Epigenetic modifications such as DNA methylation,histone post-translational modifications,non-coding RNA are reversible,heritable alterations which are induced by environmental stimuli.Major risk factors of diabetes and diabetic complications including hyperglycemia,oxidative stress and advanced glycation end products,can lead to abnormal epigenetic modifications in retinal vascular endothelial cells and retinal pigment epithelium cells.Epigenetic mechanisms are involved in the pathogenesis of macular edema and neovascularization of diabetic retinopathy (DR),as well as diabetic metabolic memory.The heritable nature of epigenetic marks also plays a key role in familial diabetes mellitus.Further elucidation of epigenetic mechanisms in DR can open the way for the discovery of novel therapeutic targets to prevent DR progression.

Objective To further solve the mutual restricted problems among precision, speed and disregistrated rate of registration algorithm based on mutual information (MI). Methods A new strategy on the search of registration parameters, a triple level registration strategy, was proposed. It searched the translation parameters and the rotation parameters respectively. Based on analyzing the advantage and limitation of MI-based registration, Euclid closeness of Fuzzy theory was introduced into the process of the triple level registration. Results The computer simulation results demonstrated that the proposed registration method, on the condition of retaining the same precision, improved both the speed (step numbers and registration time) and the disregistrated rate. Conclusion The proposed triple level registration strategy is a registration strategy to be able to harmonize precision, speed and disregistrated rate effectively.

Objective To identify the use of body mass index (BMI) to predict the areas under curve (AUC) of hypertension,and to find the optimal cutoff of predicting the incidences of hypertension in Chinese adults. Method Using the data from Nationwide Nutrition and Health Survey to find the new cases of four-years hypertension,and to calculate the four-year cumulative incidence (CI) of hypertension,and operate the receiver operating characteristic (ROC),analyze the AUC and calculate the sensitivity and specificity of optimal cutoff. Results Four-year CI of hypertension were 17.2% (20.3% for men and 14.2% for women),the AUC were 0.62 and 0.61 for men and women,respectively. Conclusion The optimal cut off was applicable in monitoring the incidences of hypertension,and more verification should be carried out in the future when applying this cut off.

Adolescent ; Adult ; China ; epidemiology ; Humans ; Middle Aged ; Motor Activity ; Rural Population ; Suburban Population ; Urban Population

Objective:To investigate the prevalence of frailty in elderly patients with stage 3-5 non-dialysis chronic kidney disease(ND-CKD)and to analyze its related factors.Methods:A cross-sectional study was conducted.Patients ≥65 years old with stage 3-5 CKD who had never undergone dialysis in the nephrology department and the internal medicine department of our hospital between October 2017 to September 2018 were enrolled.Patients were divided into the non-frail group and the frail group according to the Fried frailty phenotype.Clinical data and laboratory results were collected and comprehensive geriatric assessment was carried out to evaluate participants' medication, comorbidities, daily living ability, nutritional status, depression, cognitive and physical performance.The relevant factors for frailty were analyzed.Results:A total of 193 elderly patients with stage 3-5 ND-CKD were enrolled, 106 male and 87 female, including 68 outpatients and 125 inpatients, with a median age of 79.00(73.00, 85.00)years.There were 143 frailty patients(74.1%), including 41 outpatients and 102 inpatients, accounting for 60.3% and 81.6% of the eligible outpatients and inpatients respectively.Multivariable Logistic regression analysis showed that CKD stage( OR=9.74, 95% CI: 1.12-84.54)and polypharmacy( OR=3.69, 95% CI: 1.09-12.42)were associated with frailty in outpatients, and CKD stage( OR=11.75, 95% CI: 1.38-99.99)and malnourishment or risk of malnutrition( OR=4.22, 95% CI: 1.40-12.74)were correlated with frailty in inpatients. Conclusions:The prevalence of frailty is high in elderly patients with stage 3-5 ND-CKD.CKD stage, polypharmacy and malnourishment or the risk of malnutrition are closely correlated with frailty.

Objective:To evaluate the knowledge, attitudes and practices ( KAP) on National Essential Medi-cine System among pharmacists from secondary public hospitals in Shaanxi province. Methods: The quantitative re-search of KAP questionnaire is used, and the content of questionnaire includes personal information, knowledge, atti-tudes and practices. Results: A total of 520 copies of questionnaires were distributed and 82. 3% were effective. Respondents’ overall knowledge and attitudes are at the middle level;the main way to obtain knowledge is via training and meeting;respondents’ education level and frequency of participating in training have a significant impact on their level of knowledge;the degree of attention paid by hospitals has yet to be strengthened; and respondents are mostly concerned about the supply and distribution of essential drugs. Conclusion: In order to improve the awareness and recognition levels of pharmacists on the implementation of National Essential Medicine System in secondary public hospitals, the government should take the relevant measures, including introducing the high educated persons into secondary public hospitals, organizing related training programs and standardizing the daily monitoring of essential drugs in secondary public hospitals, etc.

Objective To analyse the changes in bilateral optic radiation and visual cortex in patients with primary glaucoma detected by magnetization transfer imaging ( MTI ),and try to explore the influence of the disease on posterior visual pathway.Methods MTI was performed in 20 patients with primary glaucoma with normal signal on conventional magnetic resonance imaging (MRI).The same scanning was performed in 31matched healthy controls.MTI was obtained using spoiled gradient recalled acquisition sequence (SPGR).Magnetization transfer ratio ( MTR ) of bilateral optic radiation and visual cortex was measured after post-processing.The MTR value differences of the same area between two groups were compared by independent-sample t test or Satterthwaite t test if variances were not equality.Result The MTR value in the left and right optic radiation were ( 32.8 ± 2.2 ) ％ and ( 32.7 ± 2.0 ) ％ in the glaucoma group,(34.6 ± 1.4 )％ and (34.8 ± 1.3 )％ in the control group.There was a statistically significant difference between the two groups (left t =3.284,right t =4.040 ;P ＜ 0.01).The MTR value of the left and right visual cortex were ( 30.1± 2.0 ) ％ and ( 30.8 ± 1.8 ) ％ in the glaucoma goup,and (32.3 ± 1.2 )％ and (32.4 ± 1.2 )％ in the control group.Statistically significant difference was found between the two groups ( left t =4.319,right t =3.445 ;P ＜ 0.01).Conclusions Potential neuropathology changes occurring in the posterior visual pathway of patients with glaucoma indicate that the whole visual pathway may be involved by glaucoma.The micro physiological changes can be detected by MTI which can not be found by conventional MRI.It is a useful method of studying trans-synaptic damage of visual pathway n vivo glaucoma which provides more information for guiding the clinic diagnosis,cure and prognosis of glaucoma.

Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.

Objective:To investigate the clinical features and prognosis of patients with choroidal tuberculoma.Methods:A retrospective and observational study. From 2011 to 2022, 15 patients (16 eyes) with choroidal tuberculoma diagnosed and treated in Department of Ophthalmology, Shanghai Eye & ENT Hospital of Fudan University were included. The patients underwent examinations including best corrected visual acuity (BCVA), fundus color photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA). Chest CT examination, purified protein derivative test and interferon-γ release test were also performed. BCVA was performed using the Snellen visual acuity chart, which was converted to Logarithm of the minimum angle of resolution (logMAR) visual acuity when recorded. All the patients received antitubercular therapy and the duration was 12-15 months. Thirteen patients were combined with oral corticosteroids. The average follow-up time was 36 months. Rank sum test was used to compare logMAR BCVA before and after treatment.Results:Among the 15 patients, 5 were male and 10 were female; 1 case was bilateral involvement; 7 patients had a strong positive tuberculin skin test; 8 patients had a positive interferon-γ release assay. Six patients had pulmonary tuberculosis. One patient had peritoneal tuberculosis. Lesions were located in the posterior pole in 12 eyes, 1 eye with papillary tuberculoma. Peripheral lesions were found in 4 eyes. There were 9 eyes each with anterior segment inflammation or vitreous inflammation; 7 eyes were with exudative retinal detachment. OCT examination revealed a hyporeflective thickening of the choroidal stroma, the corresponding elevation of the retina, and often accompanied by subretinal fluid. FFA revealed hyperfluorescence of the mass and fluorescence accumulation with subretinal fluid at the late stage. ICGA revealed hypofuorescence of the lesion. The lesions subsided after treatment, and there was no recurrence during follow-up period. Cataract surgery was performed in 4 eyes due to complicated cataract. One eye undergone vitrectomy due to secondary rhegmatogenous retinal detachment. Anti-vascular endothelial growth factor therapy was performed in 1 eye due to secondary choroidal neovascularization. Ocular wall perforation occurred in 1 eye, and the condition was stable after treatment. Before treatment, the average logMAR BCVA was 1.02±0.57, which improved to 0.31±0.35 after treatment. The difference between the mean logMAR BCVA before and after treatment was statistically significant ( P<0.05). Conclusions:Combination of medical history, clinical manifestations, laboratory tests, and imaging can assist in the diagnosis of choroidal tuberculoma. The main manifestations are subretinal yellowish-white lesions in posterior pole. Standardized anti-tuberculosis therapy can effectively improve the prognosis of vision.

Objective To study the changes in serum autophagy markers in children with retinopathy of prematurity(ROP)and its clinical value.Methods Premature infants who were screened for ROP in our hospital from January 2020 to December 2022 were selected as the study subjects.Those screened out with ROP at 4-6 weeks of birth were assigned to the ROP group and those without ROP to the control group.The levels of serum autophagy markers LC3-Ⅱ,Beclin-1 and P62 were detected at the 3rd day,1st,2nd and 3rd weeks of birth.The two groups were compared in terms of serum autophagy markers.The diagnostic efficacy of serum autophagy markers on ROP was analyzed.Results There was no significant difference in serum LC3-Ⅱ,Beclin-1 and P62 levels between the ROP group and control group at the 3rd day of birth(P>0.05).At the first,second and third weeks of birth,how-ever,the ROP group showed significantly lower levels of serum LC3-Ⅱ and Beclin-1 but higher level of P62 com-pared to the control group(both P<0.05).The levels of serum LC3-Ⅱ,Beclin-1 and P62 at the first,second and third weeks of birth had diagnostic value for ROP.The children in the ROP group who did not receive mechanical ventilation and oxygen inhalation,and did not develop with sepsis and bronchopulmonary dysplasia showed lower serum LC3-Ⅱ and Beclin-1 levels and higher P62 levels at the first,second and third weeks of birth compared to those without the above-mentioned treatment as well as those complications(all P<0.05).In the ROP group,those with severe ROP showed lower serum LC3-Ⅱ and Beclin-1 levels and higher P62 levels at the 3rd day,and 1st,2nd and 3rd week of birth(all P<0.05).Conclusion The levels of serum autophagy markers in children with ROP show significant changes since the first week of birth,so they have diagnostic efficacy for the diseases.