Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).

AIM: To assess the degree of oxidative damage during acute myocardial infarction and reperfusion, and to clarify the protective effect of Tongxinluo in mini-swine model. METHODS: Thirty mini-swines were randomized into 5 study groups: sham group, model group, low dose (0.05 g·kg~(-1)·d~(-1)), medium dose (0.2 g·kg~(-1)·d~(-1)) and high dose (0.5 g·kg~(-1)·d~(-1)) of Tongxinluo groups (pretreated with Tongxinluo for 3 d). Animals except in sham group were subjected to 3 h of coronary occlusion followed by 1 h of reperfusion. Concentrations of total antioxidative capability (T-AOC), total superoxide dismutase (T-SOD), reduced glutathione (GSH) and malondialdehyde (MDA) in blood sample and the myocardium were measured. RESULTS: (1) T-AOC, T-SOD and GSH in serum significantly decreased (all P<0.05), while MDA significantly increased (P<0.01) at 3 h after AMI in comparison with those at baseline. Compared to those at 3 h after AMI, the contents of T-AOC, T-SOD and GSH at 1 h after reperfusion significantly decreased (all P<0.01), accompanied by increase of MDA (P<0.01). (2) Compared to those in normal area, levels of T-AOC, T-SOD and GSH in reperfusion myocardium decreased significantly (all P<0.01) and MDA increased significantly (P<0.01). T-AOC, T-SOD and GSH in no-reflow myocardium further decreased (all P<0.01) and MDA increased (P<0.01) as compared to those in reperfusion myocardium. (3) Compared to model group, medium dose of Tongxinluo increased the contents of T-AOC and T-SOD and reduced MDA production in serum at 3 h after AMI (all P<0.05), while medium dose of Tongxinluo increased T-SOD level at 1 h after reperfusion (P<0.05). High dose of Tongxinluo increased the levels of T-AOC and T-SOD and decreased MDA content in serum at 3 h after AMI and 1 h after reperfusion (all P<0.05). (4) The medium dose of Tongxinluo increased T-AOC content (P<0.05) and reduced MDA (P<0.05) in reperfusion myocardium, while high dose of Tongxinluo increased T-AOC, T-SOD and GSH (all P<0.05), reduced MDA (P<0.01) in reperfusion myocardium, and also increased T-AOC, T-SOD (all P<0.05), reduced MDA (P<0.01) in no-reflow area as compared to those in model group. CONCLUSION: Impairment of antioxidant defense system in vivo and imbalance of redox homeostasis in myocardium region might play an important role in the pathogenesis of no-reflow after myocardial acute infarction following reperfusion. Tongxinluo protects myocardium from reperfusion injury by improving antioxidant defense and attenuating oxidative damage.

Objective To investigate the correlation between the prognostic nutritional index (PNI) and clinicopathological features and long-term prognosis of gastric cancer patients after radical gastrectomy.Methods The clinical data of 135 gastric cancer patients who underwent radical gastrectomy in this hospital from 2002 to 2006 was analyzed retrospectively.The PNI value was calculated by serum albumin (g/L) + 5 x lymphocyte count (× 109/L).The receiver operating characteristic (ROC) curve and Youden index was used to determine the cutoff value of the PNI.Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.Result The mean PNI value was 47.3 ± 5.9.The mean values of the PNI in age (t =2.909,P =0.004),tumor size (t =2.227,P =0.028),tumor depth (t =3.314,P =0.001),negative lymph node (t =2.381,P =0.019),negative lymphovascular invasion (t =2.781,P =0.006) were significantly higher than those in patients without such factors.When the PNI was 47,the Youden index was maximal,with a sensitivity of 70％ and specificity of 63％.The mean age in high PNI group was significantly lower than that in low PNI group (x2 =6.443,P =0.011).Tumor infiltration depth in high PNI group was less than in low PNI group (x2 =7.394,P =0.007).The proportion of lymphovascular invasion in high PNI group was significantly lower than in low PNI group (x2 =4.540,P =0.033).The overall survival rate in high PNI group was higher than in low PNI group (P =0.002).The univariate and multivariate analyses showed that tumor location (OR,2.144 ; 95 ％ CI 1.239-3.712 ; P =0.006),lymph node metastasis (OR,4.887 ; 95 ％ CI 1.856-12.866 ; P =0.001),lymphovascular invasion (OR,1.842 ; 95％ CI 1.078-3.145 ; P =0.025) and the PNI value (OR,2.282 ; 95 ％ CI 1.344-3.874 ; P =0.002) were independent factors for predicting overall survival rate.Conclusions The PNI value is a simple and useful tool to predict the prognosis of patients with gastric cancer.

Background Recently,the number of randomized controlled trials on ophthalmic diseases that published in international journals from mainland China has increased gradually.There is no systematic summary in this field.Objective To systematically search and analyze the distribution of ophthalmic diseases related randomized controlled trials (RCT) published in SCI journals from mainland China up to November,2012.Methods The search was performed on Pubmed using “Ophthalmology”,“Eye” and all of their inferior subjective terms,with type of literature being limited as randomized controlled trial,and country as China.All retrieved papers were screened,data extracted and analyzed.Results There were 68 ophthalmic diseases related RCT papers published from mainland China since 1989.After 2005,the number of RCT papers from mainland China increased quickly with 7 in 2006,11 in 2009,and 15 in 2011.The 68 RCT papers were focused on cataract,optometry,glaucoma,corneal and conjunctival diseases,ophthalmic immune and pharmacology,and fundus diseases.The RCT papers were published in a total of 35 SCI journals including most kinds of ophthalmic journals such as Ophthalmology,IOVS and a few journals on other specialty.The journal Clin Experiment Ophthalmol had the maximum RCT papers from China (8 papers).The 68 RCT papers came from 26 departments in mainland China,mainly from the hospitals affiliated to medical university in Guangzhou,Beijing,Shanghai,Wenzhou and Hangzhou.Conclusions The number of ophthalmic diseases related RCT papers published in SCI journals from mainland China increased continuously.The papers were mainly focused on cataract,optomctry and glaucoma.The number of these papers,however,was still small and imbalance between districts existed.

Objective To observe the effect of preoperative oral administration of carbohydrate on blood glucose,insulin resistance(IR) and inflammatory reaction after gastrointestinal operation.Methods 48 patients receiving gastrointestinal operation were randomly divided into the study group(n =23)and the control group(n =25).Patients in the study group were orally given 25％ glucose solution 300 ml 3 hours before operation.Before anesthesia induction,gastric contents were aspirated through nasogastric tube to examine its volume and pH.Serum high sensitivity C-reactive protein(hsCRP),fasting blood glucose,insulin level and homeostasis model assessment-insulin resistance(HOMA-IR) were detected before operation and on the first morning after operation between the two groups.Results No anesthesia or operation related complications occurred in either groups.Patients had similar gastric contents volume and the PH value of gastric contents.There was no significant difference in serum hsCRP,fasting blood glucose and HOMA-IR between the two groups before operation.But on the first day,fasting blood glucose,HOMA-IR and hsCRP were significantly lower in the study group than in the control group(6.51 ±1.15 vs 7.49 ±0.57 mmol/L,P =0.038;4.34 ± 1.60 vs 6.09 ±2.81,P =0.043;40.45 ± 27.02 vs 80.02 ± 38.98 mg/L,P =0.03).Conclusion Preoperative oral administration of carbohydrate can obviously lower the postoperative blood glucose level and insulin resistance and alleviate postoperative inflammatory reaction.

Objective To discuss the diagnostic value of serum sialic acid for glioma.Methods A retrospective study was conducted.The levels of sialic acid in serum samples of 95 glioma patients, 175 patients with brain benign tumor and 400 normal persons from October 2014 to March 2015 were detected by automatic biochemistry analyzer using enzymic method.The SNK-q test and analysis of variance were used to compare the difference of the groups.By making receiver operating characteristic ( ROC) curve, the cut-off value, sensitivity, specificity, positive predictive value and negative predictive value were calculated to assess the diagnostic value of serum salivary acid.Then the cut-off value was validated by using the serums of 30 glioma patients and 30 normal persons who were out-patients and healthy controls.Results The levels of serum sialic acid in patients with gliomas, patients with brain benign tumor and healthy individuals were (0.66 ±0.14 ) g/L, (0.61 ±0.09 )g/L, (0.54 ±0.07 )g/L.The serum salivary acid of glioma patients were higher than brain benign tumor patients (q=6.74,P<0.05) and normal persons (q=16.42,P<0.05), and there was no significant difference (F=1.67,P>0.05) among the glioma patients of different grades (8 of gradeⅠ,32 of gradeⅡ,24 of grade Ⅲ,31 of grade Ⅳ).There was no significant difference between the low grade patients (gradeⅠandⅡ) and the high grade patients (gradeⅢandⅣ) (t=0.55, P>0.05), but the level of serum sialic acid of high grade group had an increasing trend than the low grade group.The area under the ROC curves was 0.79.The cut-off value of serum salivary acid for diagnosing glioma was 0.61 g/L.The sensitivity was 67.74%, and the specificity was 80.60%.The positive predictive value was 44.68%, and the negative predictive value was 90.76%.Then the cut-off value was used as a diagnostic criteria, and the detected results of 30 glioma patients and 30 normal persons showed that the sensitivity was 63.30% and the specificity was 83.30%.Conclusions The serum sialic acid has good specificity and negative predictive value for diagnosing glioma.It may be a valuable diagnostic marker.

BACKGROUND:Toxic effects of excessive thyroid hormone on myocardium can not be ignored with the increased incidence of hyperthyroidism. As a quantitative marker of heart failure, brain natriuretic peptide has a good application prospect to estimate the changes of cardiac function and myocardial damage in hyperthyroid cardiomyopathy. OBJECTIVE:To explore the correlation of brain natriuretic peptide and cardiac function of rabbits with hyperthyroid cardiomyopathy exhibiting different left ventricular geometries. METHODS:Twenty New Zealand purebred rabbits were used in this study. Hyperthyroidism model was established by intraperitoneal injection of levothyroxine (45 μg/kg) for 4 weeks. The success of establishing model is defined upon the appearance of irritation, decreased body weight and increased appetite. Totaly 18 rats were successfuly established. The left ventricular data of hyperthyroidism rabbits were measured by conventional echocardiography. According to the classification of Ganauet al, the 18 hyperthyroidism rabbits were divided into two groups: concentric hypertrophy (n=7) and eccentric hypertrophy (n=11). In addition, ten rats, receiving intraperitoneal injection of 5 mL saline per day, were taken as the control group. RESULTS AND CONCLUSION: Plasma brain natriuretic peptide level of rabbits in the concentric hypertrophy and eccentric hypertrophy groups was obviously higher than that of the control group (alP < 0.01), and the level in the eccentric hypertrophy group was obviously higher than in the concentric hypertrophy group (P< 0.01). Compared with the control group, the average peak diastolic velocity of mitral ring was significantly lower in the concentric hypertrophy and eccentric hypertrophy groups (alP< 0.01), the average peak systolic velocity of mitral ring was also lower in the eccentric hypertrophy group (P < 0.01). The peak systolic and diastolic velocity had a negative correlation with brain natriuretic peptide (alP < 0.01). Experimental findings indicate that brain natriuretic peptide is a sensitive indicator to reflect the cardiac function and myocardial damage in rabbits with hyperthyroid cardiomyopathy, exhibiting different left ventricular geomeies.

Objective To explore the safety, efficacy and 1-year follow-up outcome of radiofrequency ablation combined with magnetic navigation assistance system in elderly patients with atrioventricular node reentrant tachycardia (AVNRT). Methods Forty cases of patients with AVNRT identified by the electrophysiological test were enrolled in the study. Twenty cases were ablated with magnetic navigation system. The other 20 cases underwent the conventional catheters operation. With the cardiodrive, the 8 Frablation magnetic Helios I (Stereotaxis Inc, USA) was advanced to the Koch triangle area from the inferior caval vein (IVC). With the assistance of magnetic navigation (AXIOM Artis, Siemens, Germany), the direction of tip and the advancement or retraction of the catheters were regulated. The success rate, the time of procedure, the fluoroscopy time and the 1-year follow-up outcome were analyzed, and the complications of procedure were recorded. Results Forty cases with AVNRT underwent radiofrequency ablation successfully. In magnetic navigation group, 19/20 cases underwent magnetic catheter operation. The cases who failed to finish magnetic catheter operation underwent successfully conventional catheter operation. There was no perforation complication and no significant statistic difference in the success rate between two groups. No recurring case was found in the two groups 1 year later. The total of fluoroscopy time in magnetic navigation group was more than that in standard ablation group [(16.4±2.7) min vs. (11.1±1.0)rain, P<0.01], but the decreasing trend of fluoroscopy time in magnetic navigation group was showed. The operator's fluoroscopy time in magnetic navigation group was obviously less than that in standard ablation group [(4.5±0.6) min vs. (11.1±1.0) min, P<0.01]. Conclusions The radiofrequeney ablation combining with magnetic navigation system has the similar safety and efficacy to the conventional ablation in elderly patients with AVNRT, but the operator's fluoroscopy time was significantly decreased.

BACKGROUND: Studies have shown that high glucose environment has a significant inhibitory effect on the survival of adipose-derived stem cells, which significantly affects the therapeutic efficacy of adipose-derived stem cells on type 2 diabetes mellitus. OBJECTIVE: To investigate the therapeutic effect of rosiglitazone combined with adipose-derived stem cell transplantation in rats with type 2 diabetes mellitus. METHODS: A total of 108 male Sprague-Dawley rats were chosen, 20 of which were randomly taken as normal controls and the rest 88 rats were used to make type 2 diabetes mellitus models through intraperitoneal injection of low-dose streptozotocin combined with high-sugar/high-fat diet. At 20 days after modeling, the model rats were randomized into model, rosiglitazone, cell transplantation and combined groups, followed by administration of normal saline (by gavage and via tail vein), rosiglitazone (by gavage), adipose-derived stem cells (via tail vein), and rosiglitazone (by gavage)+adipose-derived stem cells (via tail vein), once a day, for consecutive 7 days. Three weeks after treatment, fasting blood glucose level, insulin level, C-peptide level, body mass changes were detected; distribution and survival of adipose-derived stem cells were observed; the changes of pancreas histomorphology was observed, the apoptosis in islet cells was detected, and the CXCL1, CXCL2 and CXCR2 protein expression levels in the pancreas tissue were determined. RESULTS AND CONCLUSION: Compared with the normal control group, the fasting blood glucose level was increased (P < 0.05), while the insulin level, C-peptide level and body mass were significantly decreased in the model group (P < 0.05); the number of apoptotic islet cells was increased (P < 0.05); the expression levels of CXCL1, CXCL2 and CXCR2 in the pancreas tissue were elevated (P < 0.05); and the pancreas tissue morphologies were in disorder, with few islet cell masses. Compared with the model group, the fasting blood glucose level was decreased (P < 0.05), while the insulin level, C-peptide level and body mass were significantly increased in the rosiglitazone, cell transplantation and combined groups (P < 0.05); the number of apoptotic islet cells was decreased (P < 0.05); the expression levels of CXCL1, CXCL2 and CXCR2 in the pancreas tissue were declined (P < 0.05); and the pancreas tissue morphologies were improved to different extents, and the combined group showed the best improvement. There were many transplanted adipose-derived stem cells in the cell transplantation and combined groups, especially in the latter one. Overall findings indicate that rosiglitazone combined with adipose-derived stem cell transplantation is an effective treatment for type 2 diabetes mellitus in rats, which is better to inhibit inflammations.

Objective To compare and quantitatively analyse the different characteristics of multimodal imaging of geographic atrophy (GA) in age-related macular degeneration (AMD).Methods The study included multimodel images of 32 eyes of 27 patients with GA secondary to AMD.There were 14 males (17 eyes) and 13 females (15 eyes).The age ranged from 64 to 83 years,with the mean age of (74.4±7.6) years.All eyes were examined by color fundus photography (CFP),fundus autofluorescence (FAF),fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (OCT).Using image J software,two trained ophthalmologists,operating in masked fashion,graded the area of lesions of CFP,FAF and FFA independently and compared the sizes of GA area.OCT was performed to confirm the border of lesion when FAF difficult to be determined.The results consistency of two ophthalmologists was analyzed by Bland-Altman.Results The results consistency was high of two ophthalmologists,with the variation range of FFA＜ FAF＜CFP.The GA area of CFP,FAF and FFA were (19.81 ±13.03),(21.50± 13.61),(23.10± 14.29) mm2.The difference of GA area between three multimodel images was statistically significant (F=0.466,P=0.629).Conclusion The mean size of GA measured by CFP,FAF and FFA showed no statistical difference.