Objective To explore the clinical features of hepatitis G virus (HGV) infection and HGV replication sites in vivo. Methods A sensitive and specific reverse transcription-nested polymerase chain reaction (RT-nested PCR) was set up to detect the plus-stranded and minus-stranded HGV RNA in sera of 129 high risk population as well as in peripheral blood mononuclear cells (PBMCs) from 59 cases of them. The clinical features of HGV infection were analyzed in the meantime. Results Among 9 patients with single HGV infected, 3 cases were diagnosed as acute hepatitis, 3 cases as chronic hepatitis and the other 3 cases as healthy carriers. The detection rate of HGV RNA in PBMCs is much lower than that of HCV RNA (35.7 % vs. 77.3 % , P＜0.05). In all 59 PBMCs and 129 serum samples no minus-stranded HGVRNA was found. Conclusion HGV infection can cause acute or chronic hepatitis with mild clinical manifestation. HGV can invade PBMCs but can not replicate in PBMCs, and the ability of HGV to invade PBMCs is lower than that of HCV.

Background Primary angle-closure glaucoma (PACG) is the most common type of glaucoma in China.A screening to identify the possible angle closure is important in the prevention and treatment of PACG.Objective This study was to determine the characteristics and the optimal parameters measured by the scanning peripheral anterior chamber depth analyzer (SPAC) in the screening of occludable angle of a sample of adult Chinese population.Methods A cross-sectional study was performed in Handan from February to April in 2013.One hundred and eighty Chinese adults were enrolled with the age of 40 years and older and acceptable criteria during 5-year following-up duration of the Handan Eye Study.Routine eye examinations were carried out in all subjects under the informed consent,including visual acuity,optometry,anterior ocular segment examination under the slit lamp microscope,and then SPAC measurement and gonioscopy were performed in a dark room.Occludable angle was defined as posterior trabecular meshwork being invisible in ≥ 180° range under the static gonioscope.Occludable angle by SPAC was estimated using available central chamber depth (ACD) and a combined indicator,numerical grade was 5 or fewer and/or the categorical grade was S or P,separately.Receiver operating characteristic (ROC) curve was calculated to assess the performance of these parameters in detecting eyes with occludable angle for the population-based sample,and area under curve (AUC) was drown to compare the screening efficiencies between available ACD and combined indicator.Results In 180 subjects,occludable angles were found in 62 and open angles were in 118.Compared to the subjects with open angle,the subjects with occludable angle showed the older age (P＜0.001),more females (P＜0.05),lower visual acuity (P＜0.001),greater hyperopic diopter (P＜0.05),smaller ACD value (P＜0.001) and shorter axial length(P＜0.001).In eyes with occludable angle by using SPAC,the ACD showed an AUC of 0.832.Using a cutoff of 2.7 mm for ACD,the sensitivity and specificity were 85.48％ and 68.64％,and under the cutoff of 2.8 mm,the sensitivity and specificity was 90.32％ and 61.02％,respectively.For the combined parameters,the sensitivity and specificity was 62.90％ and 90.68％,respectively and the AUC was 0.768.Conclusions When gonioscopy is used as a reference,a cutoff of 2.8 mm ACD by SPAC shows the highest sensitivity for the screening of occludable angle in Chinese population.

Background Early diagnosis of primary angle-closure glaucoma (PACG) and screening or case detection of high risk population have become a major challenge in the prevention and treatment of PACG.Commonly used methods for evaluation of anterior chamber depth (ACD) and anterior chamber angle nowadays have their shortcomings.Scanning peripheral anterior chamber depth analyzer (SPAC) measures ACD and evaluates the risk of angle closure.Also,SPAC is handy,objective and noninvasive.Objective This study was to evaluate the repeatability (within-rater differences) and reproducibility (between-rater differences) of SPAC to measure anterior chamber-related parameters and agreement of SPAC to estimate occludable angle between two operators.Methods A prospective cross-sectional study was designed.Thirty subjects with shallow ACD (modified van Herick grading≤ 3 and Shaffer grading≤2) aged 35 years and older,who met the inclusion criterion were enrolled as shallow anterior chamber group and 30 age-and gender-matched normal adults (modified van Herick grading≤3 and Shaffer grading≤2)from the follow-up research of the Handan Eye Study in February 2013.After an elementary eye examination,a randomly selected eye of each subject in both groups received three consecutive SPAC measurements by each of the two examiners,respectively to obtain ACD,central corneal thickness (CCT) and corneal radius of curvature (CRC).Meanwhile,the identity of occludable angle as the numerical grade was 5 or fewer and/or the categorical grade being S or P was also obtained.The repeatability of each examiner was evaluated by the repeatability limit (RL) and the reproducibility of the two examiners was evaluated by intraclass correlation coefficient (ICC).The agreement of occludable angle estimation between two operators was evaluated using Kappa coefficient.Results The RLs percentage for ACD,CCT and CRC ranged from 0.36％ to 3.29％,and 0.90％ to 4.72％ in the normal control group and shallow anterior chamber group from operator A,and those from operator B were 0.38％ to 2.55％,and 0.51％ to 3.42％.The ICCs for ACD,CCT and C RC of SPAC were 0.966,0.859,0.989 and 0.915,0.905,0.971,respectively from operator A and operator B.The Kappa coefficients for the identity of occludable angle between two operators were 1.000 and 0.520 in the normal control group and the shallow anterior chamber group,respectively.Conclusions Measurements of the three parameters provided by SPAC in normal and shallow anterior chamber subjects show a good repeatability and reproducibility.The results of identity of occludable angle from two examiners have a good agreement for normal subjects and a moderate reproducibility for subjects with shallow ACD.

Background Angle closure is the pathological basis of primary angle-closure disease (PACD).Understanding different types of angle closure mechanisms is significant for evaluation of risk factors,prevention,diagnosis and treatment of PACD.Ultrasound biomicroscopy (UBM) is commonly used for investigating the types of angle closure mechanisms in clinical works.However,UBM is a contact examination,which limits its application.Anterior segment optical coherence tomography (AS-OCT) is a non-contact examination of anterior segment imaging,through which qualitative and quantitative evaluations of the anterior chamber angle can be made.Objective This study was to investigate the reproducibility of mechanism categories of angle closure based on AS-OCT images and UBM images.Methods Cross-sectional study was performed.PACD outpatients from September to October in 2013 in Beijing Tongren Hospital were enrolled and received both UBM and AS-OCT examinations.UBM images were obtained in superior,inferior,nasal and temporal quadrants of the anterior chamber.AS-OCT images were obtained in the anterior segment quadrant mode at 0-180,45-225,90-270,and 135-315 degree meridians.UBM and ASOCT images were categorized into three dominant angle closure mechanisms:pupil block,anterior located ciliary body and thick peripheral iris roll,separately.And the same mechanism of at least two UBM/AS-OCT images of one eye was defined as the angle closure mechanism of this eye.If both eyes of one PACD patient were eligible for inclusion,the right eye was selected for analysis.The reproducibility of two examinations was evaluated by Kappa coefficients.Results Finally 40 PACD patients (40 eyes,27 right eyes and 13 left eyes) were enrolled for analysis.Based on UBM images,12 eyes (30.0％) were classified as pupil block,23 eyes (57.5％) as anterior located ciliary body and 5 eyes (12.5％) as thick peripheral iris roll.Based on AS-OCT,12 eyes (30.0％) were classified as pupil block,21 eyes (52.5％) as anterior located ciliary body and 7 eyes (17.5％) as thick peripheral iris roll.The Kappa coefficient for the classification of angle closure mechanisms was 0.870.Conclusions Criterion of angle closure mechanism categories based on AS-OCT images was established.Mechanism categories obtained from AS-OCT and UBM images showed a good reproducibility.

Lots of blinding diseases are caused by retinal ganglion cells apoptosis, but there is no the effective and ideal therapy in clinic currently. Recent study showed that stem cells can be an alternative renewable source of retinal ganglion cells, and they may be potential to repair the visual function. These results provide a new model of optic nerve regeneration for the treatment of these blinding diseases. But, some problems in clinical applications are waiting for further solving. Applications of stem cells in optic nerve regeneration is reviewed in this paper.

Objective To assess the level of soluble Fas (sFas) and soluble Fas ligand (sFasL) in the sera of patients with systemic lupus erythematosus (SLE),rheumatoid arthritis (RA),multiple sclerosis (MS)and insulin dependent diabetes mellitus (IDDM).Method The level of sFas and sFasL was determined by a sandwich enzyme linked immunosorbent assay.Anti ssDNA (single stranded DNA) was detected by indirect enzyme linked immunosorbent assay.Results The level of sFas in patients with SLE,RA,IDDM and MS was significantly higher than that in healthy individuals.It was interesting that among these autoimmune diseases,the level of sFas in the sera of patients with SLE was dramatically higher than that of the other diseases.The high level of sFasL accompanied by sFas was found in the sera of SLE and RA patients.In the sera of patients with SLE,the anti ssDNA antibody always accompanied by high concentration of sFas and,by contrast,no anti ssDNA antibody was found in all the patients in whose sera no sFas was found.In patients with IDDM,the sFasL level of the serum was significantly lower than that of the serum of healthy donors.Conclusion Serum sFas level of patients with SLE,RA,MS and IDDM is higher than that of healthy individuals.These results indicate that the sFas level can be used as a marker of disease progress and relaxing after treatment with the medicine.It is also demonstrated that there is relationship between the level of anti ssDNA antibody and sFas.The level and significance of serum sFas and sFasL in these autoimmune disease patients are under investigation.

OBJECTIVE: To study the expression of angiopoietin receptor Tie-2 in the renal tissue of diabetic rats and the effects of Astragalus. METHODS: SD rats were randomly divided into normal control group, diabetes group and Astragalus-treated group. The expression of receptor Tie-2 in the renal tissue was assessed by using real-time quantitative polymerase chain reaction and immunohistochemical method. RESULTS: Glomerule Tie-2 protein expression was significantly elevated in the diabetes group as compared with the normal control group (P<0.01). Glomerule Tie-2 protein expression in the Astragalus-treated group was decreased as compared with the diabetes group (P<0.01). CONCLUSION: Tie-2 may play an important role in the pathogenesis of the early stage diabetic renal injury. The reno-protection effect of Astragalus may be mediated by down-regulating the expression of Tie-2 in the kidney tissue of diabetic rats.

Objective To determine the optimal cutoff value of carcinoembryonic antigen (CEA) and amylase in cyst fluid for mucinous cystic neoplasm,to explore the difference of cutoff value of CEA between Chinese and western populations and the diagnostic accuracy of CEA combined with amylase for mucinous pancreatic cysts.Methods A total of 116 patients received EUS-FNA in Chinese PLA General Hospital from April 2014 to May 2016 with cyst fluid for biochemical and histological examinations and biopsy for pathological examination.The optimal value of amylase and CEA for mucinous pancreatic cysts were obtained from receiver operator characteristics curve of CEA and amylase.The accuracy,sensitivity and specificity of CEA,amylase and combination of both were calculated.Results Diagnosis of 70 patients were confirmed by surgery,forceps or cytology.There were 32 cases of non-mucinous pancreatic cysts including 6 pseudocysts and 26 serous cystadenoma.There were 38 cases of mucinous pancreatic cysts including 31 mucinous cystic neoplasm and 7 intraductal papillary mucinous neoplasm.The optimal cutoff of CEA was 72.35 ng/mL.The accuracy,sensitivity and specificity were 84.3％,81.6％ and 87.5％ respectively.The accuracy,sensitivity and specificity for mucinous cystic neoplasm were 80.0％,71.1％ and 90.6％ respectively when adopting CEA ＞ 192 ng/mL.The optimal cutoff of amylase was 461.70 IU/L,and accuracy,sensitivity and specificity were 57.1％,68.4％,43.8％ respectively.Combination of CEA＞72.35 ng/mL and amylase＜461.7 IU/L yielded higher accuracy (85.7％) and specificity (93.8％) with lower sensitivity (78.9％).Conclusion CEA can be used in the differential diagnosis of mucinous and nonmucinous pancreatic cysts.The optimal cutoff of CEA in Chinese was lower than that in western populations.And the combined analysis of CEA and amylase could increase the diagnostic accuracy.However,in order to confirm this conclusion,a study of larger scale is needed.

Atropine is one of the useful methods that can slow down myopia progression.The effect of atropine has been proved by clinical researches, among which, various concentrations of atropine from 0.01% to 1% are all effective on control myopia progression for children, and atropine 0.01% has been verified to have the best balance between efficiency and side effects.Though many hypotheses and theories have been proposed to explain the mechanism of atropine, no community agreement has been reached among global scientists.Researches have shown that the possible receptors of atropine include M1-M5 acetylcholine families, γ-aminobutyric acid (GABA) receptors, dopamine receptors, ZENK gene and α 2-adrenergic receptors, which are located on retina and posterior sclera.The inhibitory effect of atropine on myopia progression might be achieved through cholinergic, G-protein and GABA signaling pathway.The target site of action of atropine is located on retinal pigment epithelium, choroid and scleral collagen.The effects of topical application of atropine combined with orthokeratology are better than wearing orthokeratology only.The mechanism, site of action and most relevant clinical researches of atropine of various concentrations were reviewed in this article.

Objective:To examine a nomogram model for individualized prediction of the risk for recurrence of early gastric cancer(EGC)in elderly patients undergoing endoscopic submucosal dissection(ESD).Methods:This was a retrospective cohort study, with a total of 3 987 elderly EGC patients who underwent ESD treatment between January 2000 and December 2016 after admission to the gastroenterology department of our hospital.Twenty-eight relapsed patients with complete clinicopathological data and follow-up data were selected as the relapse group, and 276 non-relapsed patients were selected as the control group.General data of all patients were collected and a logistic regression analysis was performed to analyze independent risk factors for the recurrence of EGC in patients after ESD.A corresponding nomogram risk prediction model was established by using the R software.Results:Among the 3 987 elderly EGC patients, 29 relapsed after an average follow-up of 2.7 years, and the recurrence rate was 0.73%(29/3 987). The differences in baseline data such as age(≥75 years old), lesion size(≥3 mm), T stage and lymph node metastasis between the recurrence group and the control group were statistically significant(11 cases or 39.3% vs.171 cases or 62.0%, 19 cases or 67.9% vs.111 cases or 40.0%, 9 cases or 32.1% vs.153 cases or 55.4%, 19 cases or 67.9% vs.102 cases or 39.0%, P<0.05). Logistic regression analysis showed that age over 75 years( OR=2.128, 95% CI: 1.373-3.624), T stage( OR=1.763, 95% CI: 1.079-2.934), lesion size≥3 mm( OR=2.604, 95% CI: 1.363-4.217), and lymph node metastasis( OR=2.871, 95% CI: 1.425-5.639)were independent risk factors for the recurrence after ESD in EGC patients( P<0.05). The nomogram model was established based on the above risk factors, and the validation results showed that the predicted value was basically the same as the actual measured value and had good predictive performance.The internal validation results showed that the consistency index was 0.817(95% CI: 0.722-0.941), suggesting that the model had a high accuracy and discrimination. Conclusions:Before ESD for elderly EGC patients is performed, factors such as age, tumor size, T stage and lymph node metastasis should be fully considered to comprehensively evaluate the recurrence rate of EGC after the procedure.This predictive model can improve the diagnostic efficacy of postoperative recurrence and has high clinical value.