Background In recent years,some researches show that getting younger over the diabetes mellitus (DM) was an obrious trend.But studies of early diabetic retinopathy in young people with diabetes were few.Both patients and doctors did not put enough importance on it.Objective This study was to evaluate the earlier dynamic changes of retina morphology and function caused by type 2 DM in young population.Methods A cohort study was designed.One hundred and thirty-six young patients who were initially diagnosed as type 2 DM in Cangzhou Central Hospital were included from January to March in 2010 and 91 healthy individuals with the matched age were enrolled at the same period.Glycated hemoglobin (HbAlc) level in blood was assayed yearly,and ophthalmoscope,optical coherence tomography (OCT) and visual contrast sensitivity (CS) examinations were performed to evaluate the dynamic changes of retinal nerve fiber layer (RNFL) thickness around optical disc,retinal function and retinal microvessels of DM patients.In addition,the correlation between RNFL thickness or CS and average HbAlc level in DM patients was assessed.This study followed Declaration of Helsinki,and written informed consent was obtained from each subject.Results The levels of HbAlc in DM patients were (7.5 ±1.6) ％,(7.2 ±1.6) ％,(7.4 ±1.6) ％,(7.6±1.6)％ and (7.7 ±1.6)％ in 2010,2011,2012,2013 and 2014,respectively,and HbAlc≥7.0％ was observed in 74 patients (54.4％).The RNFL thicknesses of full optic disk and superior 1/4 quadrant of the optic disk were significantly declined in 2012,2013 and 2014 in the DM group compared with the normal control group (full disk:t =2.216,5.003,7.303;all at P ＜ 0.05.superior 1/4 quadrant:t =2.382,5.657,7.194;all at P ＜ 0.05),but no significant differences were found between them in 2010 and 2011 (all at P＞0.05).In the DM group,RNFL thicknesses of full optic disk were (99.94±10.01) μm and (96.32±10.32) μm in 2013 and 2014,which were significantly lower than (104.55±9.23) μm in 2010 (t=7.819,13.959,both at P＜0.05);the RNFL thicknesses of superior 1/4 quadrant around disk were (118.64± 13.98) μm and (115.06 ± 14.35) μm in 2013 and 2014,which were significantly lower than (127.48± 13.67) μm in 2010 (t =10.504,14.758,both at P＜0.05),However,the RNFL thicknesses were not significantly changed among the different time points in the normal control group (all at P＞0.05).In addition,the CS values of 3.0,6.0,12.0,18.0 c/d in 2013 and 2014 in the DM group were lower than those in the normal control group (all at P＜0.05),and the CS values in 2013 and 2014 were reduced in comparison with 2010 in the DM group (all at P＜0.05).Positive correlations were found between the differences of RNFL thickness or CS and the average HbAlc level in the DM group (r =0.640,F =8.991,P =0.000;r =0.541,F =7.572,P =0.000).Retinal microaneurysms were seen in two type 2 DM patients by ophthalmoscope at the end of follow-up.Conclusions The young people with type 2 DM have poor blood glucose control.The RNFLs are thinning and visual functions are declining in young type 2 DM patients with the lapse of disease course,and these retinal damages are associated with poor control of blood glucose.

OBJECTIVETo observe the difference in the therapeutic efficacy of warm needling therapy on knee osteoarthritis (KOA) patients of different Chinese medical syndrome types.

METHODSTotally 197 KOA outpatients [including wind-cold-damp retention syndrome (50 cases, 61 knees), yang deficiency cold coagulation syndrome (48 cases, 58 knees), stagnation of blood stasis syndrome (49 cases, 63 knees), and insufficiency of Shen-essence syndrome (50 cases, 66 knees)] were treated with warm needling therapy, 10 days as one therapeutic course, 3 courses in total. The symptom score and changes of clinical efficacy were assessed. The contents of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in the synovial fluid were determined before and after treatment.

RESULTSThe symptom scores and the clinical efficacy were improved in all syndrome groups after treatment (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05) and the worst effects shown in the stagnation of blood stasis syndrome (P < 0.05). The contents of IL-1, IL-6, and TNF-alpha in the synovial fluid decreased after treatment in all syndrome groups (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05).

CONCLUSIONWarm needling therapy had favorable therapeutic effects on KOA patients of wind-cold-damp retention syndrome, yang deficiency cold coagulation syndrome, and insufficiency of Shen-essence syndrome, with the best effects shown on KOA patients of yang deficiency cold coagulation syndrome.

Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Osteoarthritis, Knee ; diagnosis ; therapy ; Synovial Fluid ; chemistry ; Tumor Necrosis Factor-alpha ; analysis ; Yang Deficiency ; therapy

Objective To assess the relationship between serum vitamin D and autoimmune thyroid disease.Methods Subjects included total 520 persons receiving regular health examination,and serum calcium,phosphorus,parathyroid hormone (PTH),thyroid peroxidase autoantibody (TPOAb) and 25-dihydroxy vitamin Ds was measured.The incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μ g/L)was observed.The relationship between 25-dihydroxy vitamin D3 deficiency and autoimmune thyroid disease was analyzed.Results The serum 25-dihydroxy vitamin D3 of all the subjects was (24.47 ± 7.21) μ g/L,and the incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μg/L) was 61.15％ (318/520),and the positive rate of TPOAb was 21.54％ (112/520).The proportion of TPOAb ＞ 50 kU/L or ＞ 100 kU/L in subjects with 25-dihydroxy vitamin D3≤30 μ g/L was higher than that in subjects with 25-dihydroxy vitamin D3 ＞ 30 μg/L [25.79％(82/318) vs.19.80％(40/202) and 9.43％(30/318) vs.4.46％(9/202)],and there was significant difference (P ＜ 0.05).The relationship between 25-dihydroxy vitamin D3 and TPOAb was assessed and showed significant inverse correlation (r =-0.13,P ＜0.05).Conclusions Vitamin D deficiency is very common in the population,and autoimmune thyroid disease is related with vitamin D deficiency,which may has impact on the body's immune regulation.Specific mechanism and whether vitamin D supplementation can intervene and treat autoimmune thyroid disease need further study.

By using enrichment culture in liquid minimal medium or direct culture on minimal medium plates, thirteen bacterial strains (AD27-AD39) capable of utilizing atrazine as a sole nitrogen source for growth were isolated from a mixture of industrial wastewater and sludge from an atrazine manufacturing plant. Based on 16S rRNA gene sequencing, eleven strains were identified as Arthrobacter spp. and two strans were identified as Pseudomonas spp.. We further studied in detail the composition of atrazine-degrading genes and degradation characteristics of Arthrobacter sp. AD30 and Pseudomonas sp. AD39 that have high degradative activity. From PCR assays, it was indicated that both AD30 and AD39 strains contained atrazine-degrading genes trzN and atzBC and was capable of degrading toxic atrazine to nontoxic cyanuric acid. The biodegradation experiments showed that the percentage of atrazine removal were 92.5%,were 92.5%, 97.9% and 99.6% respectively after AD30, AD39 or the mixture of the two strains were inocu- lated and incubated at 30?C for 48 hours in minimal media containing 200 mg/L atrazine, indicating that atrazine degradation by the mixed bacteria was more effective than the single strain. In addition, after industrial wastewater containing 176 mg/L atrazine was inoculated with the mixed bacteria and incubated at 30?C with shaking for 72 hours atrazine were removed by 99.1%, implicating that the mixed bacteria are good candidate for biotreatment of atrazine-containing industrial wastewater.

Objective To investigate the predicting value of serial serum human stromelysin-2 (ST2)testing on prognosis in elderly patients with acute heart failure(AHF).Methods 75 AHF patients aged 60 to 90 were selected in our study who were in Beijing Hospital during 2013.1 ～ 2014.8,blood sampling of serum ST2 took place at admission and 72-96 h later.Moreover,38 healthy people aged 70 to 80 were chosen as control group.Follow-up was performed 1 year after acute attack.We defined the end of observation as recurrence of heart failure or any cause of death.The data was analyzed by SPSS19.0.Results Among 55 AHF patients,sST2 level was higher in patients with endpoint events than those without it on the two moment(P=0.000).And we found that the change in sST2 was higher in patients with endpoint events than those without it(P=0.023);and the percentage change in sST2 was also significantly different(P=0.033).Receiver operator curve analysis of the change in sST2 from baseline to 72-96 h later was strongly reflective of prognosis with area under the curve(AUC) of 0.696(P=0.013).And the change in sST2 Combined with the sST2 level at admission to predict the prognosis of AHF,the result would be more exciting,the area under the receiver operating characteristic (ROC) curve is 0.861 (P ＜ 0.001).The endpoint event rate of the patients whose level of sST2 at admission was below 1408 ng/L and the change level in sST2 below 101 ng/L was 21.4％(3/14),while the data in patients whose level of sST2 at admission is above 1 408 ng/L and the change level in sST2 above 100 ng/L was 85.7％(12/14).Conclusions in elderly patients of AHF,sST2 elevate markedly.The result shows that the level of sST2 may be used to evaluate AHF prognosis.And the change in sST2 are able to predict the prognosis of AHF.Compared with NT-proBNP,serial sST2 testing appears to be a promising candidate for monitoring these patients.

Carcinoma, Adenosquamous ; diagnosis ; Carcinosarcoma ; diagnosis ; Female ; Humans ; Middle Aged ; Thymus Neoplasms ; diagnosis

Adult ; Aged ; Bursitis ; therapy ; Exercise Therapy ; methods ; Female ; High-Energy Shock Waves ; Humans ; Male ; Middle Aged ; Treatment Outcome

AIM:To evaluate the efficacy of EX-PRESS glaucoma filtration device combined with phacoemulsification and intraocular lens implantation for refractory glaucoma complicated with cataract.

METHODS: Totally 60 patients(60 eyes)of refractory glaucoma were chosen as the research objects between January 2013 and January 2016 in our hospital, who were divided into research group and the control group according to the operation method. Research group(29 patients 29 eyes)was given EX-PRESS glaucoma drainage device combined with phacoemulsification and intraocular lens implantation; control group(31 patients 31 eyes)was given trabeculectomy combined with phacoemulsification and intraocular lens implantation. The visual acuity, intraocular pressure(IOP), the successful rate and other clinical indicators were observed and analyzed.

RESULTS: The surgery of all the 60 patients achieved success.The successful rate of research group was 93%, that of control group was 81%, while the difference was not significant(P=0.26). The best corrected visual acuity(BCVA)of both groups was better than before treatment at 6mo after surgery without statistically significant. The postoperative BCVA was not different between the two groups. The IOP between the two groups was significantly different(P<0.05). The IOP of research group at 1d, 1 and 3mo was significantly lower than control group(P<0.05). The IOP at 6mo after surgery was not significantly between the two groups. The IOP at different time was significantly different(P<0.05). The IOP at 1d after surgery was significantly different compared to that at 6mo(P=0.007).

CONCLUSION:It has good clinical effect that EX-PRESS glaucoma filtration device combined with phacoemulsification for refractory glaucoma complicated with cataract. It is a treatment with high feasibility, safety and effectiveness.

AIM: To evaluate the clinical effect and safety of orthokeratology for minor to moderate myopia in adolescents.

METHODS:Sixty-three adolescent patients with mild to moderate myopia were selected in our hospital from January 2016 to January 2018. Visual acuity, corneal curvature, central corneal thickness, diopter, macular retinal thickness, axial length, intraocular pressure, tear film rupture time, corneal staining and complications were observed before and after wearing glasses for 1wk, 1, 6mo and 1a respectively.

RESULTS: There were significant differences in naked vision, diopter, corneal curvature and tear film rupture time before and after wearing glasses in this group(P<0.001). And there were no differences in axial length, central corneal thickness, macular retinal thickness and intraocular pressure(P>0.05).

CONCLUSION: Corneal plastic lens is a safe and effective non-surgical method for myopia correction in adolescents at the stage of growth and development.

AIM: To examine the micrangium through optical coherence tomography(OCT)in diabetic patients and to quantify the thickness of macular retia at different timing.

METHODS: Control group(Group A)had 40 patients with 59 eyes, who were all diagnosed as cataract but no diabetes history. Experiment group(Group B)had 49 patients with 52 eyes, and patients were all diagnosed as Type 2 diabetes for over 2a with cataract. All patients were examined using OCT before and after operation, including regular eye examinations. At 1d, 1wk and 1mo after operations, those data were examined again, except OCT.

RESULTS: Compare to patients both had cataract and diabetes, cataract patients showed a better visual acuity after operation(χ²=8.38,P=0.004). Thickness of central fovea of macula: for patients both had cataract and diabetes, their central fovea of macula thickened significantly in 1wk after operation. However, for patients only had cataract, thickness of their central fovea of macula did not increase until 1mo after operation. Thickness of strata neuro- epithelium at central fovea of macula area: for patients both had cataract and diabetes, their strata neuro- epithelium thickened in 1d after operation. However, for patients only with cataract, it did not happen until 1mo. Thickness of pigmentary epithelium at central fovea of macula area: for patients both had cataract and diabetes, their pigmentary epithelium thickened in 1wk after operation. However, for patients only with cataract, it was not until 1mo.

CONCLUSION: Patients with cataract and diabetes are more likely to develop macular hydroncus after operation, and it is more serious than patients with cataract alone. Blood-retinal barrier damage is the major cause for retinal damage after phacoemulsification. Corrected visual acuity is along with the thickness of pigmentary epithelium at central fovea of macula area.