Objective To investigate the effects of subretinal fluid drainage combined with intravitreal anti-vascular endothelial growth factor (VEGF) drugs in the treatment of severe exudative retinal detachment Coats disease.Methods Thirteen patients (13 eyes) with 3B Coats' disease diagnosed at the Eye Center of Tongren Hospital were included in the study.The participants were aged from 1 year to 11 years with a mean age of (4.15 ± 2.99) years.The visual acuity was no light perception in 1 case,from light perception to counting finger in 7 cases,from 0.01 to 0.1 in 2 cases,and could not be measured due to young in 3 cases.Patients underwent retinal fluid drainage combined with intravitreal ranibizumab (IVR,0.5 mg,0.05 mL) at the pars plana of ciliary body,and with retinal laser photocoagulation or cryotherapy according to the retinal peripheral vascular activity.During the follow-up,the visual acuity,intraocular pressure,slit lamp,indirect ophthalmoscope and color ophthalmoscope were examined and observed.The abnormal blood vessel change,absorption of subretinal fluid,retinal reattachment and complication were observed.Results Two subretinal fluid drainage were performed in 3 cases,one subretinal fluid drainage in 10 cases.Six cases were combined with two intravitreal injections,4 cases with three intravitral injection,3 cases with intravitreal injection for more than three times.Five cases were treated with simple photocoagulation,3 cases with simple retinal cryotherapy,and 5 cases with laser combined with cryotherapy.In 13 patients,the visual acuity was improved in 2 cases,unchanged in 8 cases,and could not be measured due to young in 3 cases.Eight cases had complete retinal reattachment.No significant postoperative complications occurred during follow-up,such as endophthalmitis,retinal hole and vitreous hemorrhage.Conclusion Subretinal fluid drainage combined with intravitreal injection is an effective method for severe 3B stage Coats disease.

Objective To investigate the effect of gastric filling degree on the thickness of advanced gastric carcinoma and the clinical value of the thickness measured by CT.Methods Totally 38 patients with advanced gastric carcinoma were enrolled and 21 patients were newly diagnosed,17 patients were reexamination after non surgical treatments.The stomach cavity was filled with oral gas-producing powder.The plain scanning (before filling) and enhanced scanning in venous phase (after filling) were performed.The thickness of the normal gastric wall and gastric carcinoma before and after filling were measured on axial images,and the differences were compared.The patients were measured again one month later by the same investigator,and the consistency between the twice measurements was evaluated.Results Before and after filling,the normal gastric wall thickness of each regions was significantly different (all P＜0.001),and the change was greatest at the region of greater curvature.Carcinoma thickness was similar in newly diagnosed patients (P＜0.05),but significantly different in patients for reexamination (P＜0.05).The twice measurements had a good consistency.Conclusion The thickness of gastric carcinoma can be considered as a baseline measurement indicator in newly diagnosed patients.It is critical to maintaining a similar gastric filling degree during reexamination,which is helpful to evaluate the efficacy of treatment accurately.

Objective To investigate the effects of growth differentiation factor 11 ( GDF11 ) on β-cell function in db/db mice and its possible mechanism. Methods Twenty eight-week-old male db/db mice were randomizedtoi.p. administration of GDF11(0.3mg·kg-1·day-1)or equivalent PBS(n=10)for 6 weeks.10age-matched male db/m were used as normal control, received equivalent PBS injection for 6 weeks. Blood glucose levels, body weights and food intake were monitored weekly. IPGTT and glucose-stimulated insulin secretion ( GSIS) were analyzed. After 6 weeks of intervention, serum HbA1C , TG, TC, and FFA were measured respectively. The concentrations of hormones in serum and pancreas were evaluated. The mRNA expression of Pdx-1, MafA, Nkx6. 1, and insulin2 were determined by RT-PCR. The expression of phosphorylated Smd2 (P-Smad2), Smad2 in islet were examined by western blot. Results Compared with NC group, GDF11 administration decreased FBG, HbA1C , modified lipid profiles. GDF11 improved glucose tolerance and augmented GSIS. Moreover, GDF11 increased serum insulin and pancreatic insulin content, while decreased serum glucagon concentration. The expression of Pdx-1, MafA, Nkx6. 1, and Insulin2 were significantly increased in GDF11 group. GDF11 elevated the expression of P-Smad2 in islets. Conclusion s GDF11 may preserve β-cell function and facilitate the secretion and production of insulin. Diminishing the metabolic abnormalities, alleviating the secretion of glucagon, as well as maintaining the key transcript factor activation may contribute to the amelioration of β-cell function after GDF11 administration. Smad2 pathway may be related to the protective effects of GDF11.

Objective To investigate the effect of growth differentiation factor 11 ( GDF11 ) on aorta in apolipoprotein E-Null( ApoE-/-) mice and its possible mechanisms. Methods Four-week-old healthy male ApoE-/-mice were fed with high-fat diet for 1 week and were then divided into 4 groups:vehicle group(n=10), GDF11 group (n=10),adeno-associated virus-green fluorescent protein group(AAV-GFP group, n=10), and AAV-GDF11 group ( n=10 ) . The mice received intraperitoneal injection with phosphate buffered saline, GDF11 protein, a single injection of purified AAV-GDF11 or AAV-GFP through the tail vein, respectively. After 4 weeks, serum GDF11/8 level and endothelium-dependent vasodilatation were detected. After 12 weeks, serum GDF11/8, interleukin-6 (IL-6), tumor necrosis factor-α( TNF-α), total cholesterol ( TC), triglycerides ( TG), oxidized low density lipoprotein(ox-LDL), and free fatty acids(FFA)levels were measured, the plaque areas in aortic enface and cross sections were measured by oil red O or HE staining, the macrophages/T lymphocytes infiltration in plaques were detected with immunohistochemistry, and the mRNA expressions of IL-6, TNF-α, and IL-10 were determined by real-time PCR. Results Compared with vehicle or AAV-GFP groups, GDF11 and AAV-GDF11 groups presented improved endothelium-dependent vasodilatation, decreased levels of blood inflammatory factors, blood lipid, reduced plaque on face area sections[Vehicle group : GDF11 group:(31. 23 ± 3. 12)% vs (17. 18 ± 2. 17) %;AAV-GFP group : AAV-GDF11 group:(38.01±4.43)% vs(14.54±2.86)%,P<0.05]andcrosssections[Vehiclegroup :GDF11 group:(19. 87 ± 2. 11)% vs (10. 32 ± 1. 47)%;AAV-GFP group : AAV-GDF11 group:(23. 02 ± 2. 76)%vs (9.06±1.63)%, P<0. 05]. There were less macrophages and T lymphocytes infiltration in plaques and lower mRNA expressions of inflammatory factors at aortic wall. Conclusion GDF11 reduces the area of atherosclerotic lesion in ApoE-/-mice, which may be involved in endothelial protection, such as to reduce inflammatory reaction, and to change cellular composition in plaques.

Objective:To investigate the clinical significance of coagulation function related indicators in the prognosis of non-small cell lung cancer.Methods:The clinical data of 248 patients with non-small cell lung cancer from June 2014 to December 2017 in the Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to determine the best cutoff values of prognostic indicators,the Cox regression model was used for multivariate analysis, and the Kaplan-Meier method was used for survival analysis.Results:ROC curve analysis showed that the best cutoff values for D-dimer (D-D), fibrinogen (FIB) and prothrombin time (PT)were 0.18 mg/L, 4.25 g/L and 12.0 s, respectively. Cox multivariate regression analysis showed that increased expression of D-D ( HR=1.197, 95% CI 1.100-1.303), PT ( HR=1.111, 95% CI 1.049-1.176) and FIB ( HR=1.510, 95% CI 1.276-1.788) were risk factors for the prognosis of non-small cell lung cancer ( P<0.001). Kaplan-Meier survival analysis results showed that the overall survival in the high expression group of D-D, FIB and PT was shorter than in of the low expression group ( P<0.001). Conclusion:D-D, PT and FIB are independent factors affecting the prognosis of non-small cell lung cancer.

Dynamic electrocardiography (DCG) or Holter is the best device to detect arrhythmia and can help early detection of some sudden cardiac death risk factors. The acquisition and recording system of the DCG, however, affects the data quality and the patients' comfort directly. This paper reviews the related latest studies, and discusses the importance of new ECG electrode and wireless dynamic monitoring in DCG monitoring field. Moreover, the existed main problems are summarized and classified and the prospects for the development trend are presented.
Electrocardiography, Ambulatory ; instrumentation ; trends ; Electrodes ; Humans ; Wireless Technology

Objective To investigate the effects and possible mechanism of growth differentiation factor 11 (GDF11)on angiogenesis in diabetic hindlimb ischemia. Methods Sixty SD rats were used in this study. Diabetes was induced by intraperitoneal injection of streptozotocin. 3 days after streptozotocin administration, 40 rats with plasma glucose concentration≥16.7 mmol/L were selected in the subsequent experiments. 12 weeks after diabetes was induced,the left femoral artery and all the sides branches were dissected free and excised. After resection of the left femoral artery,rats were randomized to four groups:PBS group(n=10),GDF11 group(n=10),IgG Ab group (n=10),or GDF11 Ab group(n=10). After 0,7,and 14 days,the serial blood flows were measured by a Laser Doppler perfusion image(LDPI)analyzer. To detect capillary endothelial cell,the sections of muscles were reacted with anti-CD31 monoclonal antibodies,and subsequently reacted with Cy3-conjugated anti-rabbit IgG antibody. The expression levels of HIF1α and VEGF were detected by western blotting. Results In GDF11 group significantly increased the blood perfusion and capillary density of ischemia hindlimb of the diabetic rats were found,which was correlated to an increased level of HIF1α and VEGF. In contrast, GDF11 Ab could lead to the opposite effects. Conclusion GDF11 treatment promotes the recovery of diabetic hindlimb ischemia, which may be related to the improvement of expression of HIF1 alpha and VEGF.

Objective:To study the relationship between compartmental kneeosteoarthritis (KOA) and osteoporosis (OP).Methods:A total of 118 KOA patients with 50~80 years old and 16.5~38 of body mass index (BMI) were selected as the KOA group, in which the patient with OP caused by secondary factors were excluded. 42 patients who did not suffer from KOA who matched the age of patients in the KOA group were selected. The age, BMI, bone mineral density (BMD) and other data of the two groups of patients were collected. The correlation analysis between KOA and OP was conducted to determine the degree of correlation, so as to reveal the relationship between the incidence, progression, prognosis of KOA and OP.Results:BMD was correlated with BMI. BMD was negatively correlated with age. The incidence of KOA and OP was correlated with age. There is a large correlation between KOA and OP, and the probability of KOA associated with OP is high. For KOA patients, OP is less likely to be accompanied by a higher BMI, while OP is more likely to be accompanied by a lower BMI.Conclusions:OP is one of the pathogenic factors of KOA. KOA patients should be treated with anti-OP before and after surgery.

Objective To investigate the effect of myeloid-derived growth factor ( MYDGF) on the secretion of glucagon-like peptide 1 ( GLP-1) in type 2 diabetic mice and its mechanism. Methods A type 2 diabetes model was established by injecting streptozotocin into C57BL/6J wild type ( WT) mice and MYDGF knockout ( KO) mice, which were divided into diabetic group ( WT-D, KO-D) and non-diabetic group ( WT-ND, KO-ND) . Six weeks later, the relevant indicators were detected. Next, those mice were divided into wild-type diabetes group (WT-GFP), wild-type diabetes MYDGF intervention group (WT-MYDGF), knockout type diabetes group (KO-GFP), and knockout type MYDGF intervention group ( KO-MYDG ) according to whether or not the AAV-MYDGF intervention was performed. The wild-type non-diabetic mice were used as a blank control group to observe the effects of MYDGF on biochemical indexes, GLP-1 secretion, and mitogen-activated protein kinase kinase ( MEK)/extracellular regulated protein kinases ( ERK) signal pathway in mice. Results After 6 weeks of intervention, there was no significant difference in the glucose and lipid metabolism indexes between WT-ND and KO-ND groups ( P>0.05) . Compared with WT-D group, fasting plasma glucose (FPG), HbA1C, and blood lipid levels in KO-D group were increased, while gcg, pc3 mRNA, and GLP-1 secretion levels were decreased (all P<0.05). Compared with the WT-GFP group, FPG, HbA1C , and blood lipid levels were decreased in WT-MYDGF group, while gcg and pc3 mRNA, and GLP-1 secretion levels were increased (all P<0.05). KO group revealed a result similar to that in WT group after MYDGF intervention. Western blotting showed that the phosphorylation level of ERK1/2 was lowered in KO diabetic mice compared with WT diabetic mice, which was enhanced in WT and KO mice after MYDGF intervention. Conclusions MYDGF promotes the secretion of GLP-1 by activating MEK/ERK signaling pathway, thereby delaying the development of diabetes.

Objective:To observe the clinical effect of 3D digital head-up vitreoretinal surgery and conventional optical microscope surgery in the treatment of persistent fetal vasculature (PFV).Methods:A retrospective case analysis study was performed. From November 2017 to August 2019, the enrolled patienres included that 20 eyes of 19 patients with PFV undergoing 3D digital head-up vitreoretinal surgery and 26 eyes of 26 patients with PFV undergoing traditional microscopic vitrectomy in the Eye Center of Beijing Tongren Hospital. The operation age of patients in the two groups were ≤14 years old and followed up for at least 1 month. There were no significantly statistical differences in gender ( χ2=0.114), age ( t=0.337), axial length ( t=0.578) between the two groups ( P=0.267, 0.782, 0.650). All the patients were operated under general anesthesia by the same doctor. All the surgical procedures were completed by the surgeon watching the 3D screen with 3D glasses, and all the surgical process were observed by the other medical staff including the nurses and the anaesthetists in the observation group. While in the observation group, the surgical doctor and one assistant doctor watched the surgery through the operating microscope, the other doctors watched the 2D surgical video system. The general information, pre-and postoperative visual acuity, anatomical changes and surgical complications were reviewed and compared between the two groups. Difficulty and complexity of each surgery were classified by the chief surgical doctor into 5 scores. 1: easy, 2: a little difficult, 3:much difficult, 4 very difficult; 5:most difficult. Opinions of medical staff majored in or not majored in ophthalmology were also recorded. Independent sample t test was used to compare the count data between the two groups, while chi-square test was used to compare the measurement data. Results:The average operating time was 34.7±8.5 minutes and the difficulty score was 2.8±0.9 in the observation group. The average operating time was 37.5±1.6 minutes and the difficulty score was 3.1±1.1 in the comparison group. There was no significant statistically differences between the two groups ( t=0.782, 0.938; P=0.703, 0.562). Seven eyes had visual acuity improvement at last visit while 13 eyes with no changes compared with pre-operative visual acuity in the observation group, 8 eyes showed visual acuity improvement at last visit while 18 eyes showed no changes compared with pre-operative visual acuity in the comparison group. There was no significantly statistical differences between the two groups ( χ2=0.279, P=0.254). No surgical complications such as endophthalmitis or secondary glaucoma were observed in the two groups. 3D digital system showed better stereoscopic pictures and better resolution compared with traditional microscopic vitrectomy. All the medical staff which participated in the surgery preferred to the 3D digital vitrectomy system. Conclusions:3D heads-up digital vitrectomy shows better stereoscopic pictures and better resolution. 3D heads-up digital vitrectomy and traditional microscopic vitrectomy yielded comparable visual and anatomical outcomes for treatment of pediatric vitreoretinal diseases, however, there is not a significant difference in clinical outcomes.