Objective:Evaluate the influence of different pressure transmission media of urodynamic water filled catheter(WFC) and air charged catheter(ACC) on the pressure measurement results to determine whether they can be used interchangeably.Methods:The results of 2 147 patients who underwent urodynamic examination in our hospital from January 2014 to December 2020 were retrospectively analyzed. A total of 2 538 times of bladder manometry data were obtained, including 1 299 times in WFC group, 856 times in male and 443 times in female, aged 37(24, 50)years, course of disease 1.2(0.4, 5.0) years, 1 130 times in neurogenic bladder(NB)and 169 times in non-neurogenic bladder(N-NB); In ACC group, there were 1 239 times, 773 times for male and 466 times for female, with age of 37(24, 55)years, course of disease of 1.5(0.5, 6.0)years, 1 040 times for Nb and 199 times for N-NB. There was no significant difference in baseline data of general clinical data between the two groups. The intravesical pressure(Pves), intra-abdominal pressure(Pabd)and detrusor pressure(Pdet) of WFC and ACC patients during filling and urination were analyzed. For traumatic spinal cord injury(SCI) and idiopathic patients, the two sets of pressure measurement data were analyzed separately. Nonparametric test and Chi-square test were used to compare the Pves, Pabd, and Pdet recorded by the two manometry catheters before, at the end and after urination, the maximum detrusor pressure at DO(Pdet.max-DO), and the maximum detrusor pressure during spontaneous urination (Pdet. max) and the detrusor pressure (Pdet.Qmax) corresponding to the maximum urine flow rate, the maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) during resting urethral pressure profile, and the initial cough Pdet signal pattern (typeⅠ, typeⅡand typeⅢ).Results:Regardless of the cause, the Pabd values measured by ACC were significantly higher than WFC before filling, end filling and after voiding[18(10, 26)cmH 2O vs.15(11, 21)cmH 2O; 23(16, 31)cmH 2O vs. 20(14, 26)cmH 2O; 23(15, 31)cmH 2O vs.18(12, 24)cmH 2O], and Pdet were significantly lower than WFC[0(0, 0) cmH 2O vs. 0(0, 1)cmH 2O; 5(1, 13)cmH 2O vs. 9(4, 17)cmH 2O; 6(1, 12)cmH 2O vs. 7(3, 14)cmH 2O]. In the initial cough state, Pves and Pabd increase value were also significantly lower than that of WFC [22(12, 36)cmH 2O vs. 23(14, 38)cmH 2O; 20(10, 33)cmH 2O vs. 21(12, 36)cmH 2O]. The Pves measured by ACC was also significantly higher than WFC before filling and after voiding[18(10, 27)cmH 2O vs. 16(11, 21)cmH 2O; 30(22, 39)cmH 2O vs. 26(20, 36)cmH 2O]. Maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) measured by ACC were significantly higher than WFC [91(69, 118)cmH 2O vs.81(64, 106)cmH 2O; 77(55, 103)cmH 2O vs. 68(48, 91)cmH 2O], and there were no significant differences in Pdet.max-DO、Pdet.max和Pdet.Qmax. For patients with traumatic SCI, the Pves measured by ACC was significantly higher than WFC before filling[15(10, 24)cmH 2O vs. 14(10, 20)cmH 2O], and only MUP was significantly higher than WFC in the measurement of urethral pressure[95(71, 119)cmH 2O vs. 85(65, 112)cmH 2O], and there were no significant differences in Pdet.max-DO, Pdet.max, Pdet.Qmax and MUCP. For idiopathic patients, Pves measured by ACC before filling and after urination were significantly higher than WFC[25(20, 29)cmH 2O vs. 18(11, 23)cmH 2O; 35(29, 44)cmH 2O vs. 28(20, 38)cmH 2O], while Pdet.max-DO, Pdet.max, Pdet.Q max, MUP and MUCP were not significantly different in different pressure measurement systems. For the comparison of the initial cough Pdet signal pattern, ACC is easier to detect type Ⅰ, and WFC is easier to detect type Ⅱ and type Ⅲ. Conclusions:Compared with WFC, ACC measured higher Pves and Pabd and lower Pdet in resting state, and lower Pves and Pabd in initial cough state. The pressure values and signal pattern measured by WFC and ACC are not completely consistent, so they cannot be used interchangeably.

Objective:To observe the healing morphology, macular microstructure and visual function of idiopathic macular hole (IMH) after pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) flap.Methods:Retrospective case study. From 2016 to 2018, 39 eyes of 39 patients with IMH diagnosed in Tianjin Eye Hospital were included in the study. Among them, there were 4 eyes in 4 males and 35 eyes in 35 females, with an average age of 64.56±7.2 years. BCVA, OCT, OCT angiography (OCTA) and MAIA microperimetry examination were performed in all patients. BCVA examination was performed with the international standard visual acuity chart, which was converted to logMAR visual acuity when recording. All patients underwent PPV combined with ILM flap covering and air tamponade. According to the characteristics of OCT images postoperatively, the eyes were divided into U-shaped closed group, V-shaped closed group, irregular closed group and flat closed group, with 26, 5, 7 and 1 eyes respectively. There was a significant difference in the minimum hole diameter ( F=5.118, P=0.005) and macular hole classification ( F=3.608, P=0.024). The shallow capillary layer (SCP) blood flow density in the U-shaped closure group was significantly higher than that in the V-shaped closure group, the irregular closure group and the flat closure group (t=2.079, 2.368; P=0.047, 0.025). At 1, 3, 6 months after the operation, the same equipment and methods were used for relevant examination. The blood flow density of BCVA, SCP, perimeter of foveal avascular zone (PERIM) and mean sensitivity (MS) were compared before and after operation. Independent sample t-test was used for quantitative data comparison between different groups, and χ2 test was used for counting data comparison. Results:Six months after operation, the logMAR of the eyes in the U-shaped closure group was -0.75±0.29 higher than that before operation, and was better than that in the V-shaped closure group, the irregular closure group and the flat closure group ( t=-2.974, -2.518; P=0.006, 0.018). The integrity of external limiting membrane (ELM) and ellipsoid in U-shaped closed group was significantly higher than that in V-shaped closed group, irregular closed group and flat closed group ( χ2=15.229, 10.809; P=0.020, 0.013). The percentage of macular central fovea reflex mass in the U-shaped closed group was significantly lower than that in the V-shaped closed group, irregular closed group and flat closed group ( χ2=20.107, P=0.000). PERIM in U-shaped closure group was smaller than that in V-shaped closure group, irregular closure group and flat closure group, and the difference was statistically significant ( t=-3.391, -2.427; P=0.002, 0.022). The total MS of macular area 10° in the U-shaped closure group was significantly higher than that in the other V-shaped closure group, irregular closure group and flat closure group ( t=2.939, 2.811; P=0.001, 0.001). Conclusion:After IMH operation, the U-shaped closure showed better BCVA and macular light sensitivity, the proportion of ELM and ellipsoid to restore structural integrity are higher, PERIM is smaller, and there are fewer macular fovea strong reflex masses.

Objective:To observe the changes of microperimeter and OCT angiography (OCTA) in idiopathic macular hole (IMH) before and after operation, and to explore the correlation between the changes and visual acuity.Methods:From January 2018 to January 2019, 41 patients (41 eyes) with IMH who underwent pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) flap surgery in Tianjin Eye Hospital were included in this study. Among them, 8 patients (8 eyes) were male and 33 patients (33 eyes) were female. The average age was 64.02±6.46 years. The average course of disease was 7.00±8.85 months. BCVA, microperimeter and OCTA were performed. The retinal mean sensitivity (RMS) at 10 ° and fovea 2 ° fixation rate (P1) and binary contour ellipse area (63% BCEA) were measured by macular integrity assessment instrument. The central retinal thickness (CRT), choroidal blood flow area (CFA), superficial and deep retinal blood flow density (FAVD, FDVD), foveal avascular zone (FAZ) and blood flow densitywithin the width of FAZ 300 μm (FD-300) were measured by OCTA. Twenty one and 19 eyes with or without ILM flap operation were treated with 25G standard three incision PPV. The follow-up time was more than 6 months. Paired t-test was used to compare the indexes before and after operation. Pearson correlation analysis was performed for the correlation between logMAR visual acuity and microperimeter variables and OCTA variables. Nonparametric test was performed for paired comparison between affected eyes and contralateral eyes before and after operation.Results:At 6 months after operation, logMAR visual acuity ( t=-12.33), RMS ( t=7.94), P1 ( t=3.21), 63% BCEA ( t=-3.98), CRT ( t=-9.17), CFA ( t=8.14), FSVD ( t=3.75), FDVD ( t=3.88) were significantly improved compared with those before operation ( P<0.001). The difference of FAZ area ( t=-1.40) and FD-300 ( t=1.95) before and after operation were not statistically significant ( P>0.05). The results of correlation analysis showed that logMAR visual acuity 6 months after surgery was correlated with preoperative logMAR visual acuity, MIN, RMS, P1, 63% BCEA, FSVD, FDVD and FAZ ( r=0.432、0.527、-0.410、-0.383、0.349、-0.406、-0.373、0.407; P<0.05). At 6 months after operation, the indexes of the affected eyes were significantly improved compared with those before operation, but worse than those of the contralateral eyes ( P<0.05). Conclusions:PPV for IMH can effectively improve the visual acuity, retinal function and foveal microvascular circulation. Retinal function and blood circulation changes have a significant impact on postoperative visual acuity.

When macular diseases involves the fovea, patients' central vision is significantly reduced. A central dark spot appears in the visual field, and their visual function indicators, such as reading speed and fixation stability, are significantly impaired, which seriously affects the patients' quality of life. The human body's response to the damage of the fovea region is a spontaneous adaptation strategy adopted by the brain. The brain will select the paracentral region as the pseudo fovea to serve as the fixation site of the eye, however, the development of patient's own residual vision is not maximized by this adaptation behavior. In recent years, through continuous research, it has been discovered that the automatic eye position recognition and automatic eye tracking system in the microperimeter can accurately detect specific retinal sites, combined with the biofeedback training mode, and can combine fundus examination with biofeedback training. It can help patients with age-related macular degeneration, pathological myopia macular degeneration, Stargardt's disease, macular hole and other macular diseases to choose the best retinal site as an eye movement benchmark, maximize the patient's residual vision and improve the patient's visual function.

Objective To investigate the correlation between wholeGorgan MRI score (WORMS)and pain in patients with knee osteoarthritis (OA).Methods 1 1 9 patients with knee OA were enrolled,and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)was used to estimate the pain.Knees of all the subj ects underwent scanning with sagittal,coronal,transverse TSEG T2 WIGFS and sagittal 3DGFLASHGWE sequences at 3.0T MR.The pathological changes of knee cartilage lesions,subarticular bone marrow edema (BME),bone cysts,bone attrition,osteophytes,meniscal inj ury,ligament inj ury,synovial thickening and joint effusion were evaluated according to the WORMS.The correlations between the above pathological changes and the pain were analyzed.Results There were significant and positive correlations between articular cartilage lesions and osteophytes,articular cartilage lesions and BME,BME and cyst,bone attrition and osteophytes,and BME and osteophytes,with the correlation coefficients of 0.6 70,0.5 9 8,0.5 1 8,0.5 1 4 and 0.505 ,respectively (P＜0.05 ).Multiple regression analysis showed that BME,bone attrition,synovial thickening and joint effusion were the main factors affecting the severity of pain after adj usted for age and BMI (P＜0.05).Conclusion The source of OA pain is multifactorial.The severity of BME,bone attrition,synovial thickening and joint effusion are the main factors associated with joint pain.As a nonGinvasive examination method,MR can make a comprehensive evaluation of the pathological changes of knee OA.

Objective: The aim of the present study was to investigate the survival rate and its prognostic factors for patients with biliary tract cancer, and then a prognostic risk prediction model was constructed to predict the survival probability of patients. Methods: A total of 14 005 patients with biliary tract cancer (including gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer), who were diagnosed between 2010 and 2015 in the US National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) were included in the development cohort. The prognostic risk factors of biliary tract cancer were investigated using multivariate Cox regression models. The predictive nomograms were then constructed to predict the overall survival probability of 1, 3, and 5 years, and the predictive discrimination and calibration ability of the nomograms were further evaluated. Meanwhile, 11 953 patients who were diagnosed during 2004 to 2009 from SEER Program were then selected to validate the external predictive accuracy of the prediction models. Results: The 1, 3 and 5-year cumulative survival rates of patients with biliary tract cancer were 41.9%, 20.4% and 15.3%, respectively, in the development cohort. Age greater than 50 years, African Americans and Native Americans and Alaska Natives, higher T, N and M stage and poor histological differentiation grade were risk factors for death, while married status, Asia-Pacific Islanders, insured status and surgery on primary site were protective factors. Gender was not significantly associated with the overall survival. The C statistic of the prediction model was 0.73 (95%CI: 0.72-0.74), and the calibration curve showed that the interaction curves of predictive and actual survival rates of 1, 3 and 5 years were close to the 45 degree diagonal. Results in the validation cohort were similar with those in the construction cohort, with a C statistic of 0.70 (95%CI: 0.69-0.72), indicating high external applicability of the prediction model. Findings from gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer are in consistent with the overall biliary tract cancer. Conclusions The survival rate of patients with biliary tract cancer is relatively poor, and the survival prediction model based on prognostic factors has high prediction accuracy. In the future, this prognostic prediction model could be applied to clinical practice to guide individualized treatment for patients with biliary tract cancer.

OBJECTIVETo study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells.

METHODSPig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBα protein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium.

RESULTSPalmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73∓0.61 vs 1.25∓0.90, P<0.05; 5.79∓0.05 vs 4.07∓0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070∓3.907 vs 29.390∓1.072, P<0.05), while IκBα protein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04∓0.22 vs 3.98∓0.18, P<0.05). Palmitate treatment significantly elevated TNF-α (2.52∓0.30 vs 1.38∓0.26, P<0.05) and IL-6 (IL-6: 3.28∓0.32 vs 1.44∓0.28, P<0.05) concentrations in the cell culture medium.

CONCLUSIONPalmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.

Animals ; Blotting, Western ; Endothelial Cells ; drug effects ; metabolism ; I-kappa B Proteins ; metabolism ; Interleukin-6 ; metabolism ; NF-KappaB Inhibitor alpha ; Palmitates ; pharmacology ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Swine ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells. Methods Pig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBαprotein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium. Results Palmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73±0.61 vs 1.25±0.90, P<0.05;5.79±0.05 vs 4.07±0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070±3.907 vs 29.390±1.072, P<0.05), while IκBαprotein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04 ± 0.22 vs 3.98 ± 0.18, P<0.05). Palmitate treatment significantly elevated TNF-α(2.52 ± 0.30 vs 1.38 ± 0.26, P<0.05) and IL-6 (IL-6:3.28±0.32 vs 1.44±0.28, P<0.05) concentrations in the cell culture medium. Conclusion Palmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.

Objective To study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells. Methods Pig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBαprotein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium. Results Palmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73±0.61 vs 1.25±0.90, P<0.05;5.79±0.05 vs 4.07±0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070±3.907 vs 29.390±1.072, P<0.05), while IκBαprotein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04 ± 0.22 vs 3.98 ± 0.18, P<0.05). Palmitate treatment significantly elevated TNF-α(2.52 ± 0.30 vs 1.38 ± 0.26, P<0.05) and IL-6 (IL-6:3.28±0.32 vs 1.44±0.28, P<0.05) concentrations in the cell culture medium. Conclusion Palmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.