Objective To investigate the brain protective effect of isoflurane preconditioning on the rat liver against ischemia-reperfusion through determining the content of S-100β protein in peripheral blood in combination with mitochondrial ultrastructure in rat brain.Methods A total of 45 SD rats were randomly divided into three groups,sham group (group S):the only separation of the hepatoduodenal ligament,but did not block the hepatic portal blood supply; ischemia-reperfusion group (group I/R):liver ischemia 60min,reperfusion 120 min; isoflurane preconditioning group (group ISO):60 min before liver I/R,ISO pretreatment for 30 min,elution in the air after 30 min; 24 h after recirculation the forebrain tissues were rapidly removed.The changes of mitochondrial ultrastructure were observed by electron microscopy.The content of S-100β protein in serum was measured before ischemia and reperfusion 120 min through the application of Elisa kit.Results Marked swelling of mitochondria with disrupted cristae and damaged matrix were observed in group I/R,while relative intact mitochondria were seen in sham and ISO groups.The content of S-100β protein in serum was significantly higher in I/R group [(1.52 ±0.26) μg/ml] than in sham [(0.31 ±0.05)μg/ml] and ISO [(0.79 ± 0.21) μg/ml] groups (P ＜0.05).Conclusions The liver ischemia-reperfusion may injure the brain of the rat and isoflurane preconditioning can protect the rat brain from injury.

Objective To investigate and analyze the clinical effect of shoulder joint impingement syndrome treated with shoulder arthroscopy combined with drugs.MethodsFrom January 2015 to December 2016, 20 patients suffering from impingement syndrome in People's Hospital of Fenghua District were selected as the subjects in this study.Randomly selected patients were divided into the control group and the experimental group two groups, each group of patients were 10 cases.The control group in patients with arthroscopic exploration plus subacromial decompression molding, experimental group was given drug treatment on the basis of the control group, before the end of surgery in patients with intra-articular injection of sodium hyaluronate and Compound Betamethasone Injection.The therapeutic effects of the experimental group and the control group were compared.ResultsAfter the corresponding treatment, there were no complications in the experimental group and the control group.The VAS scores, shoulder abduction and external rotation angles of the experimental group and the control group were significantly higher than those of the control group, with statistical difference (P<0.05).After treatment, the VAS score of the experimental group was (1.7±0.3) points, the external rotation angle was (36.5±13.5) degrees, and the shoulder abduction was (110.5±3.7) degrees.The score of VAS in the experimental group was significantly lower than that in the control group, and there was a statistical difference (P<0.05).ConclusionThe clinical effect of arthroscopic subacromial impingement syndrome combined with drug treatment, can effectively relieve the pain of the patients, improve the patient's shoulder to a certain extent, with further clinical promotion and application significance.

With the wide application of contrast media in modem medicine,contrast-induced nephropathy (CIN) has attracted more clinical attention.Renal ischemia and renal tubular toxicity have been considered to be the pathogenesis of CIN.The most promising biomarkers,except for serum creatinine,include neutrophil gelatinase associated lipocalin (NGAL),cystatin C (Cys C),kidney injury molecule-1 (KIM-1),urine N-acetyl beta-D amino glucosidase (NAG) and micro molecular RNA (microRNA).Before use of contrast media for angiography,both the patient's own risk factors and the contrast-associated risk factors should be carefully evaluated.The patient's own risk factors include basic renal function,diabetes,anemia,homocysteine,etc.The contrast-associated risk factors include the osmotic pressure,viscosity,dosage,application frequency of the used contrast agent,etc.At present,hydration therapy is still the main method for CIN,and other therapeutic methods include medication,such as statins,vasodilators,antioxidants,traditional Chinese medicine,etc.,and blood purification therapy.This paper aims to make a brief summary about the research progress in CIN,focusing on its diagnosis,pathogenesis,risk factors and preventive measures.

Objective:To discuss the characteristics of ultrasound diagnosis of optic disc capillary hemangioma.Methods:The study analyzed retrospectively 7 cases of optic disc capillary hemangioma diagnosed in the Beijing Tongren Hospital from 2015 to 2018. The size, morphology, internal echo, and secondary changes of the lesion were analyzed during ultrasound examination.Color Doppler flow imaging was used to check the blood flow in the lesion.Results:Pre-optic disc occupying lesions could be detected in the ultrasound images of the 7 cases. Lesion size: average base diameters (5.39±1.90)mm×(4.79±1.28)mm, average height (3.61±1.37)mm. Lesion morphology: 5 cases were round, and 2 cases were irregular. Echo within the lesion: 3 cases had medium echo inside the lesion, and 4 cases had high echo inside the lesion. Internal echo characteristics: 5 cases had uniform echo, and 2 cases had uneven echo. Secondary changes: 6 cases had secondary retinal detachment and vitreous opacity, and 1 cases was accompanied by retinal hemangioma in other parts. In all cases, blood flow signals could be detected inside the space-occupying lesions, which were in the form of branches, stripes or spots, and the blood flow spectrum showed a parallel spectrum of arteries and veins.Conclusions:Ultrasound examination of optic disc capillary hemangioma has certain characteristics, which can provide a valuable follow-up basis for clinical diagnosis.

Objective:To compare the agreement of biometric parameters measured by a new swept-source optical coherence tomography IOLMaster 700 and a new Scheimpflug imaging combined with partial coherence interferometry biometer Pentacam AXL in cataractous eyes.Methods:A cross-sectional study was performed.A total of 146 eyes from 76 cataract patients were enrolled in Beijing Tongren Eye Center from 2 to 11 in January 2018, including 69 eyes in 36 males and 77 eyes in 40 females, the age ranged from 35 to 88 years, the mean age was (64.52±11.36) years.Axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), central corneal thickness (CCT) and white-to-white (WTW) were measured with IOLMaster 700 and Pentacam AXL, respectively.The differences and correlations of the biometry parameters between the two devices were assessed.Bland-Altman method was used to evaluate the agreement of these parameters between the two devices and the 95% limits of agreement was calculated.This study adhered to the tenets of the Declaration of Helsinki and was approved by an Ethics Committee of Beijing Tongren Hospital (TRECKY2018-049).Results:The mean values of the AL measured by IOLMaster 700 and Pentacam AXL were (24.03±1.72)mm and (23.98±1.73)mm, Km were (44.04±1.71)D and (43.88±1.72)D, ACD were (3.24±0.47)mm and (3.28±0.47)mm, WTW were (11.82±0.51)mm and (11.49±0.49)mm, respectively.Compared with the values in Pentacam AXL, the AL, Km and WTW were larger while ACD was smaller in IOLMaster 700 with significant differences ( t=18.06, 8.94, 23.83, -15.36, all at P<0.01). The mean CCT values from the IOLMaster 700 and Pentacam AXL were (534.18±30.12)μm and (533.42±28.71)μm, respectively, with no significant difference ( t=1.04, P=0.30). The AL, Km, ACD, CCT and WTW from IOLMaster 700 were highly correlated with those from Pentacam AXL ( r=0.999, 0.992, 0.998, 0.956, 0.942; all at P<0.01). The Bland Altman analysis showed that the 95% limits of agreement of AL, Km, ACD, CCT and WTW were-0.02-0.11 mm, -0.27-0.59 D, -0.10-0.02 mm, -16.5-18.1 μm and 0.00-0.67 mm. Conclusions:IOLMaster 700 and Pentacam AXL have good agreements and narrow 95% limits of agreement in the measurements of AL, ACD, CCT, which can be clinically interchangeable.The 95% limits of agreement of WTW and Km are out of the clinically acceptable range, so the WTW and Km measured by the two devices are not interchangeable.

Objective:To analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound, and compare with choroidal hemangioma.Methods:This was a retrospective study.From January 2016 to February 2018 in Beijing Tongren Hospital, a total of 21 eyes from 21 patients who were clinically diagnosed as choroidal metastasis were included as the choroidal metastasis group and 46 eyes from 46 patients who were diagnosed as choroidal hemangioma during the same period were included as the choroidal hemangioma group. All patients underwent contrast-enhanced ultrasound examination, and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues, including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (mTT). The quantitative parameters between choroidal metastasis and normal orbital tissues were compared. And the quantitative parameters between choroidal metastasis and choroidal hemangioma were compared. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance.Results:The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues, while RT, TTP and mTT were significantly shorter than these of normal orbital tissues (all P<0.01). The IMAX of choroidal metastasis was lower than that of choroidal hemangioma, and RT, TTP and mTT were shorter than choroidal hemangioma (all P<0.01). The ROC curve analysis showed that area under curves of the IMAX, RT, TTP and mTT were 0.775 (95% CI=0.666-0.884), 0.970 (95% CI=0.896-0.996), 0.729 (95% CI=0.607-0.831) and 0.992 (95% CI=0.931-1.000) respectively. The sensitivities were 71.7%, 95.7%, 76.1% and 95.7%, and the specificities were 85.7%, 90.5%, 66.7% and 95.2%, respectively. Conclusions:Contrast-enhanced ultrasound can reflect the differences in perfusion characteristics between choroidal metastasis and choroidal hemangioma. RT and mTT are useful parameters in differential diagnosis between the two types of tumors.

Objective To compare the agreement of axial length (AL),anterior chamber depth (ACD) and keratometry measured by IOLMaster 500 with IOLMaster 700 in cataract eyes with high myopia.Methods A cross-sectional study was performed.One hundred and fifty-two eyes of 87 cataract patients with high myopia were included from September to October 2017 in Beijing Tongren Hospital.The best corrected visual acuity (BCVA) was 0.05-1.0,and the refraction power was-6.25--21.00 D,with an average power of (-13.625 ± 7.375) D.A L,ACD and keratometry (Kf,Ks) were measured by IOLMaster 700 and IOLMaster 500 respectively for all the eyes.The eyes were assigned to AL＞26-≤28 mm group,AL＞28-＜30 mm group and AL≥30 mm according to the results of IOLMaster 500.The measured differences between two devices were assessed using paired samples t-test,and the measured consistency of the two devices was evaluated using Bland-Altman agreement analysis.This study protocol was approved by Ethics Committee of Beijing Tongren Hospital and complied with Declaration of Helsinki.Results There were no significant differences in the AL and Kf measured by the two devices in all the three groups (all at P＞0.05).Both ACD and Ks values measured by IOLMaster 700 were lower than those by IOLMaster 500 (both at P＜0.05),which were clinically acceptable.The percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,2.17％ and 3.03％ for AL differences and 4.10％,4.34％ 和 3.03％ for Kf difference in the three groups.Significant differences were found in ACD and Ks between IOLMaster 700 and IOLMaster 500 at a clinically acceptable level (both at P＜0.05),and Bland-Altamn agreement analysis showed that the percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,4.34％ and 3.03％ for both ACD and Ks differences in the three groups.Conclusions There is a good agreement in AL,ACD,Kf and Ks measured by IOLMaster 700 with IOLMaster 500 and is clinically interchangeable in cataract eyes with high myopia.However,IOLMaster 700 is better because it can provide the OCT image of macula.

Objective To observe the application value with color Doppler flow imaging (CDFI) in the detection ofmacular diseases in senile cataract.Methods A cross-sectional descriptive study.From December 1 to December 30,2017,720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study.There were 330 males (629 eyes) and 390 females (751 eyes),with the mean age of 70.35 ± 19.05 years.There were 716 right eyes and 664 left eyes,with the visual acuity 0.05-0.8.The fundus of all the patients can be observed.All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A.Comparing the detection rate of macular lesions between the two methods by using X2 test.Using statistical methods to evaluate diagnostic tests,a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions.Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT),average thickness (AT),with or without macular anterior membrane,retinal folds,retinal cystoid edema,hard exudation,macular hole or lamellar macular hole,superficial detachment of neuroepithelium,detachment of pigment epithelium,vitreous macular traction.Results Two hundreds and thirty-nine eyes (17.3％) showed macular disease by OCT,and 161 eyes (11.7％) showed the abnormal echo in the macular region by CDFI.The detection rate of the macular disease between two methods were statistically significant (χ2=851.661,P＜ 0.001),however,the consistency was well (r=0.766,P=0.000).Logistic analysis showed that the detection rate of macular lesions was related to retinal folds,cysts in retina and CFT (r=1.396,1.041,0.12;P＜0.01).Conclusion CDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.

Objective To evaluate the value of color Doppler ultrasonography in the diagnosis of retinoblastoma (RB). Methods One hundred and eighty-two patients (199 eyes) with RB confirmed by pathology from June 2012 to June 2016 in Beijing Tongren Hospital were included in this study. The two-dimensional gray-scale image and color Doppler imaging ultrasound features were observed. The variance analysis was used to compare the width and height of different morphologies. Comparison the detection rate of the two methods by χ2test.Results The ultrasonography of RB was characterized by substantial masses of the eyeball, which could be hemispherical, spherical, irregular, filled with vitreous cavity, or diffuse along the retina. The results of variance analysis showed statistical difference in three shapes (F= 29.134, 24.474, P<0.001),LSD-t test showed difference between hemisphere and spherical,spherical and irregular shape, hemispherical and irregular shape. The t values of basal width were 2.457,-2.333 and-6.205, respectively and all P < 0.05 respectively. The t value of height were 3.917,-6.711 and-7.244, respectively and all P < 0.05.All lesions were uneven echo. Calcification and localized low echo area within the mass was observed in 93.47% (186/199) and 52.76% (105/199) eyes respectively. 46.73% (93/199) retinal detachment and 31.16% (62/199) vitreous opacity is present. Colorful blood flow signals extended from the central retinal vessels could be seen inside the masses of 98.49% (196/199) eyes. Two-dimensional image and color Doppler imaging ultrasound were consistent with the pathological diagnosis in 96.5% (192/199) and 99.5% (198/199) RB cases, respectively.The difference was statistically significant (χ2=4.167, P=0.031). Conclusions Retinoblastoma has characteristic ultrasound manifestations. Color Doppler ultrasonography is a valuable clinical tool in the diagnosis of RB.

Objective To explore the value of conventional ultrasound, color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of sub-retinal hemorrhage. Methods A total of 26 patients with sub-retinal hemorrhage were examined by conventional ultrasound, color Doppler ultrasound and CEUS. The results of medical history, ultrasound, color Doppler ultrasound and CEUS were recorded and analyzed.And the difference of the detection rate between the three methods was analyzed by χ2test. Results The mean fundus diameter of the sub-retinal hemorrhage was (5.31±2.21) mm, and the mean height was (1.97±0.98) mm. In twenty-two eyes (84.6%) the lesions were located in the posterior pole of the ocular wall, while in two eyes (7.7%) the lesions were located in the equator and peripheral of the ocular wall. Seven eyes (26.9%) had dome-shaped mass, ten eyes (38.5%) had flat-shaped mass, and nine eyes (34.9%) had irregular-shaped mass. The echogenecity of the lesions was homogeneous in twelve eyes (46.2%), and heterogeneous in fourteen eyes (53.8%). The lesions showed clear margin in seventeen eyes (65.4%). Blood flow signals can be detected in twenty-three eyes (88.5%). The surface of the lesions was filled by contrast-medium in all cases. The detection rate of sub-retinal hemorrhage with color Doppler and contrast-enhanced ultrasound was higher than that of conventional ultrasound, and the difference was statistically significant. Conclusion Color Doppler ultrasonography and CEUS can provide a powerful basis for the clinical diagnosis of sub-retinal hemorrhage, while CEUS has higher application value.