Objective:To observe and evaluate the safety and efficacy of anti-vascular endothelial growth factor (VEGF) in the treatment of eyes with macular edema (ME) secondary to branch retinal vein occlusion (BRVO) in Lhasa, Tibet.Methods:A retrospective case series. From September 2018 to January 2022, a total of 41 patients (41 eyes) with BRVO-ME, who were diagnosed in Department of Ophthalmology of Tibet Autonomous Region People’s Hospital, were included in this study. There were 21 eyes in 21 males and 20 eyes in 20 females. The median age was 53 (31,75) years. There were 24 patients with hypertension (58.8%, 24/41). Best corrected visual acuity (BCVA), ocular pressure, fundus color photography and optical coherence tomography (OCT) were performed in all eyes. The BCVA was performed using the international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for record. The foveal macular thickness (CMT) was measured by OCT. All eyes were treated with intravitreous injection of anti-VEGF drugs, once a month, among which 23 eyes (56.1%, 23/41) received intravitreous injection of ranibizumab (IVR), and 18 eyes (43.9%, 18/41) received intravitreous injection of conbercept (IVC), and were grouped accordingly. There was no significant difference in age ( Z=-0.447), gender composition ( Z=-0.485), logMAR BCVA ( t=-1.591), intraocular pressure ( t=-0.167) and CMT ( t=-1.290) between two groups ( P>0.05). During the follow-up, the same devices and methods were used at baseline to perform relevant examinations, and the changes of BCVA, intraocular pressure, CMT and new cardiovascular and cerebrovascular events were compared between baseline and the last follow-up. logMAR BCVA, intraocular pressure and CMT were compared between baseline and last follow-up using Student t test. The comparison of injection times and follow-up time between IVR group and IVC group was conducted by Mann-Whitney U test. Results:At baseline, logMAR BCVA, intraocular pressure, and CMT were 0.852±0.431, (12.5±2.5) mm Hg (1 mm Hg= 0.133 kPa), and (578.1±191.1) μm, respectively. At the last follow-up, the number of anti-VEGF drug treatments was (2.7±1.2) times; logMAR BCVA and CMT were 0.488±0.366 and (207.4±108.7) μm, respectively, with CMT > 250 μm in 14 eyes (34.1%, 14/41). Compared with baseline, BCVA ( t=4.129) and CMT ( t=-0.713) were significantly improved, with statistical significance ( P<0.001). The injection times of IVR group and IVC group were (2.6±0.9) and (3.0±1.5) times, respectively. There were no significant differences in the number of injection times ( t=-1.275), logMAR BCVA ( t=-0.492), intraocular pressure ( t=0.351) and CMT ( t=-1.783) between the two groups ( P>0.05). No new hypertension, cardiovascular and cerebrovascular events occurred in all patients during follow-up. At the last follow-up, there were no eye complications related to treatment modalities and drugs. Conclusion:Short-term anti-VEGF treatment can improve the visual acuity of BRVO secondary ME patients and alleviate ME in Lhasa, Tibet. The safety and efficacy of ranibizumab and conbercept were similar.

Objective To observe the clinical value of cone-beam computed tomography (CBCT) combined with iGuide system in percutaneous transthoracic needle biopsy (PTNB) of pulmonary lesions.Methods A total of 30 patients with solitary lung lesion underwent PTNB procedures were enrolled.The needle path was planned with iGuide system and 3D CT-like MPR images after CBCT.A coaxial system with 18-gauge cutting needle was used for biopsy.Procedure related data,complications and radiation exposure of patients were recorded.Results Among 30 patients,malignant lesions were found in 24,and benign lesions were in 6 patients.On PTNB,28 patients were correctly diagnosed,1 case was with insufficient samples but obtained correct pathologic result with second biopsy,1 case was false-negative finding.The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of PTNB in diagnosis of lung diseases was 96.67％ (29/30),96.00％ (24/25),100％ (5/5),100％ (24/24) and 83.33％ (5/6),respectively.The mean procedure time was (13.03+3.61)min,and exposure dose was (7.95+4.57)mSv.After PTNB procedures,pneumothorax and hemoptysis occurred in 6 (6/30,20.00％) and 3 (3/30,10.00％) patients,respectively.Conclusion CBCT combined with iGuide system for guiding PTNB is accurate and safe with reasonable radiation exposure.

Objective To longitudinally analyze microstructural white matter changes in high risk mild cognitive impairment (MCI) patients with DTI.Methods Structural MRI,DTI and psychometric analyses were performed in 102 individuals with 1 year follow-up.At the end of the follow-up,11 participants were diagnosed with MCI (CN-MCI group),while 91 participants were classified as cognitively stable (CN-stable group).The differences of fractional anisotropy (FA) and mean diffusivity (MD) between the two groups were analyzed,and the relationship with MCIs and cognitive ability was observed with multivariate logistic regression analysis.Results At the baseline assessment,MD of CN-MCI group increased in fornix and left parahippocampal gyrus white matter compared with those of CN-stable group (P＜0.05).For 1-year follow-up reassessment,the MD of CN-MCI group increased in the fornix,left parahippocampal gyrus white matter,left eingulum and splenium,while FA of CN-MCI group reduced in fornix and left parahippocampal gyrus white matter compared with those of CN-stable group (P＜0.05).Multivariate Logistic regression analysis showed that MD of the fornix could be a predictor of conversion from a high risk MCI to MCI,and MD of left parahippocampus gyrus white matter was a risk factor for increased CDR scores.Conclusion For high-risk MCI individuals,microstructural white matter changes may be used as potential imaging biomarkers in the early phase of AD.

Objective: To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use.Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI.Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels.Logistic models were applied in multiple analysis adjusting for possible confounders.Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years.Among them, 78.3% were on hypoglycemic therapy.The cutoff points of quartiles of VAI were calculated for the males and females, respectively.According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e.Q1, Q2, Q3, and Q4.The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χ2=12.20, P<0.001).After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM.Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003).With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282).Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI.High level of VAI is an indicator of poor glycemic control.

Objective To investigate the effect of the courses of image diagnostics on clinical pro-bation period via the combination of PBL and multimedia network teaching model. Methods 126 under-graduates from the department of medical image (Grade 2011 and 2012) were selected as teaching subjects, and PBL combined with multimedia network teaching was adopted in the teaching of the course of medical imaging diagnosis. After class we implemented a questionnaire survey, and let the students write learning experience. Statistical analysis was conducted by using SSPS 13.0 to reflect the teaching participation in the students' questionnaire and a. summary analysis of the learning experience of the students was also made. Results 123 valid questionnaires were collected. 94.31%(116 people) of students were active participants in these courses, 90.25%(111 people) of the students thought they could actively communicate in teaching, and 43% (110 people) of the students thought they got fully prepared before class. 123 articles in accor-dance with the requirements of experience were received; most students took positive attitude to the active influence the teaching methods had brought; some student pointed out that the teaching method had the disadvantages such as too much time to prepare, too much information, and so on. Conclusions The com-bination of PBL and multimedia network teaching has preliminary results. It is a novel model that is available for teaching image diagnostics on clinical probation period.

OBJECTIVETo investigate the effects of miR-106b expression on the proliferation of human hepatocellular carcinoma cells.

METHODSReal-time PCR was used to detect the expression of miR-106b in human hepatocellular carcinoma (HCC) cell lines and normal liver epithelial THLE3 cells. Over-expression of miR-106b was transfected by miR-106b mimics, and inhibition of miR-106b expression was transfected by miR-106b inhibitors. The effects of miR-106b expression on the proliferation of HCC cells were detected by MTT, clone formation assay and anchorage-independent growth ability assay. Bromodeoxyuridine labeling and flow cytometry analysis were used to examine the effects of miR-106b expression on the cell cycle distribution of the HCC cells.

RESULTSCompared with that in the normal liver epithelial THLE3 cells, the relative expression of miR-106b in HepG2, QGY-7703, BEL-7402, MHCC97H, HCCC-9810, Hep3B, MHCC97L and Huh7 cell lines were 5.37 ± 0.35, 8.45 ± 0.75, 19.22 ± 1.74, 11.93 ± 1.26, 17.03 ± 0.97, 4.19 ± 0.67, 7.94 ± 1.35 and 3.82 ± 0.87, respectively (P < 0.05 for all). Three days after transfection, the miR-106b over-expression was accelerated, while miR-106b inhibitor suppressed the proliferation of HCC cells. The numbers of clones formed were (4.13 ± 0.75) and (3.78 ± 0.47) times higher than that of control cells, and (147.73 ± 15.56) and (138.87 ± 15.58) clones in diameter >1.0 mm were formed by miR-106b-overexpressing cells. When the miR-106b expression was inhibited in the HepG2 and QGY-7703 cells, the clone numbers were (0.18 ± 0.05) and (0.24 ± 0.07) times of that in the controls, and the numbers of clones formed were (23.29 ± 7.14) and (20.60 ± 8.07) (P < 0.05 for all). The positive rates of BrdU labeled miR-106b-overexpressing HepG2 and QGY-7703 cells were (51.89 ± 4.91) % and (54.74 ± 6.10) %, those of the miR-106b-inhibited cells were (6.48 ± 3.15) % and (7.52 ± 2.03) %, significantly different from that in the control cells (P < 0.05 for all). The S phases were dramatically increased from 29.93% and 31.04% to 56.76% and 57.22% in the miR-106b-overexpressing HepG2 and QGY-7703 cells, while they were 19.43% and 19.92% in the miR-106b-inhibited HepG2 and QGY-7703 cells.

CONCLUSIONSMiR-106b overexpression may promote the proliferation and metastasis of HCC cells. The mechanism of this effect may be related to promoting cells into S phase and inhibiting cell apoptosis.

Apoptosis ; Carcinoma, Hepatocellular ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; metabolism ; Real-Time Polymerase Chain Reaction ; Transfection

Objective:To compare the huge changes in working process between complete digital radiology and conventional radiology (screen-film system). Methods: Through analysis of the pre-digital and post-digital working processes, the different working effectiveness were analyzed. Results: The working effectiveness of post-digitization transcended that of pre-digitization evidently, especially in waiting time, delivery and archive of reports and images, and accuracy of diagnosis. Conclusion:Digital radiology is a development direction in the future, which can increase the working effectiveness and detectability of disease.

According the development requirement of medical imaging skill,centered on diseases,we discussed the teaching reform of imaging diagnostics course,including the optimized integration of the course,bilingual teaching,teaching methods,format of subject test and strengthening practice teaching,hoping to improve the whole team' professional quality.

Objective To explore the clinical efficacy of interventional therapy for transplant renal artery stenosis (TRAS) after allograft renal transplantation.Methods Twenty-two patients with TRAS were treated with interventional therapy,including 10 patients (balloon group) underwent percutaneous transluminal angioplasty (PTA) and 12 patients (stent group) underwent stent implantation.The blood pressure,renal function and quality of life were recorded before and after interventional therapy within two years.Besides,two groups were compared with another group of 6 patients (medicine group) receiving medical treatment only.Results The technical success rate was 90.00% for PTA and 100%for stent implantation.The interventional treatment of TRAS with PTA or stent implantation was associated with significant improvement in blood pressure and renal function,while the conservatively medical treatment of TRAS was inefficient.There was no statistical difference in the short-term improvement of blood pressure or renal function between balloon group and stent group.Six to twenty-four-month follow-up indicated that there were 2 patients with restenosis (2/12,1 6.67%) in stent group.The total restenosis rate for PTA was 40.00%.Eleven patients in stent group achieved normal daily activities and works,except one was treated ineffectively with an uncertain cause.Conclusion Stent implantation for TRAS,especially for TRAS of type Ⅰ and Ⅱ,can be used as the primary therapy.

Objective To summarize the experience of adjuvant therapy for primary hepatocellular carcinoma. Methods 316 cases of operable hepatocellular carcinoma were divided into three groups. Only hepatectomy were performed in group one (21 8cases).Preopemtive adjuvant TACE were done in group two (52 cases). Preoperative adjuvant TACE and postoperative trans-portal vein chemotherapy were done in group three (46 cases), which was named hepatectomy sequencing two vessel therapy. Results 1, 3 and 5 year survival rote were 51.2 %, 30.0 % and 20.5 % respectively in group one, 57.2 %, 43.0 % and 31.5 % in group two, 84.0 %, 62.5 % and 51.0 % in group three. The postoperative disease-free survival rate in group three was significantly higher than that in group one and group two (P ＜0.05). Conclusion Hepatectomy sequencing two vessels therapy in perioperative period might improve the survival rate, which can prevent and delay the incidence of recurrence and may improve the effect of liver resection.