AIM: To observe of optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) image feature in polypoidal choroidal vasculopathy (PCV).METHODS: Selected 21 patients 21 eyes with PCV in our hospital from January 2016 to December 2016.All the eyes were examined by ICGA, and was examined by OCTA after ICGA examination 1h.We observed the characteristics of OCTA and ICGA images.RESULTS:ICGA examination showed that there were 8 cases of choroidal abnormal branch vascular network (BVN), polypoid lesions 10 eyes, BVN with polypoid lesions 2 eyes, no abnormal performance 1 eyes.OCTA examination showed 8 eyes of BVN, and the location, range and shape of BVN were similar to ICGA in OCTA examination.ICGA examination showed 10 cases of polypoid lesions.OCTA showed strong signal highlights.ICGA examination showed 2 cases of BVN complicated with polypoid lesions, and OCTA examination showed strong signal highlights of BVN and corresponding parts.ICGA examination showed no abnormal performance in 1 eyes, and no abnormal findings in OCTA examination.CONCLUSION: OCTA and ICGA are similar in the location and morphology of PCV lesions, and OCTA may play a role in the diagnosis of PCV restricted ICGA.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.

OBJECTIVE: To analyze the therapeutic effect of proton pump inhibitor(PPI) on alleviation of hoarseness symptoms in patients with laryngopharyngeal reflux(LPR). METHOD: The LPR outpatients in ENT department of our hospital(60 cases)complained of hoarseness were enrolled in the study from August of 2013 to October of 2014. All of them were randomly divided into group A and B. The individuals in group A (30 cases) taked golden voice capsule to treat for 3 months, while the individuals in group B (30 cases) taked golden voice capsule and omeprazole to treat for 3 months. The data about reflux symptom index (RSI), reflux finding score (RFS) and voice handicap index (VHI)from the first month to the third month after treatment were recorded and compared group A with group B. RESULT: The scores of RSI and RFS in patients (60 cases) before treatment were significantly correlated with their VHI (r=0. 823, P<0. 01; r=0. 873, P<0. 01). The score changes of RSI and VHI from the first to the third month after treatment in group B were significantly higher than those in group A (P<0. 01). Meanwhile, the score changes of RFS from the third month after treatment in group B were significantly higher than those in group A (t=8. 307, P<. 01), but the differences were not significant for RFS from the first to the second month after treatment between group A and group B(t=1. 128, P>0. 05; t=0. 376, P> 0. 05). CONCLUSION PPI therapy could significantly alleviate the hoarseness symptom in LPR patients.
Hoarseness ; drug therapy ; Humans ; Laryngopharyngeal Reflux ; drug therapy ; Proton Pump Inhibitors ; therapeutic use

Objective:To understand the expression levels of Tim-3,a new proinflammatory factor in the early stages of Echinococcus granulosus infection in mice.Methods: BALB/c mice were infected with E.granulosus.Peritoneal macrophages and spleen cells were collected at 1,5,9 and 13 days post-infection.At different time points ,the levels of Tim-3 in peritoneal macrophages and spleen CD3+lymphocyte subsets were detected by FCM , and the relative expression of TLR 4 mRNA was detected by qRT-PCR.Results:There was no significant difference in the expression levels of Tim-3 of CD3+spleen lymphocyte subsets between E.granulosus group and control group (P>0.05).The expression levels of Tim-3 of spleen macrophages (9,13 days) and peritoneal macrophage (5,9,13 days) were much higher in E.granulosus infected group than those in control group with statistical significance (P<0.05).The numbers of macrophages were no change.Compared with control groups,the relative expression of TLR4 mRNA at 1 day post-infection was statistically higher in E.granulosus infected group ( P<0.05 ).Conclusion:During early stage of E.granulosus infection in mice,the levels of Tim-3 expression are upregulated,while the expression of TLR4 are downregulated,which may inhibit the function of macrophages resulting in host-immunity-defensive-system inhibition and immune tolerance of E.granulosus to host.

Objective:To investigate the effects of TGF-β1 on T lymphocytes of BALB/c mice infected with Echinococcus granulosus( E.granulosus ) in vitro.Methods: The inhibitor group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and SB525334.The control group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and PBS.The blank group:the spleen cells of BALB/c mouse were co-cultured with RPMI-1640 medium and SB525334.The lymphocytes were collected at 48 h post-infection.The T lymphocyte subsets, the number of CD4+CD25+T cells, the number of NK cells, and the expression of NKG2D receptor were detected by flow cytometry.The NK cell activity was determined with the lactate dehydrogenase leakage assay(LDH).Results:The inhibition the TGF-β1 receptors resulted in the increase of in the number of CD4+T cells,the decrease in the number of CD8+T cells,the increase of in the ratio CD4+/CD8+T cells,the decrease of in the number of CD4+CD25+T cells,the increase in the expression of the NKG2D receptors,the increase in the lysis rate of Yac-1 cells by NK cells,and a positive cor-relation between the expression of activity receptor NKG2D and killing activity of NK, which were mediated by E.granulosus.Conclusion: The inhibition of TGF-β1 receptors can enhance the immune response of T lymphocytes against E.granulosus infection in vitro.

Objective To investigate the clinical features of Guillain-Barre syndrome (GBS) and clarify the long-term prognosis of acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Methods We conducted an analysis of the clinical data of 50 patients with GBS treated in our hospital between 2003 and 2007. According to the eleetrophysiological criteria, the eases were classified into AIDP (n=24) and AMAN eases (n=22), with 4 eases of unknown classification. The patients unable to walk upon discharge were followed up for more than 6 months, and the clinical features and prognosis of the two groups were compared. Results The age, gender, cranial nerve involvement, Hughes grade at the initial neurological examination and at the time of symptom peak did not differ significantly between the patients with AIDP and AMAN (P>0.05), and most of the AMAN patients had a good recovery. The number of patients capable of walking at one month after the onset was comparable between the two groups (P>0.05). In AMAN group, the percentages of patients with slow recovery and those having rapid recovery were significantly higher than those in AIDP group (P<0.05). Conclusion The clinical recovery of AMAN patients can be either rapid or prolonged, and rigorous immunotherapy should be administered to achieve early recovery and ensure more favorable outcomes of the patients.

OBJECTIVETo investigate the growth inhibition and apoptosis of gastric cancer cell MKN45 induced by oridonin and its mechanism.

METHODSThe MTT method was used to investigate the inhibitory effect of oridonin on MKN45 cells. The AO/EB and Hoechst 33258 staining were used to observe the cell morphologic changes of apoptosis induced by oridonin. Prophase apoptotic ratio and cell cycle change were evaluated by GuavaEasycyte PCA-96 system. The expressions of Bcl-2, Bax and caspase 3 proteins were determined by Western blot.

RESULTSOridonin significantly inhibited the proliferation of MKN45 cells in dose- and time-dependent manner. Typical apoptotic features of the cells treated with oridonin were found by AO/EB and Hoechest33258 staining. When MKN45 cells were treated with different doses of oridonin for 12 h, the prophase apoptotic ratio was stepped up from 3.3% (untreated group) to 8.7%-17.9%; after 24 h, from 4.8% (untreated group) to 13.9%-29.3%. There was significant difference between treated and untreated groups (P <0.01). After treatment with oridonin for 24 h, MKN45 cells were arrested at G(2)/M phase. Western blot analysis showed up-regulated expression of Bax and caspase-3, and no significant change of Bcl-2, but Bcl-2/Bax ratio decreased significantly.

CONCLUSIONSOridonin significantly inhibits the proliferation of MKN45 cell. Apoptosis of MKN45 induced by oridonin may be associated with the up-regulated expression of Bax and the change of Bcl-2/Bax ratio, thus to activate the caspase pathway.

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Diterpenes, Kaurane ; pharmacology ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Stomach Neoplasms ; metabolism ; bcl-2-Associated X Protein ; metabolism

BACKGROUNDVaspin is a newly-identified adipocytokine related to obesity and insulin sensitivity. However, its pathophysiologic role in humans remains largely unknown. The aim of our study was to investigate the relationship between serum vaspin level and glucose metabolism or obesity in Chinese adults.

METHODSA total of 123 subjects, including 84 subjects with normal glucose tolerance (NGT) and 39 subjects with diabetes, were enrolled in this study. Anthropometric parameters, abdominal fat areas, plasma glucose concentration, serum insulin, lipids, and vaspin level were measured in each participant.

RESULTSSerum vaspin concentration was significantly higher in diabetic patients than that in NGT subjects (592 (438 - 695) pg/ml vs 380 (294 - 517) pg/ml, P = 0.020) in women. In all participants, age, fasting plasma glucose concentration (FPG), 2-hour post-load plasma glucose (PG2h), hemoglobin A1c (HbA1c) and high-density lipoprotein cholesterol (HDL-c) significantly increased from the lower tertile to the higher tertile of vaspin. Univariate linear regression analyses revealed that vaspin level was only positively correlated with age (beta = 0.340, P = 0.002) in NGT subjects. And vaspin was positively associated with FPG (beta = 0.365, P = 0.023), PG2h (beta = 0.526, P = 0.001), HbA1c (beta = 0.388, P = 0.016), and HDL-c (beta = 0.353, P = 0.027), while negatively with homeostasis model assessment of beta cell function (HOMA-beta) (beta = -0.361, P = 0.024) in diabetic patients. In stepwise multivariate regression analyses, age was independently associated with circulating vaspin in NGT subjects, whereas PG2h was an independent predictor of vaspin in diabetic patients. In addition, there was no significant difference of serum vaspin level between men and women. And no significant correlations between vaspin and body fat indexes were detected.

CONCLUSIONSSerum vaspin level is higher in diabetic patients than that in NGT subjects in women. Age predicts serum vaspin level in NGT subjects, while PG2h is independently associated with vaspin in diabetic patients.

Adult ; Aged ; Blood Glucose ; metabolism ; Diabetes Mellitus ; blood ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Postprandial Period ; Serpins ; blood

Objective:To explore the application value of wide detector multi-slice spiral CT target scanning technique in the preoperative evaluation of pancreatic cancer.Methods:The clinical data of 22 patients with pancreatic cancer who underwent pancreatic arterial contrast enhanced CT scanning and were diagnosed by pathology in the First Affiliated Hospital of Naval Medical University from September 2019 to October 2019 were analyzed retrospectively. The CT phantom experiment was carried out on the international standard phantom CATPHON500. By changing the scanning radiation dose, scanning mode and scanning field of view, the spatial resolution and density resolution of the image were compared and analyzed. The target scan technical parameters obtained from the experiment were applied to the late arterial phase of MDCT enhanced scan in 22 patients with pancreatic cancer. Executive current, volume scanning mode and small scanning field were used for scanning. The attenuation value (CT value) and noise value (SD value) of pancreatic cancer tissue and normal pancreatic tissue were measured at different phases, the attenuation difference and contrast signal-to-noise ratio (CNR) of the two tissues were calculated, the contrast difference between the two tissues was evaluated, and the CT values of celiac trunk, renal artery and vein, superior mesenteric artery and vein, splenic vein and portal vein were measured, and the display of tumor tissue and peripancreatic important vessels was evaluated.Results:In the phantom experiment, under the condition of the same radiation dose, the image quality of the volume scan mode was better than that of the spiral scan mode (1%@4 mm versus 1%@9 mm at 5 mGy and 1%@2 mm versus 1%@6 mm at 25 mGy). In comparison between pancreatic tumor and pancreatic tissue, the enhancement process of pancreatic tumor tissue was increased at first and then decreased, while that of pancreatic tumor tissue was slightly enhanced. The attenuation difference between pancreatic tissue and tumor tissue and CNR also increased at first and then decreased, reaching the maximum at the late arterial stage [(91.96±29.29)HU, 8.60±5.71]. The differences between each phase were statistically significant ( F values were 47.20 and 19.80 respectively, all P values <0.05). The evaluation of vascular variation and invasion showed that a better arterial phase image could be obtained on the late arterial target scan images, while taking into account the display of splenic vein, mesenteric vein and portal vein. Conclusions:The wide detector MDCT target scanning technique can improve the spatial resolution and density resolution of the image, greatly improve the contrast between tumor tissue and peripancreatic tissue and blood vessels, and provide more accurate tumor staging and resectability evaluation information for preoperative evaluation of pancreatic cancer.

AIM: To investigate the application value of optical coherence tomography angiography(OCTA)in observing retinal microvasculature in patients with diabetic retinopathy(DR). METHODS: Prospective research. The 84 patients(98 eyes)with DR admitted to our hospital during 2017-06/2019-12 were selected as the study group, and were further divided into non-proliferative DR group and proliferative DR group according to the degree of DR. Another 60 cases(68 eyes)with simple diabetes mellitus who underwent physical examination in our hospital during the same period were selected as the control group. The OCTA was used to quantitatively analyze the microvessels in the retinal macular area of the subject, and the built-in analysis software was used to obtain the blood flow density(SCP, DCP)of the superficial and deep parafoveal retina, the area and circumference of the foveal avascular zone(FAZ), the roundness index, full-thickness retinal blood flow density(FD-300). The differences of quantitative indexes, the correlation between OCTA parameters and DR severity and the diagnostic value of DR were compared.RESULTS: The study group's FD-300, SCP and DCP were lower than those of the control group(t=6.476, 8.907, 5.078; all P<0.05), while the FAZ circumference and the roundness index were higher than those of the control group(t=4.380, 10.542; all P<0.05). The FD-300, SCP and DCP of the proliferative DR group were lower than those of the non-proliferative DR group(t=2.668, 3.408, 3.103; all P<0.05), while the FAZ circumference and the roundness index were higher than those of the non-proliferative DR group(t=2.550, 5.563; all P<0.05). Pearson correlation analysis shows that FD-300, SCP, DCP were negatively correlated with disease severity(r= -0.485, -0.546, -0.522; all P<0.05), FAZ circumference and morphological index were positively correlated with disease severity(r=0.426, 0.443; all P<0.05). ROC curve analysis showed that the area under the curve for FD-300, SCP, DCP, FAZ circumference, and FAZ morphological index to diagnose DR were 0.835(95%CI: 0.722-0.947), 0.806(95%CI: 0.701-0.911), 0.849(95%CI: 0.770-0.928), 0.768(95%CI: 0.641-0.896), 0.742(95%CI: 0.633-0.850), respectively. CONCLUSION: OCTA can clearly monitor the morphology of superficial and deep capillaries in the macular area of patients with DR. The quantitative index of blood flow density is negatively correlated with the severity of the disease, which has high clinical value for the diagnosis of DR.