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

OBJECTIVETo investigate the clinical significance and detection of the expression of CD25- CD127- on CD4+ T cells in peripheral blood in patients with hepatitis B.

METHODSThe 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). (2) The 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). (3) Compared 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).

CONCLUSIONIt 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.

Adult ; CD4-Positive T-Lymphocytes ; immunology ; DNA, Viral ; blood ; Female ; Flow Cytometry ; Hepatitis B ; immunology ; virology ; Humans ; Interleukin-2 Receptor alpha Subunit ; blood ; Interleukin-7 Receptor alpha Subunit ; blood ; Male

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

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.

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

OBJECTIVETo observe the effects of recombinant human epidermal growth factor (rhEGF) on skin wound healing.

METHODSThe dorsal trauma model of rats was used. A total of 68 dorsal wounds in 34 rats were created and divided into the rhEGF group and the isotonic saline group according to self-control. The process of wound healing was observed and a mean healing time was calculated. Furthermore, the dynamic analysis was performed at different times on wound OHP contents, ratio of collagen I/III and cell DNA cycle.

RESULTSThe wound healing was accelerated obviously in all wounds treated with rhEGF. The mean time of wound healing of the two groups was (17.2 +/- 1.3) days and (20.5 +/- 1.6) days respectively (P < 0.01). In the rhEGF group, the new granulation tissue was more and the re-epithelialization was faster than that of the saline group. External rhEGF increased OHP content, reduced collagen I/II ratio and accelerated cell DNA replication.

CONCLUSIONExternal rhEGF can shorten wound healing time, increase granulation tissue and OHP contents, reduce collagen I/III ratio and accelerate cell DNA replication, thus obviously promoting skin wound repair.

Animals ; Epidermal Growth Factor ; pharmacology ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; pharmacology ; Skin ; injuries ; Wound Healing ; drug effects

OBJECTIVETo summarize our experiences in the treatment of type C3 (AO/OTA) distal radius fractures fixed with AO 2.4 mm locking plates combined with percutaneous pinning after manipulative reduction.

METHODSFrom May 2009 to March 2012, 19 patients (2 cases of both sides) with type C3 (AO/OTA) distal radius fractures were treated with volar locking plates combined with percutaneous pinning for distal radius after manipulative reduction. Among the patients, the average age was (45.3 ± 17.4) years old (ranged, 31 to 66 years old). The fracture were complicated with ulnar styloid fracture in 14 wrists and 6 wrists had distal radioulnar joint instability. All the patients had closed fracture and the mean duration was (6.7 ± 3.5) days (4.5 to 9 days). The Henry approach was applied to expose the fracture site. Joint capsule and ligaments were retained for indirect reduction. After indirect reduction, the poking reduction technique was used to correct the residual compression, and congruence of distal ulnar radial joint was verified under fluorscopic guidance. Styloid process was first pinned percutaneously and then AO 2.4 mm volar locking plate was used to support rigid fixation. The fractures complicated with distal radioulnar joint instability and ulnar styloid fracture were treated with forearm plaster support in supination for 6 weeks.

RESULTSNineteen patients (21 wrists) were followed up for an average duration of 10.5 months (ranged, 7 to 17 months). Radiographic bone union of distal radius was achieved in all cases, nonunion of the ulnar styloid occurred in 3 cases, and no distal radioulnar joint instability occurred. Tendon irritation was found in 2 cases and disappeared after the internal fixation was removed. The volar tilt, radial angle, radial length, incongruence of articular surface and distal radioulnar joint were observed at the follow-up. According to Batra and Gupta scoring system, 13 wrists were assessed to have a score of more than 80, 5 wrists 70 to 90, 3 wrists less than 70. Meanwhile, the subjective and objective evaluation was executed,range of motion of wrist, residual deformity and complications were observed. According to Sarmiento's modification of the system of Gartland and Werley, 17 wrists got an excellent result, 3 good and 1 fair.

CONCLUSIONType C3 (AO/OTA) distal radius fractures could be managed with manipulative reduction. Locking plate internal fixation combined with percutaneous pinning can offer enough support for early mobilization and rehabilitation, resulting in a better clinical outcome and satisfactory prognosis.

Adult ; Aged ; Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; complications ; surgery

OBJECTIVETo study the linkage between -148C/T polymorphism of beta-fibrinogen gene and plasma fibrinogen levels in patients with acute cerebral infarction.

METHODSOne hundred and fifty-one patients with cerebral infarction and 101 healthy individuals were enrolled in this trial. The beta-fibrinogen gene -148C/T polymorphism was analyzed by PCR-restriction fragment length polymorphism, and plasma fibrinogen levels were obtained from prothrombin time assay.

RESULTSPlasma fibrinogen levels of patients were significantly higher than those of controls (P<0.01). In both groups, T allele carriers had higher plasma fibrinogen levels than other those did (P<0.01); and the fibrinogen level difference was still significant if both groups was based on their sex (P<0.05). Divided by age, each group of the study cases has significant difference between two genotypes (P<0.05). T -148 allele frequency of the middle age case in study group was higher than that in control group (P<0.05).

CONCLUSIONHigh plasma fibrinogen level is a risk factor to cerebral infarction. Plasma fibrinogen level is affected by -148C/T polymorphism of beta-fibrinogen gene. With or without other risk factors and environmental factors affecting, T allele increases plasma fibrinogen level and may be a heritable risk factor to cerebral infarction.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Asian Continental Ancestry Group ; genetics ; Cerebral Infarction ; genetics ; Female ; Fibrinogen ; genetics ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Stroke ; genetics ; Young Adult

OBJECTIVETo observe the effect of adrenomedullin (ADM) on the pulmonary vascular collagen metabolism in hypoxic rats in order to study the effect of ADM on chronic hypoxic pulmonary vascular structural remodeling and its possible mechanism.

METHODSNineteen male Wistar rats were randomly divided into three groups: normal control (n=6), hypoxia (n=7) and ADM-treated hypoxia (n=6). ADM was subcutaneously administered into rats of the ADM-treated hypoxia group by mini-osmotic pump (300 ng/h) for two weeks. After two weeks of hypoxic challenge, mean pulmonary arterial pressure (mPAP) was evaluated using a right cardiac catheterization procedure. The ratio of right ventricular mass to left ventricular plus septal mass[RV/ (LV+S)] was measured. The changes of pulmonary vascular microstructure were observed. Meanwhile, the expression levels of collagen I, collagen III and transforming growth factor (TGF)-β in pulmonary arteries were detected by immunohistochemical assay.

RESULTSmPAP and RV/(LV+S) increased significantly in the hypoxia group compared with normal controls (P<0.01). The muscularization of small pulmonary vessels and the relative medial thickness of pulmonary arteries increased obviously in the hypoxia group compared with those in the normal control group (P<0.01). Meanwhile, the expression levels of collagen I, collagen III and TGF-β of pulmonary arteries in the hypoxia group increased markedly compared with those in the normal control group. However, mPAP and RV/(LV+S) were significantly reduced in the ADM-treated hypoxia group compared with those in the hypoxia group (P<0.01). ADM ameliorated pulmonary vascular structural remodeling of hypoxic rats, with a decrease in the expression of collagen I, collagen III and TGF-β of pulmonary arteries.

CONCLUSIONSADM might play a regulatory role in the development of hypoxic pulmonary hypertension and hypoxic pulmonary vascular remodeling, through inhibiting the expression of TGF-β and alleviating the collagen accumulation of pulmonary arteries.

Adrenomedullin ; pharmacology ; Animals ; Collagen ; metabolism ; Hypertension, Pulmonary ; etiology ; metabolism ; Hypoxia ; complications ; Male ; Pulmonary Artery ; metabolism ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; analysis ; physiology