Nonspecific orbital inflammation(NSOI)is an orbital inflammation that is not associated with an infection. Even though it's often considered the most common diagnosis in orbital biopsies, it's still an exclusionary diagnosis that means systemic illnesses and other possible causes have to be ruled out. Though it is always an excluded clinical diagnosis, acute orbital symptoms such discomfort, exophthalmos, periorbital edema, chemosis, diplopia, and vision impairment are commonly associated with NSOI. Clinical diagnosis and management of NSOI provide a substantial difficulty. There are presently no recognized diagnostic criteria or standard treatment strategy for NSOI, and the clinical symptoms and histological features show significant variation. This guide was formulated under the auspices of the Ocular Oncology Committee of the Opthalmology Branch of the Chinese Medical Doctor Association, Opthalmology Committee of International Association of Intelligent Medicine, Opthalmology Committee of International Association of Translational Medicine making a detailed summary of the definition, classification, diagnosis and treatment of the NSOI, with a view to aiding clinicians to improve diagnostic efficiency and formulate a better treatment plan for patients.

Objective:To explore the distribution of different subsets of monocyte in peripheral blood of patients with thyroid-associated ophthalmopathy (TAO).Methods:A cross-sectional study was performed.Fifty-nine TAO patients and 30 healthy subjects were recruited continuously in Zhongshan Ophthalmic Center from January 2017 to December 2019.Clinical data of subjects were recorded, and the severity and activity of TAO were graded based on the criteria of NOSPECS and CAS.TAO patients were grouped according to clinical activity of TAO, and the patients were treated by triamcinolone acetonide (TA) injection or methylprednisolone pulse therapy (MPT) accordingly.Peripheral blood of the subjects was collected and monocytes were isolated.The proportion of different monocyte subsets was assayed by a flow cytometry.The differences in distribution of monocyte subsets between TAO group and normal control group, stable TAO group and active TAO group, TA injected group and MPT treated group were compared and analyzed.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-Sen University (No.2014MEKY005), and the written informed consent was obtained from each subject before any medical intervention.Results:The proportion of classical monocyte (CMo) subset in TAO group was (81.77%±5.53)%, which was significantly lower than (84.35±5.83)% in the normal control group ( P=0.034); the proportion of intermediate monocyte (IMo) subset in the TAO group was (10.17±4.19)%, which was significantly higher than (7.69±4.09)% in the normal control group ( P=0.006); no significant difference was found in the proportion of non-classical monocyte (NMo) subset between the two groups ( P=0.892). The proportion of CMo subset in the active TAO group was (77.29±5.80)%, which was significantly lower than (82.64±5.03)% in the stable TAO group ( P<0.01), and the proportion of IMo subset in the active TAO group was (13.79±4.82)%, which was significantly higher than (9.20±3.56)% in the stable TAO group ( P<0.01); no significant change was found in the proportion of NMo subset between the two groups ( P=0.283). There was no difference in the proportion of different TAO subsets before and after TA injection ( P>0.05). In MPT treated group, the proportion of CMo subset in TAO patients was significantly increased and the proportion of IMo subset was significantly decreased (both at P<0.05); there was no significant difference in proportion of NMo subset before and after MPT treatment ( P=0.187). Conclusions:IMo subset is enriched in patients with TAO, and the IMo subset content varies over the disease activity.MPT may inhibit the shift of CMo subset towards IMo subset.

Objective:To establish a predictive model and investigate its value in evaluating short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods:Patients with HBV-ACLF admitted to Tianjin Second People's Hospital and Beijing Youan Hospital, Capital Medical University from May 2015 to October 2018 were enrolled. The data of gender, age, laboratory markers at admission, model for end-stage liver disease (MELD) score and clinical complications were collected for analysis. According to the prognosis on 12-week, patients were divided into survival group and death group. Univariate analysis and binary Logistic regression analysis were used to test the risk factors for short-term prognosis of the patients with HBV-ACLF, and a prediction model was established. The accuracy of each index and the established model were verified by the receiver operating characteristic (ROC) curve.Results:A total of 148 patients with HBV-ACLF were enrolled in the study, 91 cases survived while 57 cases died during the 12-week period. The age, total bilirubin (TBIL), neutrophil percentage (NEUT%), hepatitis B surface antigen (HBsAg), MELD score of death group were higher than those of survival group [age (years old): 50.00 (44.50, 55.00) vs. 43.00 (34.00, 53.00), TBIL (μmol/L): 310.30 (240.70, 405.70) vs. 266.40 (184.20, 360.20), NEUT%: (74.52±13.05)% vs. (66.64±12.35)%, lg HBsAg (kU/L): 3.72 (3.29, 3.92) vs. 2.97 (2.49, 3.78), MELD score: 24.27 (19.71, 27.40) vs. 21.88 (18.83, 24.38), all P < 0.05], while albumin (ALB), total cholesterol (CHO), prothrombin activity (PTA) and alpha-fetoprotein (AFP) were lower than those of survival group [ALB (g/L): 29.80 (27.05, 31.05) vs. 30.80 (28.00, 33.90), CHO (mmol/L): 1.98 (1.50, 2.38) vs. 2.49 (2.05, 3.01), PTA: (30.37±7.09)% vs. (32.94±6.03)%, AFP (μg/L): 21.54 (9.28, 51.54) vs. 66.16 (24.50, 152.80), all P < 0.05]. Logistic regression analysis showed that NEUT%, HBsAg and AFP were independent risk factors for short-term prognosis of patients with HBV-ACLF [odds ratio ( OR) was 77.843, 1.439, 0.995, respectively, all P < 0.05]. According to the results of regression analysis, the NHA-ACLF model (NEUT%+HBsAg+AFP) was established. The formula was logit (NHA-ACLF) = -5.441+5.688×NEUT%+0.430×lg HBsAg-0.005×AFP. The area under the ROC curve (AUC) of the NHA-ACLF model for pred HBV-ACLF patients was 0.790, which was better than NEUT% (AUC = 0.696), lg HBsAg (AUC = 0.670), AFP (AUC = 0.703) and MELD score (AUC = 0.640). When the cut-off value of NHA-ACLF model score was 0.459, the sensitivity was 73.7%, and the specificity was 79.1%. Conclusions:NEUT%, HBsAg and AFP are independent predictive indicator for short-term prognosis in patients with HBV-ACLF. Compared with MELD score, the risk assessment model NHA-ACLF has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.

Objective:To Analyze the clinical features and influencing factors of elderly patients with new coronavirus pneumonia (COVID-19) and provide reference for clinical diagnosis and treatment.Methods:A retrospective analysis was performed for 109 inpatients diagnosed with COVID-19, including 39 in the elderly group and 70 in the non-elderly group, and the clinical data and prognosis of the two groups were compared.Results:The incidence of severe and critical cases in the elderly group was higher than that in the non-elderly group [48.7% (19/39)] vs.[15.7%(11/70)], P=0.032. The proportion of patients with chronic underlying diseases in the elderly group was significantly higher than that in the non-elderly group [84.6% (33/39)] vs. [30% (21/70)], P=0.003. There were 15 cases with chest tightness in the elderly group (38.5%), 12 cases of wheezing (30.8%) which were significantly higher than those in the non-elderly group. The laboratory examination tests of elderly groups showed a significantly lower absolute count of peripheral blood lymphocytes than non-elderly groups, and there was a significant difference ( P=0.029), and C-reactive protein and Neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the elderly group than that of non-elderly groups ( P<0.001). The abnormal value of alanine aminotransferase (ALT), aspartate aminotransferase (AST), Albumin (ALB), creatinine (CREA), creatine kinase (CK), myoglobin (MYO) in the elderly group were higher than those in the non-elderly group ( P<0.05). Age, underlying disease, NLR are independent risk factors affecting prognosis. Conclusions:Elderly patients with the COVID-19 often have multiple underlying diseases, if the rates of laboratory lymphocyte count, C-reactive protein, liver and kidney function and myocardial enzyme spectrum abnormalities increased more obviously, the patients are more likely to develop into severe and critical status. Factors affecting the prognosis include age greater than 60 years, presence of underlying disease and serum NLR levels.

OBJECTIVE:To optimize formulation matrix of processed Aconitum carmichaelii hydrogel patch,and to investigate its in vitro drug release.METHODS:The ratio of NP700,dihydroxyaluminum aminoacetate,tartaric acid and PVP K90 in processed A.carmichaelii hydrogel patch matrix was optimized by central composite design-response surface method (CCD-RSM) with initial adhesion,peel strength and sensory evaluation as evaluation indexes.The modified Franz diffusion cell method was used for in vitro drug release test processed A.carmichaelii hydrogel patch using accumulative release amount of six ester type alkaloids benzene [benzoyl mesaconine (BM),benzoyl aconitum (BA),benzoylhy paconine (BH),mesaconitine (MT),hypaconitine (HT) and aconitine (AT)] as evaluation indexes.RESULTS:The optimal matrix formulation was NP700-dihydroxyaluminum aminoacetate-tartaric acid-PVP K90 (1.72 ∶ 0.10 ∶ 0.02 ∶ 1.65,m/m/m/m).In validation test,the contents of six ester type alkaloids were 52.77,28.52,28.78,8.81,8.75,8.21 μg/g(RSD＜5％,n=3),comprehensive score was 118.67 ± 1.33 (RSD=4.62％,n=3).The release behavior of BM in vitro conformed to the Higuchi equation.The release behaviors of other 5 alkaloids were consistent with the Higuchi equation.12 h accumulative release amounts of BM,BA,BH,MT,HT and AT were 12.04,2.95,3.55,2.64,2.48,1.97 μg/cm2,respectively.CONCLUSIONS:The processed A.carmichaelii hydrogei patch prepared by matrix prescription is good in appearance,adhesion and in vitro release.The research can provide a basis for the development of new dosage form of processed A.carmichaelii.

The parathyroid hormone related peptide (PTHrP) participates in regulating calcium and phosphorus metabolism and multiple organ growth,and plays an important role in the processes of malignant tumor bone metastasis and hypercalcemia.Currently,more and more researches have confirmed that PTHrP can be secreted by a variety of types of tumor cells.PTHrP participates in regulating tumor cell proliferation and invasion,and it is closely related to the prognosis of patients,which provides a new target of cancer treatment.

Objective To investigate the correlation of serum total bile acid (TBA) levels with the inflammation grades of liver tissue in chronic liver diseases.Methods Cyclophorase assay was used to detect the serum TBA levels in 172 patients with various chronic liver diseases,and the inflammation grades of liver tissue were determined by liver biopsy.The correlation between serum TBA levels and the inflammation grades of liver tissue was evaluated using SPSS 12.0 software.Results Serum TBA level was positively correlated with the inflammation grade of liver tissue ( r =0.275,P ＜ 0.01 ).The inflammation grade reached G2 when serum TBA was 20 μmol/L.Conclusion Serum TBA level may be useful for evaluating the inflammation grade of liver tissue in chronic liver diseases.

OBJECTIVEUsing Apocynum venetum as a model drug to prepare pulsed-release tablets based on diffusion, swelling, osmotic pressure mechanism and to evaluate the release characteristics.

METHODThe pulsatile release tablets were prepared by film coating methods using HPMC E5 and Eudragit The effect of formulation on pulsatile release of A. venetum was investigated.

RESULTThe pulsed-release tablet was prepared by a swelling layer coating which contains HPMC E5 and a controlled-release membrane containning Eudragit. The delayed release time of the tablets was (5.0 +/- 0.5) h.

CONCLUSIONThe pulsatile release characteristics of A. venetum pulsatile release tablets were confirmed in vitro.

Apocynum ; chemistry ; Delayed-Action Preparations ; chemistry ; Diffusion ; Drug Compounding ; methods ; Drugs, Chinese Herbal ; chemistry ; In Vitro Techniques ; Lactose ; analogs & derivatives ; analysis ; Methylcellulose ; analogs & derivatives ; analysis ; Osmotic Pressure ; Plant Leaves ; chemistry ; Polymethacrylic Acids ; analysis ; Solubility ; Tablets ; chemistry ; Time Factors

Objective To evaluate color Doppler ultrasonography(CDU) in the diagnosis of intraocular tumor. Methods Two hundred seventy-three cases(301 eye) of intraocular space-occupying lesions were examinated by high-resolution CDU to observe the two-dimensional gray-scale image and vasculature of intraocular tumors. Results Intratumor calcifying spot could be detected in 138 cases(149 eye) of 153 cases(178 eye) with retinoblastoma,and intratumor blood flow with branchy pattern could be found in 152(177 eye) of 153 cases(178 eye) with retinoblastoma. In 4 Coats disease and 2 persistent hyperplastic primary vitreous and 3 retinopathy of prematurity, intratumor calcifying spot couldn′t be detected,and the band blood flow of the detached retinal vessels could be detected. Intratumor blood flow with branchy pattern could be detected in all 66 choroidal melanomas and 4 melanomas of ciliary body with infiltrated choroid and 15 of 19 choroidal metastases. Intratumor blood flow with “simulating vessel pool” or conglomerate sparkled pattern could be found in 12 choroidal hemangioma. No intrinsic flow was detected in 8 choroidal hemorrhages or subretinal hemorrhages and 2 teratoid medulloepitheliomas. Conclusions CDU is of significance in the diagnosis and differention of intraocular tumors.

OBJECTIVETo explore the minimum observed adverse effect level(LOAEL) and intensity of pathogenesis of tin mine dust.

METHODSA cohort study design with retrospective assessment of exposure was used. Selected 4,471 male tin miners who were exposed to tin at least one year during 1960 to 1974 and were compared with 4,797 pottery dust exposed workers in the same way designed. Statistical analysis system SAS, PROC LIFETEST were used to perform the non-parameter calculation by Life Table method.

RESULTSTin mine cohort subjects were followed up to December 31, 1994. The percentage of miners who developed silicosis was 21.7% (971/4,471). 81% of the patients had been exposed to dust before 1958. The cumulative total dust exposure(CTD) was significantly correlated with silicosis risk. The risk of silicosis was 0.012 when CTD was less than 50 mg/m-3.year-1. The risk of silicosis was increased to 0.971 when CTD was beyond 400 mg.m-3.year-1. However, the risk of silicosis was only 0.369 for dust exposed workers in pottery factories when CTD was beyond 400 mg.m-3.year-1.

CONCLUSIONThere was significant relationship between cumulative dust exposure and the incidence of silicosis in tin exposed workers. And silicosis induced by tin mine dust is more serious than the pottery dust.

Cohort Studies ; Dust ; Humans ; Mining ; Occupational Exposure ; adverse effects ; Silicosis ; etiology ; Tin