Child, Preschool ; Epithelioid Cells ; Heart Atria ; pathology ; Heart Neoplasms ; Humans ; Perivascular Epithelioid Cell Neoplasms

Objective To discuss the applicable value of through cerebral doppler(TCD) technique in diagnosing migraine of children.Methods We adopted TCD technique to study the blood flow states of 60 children with migrane.Results The velocities of blood flow of intracranial arteries of children with migraine were faster and the bilateral velocities of blood flow were unsymmetrical and unsteady,the average veloctity of blood flow of intracranial arteries of children with migraine was obviously higher than those of control group(healthy children)(P

AIM: To compare the peripapillary retinal nerve fiber layer ( RNFL ) thickness and peripapillary topographic map's parameters between amblyopic eyes and non -amblyopic eyes in adolescent with anisometropic amblyopia by optical coherence tomography(OCT).
METHODS: Thirty - four juveniles with anisometropic amblyopia were selected. Peripapillary RNFL thickness and peripapillary topographic map were measured by frequency domain OCT with both eyes in all participants, and the differences between amblyopic eyes and non -amblyopic eyes were compared.
RESULTS: There was no significant difference in average thickness of peripapillary RNFL and in any other region of peripapillary RNFL. The disc area in amblyopic eyes was bigger than that in non - amblyopic eyes ( t =2. 8054,P= 0. 0263). The disc area in amblyopic eyes were significantly related to the thickness of nasal RNFL and the rim area(r= 0. 7592,0. 7501;P= 0. 0289,0. 0321).
CONCLUSION: There existed some difference in peripapillary structure between amblyopic eyes and non-amblyopic eyes in adolescent with anisometropic amblyopia.

Objective To explore the feasibility of excluding oral 75 g glucose tolerance test (OGTT)in pregnant women with fasting plasma glucose (FPG) ＜4.4 mmol/L in middle and late trimester.Methods From February 1,2012 to August 31,2013,18 851 pregnant women without pre-gestational diabetes mellitus who received 75 g OGTT in Maternal and Child Health Hospital of Hubei Province,China,at 24-28 weeks of gestation were enrolled.The criteria for gestational diabetes mellitus (GDM) were FPG ＞5.1 mmol/L and/or 1 h plasma glucose ＞10.0 mmol/L and/or 2 h plasma glucose ＞8.5 mmol/L in OGTT.The values of FPG in predicting GDM were analyzed with receiver operating characteristic (ROC) curve.The differences of detection rates for GDM among women of different ages,women with different FPG levels,and those with or without risk factors of GDM were compared by x2 test and Fisher's exact test.Results The overall detection rate of GDM was 9.11％(1 718/18 851).The detection rate of GDM was lower in women aged ＜ 25 years than women aged 25-,30-and ≥ 35 years [4.77％ (137/2 875) vs 7.76％ (803/10 350),12.43％ (552/4 440)and 19.06％ (226/1 186),respectively,x2=30.53,120.24 and 210.66,all P＜0.01].The sensitivity and specificity were 55％ and 68％,respectively,when the cutoff value of FPG was 4.4 mmol/L,and the Youden index was 0.23 and the area under the ROC curve was 0.61 (95％CI:0.59-0.63,P＜0.01).The sensitivity and specificity were 40％ and 80％,respectively,when the cutoff value was 4.5 mmol/L,and the Youden index was 0.20 and the area under the ROC curve was 0.61 (95％CI:0.59-0.63,P＜0.01).The missed diagnosis rate was lower when the cutoff point of FPG was defined as 4.4 mmol/L.The detection rate for GDM was 3.45％ (384/11 121) in women with FPG ＜4.4 mmol/L,significantly lower than in those with FPG ≥ 4.4 but ＜5.1 mmol/L and ≥ 5.1 mmol/L [8.06％ (561/6 957) and 100.00％ (773/773),x2=183.66 and 7 672.08,all P＜0.01].When FPG was ＜4.4 mmol/L or ≥ 4.4 but ＜5.1 mmol/L,the detection rate for GDM was significantly higher in women with GDM risk factors than in those without [5.09％ (118/2 318) and 10.75％ (184/1 712) vs 3.02％ (266/8 803) and 7.19％ (377/5 245),x2=23.56 and 22.06,P＜0.01].Conclusion OGTT may not be included in GDM screening in the pregnant women with FPG＜4.4 mmol/L and without GDM risk factors in the areas lack of medical resources.

AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy ( PPV ) combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. ·METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity ( BCVA ) , intraocular pressure (IOP), counting of corneal endothelial cells ( CEC) and central retinal thickness ( CRT ) were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution ( LogMAR ) visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy ( AVE) and effective phacoemulsification time ( EPT ) were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d. ·RESULTS:The mean operation time for vitrectomy were 12. 57± 1. 35min in 23G group and 17. 30 ± 1. 19min in 20G group. The difference was statistically significant ( t =-12. 488, P<0. 01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups ( t=-0. 68,-1. 186,-0. 737, P=0. 500, 0. 242,0. 465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant (t= -2. 345, P=0. 024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT ( F = 0. 465, 1. 895, 0. 689; P = 0. 499, 0. 176, 0. 411). IOP, BCVA and CRT were significant statistical different in different time-point within each group ( F=291. 245, 103. 06, 665. 402, P<0. 01 ). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points ( F = 13. 245, P<0. 01 ), but different surgeries had no interactive effects on BCVA and CRT with different time points (F=1. 212, 2. 293;P=0. 283, 0. 129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant (t=2. 049, P=0. 048). ·CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery

Background Hyaluronic acid is a mucopolysaccharide existing in extracellular matrix and having good biocompatibility.Using chemical crosslinking method can improve the physical properties of the material,so cross-linked hyaluronic has potential clinical application value.Objective The present study was to evaluate the histocompatibility and biological security of cross-linked hyaluronic acid as ophthalmic implant material.Methods Cross-linked hyaluronic acid implant material was prepared according to the criteria of Biological Evaluation of Medical Devices (GB/T16886.5-2003).Eighteen 8-week-old male New Zealand white rabbits were randomized into the experimental group and the control group.Cross-linked hyaluronic acid material with 5.0 mm diameter was implanted into corneal stroma interlaminationally in the experimental group,and only corneal stromal interlaminational pocket was made without any implanting material in the control group.Biological response of cornea was assessed in vivo from 1 week through 3 months after operation by slit lamp microscope.The corneas were obtained 2 weeks,1 month and 3 months respectively for histopathological examination.Mouse embryonic fibroblasts were cultured in cross-linked hyaluronic acid film plate,medical silicone material culture plate and regular culture plate respectively for 24 hours,and the cell growth state and morphology were observed under the inverted microscope and scan electron microscope.MTT assay was used to test the relative growth rate of the cultured cells 48 hours after cultured using extracted liquid of hyaluronic acid implant material.Results Cross-linked hyaluronic acid implant material showed a well healing to the corneas of rabbits during the observation duration,without obvious inflammatory response and neovascularization.The arrangement of stromal fibers was uniform in order,and no infiltration of inflammatory cells was seen under the light microscope.The cells grew well after cultured with cross-linked hyaluronic acid film and regular medium for 24 hours,but in the silicone culture group,fewer of adherent cells and more floating cells were found.The relative growth rate of the cells was 87.50％ 48 hours after cultured with extracted liquid of hyaluronic acid implant material.Conclusions The cross-linked hyaluronic acid material has good histocompatibility and biological security in rabbit cornea tissue.

Objective To evaluate the echocardiographic features of coronary artery dilation (CAD) and coronary artery aneurysms (CAA) in Kawasaki disease dynamically.Methods Echocardiography was performed in KD cases for measurement of the diameter of the coronary artery.Results Twelve CAD and four CAA were identified in forty-one patients.In CAD group,left coronary artery (LCA) is more susceptive to dilation than right coronary artery (RCA)(P<0.05).Both LCA and RCA were involved in CAA group,the maximum diameter of coronary artery is 10mm.Six to eighteen days after treatment,LCA were regressed significantly in CAD group(P<0.05),but the diameter of RCA in CAD group and coronary artery in CAA patients have no change(P>0.05).Ten coronary artery lesion patients were followed up,8 CAD cases regressed completely,1 CAA extended,the other CAA regressed completely.Conclusions In CAD group,LCA is more susceptive to dilation than RCA,but it regressed significantly in a short time after treatment.Echocardiography is a non-traumatic method to detect the coronary artery lesions in KD patients dynamically.

Objective To investigate the clinical features of incomplete Kawasaki disease (IKD).Methods The data of 46 Kawasaki disease (KD) patients including 14 IKD patients (IKD group)and 32 classical Kawasaki disease (CKD) patients (CKD group) was analyzed retrospectively,and compared the clinical manifestation,laboratory examination result,the incidence of coronary artery lesion (CAL) and the response to intravenous immunoglobulin (IVIG) of two groups.Results There was no significant difference in gender and age between IKD group and CKD group (P> 0.05 ).In IKD group,the fever time was longer than that in CKD group [( 11.43 ± 9.12) d vs (7.12 ± 2.83 ) d, P < 0.05], but the frequency of conjunctival congestion, lymphadenectasis of neck, indurative edema of palms and soles, changes of lips and oral cavity were less than these in CKD group [57.14%(8/14) vs 93.75%(30/32),28.57%(4/14) vs 59.38%(19/32), 35.71%(5/14) vs 78.12%(25/32),42.86%(6/14) vs 75.00%(24/32)](P< 0.01 or < 0.05).There was no difference in laboratory examination result and incidence of CAL between two groups, but the incidence of IVIG nonresponse in IKD group was higher than that in CKD group [40.0%(4/10) vs 6.45%(2/31 ),P <0.05].Conclusions The frequency of conjunctival congestion, indurative edema of palms and soles, changes of lips and oral cavity are less common in IKD patients comparing with CKD patients.The laboratory examination result and the risk of CAL in IKD patients are similar to CKD ones.Moreover, IKD is not sensitive to IVIG, so the doctors should pay more attention to it.

Objective To evaluate the influence of smoking on carotid intima-media thickness (IMT) in patients with hypertension.Methods Two hundred and three patients with hypertension were consecutively enrolled with smoking or without smoking.They were divided into two groups:smoking group (84 patients) and no smoking group (119 patients).Carotid IMT was measured.Results Carotid in smoking group was (0.1118 ± 0.0234) cm,which was thickened compared with that in no smoking group [(0.098 ± 0.0249) cm] (P ＜ 0.01).Conclusions Smoking has significant influence on carotid IMT in patients with hypertension.

Objective To evaluate value of narrow band imaging(NBI) endoscopy for children with abdominal Henoch?Schonlein purpura ( HSP ) . Methods A total of 46 patients with abdominal HSP were enrolled into the observation group(NBI intervention) from November 2010 to February 2016.Diagnostic rates of white light and NBI endoscopy in abdominal HSP patients, IgA positive rates of targeted biopsies and severe complications were retrospectively analyzed. A total of 25 abdominal HSP patients with no NBI intervention admitted from 2007 to 2009 were randomly enrolled into control group. Data of the control group were compared with those of observation group. Results In observation group, the diagnostic rate under NBI was significantly higher than that under white?light endoscopy[91. 3%(42/46)VS 67. 4%(31/46),χ2=8. 02,P<0. 05]. IgA positive rates of targeted biopsies under NBI was significantly higher than that under white?light endoscopy [ 95. 7%( 88/92 ) VS 69. 6%( 64/92 ) ,χ2 = 21. 79, P<0. 05 ] . Three patients developed such serious complications as digestive hemorrhage as predicted. Compared with control group, abdominal pain and blood stool relief time (10. 96±5. 32 d VS 19. 68±4. 29 d,t=7. 50,P<0. 01), fasting time(10. 37±5. 42 d VS 8. 80± 3. 71 d,t=7. 73,P<0. 01), hospital stay (18. 80±7. 11 d VS 23. 12±4. 36 d, t=3. 16,P<0. 01), time of stool occult blood negative ( 11. 41 ± 6. 30 d VS 19. 12 ± 4. 09 d, t=6. 22, P<0. 01 ) in observation group were significantly shortened. Conclusion NBI endoscopy is valuable for improving the diagnostic accuracy and biopsy accuracy and complication prediction of abdominal Henoch?Schonlein purpura in children.