Objective To compare the clinical value of Heidelberg retinal tomography (HRT-Ⅱ) and Heidelberg optical coherence tomography (HRA OCT) in discriminating healthy eyes and pre-perimetric glaucoma eyes.Methods A total of 33 patients with pre-perimetric glaucoma and 37 healthy subjects were included in this study.All individuals underwent imaging tests with HRT-Ⅱ and HRA OCT within 1-month period.ANOVA and Kruskal-Wallis test were used to compare all of the parameters from HRT-Ⅱ and HRA-OCT between pre-perimetric glaucoma eyes and normal eyes.Receiver operating characteristic curves (ROC) were calculated for all of the parameters to seek the best discriminant point of each instrument between pre-perinmetric glaucoma and healthy eyes.Results Statistically significant differences were found in most of the HRT-Ⅱ parameters except for disc area and height variation contour between pre-perimetric glaucomatous eyes and normal eyes (all P＜0.05),which showed that most of the HRT-Ⅱ parameters were capable of diagnosing preperimetic glaucoma except for the disc area and height variation contour (all P＜0.05).66.7％ of the areas under the receiver operating characteristic curves (AUC) from HRT-Ⅱ parameters were larger than 0.800 and 58.3％ of the AUC were larger than 0.900.Statistically significant differences were found in most of the HRA-OCT parameters except for the nasal retinal nerve fiber layer (RNFL)thickness between pre-perimetric glaucoma eyes and normal eyes (all P＜0.05),which showed that most of the HRA-OCT parameters were capable of diagnosing pre-perimetic glaucoma except for the nasal RNFL thickness (all P＜0.05).66.7％ of the AUC from HRA-OCT parameters were larger than 0.800 and 33.3 ％ of the AUC were larger than 0.900.No statistically significant difference was found between the AUC for the best parameter diagnosing pre-perimetic glaucoma from HRT Ⅱ (cup/disk area ratio,AUC =0.984) and HRA OCT (average RNFL thickness,AUC =0.940).No Statistically significant differences were found in specificity and sensitivity of diagnosing pre-perimetic glaucoma between the two best parameters cup/disk area ratio and average RNFL thickness (both P＞0.05).Conclusions Both HRT-Ⅱ and HRA-OCT can well reflect the damage of optic disc and retinal nerve fiber layer in eyes with pre-perimetric glaucoma.HRT-Ⅱ and HRA-OCT have higher accuracy and similar sensitivity and specificity for the diagnosis of pre-perimetric glaucoma.

This paper arranged the research results of the chemi-cal components and pharmacological effects of five kinds of Loni-cera. All these herbs have organic acids( chlorogenic acid) , fla-vonoids( galuteolin) , triterpenoid saponins, iridoids and volatile oils, and have antibacterial, antiviral, anti-inflammatory, an-tioxidant, hepatoprotective, immunological effects, and so on.The major medicinal ingredients and pharmacological effects of these herbs have no significant difference. Some similar pharma-cological effects are caused by different chemical components.

Objective To detect the impact of Diltiazem on the major adverse cardiac events (MACE) in six months after percutaneous coronary intervention (PCI).Methods A total of 192 patients after PCI with coronary atherosclerotic heart disease were enrolled in this study.The patients were randomly divided into Diltiazem therapy group (101 patients) and non-Diltiazem therapy group (91 patients).The high-sensitivity C-reactive protein (hs-CRP) was assessed before and 24 h after PCI,and the incidence of Major adverse cardiovascular events(MACEs) were assessed at the sixth month after PCI.Results Compared with before PCI,hs-CRP level increased significantly in both group after PCI (P＜0.01),but hs-CRP level was lower in Diltiazem therapy group than in non-Diltiazem therapy group (P＜0.05).Compared with non-Diltiazem therapy group,there was lower incidence of MACEs during six months follow-up in Diltiazem therapy group.Conclusions Diltiazem can decrease the incidence of MACEs during six months after PCI.

Objective To explore the clinical features and outcomes of patients with cerebral venous sinus thrombosis (CVT) during pregnancy and puerperium.Methods A retrospective study was performed in 24 cases of pregnant women with CVT among 15 625 deliveries in Xuanwu Hospital fromJanuary 2002 to October 2009,including 7 cases happened during pregnancy and 17 during puerperium.The etiology,clinical presentations,imaging examination results,other relevant examinations,and pregnant outcomes of these patients were analyzed.Results (1) Incidence and etiology:the incidence of CVT during pregnancy and puerperium was 0.15% (24/15 652) and 29% (7/24) of the patients fell ill during pregnancy and 71% (17/24) during puerperium.Five were complicated with severe preeclampsia,while another 5 complicated with hyperemesis.One woman was complicated with anemia.CVT was identified after spontaneous delivery in 9 cases and 8 after cesarean section.(2) Clinical presentations:Among the 24 CVT cases,22(92% ) suffered from headache,16(67% ) reported nausea and vomiting,15(63% )experienced hyperspasmia and 6 (25%) complained of blurred vision.On admission,8 (33%) patients were unconscious,3 (13%) with hemiplegia,and 8 (33%) were febrile.(3) Imaging and laboratory examinations:twelve patients underwent digital subtraction arteriography ( DSA) and were diagnosed.Fifteen women showed superior sagittal sinus thrombosis in MRI and magnetic resonance intravenous angiograph(MRV).Examination of the fundus found papilledema in 4 cases.Normal cerebral sinus fluid and laboratory routine tests were reported in 13 cases,but 6 cases of hyperlipidemia,7 cases of abnormal activated partial thromboplastin time ( APTT),5 cases of abnormal international normalized ratio (INR),3 cases elevated platelet count,4 cases of positive D-dipolymer,1 cases of low hemoglobulin level ( <10 g/L),4 cases with abnormal hematocrit,and 10 cases of elevated fibrinogen ( > 4 g/L) were identified.(4) Management and pregnancy outcomes; among the 7 cases happened during pregnancy,2 were complicated with severe preeclampsia and delivered through cesarean section immediately and discharged after proper management including depressurization,spasmolysis,dehydration and anticoagulant therapy.Five of the 7 cases presented with CVT during early pregnancy,among which 1 was discharged after dilation and curettage followed by anticoagulant therapy,2 received endovascular thrombolysis after which one was discharged and the other one left with right hemiparesis and 2 patients died.Among the 17 patients presented with CVT during puerperium,10 received anticoagulant therapy after which 4 were fully recovered,5 left with functional disturbance (3 with hemiplegia,1 with incomplete motor aphasia and hemiparesis and 1 with blurred vision) and one died.Among the rest 7 cases who underwent endovascular thrombolysis,3 were fully recovered,3 left with functional impairment ( 1 with blind and headache and 2 with hemiplegia),and one died.Altogether,there were 14 patients underwent systemic anticoagulant therapy after which 7 were fully recovered,5 left with dysfunction and 2 died.Among the 10 cases received endovascular thrombolysis,4 were fully recovered,4 remained some dysfunction and 2 died.Conclusions CVT,mostly presented as superior sagittal sinus thrombosis,are more common in puerperium than during pregnancy and DSA is the golden standard for the diagnosis of CVT.Anticoagulant therapy and endovascular thrombolysis are effective in the treatment of CVT,but may left the patients with functional disturbance or even death.Prompt diagnosis and treatment ensure a better outcome for pregnant women complicated with CVT.

Objective To investigate the underlying neural mechanism of left hemiparalexia and left hemialexia in reading Chinese characters. Methods A patient with reading disorders caused by brain infarctions at the left ventralis medialis occipitotemporal lobe and the splenium of the corpus callosum was studied. A series of neuropsychological tests, such as reading Chinese characters presented in the central foveal field or in the left and right half of the foveal field, were conducted with the patient, and neuroimaging techniques including high spatial resolution 3D-MRI and diffusion tensor tractography (DTT) were used to examine whether or not there were lesions of the neural pathway. Results The patient showed left hemiparalexia, which was characterized by making substitution or omission mistakes, mostly in the left parts of Chinese characters, and also left hemialexia(alexia for characters presented in left visual field). 3D-MRI demonstrated infarctions in the left ventral mesial occipitotemporal area and in the left side of the splenium of the corpus callosum. The left lateral mid-fusiform cortex, which has been identified as the visual word form area(VWFA), was almost intact. DTT indicated the major forceps fibers running through the splenium were all disconnected due to the infarction of the left splenium. Conclusion As a result of disruption of the splemium-major forceps pathway, visual character information in the left visual field which is initially projected to the right occipital cortex cannot be transferred from the right visual cortex to the left VWFA. This mechanism of left hemiparalexia and left hemialexia in reading Chinese characters is similar to that in reading English words.

To identify adulterants from medicinal plants of Bletilla H. G. Reichenbach, the suitable candidate DNA barcoding of Bletilla was evaluated. In this study, the internal transcribed spacer (ITS) of nuclear ribosomal DNA, the LFY homologous gene intron 2 and chloroplast ycfl gene were amplified and sequenced from forty-one samples. The intra-specific and inter-specific divergences of Bletilla were calculated, and the identification efficiency was assessed using Barcoding Gap, NJ tree by K2P distance and BLAST1 method. The result showed the intra-specific divergence of nrDNA ITS and ycJfl (0.022-0.106 and 0.017-0.106) were obviously higher than the inter-specific divergence (0-0.012 and 0-0.015), and four species of Bletilla were also accurately distinguished in NJ trees. Whereas, there was no Barcoding Gap on LFY homologous gene intron 2, thus it cannot effectively identify species of Bletilla. Using NJ tree of nrDNA ITS and ycfl gene, powdery medicine and the adulterants of Bletilla were successfully unidentified. In conclusion, nrDNA ITS and ycfl can be used as a potential DNA barcoding to identify the medicinal plants in Bletilla and its adulterants. There were only three basic differences on nrDNA ITS between "Jujing baiji" and Bletilla striata of Lu'an in Anhui province, and two basic differences in ycfl. Based on morphological and molecular data, "Jujing baiji" could be recognized as the species of Bletilla striata.

To observe the effects of a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals in treatment of lower limb arteriosclerosis.

Background: Bone histomorphometry provides comprehensive information on bone metabolism and microstructure. In this retrospective study, we aimed to obtain an overview of the typical indications, referring hospitals, and histomorphometric quantification-based diagnoses of the bone tissue in our histomorphometry laboratory, the only laboratory in Finland carrying out histomorphometric examination of clinical bone biopsies. Methods: Between January 1, 2005 and December 31, 2020, 553 clinical bone biopsies were sent to our histomorphometry laboratory for histomorphometric examination. The median age of the patients was 55 years (range, 0.2–89.9 years), 51% of them were males, and 18% comprised pediatric patients. We received bone biopsy specimens from 23 hospitals or healthcare units. The majority of the samples we sent by nephrologists. Results: The most common bone biopsy indications were suspicion of renal osteodystrophy (ROD), unknown bone turnover status in osteoporosis, and several or untypical fractures. The most common quantitative bone histomorphometry-based diagnosis was ROD. Conclusions This study provides information on the clinical application of bone histomorphometry in Finland. Precise and quantitative ROD evaluation is the most common indication for bone histomorphometry, being crucial in clinical decision-making and targeted treatment of this patient group.

The clustered regulatory interspaced short palindromic repeat-Cas9 (CRISPR-Cas9) system is the part of the prokaryotic immune system, which could recognize and delete the exogenous sequences originated from virus or plasmid. Based on its mechanism, CRISPR-Cas9 system was developed into the new generation of gene editing tool. Compared to the existed technologies such as ES targeting, ZFN or TALEN, CRISPR-Cas9 system is a more efficient, economical and promising approach to manipulate the genome. In this review, we summarize the research progress about CRISPR-Cas9 technology, especially the latest applications in gene therapy studies of human diseases.
CRISPR-Cas Systems ; Clustered Regularly Interspaced Short Palindromic Repeats ; Gene Editing ; Genetic Therapy ; Humans ; Plasmids

Autoimmune hepatitis may have various liver histopathological manifestations, with interface hepatitis with lymphoplasmacytic infiltration, rosette formation, and emperipolesis as relatively characteristic manifestations, but they are not specific. The above histological manifestations should be combined with clinical data to exclude hepatitis caused by other reasons. This article mainly elaborates on the characteristic histological manifestations of AIH and the histological manifestations of special types of AIH and discusses the value of histology in the diagnosis and differential diagnosis of AIH.