 15 to 29 years, with 59.38% in males and 62.26% in females. Injury eliminated life expectancy increased while the YPLL due to injury decreased, annually. Conclusion Although the trends of mortality rates on injuries were declining over the past 10 years, it remained high in figures. The main causes of injury shifted around, but suicide had always been the main cause over the years, in different age groups, sex or terrains. The death rate of traffic accident was increasing. Effective control strategies should be formulated based on the caused of death related to injuries and among the high-risk populations.

Objective:To investigate the clinical significance of TP53 allelic state in patients with myelodysplastic syndromes(MDS).Methods:The clinical data of 858 MDS patients who underwent second-generation sequencing(NGS)testing in the First Affiliated Hospital of Soochow University from January 2019 to December 2021 were retrospectively analyzed.Results:The median age of the patients was 52 years old,and median follow-up time was 23.8(0.4-109.6)months.Four hundred and one patients(46.7％)had at least one chromosomal abnormality,including 106 complex karyotypes and 78 monosomal karyotypes.A total of 103 cases of TP53 mutations were identified,with a mutation rate of 12％.Compared with TP53 wild-type,various types of chromosomal abnormalities were significantly more common in patients with TP53 mutations(all P＜0.001).Patients with TP53 mutations had lower hemoglobin levels,lower platelet counts and higher percentage of bone marrow primitive cell compared with TP53 wild type(all P＜0.05),and significantly shorter overall survival(OS).Among 97 evaluable patients,33 cases(34％)were mono-allelic TP53 mutation,while 64 cases were bi-allelic TP53 mutation.Patients in bi-allelic TP53 mutation subgroup had a higher proportion of chromosomal abnormalities and a lower number of co-mutations compared with mono-allelic TP53 mutation.The median OS was 33.6 months in patients with mono-allelic state and only 11.4 months in patients with bi-allelic state(HR=2.138,95％CI:1.053-4.343,P＞0.05).Median OS was not reached in TP53 wild-type patients,and there was a significant difference in OS among TP53 wild-type,mono-allelic and bi-allelic TP53 mutation patients(P＜0.001).Multivariable Cox regression analysis showed that bi-allelic TP53 was an independent predictor of poor outcomes(HR=2.808,95％CI:1.487-5.003,P=0.001),while mono-allelic TP53 mutation and wild-type TP53 were not.Conclusion:Patients with TP53 mutations have a poor prognosis,and bi-allelic TP53 mutations have a worse prognosis compared with mono-allelic TP53 mutations and independently affect the prognosis of MDS patients.

OBJECTIVETo validate transient elastography (Fibroscan) in assessment of hepatic fibrosis in autoimmune hepatitis (AIH).

METHODSLiver stiffness was assessed using Fibroscan in totally 30 patients with AIH. We compared the results of Fibroscan with the Scheuer fibrosis stage in liver biopsy in each patient.

RESULTS4 patients were shown as liver fibrosis stage S0, 6 as S1, 5 as S2, 11 as S3 and 4 as S4. Failure of the Fibroscan measurement occurred in 1 case (3.3%) because of her increased body mass index (BMI). The stiffness of Fibroscan was significantly correlated with the liver biopsy fibrosis stage (r = 0.801, P less than 0.001). The liver stiffnesses between mild and moderate fibrosis (S0-2) and advanced fibrosis (S3-4) were significantly different (t = -3.937, P = 0.001).

CONCLUSIONTransient elastography (Fibroscan) is a promising non-invasive method for detection of fibrosis in patients with autoimmune hepatitis. Its use for the follow up and management of these patients and should be evaluated further.

Elasticity Imaging Techniques ; methods ; Hepatitis, Autoimmune ; diagnostic imaging ; Humans ; Liver ; diagnostic imaging ; Liver Cirrhosis ; diagnostic imaging

OBJECTIVEIn order to provide a reliable basis for the diagnosis and treatment of autoimmune hepatitis (AIH) and its overlap syndrome, we investigated the clinical, immunological characteristics of and the therapeutic methods for AIH and AIH-primary biliary cirrhosis (PBC) overlap syndrome.

METHODSOne hundred seven patients (77 with AIH and 30 with AIH-PBC overlap syndrome) were enrolled in the study. Their clinical manifestations, serum liver function tests (LFTs) findings, serum immunoglobulins, liver histopathological changes and their responsiveness to the therapies were investigated.

RESULTSThe age distribution of AIH patients showed a single peak during their fifties and their main clinical manifestations were malaise, abdominal distension, anorexia and jaundice. Serum gamma globulin and IgG were significantly higher than their normal levels. 74% of the patients were positive for anti-nuclear antibody (ANA), 32% of the patients were positive for anti-smooth muscle antibody (AMA), and over 50% of the patients suffered from concurrent extrahepatic autoimmune diseases. The main histological changes in the liver biopsies were interface hepatitis (65%), lobular hepatitis and rosette formation of liver cells. Bridging necrosis was observed in severe AIH cases. In the AIH-PBC overlap syndrome patients, the levels of serum ALT, AST, GGT, ALP and incidences of ANA and AMA/AMA-M2 were all significantly higher than those of the AIH group. After treating AIH patients with prednisolone and azathioprine (Aza), complete response was seen in 42 cases (70%), sustained response was seen in 26 cases (43%). Sixteen cases had relapses after the withdrawal of the treatment or prednisolone dosage was reduced lower than 10 mg/d. The cases having normal serum ALT, AST, gamma-globulin and IgG levels after treatment were still responding to the reduced prednisolone dosage of 5-10 mg/d without azathioprine added. After combination with ursodeoxycholic acid (UDCA) treatment, the liver function tests (AST, ALT, TBil) of AIH-PBC overlap syndrome patients also significantly improved compared to those before the treatment (P<0.01).

CONCLUSIONAIH and AIH-PBC overlap syndrome are not rare in our clinics. Their diagnoses should be based on the clinical presentations, biochemical and immunological indices and liver histological changes. In AIH cases, once their AST, ALT, gamma-globulin and IgG levels return to normal, the prednisolone dosage can be maintained at 5-10 mg/d and Aza can even be withdrawn. Good improvement for patients with AIH-PBC overlap syndrome can be obtained with UDCA and immunosuppression treatment.

Female ; Hepatitis, Autoimmune ; diagnosis ; drug therapy ; Humans ; Liver Cirrhosis, Biliary ; diagnosis ; drug therapy ; Male ; Middle Aged ; Prognosis ; Syndrome

OBJECTIVETo introduce a new method for repair of eyelid defects.

METHODSEyelid reconstruction was performed using a prefabricated island flap with an expanded forehead myocutaneous flap and hard palate mucoperiosteal graft.

RESULTSFive patients with congenital or acquired eyelid defects were successfully treated with this method.

CONCLUSIONThe introduced method is rational and practical for clinical applications.

Eyelids ; abnormalities ; surgery ; Forehead ; Humans ; Palate, Hard ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVETo study the clinical efficacy of partial glossectomy assisted with temperature-controlled radiofrequency for treating macroglossia.

METHODSThere were 4 patients performed this procedure. We took a rhombus shape incision in the middle of the tongue and performed a wedge excision.

RESULTSThe mouth can close entirely in all of patients and there weren' t hemorrhage and obviously swollen; Tongue's sensory function hadn't disturbance. Masticate function were normal. One patient still had the symptom that tongue lied outside the oral cavity occasionally after operation. The symptom was disappeared after Temperature-controlled radiofrequency (TCRF) ablation. All of patients' parent were satisfied with the results.

CONCLUSIONSPartial glossectomy assisted with temperature-controlled radiofrequency for treating macroglossia is an effective, much safer and less invasive procedure without obvious adverse reactions. There are better prospects for applying.

Catheter Ablation ; Child ; Child, Preschool ; Female ; Glossectomy ; methods ; Humans ; Macroglossia ; surgery ; Male ; Tongue ; surgery ; Treatment Outcome