AIM:To discuss the application value of retro-mode imaging by F-10 confocal scanning laser ophthalmoscope (cSLO) for detecting drusen in patients with age-related macular degeneration (AMD).METHODS:This was a retrospective case study.During the period of October 2015 to December 2016, 67 patients with unilateral AMD (67 affected eyes and 67 fellow eyes) were included in this study.All patients underwent color fundus photography, optical coherence tomography (OCT) and retro-mode imaging by F-10 cSLO.The features of drusen by color fundus photography, OCT and retro-mode imaging were comparatively observed in the affected eyes of patients with unilateral AMD.Positive numbers of drusen in the fellow eyes of patients with unilateral AMD detected by color fundus photography, OCT and retro-mode imaging were calculated and compared.RESULTS:Retro-mode imaging by F-10 cSLO gave easier to identify images of drusen than color fundus photography and OCT in the affected eyes of patients with unilateral AMD.In the fellow eyes of 67 patients with unilateral AMD, retro-mode imaging showed drusen in 56 cases(84%), color funds photography showed drusen in 36 cases(54%), OCT showed drusen in 48 cases(72%), the difference was statistically significant(χ2=14.31, P<0.05).The positive numbers of drusen detected by retro-mode imaging were significantly higher than color fundus photography, the difference was statistically significant(χ2=13.87, P′<0.0125).There was no statistically significant difference in the positive numbers of drusen detected by retro-mode imaging and OCT(χ2=2.75, P′>0.0125).CONCLUSION:Retro-mode imaging by F-10 cSLO provides a non-invasive technique and should be useful for detecting and monitoring drusen in AMD.

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.

Objective To investigate the effects of antioxidant response element (ARE) activator- 5,6-dihydrocyclopenta[ C ]-1,2-dithiole-3-thione (CPDT) on organotypic spinal cord cultures and to study whether this activation can protect motor neurons from oxidative stress.Methods Organotypic spinal cord cultures were prepared using lumbar spinal cord slices from 8-day-old rat.Threo-hydroxyaspartate (THA) was continuously added into the culture medium for 3 weeks,which caused selective motor neuron death. Thus,the in vitro model of amyotrophic Lateral sclerosis (ALS) was established.15,30 ?mol/L of CPDT were added into the culture medium respectively.Ventral motor neurons survival was evaluated by immunohistochemical staining with monoclonal antibody SMI-32,a nonphosphorylated neurofilament marker. Ultrastructure was observed with electronic microscope.Results The pretreatment of organotypic spinal cord cultures with different concentrations of CPDT significantly increase the total number of ventral motor neurons (15?mol/L:(15.81?6.97) perexplant;30?mol/L:(16.25?6.74) perexplant respectively) compared with THA group ((5.31?5.76) perexplant) and the former had plentiful neurite extensions (n= 15,P

OBJECTIVETo analyze the relationship between Chinese medical constitutions and chemotherapy-induced leucopenia (CIL) of primary breast cancer patients.

METHODSTotally 306 breast cancer patients undergoing adjunctive chemotherapy for the 1st time, and effective 291 breast cancer patients were recruited in this study.Nine Basic Constitutional Scale was used before first chemotherapy. Chinese medical constitutions were classified and quantitatively scored. The highest grading for any item of adverse reactions in each case during the whole chemotherapy course was recorded after chemotherapy. Data were statistically analyzed using SPSS16.0.

RESULTSThere was no significant difference in CIL between different chemotherapy regimens and various Chinese medical constitutions of breast cancer patients (P > 0.05). Yang deficiency constitution is one risk factor for CIL. The higher the score of yang deficiency constitution, the more severe the CIL.

CONCLUSIONSYang deficiency constitution was correlated with the degree of CIL. The higher the score of yang deficiency constitution, the greater the risk of III-IV grade CIL in breast cancer patients.

Breast Neoplasms ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Leukopenia ; chemically induced ; Medicine, Chinese Traditional ; Yang Deficiency

BACKGROUND: Although the porcine small intestinal submucosa is very similar to the skin in the structure, its pore size and porosity are not beneficial to the growth of seed cells as the skin does. OBJECTIVE: To observe the morphological and cytocompatibility of porcine small intestinal submucosa after chemical modification using 1-ethyl-3-(3-dimethylaminopropyl) carbod imide (EDC). METHODS: A porcine small intestinal submucosa sample was immersed in 3% acetic acid solution containing 0.2% pepsin to make 1%, 2%, 3%, 4% small intestine submucosa solutions. After magnetic stirring and freeze-drying, small intestinal submucosa sponge was obtained and modified by cross-linking with 50, 100, 150 mmol/L EDC. Based on the detection of pore size and water absorption, we selected the best concentrations of small intestinal submucosa and EDC, which were further used for cell culture. Passage 2 bone marrow mesenchymal stem cells were cocultured with the small intestinal submucosa sponge, and observed under scanning electron microscope at 1, 2, 3 weeks after co-culture. RESULTS AND CONCLUSION: When cross-linked with 100 mmol/L EDC, the small intestinal submucosa sponge at a mass concentration of 1% showed a reasonable structure and good elasticity with no appearance of voids, and the pore size ranged 100-150 μm. Moreover, the small intestinal submucosa sponge at a mass concentration of 1% showed a 0.35-fold increase in the compared with that at a mass concentration of 2%, and its structure was more conducive to water flows and changes. The small intestinal submucosa sponges at a mass concentration of 3% and 4% showed no difference in the water absorbing capacity. After cross-linked with 100 mmol/L EDC, the small intestinal submucosa sponge at a mass concentration of 1% showed the best structure, pore size and water absorption, which were used for cell culture. At 3 weeks after cell culture, cell deformation was relatively intact and fast; there were many cells in the pores that were relatively large and approximately spindle-shaped, while there were less cells around the pores that were relatively small and disk-shaped. A paving stone-like alteration was observed in cells that covered the most of the scaffold surface with a large number of particle-like substances, especially in the site of cell concentration. All these findings indicate that EDC-modified small intestinal submucosa sponge has good cytocompatibility.

Objective: To investigate the effects of crystalline silica with different exposure patterns on lung fibrosis in rats. Methods: A total of 20 adult male Wistar rats were randomly divided into 4 groups consisting of five animals each and received intratracheal instillation of sterile saline or silica suspension in different patterns: saline once at day 0, saline once/week, crystalline silica 50 mg at day 0, crystalline silica 6.25 mg/week. The rats were sacrificed at 8 weeks. The lung tissues were collected for pathological analyses, and determining mRNA and protein levels of related fibrogenic molecules. Results: The collagen deposition induced by crystalline silica in lung tissues were increased. The mRNA levels of IL-1β and Col I in group c were significantly elevated than those in group saline once at day 0 (all P<0.05). Compared with group saline once/week, the mRNA levels of IL-1β, TGF-β, Col I, Col III and CTGF were significantly increased in group crystalline silica 6.25 mg/week (P<0.05) . The mRNA levels of Col I and CTGF were significantly increased in group crystalline silica 6.25 mg/week in comparison with those in group crystalline silica 50 mg at day 0 (P<0.05) . Conclusion Given the same cumulative dose of crystalline silica, multiple exposures were likely to induce more severe lung fibrosis.

Objective:To investigate the current status of disability and its associated risk factors in elderly inpatients.Methods:Clinical data of elderly inpatients aged 60 years and above at internal medicine department of 13 Grade-A Tertiary hospitals from 7 cities across China were retrospectively analyzed.A comprehensive health assessment survey for the elderly was conducted.The prevalence of disability and related risk factors were analyzed.Results:The disability rate was 18.8%(817/4 348)in this study.The disability rate was higher in south China than in north China(25.7% or 475/1 851 vs.13.7% or 342/2 497, χ2=99.735, P<0.001), and the disability rate was higher in urban areas than in rural areas(19.7% or 667/3 391 vs.15.7% or 150/957, χ2=7.809, P=0.005). After adjustment for potential confounders, the independent risk factors for disability in elderly inpatients included age(≥75 years), region(living in south China), widowhood, low education level, BMI(<18.5 kg/m 2), low income level(≤2 000 yuan/month), multimorbidity status and daily activity time(<1 hour)(all P<0.05). Conclusions:Disability is common in elderly inpatients in China, and its occurrence can be reduced by controlling chronic diseases, and improving nutrition and other ways.

OBJECTIVETo investigate the eGFR as a risk factor for long-term (4-year) outcome in Chinese renal insufficiency patients after isolated coronary artery bypass grafting (CABG) at our institution.

METHODSFrom January 1999 to September 2003, 3371 consecutive patients who underwent isolated CABG were retrospectively reviewed. Of these patients, 549 (16.29%) patients were female, 1979 (58.71%) patients with hypertension, 866 (25.69%) patients with diabetes, 1130 (33.52%) patients with hyperlipidemia, 1011 (29.99%) patients with left main stenosis > 50%, and 1150 (34.11%) patients undergoing off-pump procedures. The mean age was (60 +/- 9) years old. Estimated GFR was calculated using the Cockcroft-Gault formula. The main outcomes were in-hospital mortality, in-hospital morbidity and long-term mortality. COX analysis was used in this study.

RESULTSThere were 649 patients with glomerular filtration rate estimates < 60 ml/(min.1.73 m(2)) and 2722 patients with glomerular filtration rate estimates > 60 ml/(min.1.73 m(2)). The in-hospital mortality and follow-up mortality was higher in the estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) group (2.77% vs. 0.77%, P < 0.01), (6.81% vs. 2.63%, P < 0.01). The COX analysis result confirmed eGFR < 60 ml/(min.1.73 m(2)), derived using the Cockcroft-Gault formula (HR: 1.948, 95%CI: 1.357 to 2.797, P < 0.01) was an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

CONCLUSIONSThe estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) derived using the Cockcroft-Gault formula is an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

Adult ; Aged ; Coronary Artery Bypass ; mortality ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; physiopathology ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the experience of patients in acute cardiogenic shock required insertion of mechanical circulation support devices (MCS) before undergoing standard pretransplant evaluations.

METHODSFrom February 2005 to August 2007, 10 patients including 7 male and 3 female required emergency bridging placement of MCS. Average age was (40 +/- 16.2) years old. Mean body weight was (70.8 +/- 18.1) kg. There were 5 patients of dilated cardiomyopathy, 2 patients of arrhythmic right ventricular cardiomyopathy, 2 patients of ischemic cardiomyopathy and 1 patient of end-stage valvular heart disease. All patients were accompanied with acute decompensation of congestive heart failure. Before implantation of MCS, all patients received treatment of three or more inotropic drugs at maximal dosages, 6 patients suffered from ventricular tachycardia, 4 patients required cardio-pulmonary resuscitation treatment and 3 patients suffered from definite function defect of liver and kidney. MCS included ECMO for 8 patients, BVS5000 and MEDOS for 1 patient respectively.

RESULTSThe duration of MCS supporting was 3 to 44 d with a mean of (11.5 +/- 13.9) d. Four patients were successfully supported for getting heart transplantation, 1 patient received kidney transplantation simultaneously. Two patients recovered from acute heart failure, discharged and remained on regular heart transplantation list. One patient died from cerebral embolism after 44 days' support and 1 died from multiple organ failure after 3 days' support. Because of severe infection, MCS treatment of 2 patients was terminated ahead of schedule by their family and the patients were lost finally.

CONCLUSIONSThe use of MCS devices for acute catastrophic situation appears warranted despite the abbreviated transplant evaluations. It is important for improving the outcomes with beginning MCS support before multiple organ system failure occurs, and accurately identifying individuals who can benefit from MCS.

Adolescent ; Adult ; Aged ; Emergencies ; Female ; Heart Failure ; surgery ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Male ; Middle Aged ; Preoperative Care ; Retrospective Studies

OBJECTIVETo compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT).

METHODSOCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by > or = 2 quadrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients.

RESULTSOCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs. 73% (16/22), P = 0.741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5 +/- 34.7) microm vs. (141.1 +/- 68.5) microm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P = 0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22), P = 0.000] and plaque rupture [50% (11/22) vs. 9% (2/22), P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups.

CONCLUSIONSOCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

Aged ; Angina Pectoris ; diagnostic imaging ; Angina, Unstable ; diagnostic imaging ; Coronary Artery Disease ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Tomography, Optical Coherence