1.Understanding the development status of ophthalmic artificial intelligence, holding the challenges and opportunities
Chinese Journal of Ocular Fundus Diseases 2021;37(2):93-97
With the rapid development of artificial intelligence (AI), especially deep learning, AI research in the field of ophthalmology has presented a trend of diversification in disease types, generalization in scenarios and deepening in researches. The AI algorithm has showed a good performance in the studies of diabetic retinopathy, age-related macular degeneration, glaucoma and other ocular diseases, yielding up the great potential of ophthalmic AI. However, most studies are still in their infancy, and the application of ophthalmic AI still faces many challenges such as lack of interpretability for results, deficiency of data standardization, and insufficiency of clinical applicability. At the same time, it should also be noted that the development of multi-modal imaging, the innovation of digital technologies (such as 5G and the Internet of Things) and telemedicine, and the new discovery that retina status can reflect systemic diseases have brought new opportunities for the development of ophthalmic AI. Learn the current status of AI research in the field of ophthalmology, grasp the new challenges and opportunities in its development process, successfully realizing the transformation of ophthalmic AI from research to practical application.
2.Coronary arterial lesions in Kawasaki disease: a follow-up of 787 cases
Xiaomei ZHANG ; Li ZHANG ; Deying LIU ; Jinxiang LIU ; Jinghua WANG ; Sirui YANG
Chinese Journal of Rheumatology 2014;18(9):636-639
Objective To investigate the coronary arterial lesions (CAL) in Kawasaki disease (KD) in Jilin Province and Inner Mongolia Autonomous Region from 1999 through 2012 and evaluate the influence of glucocorticoids (GCs) on prognosis.Methods We performed a retrospective study among patients of KD in Jilin Province and Inner Mongolia Autonomous Region from 1999 to 2012,in order to observe CAL in KD,the incidence of sequelae and the influence of CGs on disease outcome.Comparison between groups was carried out by Chi-square test.Results Eight hundred and ten KD cases were reported from 32 hospitals and 787 patients accepted an Echo examination,as the main objective of this study.Fivehundred and forty were boys and 247 were girls,with the male to female ratio of 2.19:1,of which 498 cases (63.3%) had CAL.Most CAL occurred in patients at 58 day to 14 year old (2.7±2.4).The most common abnormality was CAL including dilatation (49.5%) and stenosis (13.4%).Compared incomplete to complete KD,the result showed that the occurrence of CAL was similar between these two groups,no significant differences could be found between different gender.Nineteen (2.4%) of them had cardiac sequelae and the male/female ratio was 3.67:1.The younger the age,the higher the incidence of cardiac sequelae.The most frequent cardiac sequelae was coronary artery dilatation.GCs therapy could increase the occurrence of CAL [80.2%(97/121) vs 62.6% (419/666),x2=8.71,P<0.05].Conclusion CAL is not different between patients with complete or incomplete KD and the occurrence of CAL is not associated with gender,but with age.The younger the age,the higher the incidence of CAL and the higher the incidence of cardiac sequelae.It is possible that patients treated with GCs are prone to CAL.
3.Effects of 5-HT1A receptor in hippocampal dentate gyrus on anxiety-related behavior of adult rats with Parkinson's disease
Ye LIU ; Yifan JIANG ; Xin LIU ; Sirui JIAO ; Wei HU ; Wei PENG ; Wen XIE ; Jun WANG ; Li ZHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2017;38(3):402-409
Objective To study the effects of 5-HT1A receptor in hippocampal dentate gyrus on anxiety behavior of adult rats with Parkinson's disease (PD).Methods PD model in rats was constructed by using 6-hydroxydopamine (6-OHDA) to lesion the medial forebrain bundle (MFB).In lesioned rats and sham-operated rats,we examined the changes of the number of TFH-positive neurons in the SNc and VTA.We also examined how 5-HT1A receptor of hippocampal dentate gyrus (DG) modulates the anxiety-related behavior using open field test and elevated plus-maze test,and examined monoamine neurotransmitter changes in the striatum,medial prefrontal cortex (mPFC),amygdale and ventral hippocampus using reverse-phase high performance liquid chromatography with electrochemical detection.Results In 6-OHDA-lesioned rats,the SNc of the injected side showed a total loss of TH-ir neurons compared with the unlesioned side,and the number of TH-ir neurons in the VTA on the lesioned side decreased significantly to (34± 2)%.The locomotor activity in 6-OHDA-lesioned rats decreased compared with that in sham-operated rats.Unilaterally lesioning the MFB decreased the percentage of time spent in the center in the open-field test and percentages of open arm entries and open arm time of elevated plus maze test when compared with sham-operated rats.In the sham-operated rats,intra-DG injection of 8-OH-DPAT did not affect anxiety-like behavior.In 6-OHDA-lesioned rats,intra-DG injection of 8-OH-DPAT significantly increased the percentage of time spent in the center at a dose of 100 ng and 500 ng when compared with saline injection into the DG.Injection of WAY-100635 did not affect rats in the two groups.Unilateral 6-OHDA lesions of the MFB in rats significantly decreased DA levels in the ipsilateral striatum,mPFC,amygdale and ventral hippocampus compared with those in sham-operated rats,but had no effect on 5-HT or NA levels in those structures.Conclusion Unilateral 6-OHDA lesion of the MFB not only totally damaged DA neurons in SNc and partly damaged DA neurons in VTA,but also decreased DA level in the ipsilateral striatum,mPFC,amygdale and ventral hippocampus.Unilateral 6-OHDA lesion of the MFB induces anxiety-related behavior,and activation of 5-HT1A receptor in the hippocampal dentate gyrus has anxiolytic effect in the rat model of Parkinson's disease.
4.Contrast observation of optical coherence tomography angiography between neovascular age-related macular degeneration and myopic choroidal neovascularization before and after intravitreal anti-vascular endothelial growth factor treatment
Xiaoxue MIN ; Yilin LIU ; Sirui ZHOU ; Jia MU ; Ming ZHANG
Chinese Journal of Ocular Fundus Diseases 2019;35(1):36-39
Objective To compare the features of OCT angiography (OCTA) between neovascular agerelated macular degeneration (nAMD) and myopic ehoroidal neovascularization (mCNV) patients before and after intravitreal anti-VEGF treatment.Methods A prospective cohort study.Twenty-nine patients (37 eyes) with nAMD (19 males and 10 females,aged 68.20±8.76) and 31 patients (34 eyes) with mCNV (9 males and 22 females,aged 43.10± 11.80,with the mean diopter of-9.71 ± 1.20 D) from Department of Ophthalmology,West China Hospital of Sichuan University during May and December 2017 were included in this study.Ranibizumab or Conbercept (0.5 mg/0.05 ml) was intravitreally injected in all eyes.The patients were follow-up for 3-6 months.The OCTA was conducted before treatment and 1 day,1 week,1 month and 3-6 months after treatment.In order to ensure that the scanning position was the same,the tracking mode was adopted for each scanning.According to the OCTA images,the lesion area,parafoveal superficial vessel density and perfusion area were measured and analyzed contrastively between nAMD and mCNV patients.Results The mean lesion area before and 1 month after treatment in nAMD patients were 0.38± 1.87 mum2 and 0.06±0.12 mm2,while in mCNV patients,those were 0.26± 1.06 mm2 and 0.03 ± 0.05 mm2,respectively.There were statistically significant differences (Z=4.181,4.475;P<0.001) in CNV lesion area before and 1 month after treatment between nAMD and mCNV patients.Compared with those before treatment,the absolute change (Z=1.853,P=0.064) and the percentage changes (t=2.685,P=0.010) of CNV lesion area l month after treatment in nAMD and mCNV patients show a statistical meaning.There were significantly decreases in both parafoveal superficial vessel density (F=8.997,P=0.003) and perfusion area (F=7.887,P=0.015) 3 months after treatment in nAMD patients,while decreases in parafoveal superficial vessel density (F=11.142,P=0.004) and perfusion area (F=7.662,P=0.013) could be detected 1 day after treatment in mCNV patients,before rising 1 month after treatment.Conclusions There are significantly differences in lesion area before and after the treatment of intravitreal anti-VEGF between nAMD and mCNV patients by OCTA examination.Moreover,the changes of both parafoveal superficial vessel density and perfusion area after anti-VEGF treatment are statistically different in two groups.
5.Clinical diagnosis and treatment for age-related macular degeneration: a brief analysis of the guidelines
Jia MOU ; Sirui ZHOU ; Yilin LIU ; Dan DENG ; Qu LUO ; Xiang REN ; Ming ZHANG
Journal of Chinese Physician 2018;20(8):1123-1127,1131
Age-related macular degeneration (AMD) is a common cause of blindness among people over 65 in developed countries.With the rapidity of population aging process,the prevalence of AMD will be further increased.The application of anti-vascular endothelial factor growth medicine in ophthalmology has made great progress in the therapeutic effect and prognosis of wet AMD.In this context,many countries and regions have successively formulated guidelines for the AMD clinical diagnosis and treatment,especially the United States,Europe and Australia.Through the analysis of AMD clinical guidelines of American Academy of Ophthalmology (AAO) in 2015,and by comparing it with AMD analysis and treatment guidelines of European Society of Retina Specialists (EURETINA) in 2014,this paper provides an accurate,effective and comprehensive diagnosis strategy and lays a foundation for providing AMD patients with quality diagnosis and treatment plans.
6.Clinical analysis of 66 patients of retinoblastoma
Sirui ZHOU ; Xiaoxue MIN ; Yunhan TAO ; Jia MU ; Yueqin GOU ; Mengying TAO ; Ming ZHANG
Chinese Journal of Ocular Fundus Diseases 2020;36(1):42-45
Objective To observe the clinical characteristics ofretinoblastoma (RB) in Southwest China.Methods A retrospective clinical study.From January 2010 to December 2017,66 RB patients diagnosed in Ophthalmology Department of West China Hospital of Sichuan University were included in the study.All the patients underwent ocular B-ultrasound,orbital CT or MRI examination.Ten patients underwent RetCam examination at the same time.Twenty-nine patients were diagnosed by histopathological examination,and 37 patients were diagnosed by clinical symptoms and imaging examination.According to whether the tumor invaded the orbit and optic nerve,it could be divided into extraocular stage and intraocular stage.Intraocular tumors were divided into A-E stages according to the international intraocular RB classification.Treatments were performed according to different stages.The general information,age at diagnosis,course of diseases (the time between onset symptoms and diagnosis),causes of visiting a doctor,classification,treatment methods and eyeball preservation rate were retrospectively analyzed.Results Patients all came from Southwest China (56 patients from Sichuan Province,2 patients from Yunnan Province,2 patients from Guizhou Province,and 6 patients from Tibet).The permanent residence were identified in 43 patients,including 27 patients (62.8%) from rural areas.There were 38 males (57.6%);50 unilateral tumors (75.8%) and 16 bilateral tumors (24.2%);51 firstvisiting patients (77.3%) and 15 re-visiting patients (22.7%).The average diagnostic age of first-visiting patients was 20.9 ± 14.4 months,with 23.2 ± 14.7 and 11.2 ± 7.6 months for unilateral and bilateral tumors,respectively.There were 41 patients had definite course and causes,of whom the average course was 90.6± 115.2 days.The most common cause was leucocoria in 32 patients (62.7%),followed by redness and swelling in 4 patients (9.8%),and other causes in 5 patients (12.2%).Among the 15 re-visiting patients,the average diagnostic age was 63.6± 46.8 months,the average course was 32.8 ± 45.5 months.Recurrence was occurred in 5 patients (33.3%),leucocoria in 4 patients (26.7%),postoperative complication in 3 patients (20.0%),protrusion in 2 patients (13.3%) and redness in 1 (6.7%) patient,respectively.Fifty out of 82 eyes were admitted to hospital,including 37 eyes of first-visiting patients and 13 eyes of re-visiting patients.Among 37 first-visiting eyes,there were 5 eyes (13.5%) in stage A-C,26 eyes (70.3%) in stage D-E,6 eyes (16.2%) in extraocular stage.Five eyes in stage A-C were treated with laser photocoagulation and (or) cryotherapy combined with systemic chemotherapy.Four eyes in stage D were treated with intraocular arterial chemotherapy.Nineteen eyes (51.3%) were performed with enucleation,2 eyes (5.4%) with evisceration and 7 eyes (18.9%) abandoned treatment.Among 13 re-visiting eyes,6 eyes (46.2%,with 5 eyes of recurrence) had been enucleated before,4 eyes (30.8%) were in extraocular stage and 3 eyes (23.1%) in stage D-E.Five eyes (38.5%) were treated with evisceration,4 eyes (30.8%) with enucleation,1 eye with oculoplastic surgery and 3 eyes (23.1%) abandoned treatment.The rate of eye preservation was 18.0%,29.0% for intraocular stage and 0% for extraocular stage,respectively.Conclusion RB patients in Southwest China have a longer course between onset symptoms and diagnosis,more advanced classification and lower rate of eye preservation.
7.Establishment of a new scoring model for IVIG non-response of Kawasaki disease
Danying ZHU ; Sirui SONG ; Han ZHANG ; Jian ZHAO ; Bei JIANG ; Lijian XIE ; Tingting XIAO ; Min HUANG
International Journal of Pediatrics 2018;45(7):532-536,542
Objective To analyze the possible risk factors of IVIG non-response of Kawasaki disease (KD),Shanghai Children's Hospital and Shanghai Junze Software develop an research platform,which is based on E-Science model.Through the mathematical model by integrating the risk factors to explore the method of effective prediction for IVIG non-response,and to provide the clinical basis for timely and effective treatment and prognosis of the disease.Methods The data of KD children who were hospitalized in Shanghai Children's Hospital from January 2013 to November 2016 were included.The indexes included gender,age,time of IVIG treatment,and laboratory examinations.The multivariate logistic regression was used to analyze the influencing factors of IVIG non-response.The indexes in the model were deduced according to the independent variables of the logistic regression equation.The ROC curve and the area under the curve were calculated for the new prediction model.The sensitivity and specificity of the new prediction model were calculated according to the cutoff value.Finally,the new model was compared with the Kobayashi and Egami scoring model.Results The levels of CRP,NLR,LDH,ALB and FDP in children with KD were influencing factors for IVIG nonresponse (P < 0.05).According to the logistic regression equation,the sensitivity and specificity of the model used to predict IVIG non-response were 69.7% and 80.4%,respectively,and the area under the ROC curve was 0.825 (95% CI:0.769-0.882).Kobayashi and Egami scoring models were tested,the sensitivity and specificity of the new scoring system were better than previous ones.Condusion The scoring model established in this study has a good effect in predicting IVIG non-response in KD patients and could be used in clinical practice,and it is worthy to be validated and adjusted by large-scale data.
8.Translation and assessment about the Sexual Interest and Desire Inventory-Female
Chenchen LIU ; Guangling GUO ; Chao ZHANG ; Qinqin GONG ; Sirui DONG ; Shuying ZHAO ; Fan ZOU ; Yuqian XIONG
Chinese Journal of Practical Nursing 2021;37(36):2807-2813
Objective:To translate the English version of Sexual Interest and Desire Inventory-Female (SIDI-F) into Chinese, evaluate its reliability, validity and the proper cut-off point of diagnosis of hypoactive sexual desire disorder (HSDD) in China.Methods:Chinese version of SIDI-F was developed and 96 healthy women from January 1, 2019 to December 31, 2019 in Taihe Hospital, Shiyan City, Hubei Province were selected to fill in the Chinese version of SIDI-F and the Female Sexual Function Index (FSFI). Next, analyzed the reliability, validity and the cut-off point of diagnosis of HSDD of the SIDI-F.Results:The Cronbach coefficient of the Chinese version of SIDI-F was 0.931, split-half reliability was 0.922, the intra-group correlation coefficient was 0.805. Analysis of content validity of the SIDI-F indicated that the average of scale-level content validity index was 1.00, the item-level content validity index was 1.00, and the Pearson correlation coefficient between the score of SIDI-F and the erotica score of the FSFI (FSFI-D) was 0.802. Factor analysis of the Chinese version of SIDI-F showed good construct validity. The area under ROC was 0.835. With the SIDI-F score and the best cut-off point of 26.5, Youden index was the largest, at 0.635. The validity indicators were 76.7% for sensitivity, 86.8% for specificity, 5.95 for positive likelihood ratio.Conclusions:The Chinese version of SIDI-F has high reliability and validity in Chinese population, and these show 26.5 point can be used as the best cut-off value of diagnose HSDD.
9.Standardized manipulations for pediatric Tuina in medical institutions
Xiaoxue LAN ; Yue WANG ; Ying ZHANG ; Qianji CHEN ; Yuanwen LIANG ; Rong ZHOU ; Sirui GU ; Yi AN ; Kexin SHANG ; Wenke LIU ; Xingzhu YE ; Hui SHAO ; Miao JIANG ; Changhe YU ; Hong CHEN
International Journal of Traditional Chinese Medicine 2022;44(12):1327-1346
The standardization of pediatric Tuina is beneficial to pediatric Tuina practitioners in a norm practices. The paper collects the content from teaching textbooks, TCM ancient books and database literature, and tries to develop the technical specifications of pediatric Tuina by four rounds Delphi surveys and expert consensus. This specification covers the manipulation of pediatric Tuina, the position of acupoints, the effects of acupoints and the diagnosis and treatment of pediatric Tuina, including indications, contraindications, cautious use, operation steps and methods.
10.AIDS discrimination in junior college students and the effect of AIDS knowledge on discrimination
Chinese Journal of School Health 2020;41(2):209-212
Objective:
To analyze the situation of AIDS knowledge and discrimination among freshmen in Chengdu city, and to explore possible effects of AIDS knowledge on discrimination.
Methods:
A cluster random sampling was employed to investigate 1 053 college students from 11 universities in Chengdu about their HIV/AIDS knowledge and discrimination. The scores of AIDS knowledge and discrimination of students with different characteristics were analyzed, and the influence path of AIDS knowledge on AIDS discrimination were further analyzed based on different peer relationships.
Results:
The total scores of AIDS knowledge was negatively correlated to AIDS discrimination( r s =-0.13, P <0.01). After adjusting for confounding factors, the total score of AIDS knowledge was associated with the total score of AIDS discrimination( β =-0.12, P <0.01). AIDS knowledge played a role in AIDS discrimination in intimate, general and unfamiliar peer relationships, with standardized path coefficients of -0.20, -0.24 and -0.18 respectively( P <0.01).
Conclusion
AIDS knowledge are correlated with discrimination among freshmen under different peer relationships. More anti-AIDS discrimination courses should be added to AIDS education to reduce the students’ fear and stigma of HIV/AIDS patients and related risk groups.