Adult ; Burnout, Professional ; Female ; Humans ; Jurisprudence ; Male ; Mental Health ; Middle Aged

Abstract?AIM:To compare the loss of peripapillary retinal nerve fiber layer ( RNFL ) thickness measurements by spectral-domain optical coherence tomography ( SD -OCT ) in healthy individuals and glaucoma patients with or without progression.? METHODS: A total of 60 eyes, comprising 36 glaucomatous eyes with primary open angle glaucoma (POAG) and 24 healthy controls, were included in the study over a 2-year period.All eyes underwent at least 4 serial RNFL measurements performed by Cirrus OCT every half a year over a period of 2a.Visual field ( VF) testing was performed by using the Swedish interactive threshold algorithm( SITA) Standard 30-2 program of the Humphrey field analyzer within the same week as the optic disc/RNFL photography. By masked comparative analysis of VF test results and optic disc/RNFL photographs, the eyes were classified into non -progressive and progressive glaucoma cases. Longitudinal loss of RNFL thickness was compared.?RESULTS: The mean follow-up time was 2.1 ±0.3a. Seventeen from 36 subjects were identified as progressors. Mean rates of change in average RNFL thickness were significantly higher for progressors compared with nonprogressors (2.46μm/a vs.1.21μm/a;P <0.001 ). Inferior quadrant RNFL thickness were significantly correlated with MD reduction in glaucoma eyes with progression(r=0.423, P=0.03).? CONCLUSION: Longitudinal measurements of RNFL thickness using SD-OCT show a pronounced reduction in patients with progression compared with patients without progression.Inferior RNFL thickness parameters might be more important in discriminating eyes with progressive glaucomatous optic nerve damage.

Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.

Mouret abscess is a rare extracranial complication of suppurative otitis media. It is generally believed to be a deep neck abscess caused by inflammation leading to the rupture of the bony tip of the mastoid tip. The location of Mouret abscess is deep. The symptoms are insidious at the onset, but may eventually spread to the surrounding tissue, and even lead to mediastinal abscess, cavernous sinus thrombosis, meningitis, dyspnea and other serious complications. At present, with the popularization of antibiotics, the occurrence rate of Mouret abscess is very low, and only sporadic cases have been reported.In this paper, a case of Mouret abscess caused by cholesteatoma was analyzed to explore Mouret abscess in terms of the route of infection, clinical manifestations, imaging features, diagnosis and treatment.
Abscess ; diagnosis ; drug therapy ; therapy ; Cholesteatoma ; complications ; Humans ; Mastoid ; pathology ; Meningitis ; Neck ; pathology ; Otitis Media ; Otitis Media, Suppurative ; complications

Child, Preschool ; Histoplasmosis ; complications ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Mycobacterium Infections ; etiology

Head ; Hearing Loss, Sudden ; therapy ; Humans ; Otolaryngology ; Practice Guidelines as Topic ; Reading ; United States

Objective:To design and prepare repaglinide and metformin hydrochloride tablets for pilot scale test and industrial pro-duction. Methods:Dissolution was applied to optimize the formula and preparation process. Results: The tablets were prepared ac-cording to the determined formula and process with poloxamer 188, meglumine, PVP K30, croscarmellose sodium, microcrystalline cellulose PH101, sorbitol, magnesium stearate and coating powder as the adjuvants. The dissolution behavior of the tablets in four media was similar to that of the reference. Conclusion:The preparation process of repaglinide and metformin hydrochloride tablets is simple and feasible, and the quality is controllable and stable.

Objective To investigate the mechanisms of phenytoin accelerating healing process.Methods Adult male Wistar rats that survived ligatation of the left coronary artery were randomized to phenytoin group or operation control and compared to sham-operated rats.The time-dependent proteolytic activity of MMP-2 and MMP-9 were detected by gelatin zymography.Picrosirius red staining plus polarized light micrscopy was used for qualitative and quantitative analysis of collagen include collagen volume fraction(CVF) and ratio of typeⅠ/Ⅲ collagen.In addition,infarct thickness and myocyte cross-sectional area were also evaluated by image analysis.Results Fourteen days after myocardial infartion(MI),phenytoin reduced infarct wall thinning.Compared with control group,the rats received phenytoin had less myocyte cross-sectional area.Two weeks after MI,CVF in two groups both had significantly dynamic increase and phenytoin accelerated the change.In contrast to control group,ratio of typeⅠto type Ⅲ collagen in phenytoin increased more quickly.Apart from these results,phenytoin did little to CVF in non-infarcted region.Analysis of MMPs activity in myocardial extracts by zymography demonstrated that infarction-induced expression of proMMPs and active MMPs was both upregulated in phenytoin group and operation control.We found that after MI,MMP-9 activity increased as early as 1 day and reached a maximum then gradually descended,whereas MMP-2 began to increase rapidly and remain elevated for up to 14 days thereafter.Phenytoin seemed toenhance expression of MMP-2 and MMP-9.1 day after MI,active MMP-9 in phenytoin group expressed an increasing trendency compared to MI control.Conclusion Phenytoin can attenuate the degree of post-infarction left ventricular dilation and expansion of the infarct during the early phase of MI healing.MMP-2 and MMP-9 enhanced by phenytoin probably played a prominent role.

AIM:To compare the influence of anterior chamber maintainer and viscoelastic agent on corneal astigmatism and endothelial cells after phacoemulsification.METHODS:Totally 70 patients(70 eyes) of cataract from April 2013 to April 2015 were randomly divided into the study group and the control group, with 35 cases in each group.The study group were treated with anterior chamber maintainer during phacoemulsification with support system approach, and the control group were treated with phacoemulsification under viscoelastic agent.RESULTS:The age (t=0.215, P=0.831), the density of corneal endothelial cells (t=-0.352, P=0.726) and corneal luminosity (t=-0.162, P=0.872) of two groups had no significant difference before surgery;there were no significant difference in preoperative visual acuity (t=0.463, P=0.599) and visual acuity (t=1.616, P=0.124) at 1mo after operation.And patients in the study group (t=-21.129, P<0.01) and the control group (t=-12.780, P<0.01) before surgery and 1mo postoperative when compared with the naked eye eyesight showed significant difference.The visual acuity after operations improved significantly.There were significant differences of corneal endothelial cells density (t=8.489, P< 0.01) and corneal astigmatism (t=-2.032, P=0.046) in the study group before surgery and 1mo after surgery;corneal endothelial cell density (t=8.999, P<0.01) and corneal astigmatism (t=-2.167, P=0.034) in the control group before surgery and 1mo after surgery also had significant differences.There was no significant difference in the rate of corneal endothelial cell loss between the two groups (t=0.410, P=0.683).CONCLUSION:Compared with viscoelastic agent, anterior chamber maintainer during phacoemulsification in patients with cataract won't increase the damage of postoperative surgically induced astigmatism and corneal endothelial cells, which mean the method of anterior chamber maintainer during phacoemulsification in the treatment of cataract is safe and effective.

ObjectiveTo investigate the expression and relationship between phosphatase and tensin homology deleted on chromosome ten(PTEN) and vascular endothelial growth factor(VEGF) in bladder transitional cell carcinoma(BTCC) and their clinical significance.MethodsExpression of PTEN and VEGF were detected in 60 specimens by immunohistochemistry test(SP method).ResultsThe positive rate of PTEN was 47%(28/60) in BTCC;VEGF was 68%(41/60).With the pathological grade and the clinical stage of tumors being higher,the lower expression level of PTEN showed(P<0.05);while the expression of VEGF increased with no statistical significance(P>0.05),but having a significant difference between specimens with lymph nodes metastasis and without lymph nodes metastasis(P<0.05).The expression of PTEN was negatively correlated with that of VEGF(r=-0.439,P<0.01).ConclusionThe expression of PTEN and VEGF in BTCC plays an important role during the progress of carcinoma and is helpful to evaluate the prognosis of patients.