Objective To determine the agreement of interobserver and intraobserver in diagnosing early glaucoma by optic disc morphology,and to explore the efficacy of established methods for evaluating glaucomatous optic discs.Design Prospective study. Participants Clinicians and evaluating methods for glaucomatous optic discs.Methods 120 digital fundus photographs were enrolled including early glaucoma eyes(67 cases)and non-glaucoma eyes but with glaucomatous appearance(53 cases),which were collected in Tongren Hospital.Thirteen ophthalmologists as observers were divided into three groups:GroupⅠ(5 clinicians)were trained with stan- dardized methods for evaluating glaucomatous optic disc damage recently.GroupⅡ(4 clinicians)were ophthalmologists majoring in glaucoma.GroupⅢwere ophthalmologists not specializing in glaucoma.In general groupⅡandⅢ,none had been trained with the es- tablished criteria.Observers evaluated the photos 3 times,with an interval time of 3 days.Kappa statistics were used to evaluate agree- ment between the intraobserver and interobserver.Main Outcome Measures Interobserver and intraobserver agreement,kappa value. Results In GroupⅠ,4 clinicians were in almost perfect agreement,1 clinician was in substantial agreement,kappa value ranging from 0.779(90.0%)to 0.966(98.3%).In GroupⅡ,almost perfect agreement occurred in 2 clinicians,substantial in 1 clinician and moderate in 1 clinician,kappa value ranging from 0.506(82.5%)to 0.866(93.3%).In GroupⅢ,the agreements in 4 clinicians were substantial, moderate,fair,and slight,respectively,kappa value ranging from 0.094(54.2%)to 0.778(89.2%).In term of interobserver agreement for glaucoma diagnosis,kappa values in GroupⅠranged from 0.768 to 0.983,in GroupⅡ0.354-0.834,in GroupⅢ0.335-0.737,respec- tively.Conclusions Intraobserver and interobserver agreement rates in early glaucoma diagnosis are substantially improved through training on optic disc morphologic evaluation methods.Establishing the diagnosis criteria for glaucomatous optic disc damage can raise the correct rate of diagnosis.

Bone Marrow Cells ; metabolism ; pathology ; CD28 Antigens ; blood ; metabolism ; CD4 Antigens ; blood ; metabolism ; CD4-Positive T-Lymphocytes ; metabolism ; Dendritic Cells, Follicular ; metabolism ; pathology ; Humans ; Immunoblastic Lymphadenopathy ; metabolism ; pathology ; Immunophenotyping ; methods ; Lymphoma, T-Cell ; metabolism ; pathology ; Neprilysin ; blood ; metabolism ; Receptors, Complement 3d ; blood ; metabolism ; fas Receptor ; blood ; metabolism

Objective To find out the current thyroid volume of school children and its influencing factors in Chongqing.Methods Probability sampling method(PPS) was used to select 30 counties in Chongqing in 2011.Forty children aged 8-10of 1 randomly selected school from every county chosen were enrolled in the study.Thyroid volume of children was examined by B-ultrasonograghy.Body height and body weight were measured.The relationship between gender,age,height and weight and thyroid volume was analyzed,respectively.Results One thousand three hundred and twenty-two children aged 8-10 were investigated.The median of thyroid volume was 3.53 ml.The goiter rate was 5.52％ (73/1322).Thyroid volume of female and male was 3.55 and 3.51 ml,respectively.There was no significant difference of thyroid volume between female and male (H =0.68,P ＞ 0.05).Thyroid volume of children aged 8,9 and 10 was 3.30,3.53 and 3.76 ml,respectively.There was a significant difference of thyroid volume among different age groups(H =52.49,P ＜ 0.01).Thyroid volume of children height (110-,120-,130-and ≥140 cm,respectively) was 2.96,3.22,3.59 and 4.13 ml.There was a significant difference of thyroid volume among different height groups (H =149.23,P ＜ 0.01).Thyroid volume of children weight(17-,20-,30-and ≥40 kg,respectively) was 2.71,3.31,3.91 and 4.74 ml.There was a significant difference of thyroid volume among different weight groups(H =138.44,P ＜ 0.01).For the coefficients of simple and partial correlation,there was a significant correlation between thyroid volume and age,height and weight (P ＜ 0.05).The Spearman coefficient was 0.2411,0.3950 and 0.4285,respectively.The partial correlation coefficient was 0.0640,0.1154 and 0.2319,respectively.The standard partial coefficient of age,height and weight was 0.640,0.1154 and 0.3410,respectively.The proportion of the standard partial coefficients was 1 ∶ 1.8 ∶ 5.3.The function of body weight to thyroid volume was 5.3 times that of age and 3.0 times that of body height.Conclusions The goiter rate of schoolchildren in Chongqing is relatively high.Thyroid volume is affected by age,body height and body weight.The relationship between thyroid volume and iodine nutrition needs further study.

OBJECTIVETo study the effect of a low level of galacto-oligosaccharides (GOS) on intestinal bifidobacteria and lactobacilli, and fermentation characteristics in term infants by comparing with human milk and a standard infant formula without GOS.

METHODSA total of 371 term infants from four hospitals of China were enrolled. The infants started with breast feeding. After 1-2 weeks, some of the infants were changed to feeding with formula milk and then were randomly assigned to two formula-feeding groups: with or without GOS supplementation (2.4 g/L). Growth, stool characteristics, and side effects were recorded in a 3-month-follow-up. Faecal samples were collected for analysis of intestinal bacteria (culture technique), acetic acid (gas chromatography) and pH (indicator strip) at postnatal 3 months.

RESULTSCompared with the formula-feeding group without GOS, the contents of bifidobacteria, lactobacilli and acetic acid and stool frequency increased, and faecal pH decreased significantly in the GOS-formula-feeding and the human milk group. There were no significant differences between the GOS-formula-feeding and the human milk groups. Supplementation with GOS did not lead to an increase in the incidence of crying, regurgitation and vomiting.

CONCLUSIONSA supplementation of low levels of GOS in infant formula seemed to improve stool frequency, decrease faecal pH, and stimulate intestinal bifidobacteria and lactobacilli up to levels as found in breast-fed infants.

Bifidobacterium ; isolation & purification ; Dietary Supplements ; Galactose ; administration & dosage ; Humans ; Hydrogen-Ion Concentration ; Infant Formula ; Infant, Newborn ; Intestines ; microbiology ; Lactobacillus ; isolation & purification ; Oligosaccharides ; administration & dosage

Adult ; Alanine Transaminase ; blood ; CD4-Positive T-Lymphocytes ; immunology ; metabolism ; CD8-Positive T-Lymphocytes ; immunology ; metabolism ; Carrier State ; immunology ; virology ; DNA, Viral ; blood ; Female ; Flow Cytometry ; Hepatitis B ; immunology ; virology ; Hepatitis B virus ; immunology ; Humans ; Immunologic Memory ; Interleukin-7 Receptor alpha Subunit ; immunology ; metabolism ; Male

Objective To investigate the clinical significance and detection of the expression of CD25 - CD127 - on CD4 + T cells in peripheral blood in patients with hepatitis B.Methods The expression of CD25- CD127- on CD4 + T cells were measured by using flow cytometry in 53 patients with chronic hepatitis B,53 carrier with hepatitis B virus and 26 healthy blood donors,and follow up 20 patients with HBV-DNA positive treated with interferon.Results ① Compared with healthy controls,the expression of CD25 - CD127 - on CD4 + T cells in patients and carrier with hepatitis B virus were lower( Q =4.559,P ＜0.05 ; Q =6.230,P ＜ 0.05 ).②The expression of CD25 - CD127 - on CD4 + T cells in patients with HBV-DNA positive( n =77 ) was lower than that of negative ( n =29 ) ( t =2.290,P =0.024 ).③Compared with the prior treatment,the expression of CD25 - CD127 - on CD4 + T cells in patients with B hepatitis were lower after interferon treated with 12 weeks(t =2.469,P =0.024).Conclusion It suggested that the CD25-CD127- expression on CD4 + T cells correlated with viral infections and cleared,exogenous interferon could decrease CD25 - CD127 - expression on CD4 + T cells.

AIM: To report the long- term clinical outcomes of accelerated trans-epithelial corneal cross-linking ( CXL ) protocols using KXL System ( Avedro, USA ) in the treatment of progressive keratoconus. · METHODS: Totally 52 patients ( 102 eyes ) with progressive keratoconus between December 2014 and February 2017 [ maximum keratometry values ( Kmax) ≤60.0D, minimum corneal thickness(Thk) ≥400m] were treated with an accelerate trans-epithelial CXL protocol (UV-A irradiation intensity 45mW/cm2 with a total fluence of 7. 2J/cm2 ) using KXL system ( Avedro, USA ) in Southwest Hospital. The average follow-up time was 11. 65mo (range: 9-26mo). Uncorrected distance visual acuity ( UDVA) , corrected distance visual acuity ( CDVA) , intra- ocular pressure ( IOP ) , slit-lamp microscope examination, Kmax and average keratometry values ( AveK ) , corneal stromal demarcation line depth and endothelial cell density ( ECD) were evaluated. ·RESULTS:The 52 patients (102 eyes) were included in this research, male 36 (70 eyes) and female 16 (32 eyes), average age was 19. 5±4. 6 years. Preoperative CDVA was 0. 84±0. 89 (LogMAR), postoperative CDVA was 0. 69±0. 72 ( P = 0. 398 ). Preoperative UDVA was 1. 02 ± 0. 62 (LogMAR), postoperative UDVA was 0. 85 ± 0. 59 ( P =0. 154 ). Preoperative IOP was 12. 95 ± 4. 40mmHg, postoperative IOP was 11.92±3. 66mmHg (P=0. 272). No statistical difference (P=0. 552) has been found between preoperative and postoperative ECD. Nevertheless, on the Sirius anterior system ( Sirius, CSO, Itlay) , significant statistical difference (P=0. 017) was confirmed between preoperative Kmax ( 50. 83 ± 3. 48D ) and postoperative Kmax (52. 05±3. 63D). Meanwhile, the postoperative Avek (47.74±2. 51D) was significantly lower (P=0. 041) than the preoperative Avek ( 48. 73 ± 4. 33D ). The average corneal stromal demarcation line depth ( 192 ± 23. 6μm ) was detected by the anterior segment OCT. No statistical difference ( P = 0. 816 ) has been found between preoperative and postoperative Thk. No severe complication was observed in all cases. ·CONCLUSION: Accelerated trans-epithelial CXL was effective in decreasing keratometry values for progressive keratoconus in this research, and the outcomes remained stable during the follow-up time. No endothelium damage or other severe complications were observed in this clinical research. The accelerated trans-epithelial CXL is as effective as the standard CXL.

Objective This study was undertaken to examine possible relationship between attempted suicide and underachievement,bullying,low life satisfaction and low self-concept at school.Methods An anonymous self-report survey assessing demographic characteristics and the major risk factors of teenage attempted suicide was completed by students from 16 middle schools in grades seven to twelve in 4 counties of Anhui province (age 10 to 21 years).An anonymous questionnaire was used to rate attempted suicide,bullying involvement and learning performance.Attempted suicide was defined as: experiencing specific suicide actions at least one time during the 12 months preceding the survey.Multidimensional Students' Life Satisfaction Scale and Children' s Self-concept Scale were used to evaluate satisfaction and self-conscience on and at respectively.In total,10 894 respondents substantially completed the survey.Multiple logistic-regression analyses,controlling for socio-demographic variables,was used to analyze if underachievement,bullying,low school life satisfaction and low children' s self-conscience at school had been risk factors.Results 629 participants (5.8%) reported having made at least one attempted suicide within the last 12 months.Students being underachieved were significantly having more attempted suicide events than those excellent students (X2=11.39,P=0.023).Students being both bully-victims and practiced bully were significantly more than those being only practiced bully (28.7% vs.15.8%,P＜0.001),being victims (28.7% vs.10.6%,P＜0.001) or having neither of them (28.7% vs.4.8%,P＜0.001).Results from multiple logistic regression analyses showed that underachievement,bullying,lower school life satisfaction and low self-conscience were risk factors for attempted suicide.Conclusion Data from this study confirmed that school bullying and children' s self-conscience at school were significantly associated with attempted suicide among rural middle school students in Anhui province.It is of importance to improve the school' s environments to reduce the risk of attempted suicide among this group.

Objective To observe the expression and distribution the low affinity receptor p75 of nerve growth factor in the traumatic neuroma and investigate its significance and relationship with the growth of peripheral nerve and the formation of the traumatic neuroma.Methods Fifty-one cases of traumatic neuro- ma were collected and were divided into four groups according to its course,i.e,groupⅠ(less than one month),groupⅡ(1～3 months),groupⅢ(3～6 months) and groupⅣ(more than six months).Fifteen cases of normal nerve samples were harvested as the control group(n=15).Immunohistochemical studies were performed to observe the expression of p75.the expression level was detected by the computer graph analysis system.Results There was no significant expression of p75 in the normal nerve while in the four studied groups,significant expression of p75 waspositively observed.The level of p75 was weak in the early time and achieved its peak in three months,but the high level state was maintained even after six months.The one-way ANOVA statistic analysis manifests that there were no significant differences of the expression of p75 among the groupⅡ,ⅢandⅣ(P＞0.05),but the differences among the groupⅠand the latter three groups were signifi- cant (P＜0.05).p75 was mainly distributed in the Schwans cell.Conclusion p75 is expressed in the traumatic neuroma and may play an important role in the modulation progress of the formation of traumatic neu- roma with an unknown mechanism.

OBJECTIVETo investigate contrast-enhanced ultrasound imaging features of diabetic foot ulcers.

METHODSSixteen patients with diabetic foot ulcers underwent conventional and contrast-enhanced ultrasound examinations, and the features of contrast-enhanced ultrasound imaging were analyzed. Pathological examination was also carried out in some cases.

RESULTSContrast-enhanced ultrasound showed slow enhancement in the artery phase in the 16 ulcers after administration of SonoVue. The mean time of initial enhancement was 30.02 ± 2.35 s, and the mean time for the occurrence of peak enhancement was 37.54 ± 4.13 s. In 5 cases a homogeneous enhancement pattern was clearly displayed, and in the other 11 cases, a pattern of homogenous peripheral enhancement with non-enhanced patches within the ulcers was found. Contrast-enhanced ultrasound showed a greater ulcerous area than conventional ultrasound.

CONCLUSIONContrast-enhanced ultrasound is a valuable means for evaluating the ulcerous area and the treatment efficacy for diabetic foot ulcers.

Aged ; Aged, 80 and over ; Contrast Media ; Diabetic Foot ; diagnostic imaging ; Female ; Humans ; Image Enhancement ; methods ; Male ; Middle Aged ; Phospholipids ; Sulfur Hexafluoride ; Ultrasonography