AIM:To investigate peripapillary vessel density and its relationship with other ocular parameters in highly myopic eyes with peripapillary intrachoroidal cavitation (PICC), and to analyze risk factors for PICC.METHODS:Cross-sectional study.A total of 35 highly myopic eyes with PICC, 40 highly myopic eyes without PICC and 35 normal eyes were included in this study.All participants underwent fundus photography and spectral-domain optical coherence tomography (SD-OCT).OCT angiography was also performed to image the retinal vasculature in the peripapillary areas of different sectors, including the radial peripapillary capillaries (RPC) and optic nerve head (ONH) layer.The difference of morphology changes in optic disc and peripapillary vessel density between these three groups were compared.Correlations between peripapillary vessel density and PICC and risk factors for the presence of PICC were analyzed.RESULTS: Significant differences were found among the three groups in spherical equivalent refraction (SER), best-corrected visual acuity (BCVA), axial length, peripapillary atrophy β-zone (β-PPA) area, retinal nerve fiber layer (RNFL) thickness and the presence of tilted optic disc, posterior staphyloma and myopic maculopathy (MMD) (P<0.05).There were significant differences among the three groups in the peripapillary vessel density both in RPC (54.34±5.58, 57.54±7.44, 64.42±3.50) and ONH (51.24±7.43, 52.75±9.96, 61.25±4.15) layers (P<0.001).In highly myopic eyes, vessel density was significantly lower in eyes with PICC than in those without in inferotemporal area both in the RPC (56.76±6.62,63.84±6.02,67.52±4.78) and ONH (56.47±5.79,60.38±4.72,64.18±4.37) layers.The vessel density was significantly correlated with the presence of MMD, β-PPA area and RNFL thickness in the RPC layer, whereas correlated with the presence of MMD, PICC and RNFL thickness in the ONH layer (P<0.05).Tilted optic disc and posterior staphyloma were independent risk factors for the presence of PICC (OR=8.007, 95%CI: 2.045-31.348;OR=7.558, 95%CI: 1.398-50.026).CONCLUSION:Highly myopic eyes with PICC had relatively lower peripapillary vessel densities, especially in the temporal area, than those without.Tilted optic disc and posterior staphyloma were independent risk factors for the presence of PICC.

ObjectiveTo evaluate the applicability of modified formulas based on plasma creatinine levels in Chinese patients with chronic kidney disease (CKD). MethodsA total of 327 CKD patients were investigated. Glomerular filtration rate (GFR) was estimated with Chinese equations and Ruijin equation. The accuracy of estimated GFR was compared with 99mTc-DTPA-GFR (sGFR) in CKD patients. ResultsBland-Ahman analysis demonstrated that Ruijin equation was more consistent with sGFR than the other equations. But all the equations were not well consistent with sGFR. Linear regression showed that the slopes of Ruijin equation and MDRD-1 equation were closer to the identical line. 15%, 30% and 50% accuracy of Ruijin equation were higher than the other equations. But 30% accuracy of Ruijin equation was still less than 70%. When the accuracy of estimated GFRs was compared with sGFR in different stages of CKD, GFR estimated by Ruijin equation showed good results. ConclusionsWhen plasma creatinine is checked with enzymatic method, modified GFR estimation equations may show great bias in Chinese CKD patients. More clinical trails should be carried out to evaluate and identify the application of modified GFR estimation equations in Chinese patients with CKD.

Objective To investigate the relationship between the clinical character and pathological variants as well as response to treatment of focal segmental glomerulosclerosis(FSGS) in children.Methods The clinical feature, laboratory data and histological variants of 48 children with idiopathic FSGS proven by renal biopsy were studied retrospectively. Among them,34 were boys;14 cases were girls. The age ranged from 1.75 to 16.0 years.Results Of 48 children with FSGS,nephrotic syndrome in 32(66.7%)was the predominant clinical manifestation. The pathological classification included FSGS not otherwise specified(NOS) in 29 cases(60.42%), perihilar variant in 14 cases(29.17%), tip variant 3 cases(6.25%), cellualr variant 2 cases(4.17%)and no collapsing variant. The different pathological variants had similar rate of segmental sclerosis glomeruli; perihilar variant had a higher global sclerosis glomeruli than FSGS NOS and other variants and there was a statistical significance(P 0.05).Vascular lesions were rarely seen in all kinds of histological variants of children.Conclusions Hypertension and renal insufficiency are less frequently seen in children FSGS, isolated hematuria as unique clinic presentation is common in FSGS. All pathological variants have tubular-interstitial lesions, but vascular lesions are rarely seen. Most FSGS children with nephrotic syndrome are sensitive to steroid at initial stage, and easy to develop frequent relapse gradually, immunosuppressive agent may be helpful to elevate remission rate.

OBJECTIVETo observe the effect of formula of removing both phlegm and blood stasis (TYTZ) in inhibiting the inflammatory reaction in Chinese mini-swine with coronary atherosclerosis.

METHODTotally 36 Chinese mini-swine were randomly divided to six groups: the normal control group, the model group, the Shujiangzhi group and TYTZ groups with does of 2.0, 1.0 and 0.5 g x kg(-1), and six each in every group. Except for the normal control group, all of other groups were fed with high-fat diet for 2 weeks. Interventional balloons are adopted to injure their left anterior descending artery endothelium. After the operation, they were fed with high-fat diet for 8 weeks to prepare the coronary atherosclerosis model. In the 8th week after the operation and administration, the intravascular ultrasound was adopted to observe the coronary artery plaque burden of each group and the pathological morphology of coronary artery. Such inflammatory factors as high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 were detected by ELISA. The expression of NF-kappaB p65 nuclear translocation was observed by the immunohistochemical method.

RESULTCompared with the normal control group, the model group showed significant increase in the coronary artery plaque burden at the end of the experiment (P < 0.01), notably abnormal structural changes in atherosclerotic vascular tissues, luminal stenosis, a large number of foam cells and inflammatory cell infiltration, remarkable growth of hs-CRP, TNF-alpha and IL-6 levels (P < 0.01). The immunohistochemical staining also showed the significant increase in the NF-kappaB p65 nuclear translocation of coronary artery of Chinese mini-swine in the model group. Compared with the model group, TYTZ could significantly attenuate atherosclerotic plaque burden (P < 0.01), inhibit the coronary luminal stenosis, reduce inflammatory cell infiltration, decrease such inflammatory cell factors as hs-CRP, TNF-alpha and IL-6 in serum, and inhibit the NF-kappaB p65 nuclear translocation of coronary artery (P < 0.05 or P < 0.01).

CONCLUSIONTYTZ can reduce the downstream inflammatory reaction by controlling NF-kappaB p65 nuclear translocation, so as to inhibit the occurrence and development of coronary atherosclerotic plaque in Chinese mini-swine.

Animals ; C-Reactive Protein ; metabolism ; Coronary Artery Disease ; blood ; complications ; drug therapy ; pathology ; Female ; Inflammation ; complications ; Interleukin-6 ; blood ; Male ; Medicine, Chinese Traditional ; methods ; Mucous Membrane ; drug effects ; secretion ; Swine ; Swine, Miniature ; Tumor Necrosis Factor-alpha ; blood

Background Retinitis pigmentosa (RP)is a common hereditary blinding eye disease in ophthalmology.Current researches documented that RP may have the common pathophysiologic basis to Alzheimer disease and chronic neurodegenerative disease.Understanding this mechanism will offer a new therapeutic target for RP.Objective The purpose of the present study was to investigate the roles of cyclin-dependent kinase 5 (Cdk5)/P25 activation in the apoptosis of retinal neural cells of RCS rats.Methods Eighteen SPF RCS rats and 18 RCS-rdy+ rats were randomized into 17-,25-and 35-day groups respectively and 6 rats for each.The rats were sacrificed at corresponding time points and retinal hemogenete was prepared.Expressions of CdkS,P35,P25 and tau phosphorylation in the retinas were detected by Western blot,and the kinase activity of Cdk5/P25 was analyzed by quantitative colorimetric assay.Results The expressing level of P35 protein(A340) in the retinas of 17-day-old RCS rats was near that of 17-day-old RCS-rdy+ rats(t =0.52,P＞0.05).In 25-and 35-day-old RCS rats,the expressing levels of P35 protein were 2.20±0.48 and 1.23±0.14,which were higher than those of RCS-rdy+ rats(1.43±0.13 and 0.93±0.10),showing significant differences between them(t =3.78,4.28,P＜0.05).The expression of P25 was undetectable at postnatal 17 days in RCS rats and RCS-rdy+ rats,but it showed significantly higher in RCS rats(0.300±0.003 and 0.230±0.004) than that in RCS-rdy+ rats(0.040±0.004 and 0.070±0.004) at postnatal 25 days and 35 days(t=121.81,77.51,P＜0.01).No significant difference was found in the expression of Cdk5 in RCS rats and RCS-rdy+ rats at different ages (t =-0.60,0.19,1.62,P＞ 0.05).The kinase activity of Cdk5/P25 did not show significantly different between RCS and RCS-rdy+ rats at postnatal 17 days(t =0.19,P＞0.05),but significantly higher kinase activity of Cdk5/P25 was seen in RCS rats (0.0058 ±0.0005 and 0.0056±0.0004) than that in RCS-rdy+ rats(0.0038±0.0003 and 0.0032 ±0.0007) at postnatal 25 days and 35 days (t =8.07,5.97,P＜ 0.01).No expression of tau phosphorylation was detected in RCS rats at postnatal 17 days,but significantly higher tau phosphorylation level was seen in RCS rats at postnatal 25 days and 35 days(1.80±0.22 and 1.23±0.17),which were significant different in comparison with RCS-rdy+ rats at postnatal 25 days and 35 days(1.60 ±0.20 and 1.04 ±0.12)(t=4.71,3.17,P＜0.05).Conclusions The Cdk5/P25 kinase activity shows a consistent trend with theexpressions of P25 and tau phosphorylation in the RCS rats,indicating that the upregulation of P25 induces the enhance of enzyme activity of Cdk5,which phosphorylate its substrates to result in more apoptosis of retinal neural cells.

Objective To review the radiological findings of the chondroblastomas on the atypical sites of the skeleton system.Methods We collected the total image data of 13 patients who were pathologically confirmed the chondroblastomas on the atypical sites of the bone system from the department of orthopedics in shanghai No.6 hospital since 1991.Among all the patients,11 cases were male and others were female.The range of age was 10—50 years and the average age of the patients was 26.2 years old.A retrospective analysis of radiological signs from different diagnostic imaging modalities was made.Results X-ray examination was underdone on all case.On the plain X-ray films,all cases were lytic lesions.The radiolucent lesions were seen in 10 cases,mixed density in 3 cases.10 cases manifested expansible contour. Eleven cases were performed computed tomography(CT)examination.On CT,there were visible calcification in 8 cases,sclerotic margin in 10 cases,internal septation in 4 cases.Soft masses could be seen in 3 cases.Magnetic resonance examination(MRI)was done on 5 cases.On T_1 weighted images(T_1WI), the lesion was hypo and intermediate intense signal and heterogeneous hyperintense signal on T_2 weighed images(T_2WI).The fluid-fluid level and solid-fluid level were seen on 3 cases.On one post-contrast examination,the moderate enhancement was seen on the solid portion of the tumor and however,the obvious enhancement on the septation within the lesion.Conclusion The radiological findings of the chondroblastomas on the atypical sites of the bone system were not suggestive.However,it could display some particular signs of the chondroid tumors such as calcification,septation,etc.To effectively apply the different imaging modalities can be helpful to make a right diagnosis before the operation.

Objective To evaluate values of magnetic resonance imaging(MRI)in eyes filled with silicone oil.Design Prospective cases series.Participants 40 eyes of 40 patients were filled with silicone oil after ocular injury.Methods MRI was performed in the 40 patients,including axial FSE T_1WI,T_2WI,coronal T_2WI with fat saturation,oblique sagittal T_1WI and axial T_2FLAIR.MRI findings,in- cluding morpbous,signal and complications were analyzed.Oculi axes were measured.Main Outcome Measures Morphous,signal, complications and oculi axes of the eyes filled with silicone oil.Results Affected oculi axis was 2.18cm?0.21cm,normal oculi axis was 2.48cm?0.16cm.The silicone oil in eyes demonstrated isointense signal or slightly hyperintense signal on T_1WI and T_2WI,hypointense signal after fat saturation.Hydrops was found in vitreous cavity in 33 patients,including simple hydrops in 17 patients and complicated other abnormality in 16 patients.Choroidal detachment was found in 11 patients,complicating vitreous hydrops in 5 patients and lo- calized bulge of eyeball wall.Retinal detachments were found in 4 patients,of whom 3 patients complicated with vitreous hydrops.Per- fluorocarbon liquid residual in vitreous cavity,foreign body in anterior chamber,localized thickness of the wall of the globe and meagre- mean of silicone oil in vitreous cavity were found respectively in one patient complicating vitreous hydrops.Except for eye changes, fracture of orbital wall and foreign body in orbit were found in one patient.Conclusions MRI can display the changes of eyes filled with silicone oil,and measure oculi axes biologically and accurately offering important clinical application value.(Ophthalmol CHN,2007,16: 312-315)

In order to understand whether some special amino acids in the medial vestibular nucleus (MVN) of rats are involved in the regulation of blood pressure, we used microdialysis technique and high performance liquid chromatography (HPLC) to measure the changes of glutamate and taurine in this central area. Acute hypotension was induced by hemorrhage from the femoral artery. It was observed that the basal release of glutamate and taurine in the MVN was stable about 90 min after the beginning of microdialysis. The basal release of glutamate was (18.96 +/- 0.27) pmol/sample (8 mul), and that of taurine was (7.73 +/- 0.05) pmol/sample (8 mul). Glutamate release increased (P<0.05) and taurine release reduced (P<0.05) in the MVN in the hemorrhage-induced acute hypotensive rats. Nevertheless, these changes were not observed in the hemorrhage-induced acute hypotensive rats which were pretreated by infusing 2% lidocaine into the middle ear or 100 mg arsanilic acid into the tympanic cavity. These results suggest that the hemorrhage-induced acute hypotention can influence the activity of the neurons in the MVN by the afferent impulses from vestibular organ, and that some special amino acid transmitters in the MVN are involved in this process.
Animals ; Blood Pressure ; physiology ; Glutamic Acid ; metabolism ; Hypotension ; metabolism ; physiopathology ; Male ; Microdialysis ; methods ; Rats ; Rats, Wistar ; Taurine ; metabolism ; Vestibular Nuclei ; metabolism ; physiopathology

BACKGROUNDSacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury, especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concern of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve (SN) on the same slice in high resolution computed tomography (HRCT) reconstruction and to determine the value of this information for the clinical diagnosis of related diseases.

METHODSFifty healthy volunteers and 30 patients (40 sides) with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner (Light Speed, GE, USA). Among the patients, 6 with intervertebral disk hernia (6 sides), 8 with spinal stenosis (12 sides), 11 with pelvic trauma (14 sides), 4 with pelvic malignancies (6 sides), and 1 with sacral vertebral tuberculosis (2 sides). The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1 workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied.

RESULTSThe image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was: outward-rotated oblique sagittal > outward-rotated oblique coronal > oblique coronal plane > coronal > sagittal > transverse section. The S5 nerve was partially displayed from the starting point to the segment around the posterior sacral foramen. The overall anatomy of the triangular sacral plexus was only revealed in the oblique outward-rotated sagittal section, while 100% of its individual rami, as well as two or three of the adjacent rami, were displayed from their starting points to the anterior border of the piriformis. The abnormalities included 39 sides of morphological change (97.5%), 38 sides of compression (95.0%), 35 sides of adhesion (87.5%), 32 sides of displacement (80.0%), 34 sides of shrinkage (85.0%), 6 sides of thickening (15.0%), and 2 sides of abruption (5.0%).

CONCLUSIONSThe 16-slice CT multiplanar reconstruction was able to reveal the overall anatomic features of the SN on the same slice. The section of reconstruction was a crucial factor in determining the display capability of various sacral nerves. This technology was valuable in the diagnosis and management of related diseases.

Adult ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Middle Aged ; Sacrum ; innervation ; Spinal Nerves ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Trauma, Nervous System ; diagnostic imaging ; Young Adult

Objective To assess the efficacy of two antibiotic prophylactic regimens in a prospective randomized trial in 1 year for patients undergoing insertion of catheters,and to provide the evidence for uniform consensus existing on the timing,route,and choice of antibiotic.Methods During a period of 12 months,78 patients,who consecutively entered the peritoneal dialysis programme,[45 women and 33 men,mean age (48.2?15.7)years] were included.The prophylactic regimens were a single dose of ceftriaxone (1.0 g) given intravenously 30 minutes before surgery (Group A) and given cefazolin (0.25 g/L) i.p.in the each dialysis bag for 3 days postoperatively (Group B).All operations were performed in one room.The wound was observed every day,and body temperature,Count of white blood corpuscle and type,dialysate were examined every day. Results In Group A and B,none of the patients showed peritonitis or wound infection during the post-operative period (within 10 days).One of 39 patients(2.5%) in the group A,and 2 of 39 patients (5.1%) in the group B had exit site infection (P＞0.05).Conclusions There is no significant difference in the incidence of peritonitis and wound infection between two groups. Prophylactic preoperative single-dose antibiotics intravenously do as well as antibiotics given intraperitoneally for peritoneal dialysis catheter insertion,but is much more convenient.