Adult ; Aged ; Aging ; physiology ; Evoked Potentials, Somatosensory ; physiology ; High-Frequency Ventilation ; Humans ; Middle Aged ; Somatosensory Cortex ; physiology

AIM: To observe the clinical effects of different methods of internal limiting membrane peeling in vitrectomy in treatment of idiopathic macular hole(IMH)with macular hole closure index(MHCI)<0.7.

METHODS: Totally 88 patients(88 eyes)with MHCI<0.7 IMH admitted from May 2014 to May 2017 were randomly divided into group A(44 eyes underwent extended internal limiting membrane dissection)and group B(44 eyes underwent standard internal limiting membrane dissection). The closure of macular hole, best corrected visual acuity(BCVA), central scotoma and complications were observed between the two groups.

RESULTS: At 6mo after operation, the closure rate of macular hole in group A was significantly higher than that in group B(91% vs 75%, P<0.05). At 6mo after operation, BCVA in group A was better than that in group B(0.47±0.05 vs 0.74±0.14, P<0.05). The percentage of central scotoma eyes was lower than that in group B(4% vs 23%, P<0.05), but there was no significant difference in the incidence of complications between the two groups(11% vs 9%, P>0.05).

CONCLUSION: Extended internal limiting membrane dissection is more effective than standard internal limiting membrane dissection in the treatment of IMH with MHCI < 0.7, and the former is better for the recovery of retinal function.

AIM: To investigate the clinical effect of scleral buckling surgery combined with 23G vitrectomy in treatment of intraocular foreign body with retinal detachment.

METHODS: Totally 72 cases of patients with intraocular foreign bodies and retinal detachment admitted from January 2014 to January 2018 were selected and divided into the control group(36 cases)and the observation group(36 cases)by random number table method. The patients in the control group were treated with 23G vitrectomy surgery while patients in the observation group were treated with scleral buckling surgery on the basis of the treatment in the control group. The changes of intraocular pressure(IOP)and visual acuity, successful reset, recurrence and complications were observed before operation and 3mo after silicone oil was removed.

RESULTS: There was no difference in IOP and BCVA between the two groups before operation(P>0.05). Three months after silicone oil was removed, IOP and BCVA in two groups were significantly improved compared with those before operation(P<0.05). There was no difference between the two groups(P>0.05). The success rates of one-time anatomical reduction in the observation group and the control group were respectively 97% and 81%(P<0.05). The recurrence rates of the observation group and the control group were respectively 6% and 25%(P<0.05). The incidence of complications was 22% in the observation group and 31% in the control group(P>0.05).

CONCLUSION: The treatment of scleral buckling combined with 23G vitrectomy in the treatment of intraocular foreign body with retinal detachment can significantly improve the IOP and visual acuity of patients, improve the success rate of reduction, reduce recurrence, and have high safety.

OBJECTIVETo study changes of left ventricular remodeling (LVR) in hypertension patients with carotid atherosclerosis (CAS) of phlegm-dampness syndrome (PDS).

METHODSDoppler ultrasonography data of CAS were observed in 223 hypertension patients with CAS (as the hypertension group, including 119 patients of the PDS group and 104 of the non-PDS group), 81 CAS patients with non-hypertension, and 19 non-hypertension non-CAS patients (as the control group). The difference in the degree of LVR was compared among the above groups.

RESULTSThe left ventricular posterior wall thickness (LVPWT), inter ventricular septum thickness (IVS), E/A were higher in the hypertension group than in the non-hypertension group (P < 0.05). The left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic diameter (LVESD), stroke volume (SV) were higher in the soft plaque hypertension group and the soft plaque non-hypertension group than in the hard plaque group, the thickening intimal group, and the normal intimal group (P < 0.01 , P < 0.05). The LVEDD, LVESD, and SV were higher, and the ejection fraction (EF) was lower in the PDS hypertension group than in the non-PDS hypertension group (all P < 0.05). Of them, LVEDD, LVESD, and SV were higher in the soft plaque group than in the hard plaque group (P < 0.01), the thickening intimal group (P < 0.01) and the normal intimal group (P < 0.05). There was no statistical difference in PDS hypertension between the soft plaque group and the hard plaque group (P > 0.05).

CONCLUSIONThe hypertension patients with CAS of PDS might be correlated to LVR, and LVR was more obviously in the soft plaque patients.

Aged ; Aged, 80 and over ; Carotid Artery Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Female ; Humans ; Hypertension ; diagnosis ; diagnostic imaging ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ultrasonography ; Ventricular Remodeling

OBJECTIVETo observe the dynamics of hippocampal release of glutamate (Glu) and gamma-aminobutyric acid (GABA) in epilepsy (TLE) after administration with high frequency stimulation (HFS).

METHODSThe SD were divided into four groups (n =10): (1) Control group (KB) the rats were injected intraperitoneally with saline 0.9%. (2) Kainic acid (KA) group: the rats were injected with KA. (3) Pseudo-deep brain stimulation (DBS) group: the KA-induced rats were implanted with rheophores alone. (4) DBS group: KA induced-rats with DBS in hippocampal epileptic foci. We then collected hippocampal extracellular fluid by microdialysis and the levels of Glu and GABA were measured by high-performance liquid chromatography (HPLC) and fluorescence detection.

RESULTSThere was no difference in the baseline of Glu and GABA in the four groups. In contrast, a significant increase in the content of Glu and GABA was shown in the three periods of KA-kindled seizures. Electrical stimulation of hippocampus resulted in a decrease of hippocampal Glu contents, while there was no change in GABA contents. Additionally, HFS of hippocampus normalized the Glu/GABA ratio in the chronic period of seizures.

CONCLUSIONThe high frequency stimulation of epileptic foci may protect against seizures by modulating the extracellular release of hippocampal Glu.

Animals ; Electric Stimulation ; methods ; Epilepsy ; chemically induced ; therapy ; Glutamic Acid ; secretion ; Hippocampus ; metabolism ; Kainic Acid ; Kindling, Neurologic ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; gamma-Aminobutyric Acid ; secretion

OBJECTIVETo investigate the relationship between serotonin (5-HT) and epilepsy and the mechanism of learning-memory in pilocarpine (PILO)-induced epileptic rats after 5,7-dihydroxytryptamine (5,7-DHT) microinjection in median raphe nucleus.

METHODSAdult S D rats were randomly divided into 3 groups: PILO group, PILO+ 5,7-DHT group, vehicle control group; PILO group was divided into two groups by status epilepticus (SE): PILO + SE group and PILO - SE group. The rats' seizures and cortex electroencephalography (EEG) were observed by video EEG. The rats' spatial learning-memory was evaluated by Morris water maze. Finally, serotonergic neuron in raphe nuclei was observed by immunohistochemistry.

RESULTSAfter treatment of 5,7-DHT (PILO + 5,7-DHT group), the success rate, the mortality and the frequency of chronic spontaneous seizures in pilocarpine-induced epilepsy model were all improved. Compared with the control group, the number of serotonergic neuron in raphe nuclei was decrease in PILO + SE group (P < 0.05). Moreover, it's extremely decrease in PILO + 5,7-DHT group (P < 0.01). Compared with control group, the mean escape latency was prolonged, the times of crossing target was decreased and the retention time in target zone was shortened in PILO + SE group (P < 0.05), but there was no significant difference between PILO + SE group and PILO + 5,7-DHT group.

CONCLUSIONDepletion of serotonin may facility the rats' epileptic seizures, but we could not interpret which may cause epileptic rats' cognitive deficit.

5,7-Dihydroxytryptamine ; toxicity ; Animals ; Epilepsy ; chemically induced ; metabolism ; psychology ; Male ; Maze Learning ; Memory ; Pilocarpine ; adverse effects ; Raphe Nuclei ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism

Background: and Purpose Mutations in the FIG4 gene have been linked to amyotrophic lateral sclerosis (ALS) type 11 in Caucasian populations. The purpose of this study was to identify FIG4 variants in a cohort of 15 familial ALS (FALS) indexes and 275 sporadic ALS (SALS) patients of Han Chinese origin. Methods: All 23 exons of FIG4 were sequenced using targeted next-generation sequencing.An extensive literature review was performed to detect genotype-phenotype associations of FIG4 mutations. Results: No FIG4 variants were identified in the FALS patients. One novel heterozygous missense variant (c.352G>T [p.D118Y]) and one novel heterozygous nonsense variant (c.2158G>T [p.E720X]) in FIG4 were identified in two SALS patients. The p.E720X variant is interpreted as likely pathogenic while the p.D118Y variant is a variant of uncertain significance. The patient carrying the p.E720X mutation developed lower-limb-onset slowly progressive ALS, and survived for 11.5 years. The patient harboring the FIG4 p.D118Y variant also presented with progressive ALS, with the score on the ALS Functional Rating Scale–Revised (ALSFRS-R) decreasing by 0.4 per month. The rate of decrease in the ALSFRS-R scores from symptom onset to diagnosis seemed to be lower in the patients carrying FIG4 variants than the no-FIG4-mutation ALS patients in this study. Conclusions Our findings suggest that ALS patients carrying FIG4 mutations are not common in the Chinese population and are more likely to exhibit slow progression.

Objective To investigate the features of cognitive impairment in patients with complex partial seizures (CPS) and the correlation between the cognitive function and proton magnetic resonance spectroscopy (~1H-MRS). Methods Forty-five patients with CPS and 16 healthy controls were examined by the following means: memory function examination by the clinical memory scale, intelligence function examination by Ravin's standard progressive Matrices (R'SPM) and ~1H-MRS scan in the bilateral hippocampus. Memory quotient (MQ), Intelligence quotient (IQ), the levels ofNAA, Cho, Cr and the ratio of NAA/Cr+Cho were compared between the two groups. Meanwhile, the correlation coefficients were calculated. Results The scores of pointing memory, associational learning, image free memory, association memory of portrait and MQ except insignificant figure recognition were significantly lower in patients with CPS than those in the control group (P<0.05); the scores of Ravin's standard progressive matrices and IQ were noticeably lower in patients with CPS than those in the controls. The levels of NAA, Cho, Cr and the ratio of NAA/Cr+Cho in patients with CPS were significantly lower than those in the controls (P<0.05). Patients with CPS showed positive correlation between MQ and the level ofNAA, MQ and the ratio ofNAA/Cr+Cho, IQ and the level of NAA, as well as IQ and the ratio ofNAA/Cr+Cho (P<0.05); while level of Cho and both MQ and IQ were in inverse proportion (P<0.05) and no correlation between the lever of Cr and both MQ and IQ was found in patients with CPS (P>0.05). Conclusions The patients with CPS do have the cognitive impairment including short-term memory deficit and the decreased ability of abstraction, maturity judgment and reasoning. The correlation between cognitive function and the levels ofNAA, Cho, Cr and the ratio of NAA/Cr+Cho indicated that ~1H-MRS can check the cognitive function of patients with CPS in early stage objectively. Together with neuropsychology examination, ~1H-MRS can detect the disturbance of cognitive function in the patients with CPS precisely in early stage.

Objective To observe the significance of neck CT angiography (CTA) in detecting the vertebral artery stenosis,and to study the feasibility and safety of stenting and angioplasty in patients with symptomatic vertebral artery stenosis.Methods Patients with ischemic stroke in the posterior circulation,admitted to our hospital from May 2007 to April 2011,were chosen in our study; all the patients were performed neck CTA and brain MRA; If there might be vertebral artery stenosis in the CTA,DSA was chosen.Patients diagnosed as having vertebral artery stenosis by DSA were performed stenting and angioplasty after being individual assessment and informed consent.Results Thirty-eight patients diagnosed as having ischemia in the posterior circulation and vertebral artery stenosis were received stenting and angioplasty.There were 38 vertebral artery stenoses (above 50％) detected by neck CTA in 29 patients,among which,30 stenoses were in the V1 part of vertebral artery and 8 in the V4 part; while these 29 patients detected by DSA only showed 4 stenoses in the V4 part and 28 in the V1 part (above 50％).And 9 patients with VI part of vertebral artery stenosis (above 50％) couldn't be found by neck CTA but diagnosed by DSA finally.These 38 patients treated with 41 stents,which were all successful (achievement ratio 100％).The mean ratio of stenosis before stenting was (65.0±11.2)％ and the mean ratio after stenting was (11.6±8.9)％,with significant difference.One patient experienced lacunar infarction and 1 severe stroke with lock in syndrome during the 6-25 months of follow-up; and 1 patient experienced subarachnoid hemorrhage after the procedure.Conclusion The neck CTA is useful in the screening of vertebral artery stenosis.Stenting and angioplasty are the safe and effective treatments for patients with symptomatic vertebral artery stenosis.

Background and Objectives: The impact of off-hours admission (such as weekends, nighttime, and non-working hours) vs. regular hours (weekdays and daytime working hours) on the mortality risk of patients undergoing surgery for type A aortic dissection (TAAD) repair is still uncertain. To address this uncertainty, we undertook a comprehensive systematic review and meta-analysis. We aimed to assess the potential link between off-hours admission and the risk of mortality in patients undergoing TAAD repair surgery. Methods: We conducted a thorough search of the PubMed, Embase, and Cochrane Library databases, covering the period from their inception to May 20, 2023. Our inclusion criteria encompassed all studies that examined the potential relationship between off-hour admission and mortality in individuals who had undergone surgery for TAAD repair. The odds ratios (ORs) were extracted and combined utilizing a random effects model for our synthesis. Results: Nine studies with 16,501 patients undergoing TAAD repair surgery were included in the meta-analysis. Overall, patients who underwent surgery during the weekend had higher in-hospital mortality (pooled OR, 1.41; 95% confidence interval [CI], 1.14–1.75; p=0.002) than those treated on weekdays. However, the mortality risks among patients who underwent TAAD surgery during nighttime and non-working hours were not significantly elevated compared to daytime and working hours admission. Conclusions Weekend surgery for TAAD was associated with a higher in-hospital mortality risk than weekday surgery. However, further studies are warranted to identify and develop strategies to improve the quality of round-the-clock care for patients with TAAD.