Objective:To evaluate the clinical features and follow-up effect of treatment for retinal capillary hemangioma (RCH) of myopic disc.Methods:Retrospective case series studies. A total of 14 patients (15 eyes) diagnosed with juxtapapillary RCH (JRCH) at Peking Union Medical College Hospital and followed up for more than 12 months from January 2007 to December 2019 were included. Among these patients, there were 7 males (7 eyes) and 7 females (8 eyes) with the average age of 29.8±12.7 years. There were 6 isolated JRCH cases, all of which were monocular patients, including 1 case with a single peripheral RCH; 8 cases with von Hippel-Lindau disease, including 5 cases of binocular RCH. Out of 15 eyes, 6 eyes were merged with peripheral RCH. Three eyes were simply observed, and 12 eyes were treated with photodynamic therapy (PDT) alone or PDT combined with other treatments. The average follow-up time was 55.2 months. Its clinical characteristics and long-term treatment effects were analyzed.Results:At the first visit, among the 15 eyes, 3 eyes had visual acuity <0.1, 5 eyes were 0.1-0.4, and 7 eyes were> 0.5. The endogenous and fixed exogenous JRCH were 12 (80%, 12/15) and 3 (20%, 3/15) eyes, respectively. The size of the tumor was 1/4 to 4 optic disc diameters (DD); the combined macular edema, epiretinal membrane, and macular hole were 11, 5, and 1 eyes, respectively. There were 3 eyes with tumor diameter less than 1 DD. The visual acuity at the first diagnosis was 0.6-1.0, and no treatment was given. The follow-up time was 12 months in 2 eyes and 120 months in 1 eye. At the last follow-up, his vision remained stable and the tumor did not enlarge. Six eyes with tumor diameter ranging from 1.0 to 2.5 DD, visual acuity was 0.06 to 0.6 at first diagnosis, accompanied by retinal exudation. 5 eyes were treated with PDT alone, and 1 eye was treated with PDT combined with anti-vascular endothelial growth factor drugs. The follow-up time was 12 to 84 months. At the last follow-up, the visual acuity improved or stabilized in 5 eyes and decreased in 1 eye. There were 6 eyes with peripheral RCH, including 4 eyes with retinal detachment, 2 eyes with epiretinal membrane, and 1 eye with vitreous hemorrhage. The visual acuity at the first visit was 0.02-0.6. All patients were treated with PDT combined with transpupillary thermotherapy, extrascleral drainage, and vitrectomy. The follow-up time was 12 to 132 months. At the last follow-up, all eyesight decreased.Conclusions:Visual decrease cause by JRCH often occurs at young adults. Bilateral JRCH are more common in patients with von Hippel-Lindau's disease. The tumor can cause retinal exudation, macular edema, epiretinal membrane and macular hole, resulting in gradual vision loss. PDT and/or combined anti-vascular endothelial growth factor drugs for medium sized JRCH with retinal exudation can maintain long-term vision stability. Patients with large JRCH or severe complications such as retinal detachment tend to have poor prognosis.

Objective:To observe the effects of different courses of hyperbaric oxygen (HBO) on vulnerable carotid atherosclerotic (AS) plaque and related inflammatory factors in patients with acute cerebral infarction (ACI), and to explore its mechanism.Methods:A total of 176 patients with ACI treated in the Department of Neurology of Yantai Mountain Hospital and Yantai Yuhuangding Hospital from January 30, 2018 to December 30, 2020 were selected and divided into control group ( n=86) and observation group ( n=90) according to the treatment methods. Doppler ultrasound was used to check whether ACI patients were complicated with carotid AS plaque. And the patients who died and lost contact during the observation period were excluded. Ultimately, there were 69 cases in the control group and 72 cases in the observation group. The control group was given conventional treatment, while the patients in the observation group were treated with HBO on the basis of the treatment in the control group when they were in stable conditions. Before treatment and after 6 and 12 courses of treatment, the internal carotid artery (ICA) color Doppler ultrasound was performed to check the degree of sclerosis and stenosis, the reduction of vulnerable plaque, and the increase of stable plaque, and to measure the plaque thickness, intima-media thickness (IMT), and long diameter. Before treatment and after 2 and 4 courses of treatment, the levels of matrix metalloproteinase-9 (MMP-9), C-reactive protein (CRP), endothelin (ET), and homocysteine (Hcy) were measured. Results:Compared with that before treatment, the degree of carotid atherosclerosis in the observation group was significantly reduced after 6 and 12 courses of treatment ( Z=-2.12, P<0.05; Z=-2.89, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid atherosclerosis at the same time points in the observation group were also significantly reduced ( Z=-2.01, P<0.05; Z=-2.58, P<0.05). Compared with that before treatment, the degree of carotid stenosis in the observation group was significantly reduced after 3 and 6 courses of treatment ( Z=-2.17, P<0.05; Z=-2.34, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid stenosis in the observation group were also significantly reduced ( Z=-2.00, P<0.05; Z=-2.17, P<0.05). Compared with those before treatment, the plaque thickness, the long diameter of plaque, and IMT in the observation group were decreased significantly after 6 and 12 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the plaque thickness, long diameter, and IMT in the observation group were decreased significantly ( P<0.05). Compared with those before treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were decreased significantly after 2 and 4 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were also decreased significantly ( P<0.05). Conclusion:Different courses of HBO combined with statins can improve the degree of carotid atherosclerosis and stenosis in patients with ACI, and turn vulnerable plaque into stable plaque. In addition, CRP and MMP-9 may be the potential serum markers expressing the stability of vulnerable plaques, and the stability is related to the levels of ET and Hcy after treatment.

Objective:To observe the effects of different courses of hyperbaric oxygen (HBO) on vulnerable carotid atherosclerotic (AS) plaque and related inflammatory factors in patients with acute cerebral infarction (ACI), and to explore its mechanism.Methods:A total of 176 patients with ACI treated in the Department of Neurology of Yantai Mountain Hospital and Yantai Yuhuangding Hospital from January 30, 2018 to December 30, 2020 were selected and divided into control group ( n=86) and observation group ( n=90) according to the treatment methods. Doppler ultrasound was used to check whether ACI patients were complicated with carotid AS plaque. And the patients who died and lost contact during the observation period were excluded. Ultimately, there were 69 cases in the control group and 72 cases in the observation group. The control group was given conventional treatment, while the patients in the observation group were treated with HBO on the basis of the treatment in the control group when they were in stable conditions. Before treatment and after 6 and 12 courses of treatment, the internal carotid artery (ICA) color Doppler ultrasound was performed to check the degree of sclerosis and stenosis, the reduction of vulnerable plaque, and the increase of stable plaque, and to measure the plaque thickness, intima-media thickness (IMT), and long diameter. Before treatment and after 2 and 4 courses of treatment, the levels of matrix metalloproteinase-9 (MMP-9), C-reactive protein (CRP), endothelin (ET), and homocysteine (Hcy) were measured. Results:Compared with that before treatment, the degree of carotid atherosclerosis in the observation group was significantly reduced after 6 and 12 courses of treatment ( Z=-2.12, P<0.05; Z=-2.89, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid atherosclerosis at the same time points in the observation group were also significantly reduced ( Z=-2.01, P<0.05; Z=-2.58, P<0.05). Compared with that before treatment, the degree of carotid stenosis in the observation group was significantly reduced after 3 and 6 courses of treatment ( Z=-2.17, P<0.05; Z=-2.34, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid stenosis in the observation group were also significantly reduced ( Z=-2.00, P<0.05; Z=-2.17, P<0.05). Compared with those before treatment, the plaque thickness, the long diameter of plaque, and IMT in the observation group were decreased significantly after 6 and 12 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the plaque thickness, long diameter, and IMT in the observation group were decreased significantly ( P<0.05). Compared with those before treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were decreased significantly after 2 and 4 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were also decreased significantly ( P<0.05). Conclusion:Different courses of HBO combined with statins can improve the degree of carotid atherosclerosis and stenosis in patients with ACI, and turn vulnerable plaque into stable plaque. In addition, CRP and MMP-9 may be the potential serum markers expressing the stability of vulnerable plaques, and the stability is related to the levels of ET and Hcy after treatment.

Objective To investigate the diagnostic value of prenatal ultrasound for fetal structural abnormalities.Methods The clinical data of 3 101 fetus with structural malformations, diagnosed by prenatal ultrasound and confi rmed after induced labor, and 856 cases of missed diagnosis were analyzed. All these data were collected in Maternal and Child Health Hospital of Tangshan City from January 2010 to June 2014. The types and number of fetal structural abnormalities were recorded. The rates of detection and missed diagnosis for the fetal structural abnormalities were calculated and the reasons for missed diagnosis were analyzed.ResultsA total of 3101 cases (4 171 positions) were diagnosed as fetal structural abnormalities by prenatal ultrasound. The detection rate was 11.51‰ (3 101/269 501). There were 856 cases (947 positions) of fetal structural abnormalities were missed, and the missed diagnosis rate was 3.18‰ (856/269 501). The incidence of fetal structural abmormalities was 14.68‰ (3 957/269 501). In terms of anatomy systems, the top five were cardiovascular system abnormalities (851 cases), the central nervous system abnormalities (691 cases), facial abnormalities (562 cases), urinary system abnormalities (476 cases), and respiratory system abnormalities (134 cases). In terms of single abnormalities, the top five were cleft lip and palate (549 cases), ventricular septal defect (519 cases), hydronephrosis (331 cases), spina bifi da (212 cases), and atrial-ventricular septal defect (163 cases). The top five of missed deformities were polydactylia/symphysodactylia (285 cases), ear deformities (108 cases), hypospadias (93 cases), foot abnormalities (92cases), and ventricular septal defect (52 cases).Conclusions There is a high detection rate for fetal structural abnormalities with prenatal ultrasound. Prenatal ultrasound is an indispensable means for the diagnosis of fetal malformation, but it also has some limitations. There is a high rate of missed diagnosis for polydactylia/symphysodactylia, microtia, and hypospadias.

Objective To study the effect of core stability training on motor function in patients with hemiplegia after stroke. MethodsSixty-eight patients with hemiplegia after stroke were randomly divided into a treatment group (34 cases) and a control group (34 cases).Both groups were given regular rehabilitation training.The patients in the treatment group also were taught core stability training.The trunk control test (TCT),Berg's balance scale (BBS),the modified Barthel index (MBI),functional ambulation categories (FACs) and the Fugl-Meyer assessment scale (FMA) were used to assess motor function before and after treatment. ResultsThere were significant differences between the two groups in average TCT scores,BBS scores,FACs,M BI scores and FMA scores after treatment.The gains in the treatment group were significantly superior to those in the control group.The patients'trunk control was positively correlated with the BBS,MBI,FAC and FMA results.Conclusion Core stability training can improve the motor function of patients with hemiplegia after stroke.