Background Choroidal neovascularization (CNV) is a major cause of visual loss in many fundus diseases.Fundus angiography (FA) is essential for the diagnosis,location and treatment of CNV.However, FA is an invasive examination method.Split spectrum amplitude decorrelation angiography (SSADA) OCT can quickly and clearly provide vascular signals.However, whether SSADA-OCT is feasible in the evaluation of CNV remains unclear.Objective This study was to detect and quantify CNV using OCT angiography.Methods Thirteen patients with unilateral CNV were included in Beijing Tongren Eye Center from June 2014 to August 2014.All affected eyes of the subjects were scanned with a high-speed frequency domain OCT.The SSADA-OCT images were obtained by scanning of macula covered 6 mm×6 mm area.The CNV area and grey scale were computed from the en face OCT images of retinal layer and choroidal layer.This study followed the Helsinki Declaration and was approved by the Ethics Committee of Beijing Tongren Hospital,and written informed consent was obtain from each patient prior to any medical examination.Results SSADA-OCT angiogram revealed CNV area and location confirmed by fluorescein angiography,and the CNV blood flow information of internal limiting membrane,inner plexiform layer,retinal pigment epithelium,and choroid was exhibited by OCT angiography.All CNVs with different causes showed the well defined and hyperreflected signal in macular region.The average CNV area was (0.15 ±0.09)mm2 , and the average grey scale of CNV was 75.40±32.35 in the affected eyes,and that in the contralateral eyes was 26.99±22.87 in the 300 μm area,showing significant elevation in gray scale in the affected eyes compared with the contralateral eyes (t =6.946, P＜0.001).Conclusions OCT angiography is a noninvasive observation technique of retinal and choroidal blood flow.It can provide quantitative information and detailed images of CNV.

Background Cystoid macular edema (CME) is caused by many fundus diseases.The noninvasive clinical diagnosis methods for CME are conventional color fundus photography up to now.However,these images can not display the CME range well.Confocal scanning laser ophthalmoscope (cSLO) based retinal imaging can provide clear picture with high contrast.However,whether cSLO imaging is feasible in the quantitative assessment of CME remains unclear.Objective This study was to image the boundary of CME and assess the quantification of CME image from cSLO imaging technology.Methods A series case-observational study was designed.This study protocal was approved by Ethic Committee of Beijing Tongren Hospital.cSLO based retinal imaging technology was carried out on consecutive 24 eyes of 24 patients with clinically diagnosed and OCT confirmed CME in Beijing Tongren Eye Center from August to December 2015 under the informed consent of each individual.The radial scan range was 45°× 45 ° and the line scan level was 49 at macula area.The pseudocolar image,green light reflective image (532 nm) and infrared reflective image (785 nm) were collected.The imaging was analyzed by EasyScan software (version 1.2.2).Fundus color photography and SD-OCT were carried out in each patient.The images were graded by specialists according to the SD-OCT cross sectional results.Results The primary causes of CME included epiretinal membrane (10 eyes),branch retinal vein occlusion (BRVO) (6 eyes),central retinal vein occlusion (CRVO) (4 eyes),diabetic retinopathy (DR) (3 eyes) and CRVO with BRVO (1 eye).A CME image was exhibited on the fundus color photogram with the obscure boundary;while the clear range of CME was displayed by the cSLO imaging.The mean score of CME from pseudocolar image,green light reflective image and infrared reflective image was 3.21±0.78,2.67±0.96 and 2.54±0.83,respectively,which was significantly higher than 1.33±0.82 from the fundus color photography (all at P＜0.01).Conclusions In CME patients,the imaging quality from cSLO-based retinal imaging technology is better than that from traditional fundus color photography.Combined with SD-OCT sectional scan analysis,cSLO-based retinal imaging technology may offer a method to observe and record more fundus details for CME diagnosis.

Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera.Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study.There were 35 males (51 eyes) and 32 female (39 eyes),mean age was 51.32 years.All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera,positive numbers of every retinal pathological change were calculated and compared.Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes.Results The positive numbers of retinal microaneurysm (x2 =4.157,P＜ 0.05) and epiretinal membrane (x2 =5.428,P ＜ 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera,while the positive numbers of cotton wool spots (x2 =0.523),retinal hemorrhage (x2 =0.117),hard exudates (x2 =0.325) and macular hole (x2 =0.070)were no significant different (P＞ 0.05).The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (x2 =9.143,P=0.007).Conclusion In retinal and choroidal diseases,the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.

Objective To get the facts on lifestyle and bone mineral density among the community residents who are above 40 years old in Nanchang,therefore to offer reference for prevention and treatment to the community residents with abnormal bone mineral density.Methods Use Ultrasound bone mineral density detection instrument to detect the calcaneus mineral density among 10 002 community residents who were over 40 years old.The results can be classified as normal,osteopenia and osteoporosis.A questionnaire survey was conducted among all interviewees.The questionnaire consisted of basic information,general situation,lifestyle,height,weight,waistline,hipline.The body mass index was calculated.The relationship between bone mineral density and smoking,drinking,milk,sodas,sports,etc was analyzed.Results As to osteoporosis,the morbidity of male patients was 6.8％,and that of female patients was 10.4％,as to osteopenia,the morbidity of male patients was 43.8％,and that of female patients was 39.7％.Male smokers' morbidity of abnormal bone mineral density was high,there were no significant differences among the groups,female smokers' morbidity of abnormal bone mineral density was low,there were significant differences among the groups.Drinkers' morbidity of abnormal bone mineral density was low,there were no significant differences among the groups;People taking milk and sodas,taking more exercises suffered from lower morbidity of abnormal bone mineral density,there were significant differences among the groups.Conclusions Female,the elderly,povertyin movement,low intake of milk result in high morbidity of abnormal bone mineral density,while the influence of drinking and smoking on abnormal bone mineral density requires further research.

Objective:To investigate the effect of plasma Glypican-4 level on the prognosis of children with pneumonia and acute respiratory distress syndrome(ARDS) and its predictive value.Methods:From April 2018 to April 2021, 92 children with pneumonia and ARDS admitted to the PICU of Baoding First Hospital for the first time were selected as the pneumonia+ ARDS group, 87 children with pneumonia admitted to the Pediatrics Department of this hospital were selected as the pneumonia group, and 95 children for physical examination in the same hospital were selected as control group.The pediatric critical illness score(PCIS)was used to score the children in pneumonia+ ARDS group and pneumonia group.The enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of Glypican-4 in plasma of three groups.Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of plasma Glypican-4 in pneumonia complicated with ARDS, and the prognosis-related factors was analyzed by the Cox risk regression model.Results:The heart rate, pneumonia history, 28-day mortality rate, and plasma Glypican-4 in the pneumonia+ ARDS group were significantly higher than those in control group and pneumonia group, and PCIS score in pneumonia+ ARDS group was lower than that in pneumonia group ( P<0.05). According to the prognosis of pneumonia+ ARDS group on 28 days, the children were divided into survival group (74 cases) and death group (18 cases). Compared with the survival group[(3.92±0.31)μg/L], the plasma Glypican-4 level in death group[(4.78±0.35)μg/L] increased, whose difference was statistically significant( t=10.292, P<0.001). ROC curve analysis results showed that the area under the ROC curve of Glypican-4 predicting the prognosis of children with pneumonia combined with ARDS was 0.92, whose sensitivity was 94.2% and specificity was 88.3%, as well as the cut-off value was 4.11 μg/L.Multivariate Cox analysis showed that Glypican-4 level(high expression), heart rate (high frequency) and the history of pneumonia were prognostic risk factors affecting the prognosis of children with pneumonia and ARDS( P<0.05). Conclusion:The level of plasma Glypican-4 in children with pneumonia and ARDS significantly increased, and it is closely related to the prognosis of children with pneumonia and ARDS, and has high predictive value for the prognosis of children with pneumonia and ARDS.

OBJECTIVETo explore the current status on traditional Chinese medicine (TCM) use for hospitalized acute coronary syndrome patients in China's level 2 hospitals, and to explore associated factors of TCM use for these patients.

METHODSThis survey was performed in 102 level 2 hospitals from 15 provinces or autonomous region in China. Patients admitted to these hospitals with acute coronary syndrome during September 2011 to May 2012 were eligible for this study. Information on TCM use was obtained from their medical records. Chi-square test and logistic regression analysis were used to explore the related factors of TCM use in these patients.

RESULTSWe recruited 5 432 acute coronary syndrome patients in this study, TCM was applied to 3 503 patients (64.5%). Multivariable logistic regression showed that pre-hospital TCM use was positively related with in-hospital TCM use (OR = 2.08, P < 0.01) , while pre-hospital use of 4 medicines recommended by the guidelines(including aspirin/clopidogrel, β acceptor blocker, stain and angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor blocker ), being a smoker and diagnosis of myocardial infarction rather than unstable angina at hospital discharge were negatively related with in-hospital TCM use (the ORs were 0.58, 0.78 and 0.71, respectively, all P < 0.01). The TCM use varied significantly between regions. Taking southwest region as a reference, the ORs varied between 2.98-13.37 (all P < 0.01) in eastern China, south China, central China, north China, northwest and northeast regions.

CONCLUSIONSTCM is widely used in hospitalized acute coronary syndrome patients in China's resource-constrained level 2 hospitals. Pre-hospital TCM use is positively correlated with in-hospital TCM use for these patients.

Acute Coronary Syndrome ; drug therapy ; Aged ; China ; Cross-Sectional Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Inpatients ; Logistic Models ; Male ; Middle Aged ; Prospective Studies

Angiogenesis, a process by which the preexisting blood vasculature gives rise to new capillary vessels, is associated with a variety of physiologic and pathologic conditions. However, the molecular mechanism underlying this important process remains poorly understood. Here we show that histone deacetylase 6 (HDAC6), a microtubule-associated enzyme critical for cell motility, contributes to angiogenesis by regulating the polarization and migration of vascular endothelial cells. Inhibition of HDAC6 activity impairs the formation of new blood vessels in chick embryos and in angioreactors implanted in mice. The requirement for HDAC6 in angiogenesis is corroborated in vitro by analysis of endothelial tube formation and capillary sprouting. Our data further show that HDAC6 stimulates membrane ruffling at the leading edge to promote cell polarization. In addition, microtubule end binding protein 1 (EB1) is important for HDAC6 to exert its activity towards the migration of endothelial cells and generation of capillary-like structures. These results thus identify HDAC6 as a novel player in the angiogenic process and offer novel insights into the molecular mechanism governing endothelial cell migration and angiogenesis.
Anilides ; pharmacology ; Animals ; Cell Movement ; Cell Polarity ; Cells, Cultured ; Chick Embryo ; Chickens ; Endothelial Cells ; cytology ; Histone Deacetylase 6 ; Histone Deacetylases ; metabolism ; physiology ; Humans ; Hydroxamic Acids ; pharmacology ; Mice ; Microtubule-Associated Proteins ; metabolism ; physiology ; Neovascularization, Physiologic

Objective To observe confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and color fundus camera in pigment epithelial detachment (PED) of polypoidal choroidal vasculopathy (PCV).Methods PED of 30 patients (32 eyes) were recruited from June 2016 to June 2017 in the Beijing Tongren Hospital who were detected in high-definition OCT (HD-OCT) and diagnosed as PCV by FFA and ICGA.There were 16 males (17 eyes) and 14 females (15 eyes);aged from 50-83 years,with the mean age of 66.59 years.The photographs of ocular fundus including color fundus camera,cSLO imaging,HD-OCT,FFA and ICGA were analyzed.Multimodal imaging results were regarded as gold standard.Sensitivity and specificity were calculated in serous and hemorrhagic PED diagnosis using color fundus camera and cSLO imaging.The positive number of PED was used to compare between two modes fundus imaging by using x2 test.Results Twenty serous PED eyes,3 hemorrhagic PED eyes and 9 serous/hemorrhagic PED eyes were determined using multimodal imaging.The sensitivity and specificity of color fundus camera were 45％ and 100％ in detecting serous PED and 100％ and 91％ in detecting hemorrhagic PED.The sensitivity and specificity of cSLO imaging were 83％ and 100％ in detecting serous PED and 50％ and 86％ in detecting hemorrhagic PED.The positive number of serous PED in cSLO imaging was significantly higher than color fundus camera (x2=7.752,P=0.011).The positive number of hemorrhagic PED in cSLO imaging shows no obvious difference compared with color fundus camera (x2=1.164,P=0.419).Conclusion The sensitivity and positive number of detecting serous PED with PCV in cSLO fundus imaging were higher than the color fundus camera technology.

Animals ; Embryonic Stem Cells ; virology ; Gene Expression Regulation, Enzymologic ; Histone Deacetylase 6 ; Histone Deacetylases ; biosynthesis ; genetics ; Infection ; genetics ; pathology ; virology ; Mice ; Mice, Knockout