ObjectiveTo investigate the clinical, laboratory and imaging evaluation, treatment and prognosis of patients with idiopathic hypertrophic pachymeningitis (IHP) with ophthalmic manifestations as the first symptom.MethodsA retrospective case analysis. Eight patients displaying symptoms of IHP were recruited from the Neuro-ophthalmology Department in the First Medical Center of Chinese PLA General Hospital from January 2016 to April 2019 were inculed in this study. There were 6 males and 2 females, aged from 11 to 65 years, with an average age of 48.00±19.08 years. The course of disease ranged from 30 days to 7.5 years, with an average course of 17.00±30.08 months. The age, symptoms and signs of all patients were recorded. All patients underwent ophthalmic examination, orbit or brain MRI or CT examinations, blood routine examination, biochemistry, tumor markers, immunity, hepatitis B, syphilis, HIV, thyroid function and other laboratory tests, and lumbar puncture was performed to measure the cerebrospinal fluid (CSF) pressure and indicators. The clinical manifestations, orbital or brain MRI imaging and laboratory examination characteristics were summarized. Treatment and prognosis were also observed.ResultsIn total of 8 patients, visual loss was presented in 6 patients, visual loss and diplopia were presented in 1 patient, and diplopia was presented in 1 patient. Binocular involvement in 7 patients and monocular involvement in 1 patient. Other symptoms including headache and hear loss and so on. Optic disc edema in 1 eye and optic disc pallor in 6 eyes were reviewed by fundus examination. The laboratory examination showed that the angiotensin converting enzyme abnormal in 4 patients, the anti-thyroid peroxidase antibody abnormal in 3 patients and immunoantibodies positive in 3 patients. CSF measurements showed that the protein level elevated in all patients. Orbit and/or brain MRI and CT examination showed that optic nerve involvement in 6 patients, oculomotor nerve involvement in 1 patient, and cavernous sinus region involvement in 2 patients. Glucocorticoid was effective in all patients, and the visual acuity significantly improved in 4 patients, the diplopia was completely resolved in 2 patients, and the disease modifying therapy (DMT) was combined to prevent recurrence in 7 patients. No recurrence was observed in an average follow-up time of 26.63±16.55 months.ConclusionsIHP patients may be first visit an ophthalmologist due to vision loss in bilateral eyes simultaneous or sequentially. IHP patients are often associated with headache and other cranial nerve paralysis symptoms. Definitive diagnosis of IHP depends on imaging examination. Glucocorticoid treatment is effective in early phase, but it is tendency to progress and relapse, suggesting combined with DMT as early as possible.
Objective To observe the clinical features and treatment outcomes of presumed tubercular retinal vasculitis. Methods This is a retrospective non-comparative interventional clinical research. A total of nine patients (11 eyes) with major presentation of retinal vasculitis were included in this study. Patients first consulted the eye clinic and were diagnosed presumed tubercular retinal vasculitis. The patients, seven males and two females, aged from 19 to 66 years, with an average of 43.89 years. The time interval from symptoms to diagnosis ranged from two weeks to six months with an average of 76.27 days. Visual acuity, slit lamp ophthalmoscopy, fundus fluorescein angiography (FFA), optical coherence tomography (OCT), hematological and tuberculosis related investigations were examined and analyzed. All patients had standard anti-tuberculosis treatment. Treatment outcomes were followed for six to 37 months with an average of 14.11 months. Results Baseline visual acuity ranged from hand movement to 0.8 with an average of 0.28. Among 11 eyes, six presented mild to moderate vitritis, five presented as retinal vein occlusion with no obvious vitirits. Fundus examination showed six cases with retinal hemorrhage, four cases with macular edema, two with macular epiretinal membrane, and two with vitreous hemorrhage. FFA revealed 11 cases with leakage of vessels, 11 with nonperfusion area, four with macular edema, three with retinal neovascularization, and two with choroidal lesions. OCT of nine eyes suggested six eyes with retinal edema, three with macular edema, three with macular epiretinal membrane. TST of seven patients were all b positive. T-SPOT.TB of four patients were all positive. Three of eight patients who had chest X-ray or chest CT were suggested tuberculosis infection. Four to six weeks after the start of anti-tuberculosis treatment, vitritis, exudates, retinal and macular edema subsided. During follow up, inflammation was stable with no recurrence observed. The visual acuity of last follow-up ranged from 0.15 to 0.8 with an average of 0.51. Conclusions The main presentations of presumed tubercular retinal vasculitis are vitritis, retinal vein occlusion, and retinal hemorrhage. Standard anti-tuberculosis treatment can improve inflammation and retinal hemorrhage.
Objective To investigate the effect of exogenous Rb gene on the cell cycle of vitreous retinoblastoma (RB) transplantation tumor in nude mouse. Methods Based on establishing vitreous RB transplantation tumor in nude mouse,constructing retrovirus vector of Rb gene PBabe-Rb and transfecing it into the RB transplantation model by liposome Dosper,the change of cell cycle of the RB transplantation tumor by flow cytometry(FCM)was analysed． Results FCM showed that the cells of G1phase of the treated eyes were obviously more than the control eyes with the value of DNA index(DI)and S phase fraction(SPF) decreased by the Rb gene expression. Conclusion The exogenous PBabe-Rb gene can partially suppress the progress of the cell cycle of RB transplantation tumor in vivo. (Chin J Ocul Fundus Dis，2000，16：1-70)
ObjectiveTo evaluate the protective effect of estrogen on survival of retinal ganglion cells (RGCs) after transient retinal ischemia-reperfusion (RIR) in rats.MethodsRIR was induced in 60 ovariectomized adult rats (OVX) by increasing intraocular pressure via an intracameral catheter. All of the rats were divided into two groups randomly: in experimental group, the rats underwent a subcutaneous injection with 17β-estrodiol（100 μg/kg） 2 hours before retinal ischemia; and in the control group, saline water was injected correspondingly. The number of RGCs and the thickness of the inner retinal layers were mesured by HE staining method before and 12, 24, 48, and 72 hours after reperfusion. TdT-mediated biotin-dUTP nick end labelling (TUNEL) staining technique was used to examine the apoptosis of RGCs.ResultsTwenty-four and 48 hours after reperfusion, the number of apoptotic cells in experimental group was obvious lower than that in the control group(Plt;0.05), and the number of RGCs in experimental group was higher than that in the control group(Plt;0.05).ConclusionEstrogen can protect retinal neurons from transient RIR in ovariectomized rats.(Chin J Ocul Fundus Dis, 2005,21:177-179)
ObjectivesTo conduct a bibliometric analysis to research the status of disease burden domestically and overseas so as to understand the status of diseases burden, and to provide scientific and reasonable reference for health disease prevention, control strategies formulation and future research.MethodsPubMed, Web of Science, EMbase, The Cochrane Library, WanFang Data, CBM and CNKI databases were electronically searched to collect literature on disease burden from inception to October, 2018. Two reviewers independently screened literature and extracted data. EndNote X7 software was used for literature management, Excel 2016 software and VOS viewer software were also used to analyze data. Literature was classified by the aspects of literature publication characteristics, diseases, background areas, influencing factors, evaluation indicators and poverty caused by illness.ResultsA total of 325 studies were included in the bibliometric analysis. 41 articles (12.6%) were published in journals indexed by SCIE; original research evidence accounted for 97.0% (315 articles); 272 articles were from China (83.7%). The main diseases involved were malignant tumors (58 articles, 17.8%), diabetes (29 articles, 8.9%) and hypertension (24 articles, 7.4%). Factors affecting the disease burden primarily included hospitalization days (9 articles, 2.8%), complications (5 articles, 1.5%), delays in treatment (5 articles, 1.5%), and economic income (4 articles, 1.2%). Sixity-one articles (18.8%) reported poverty due to illness, and related diseases were chronic obstructive pulmonary disease (12 articles, 3.7%), hypertension (10 articles, 3.1%), diabetes (10 articles, 3.1%), malignant tumors (9 articles, 2.8%) and hepatitis B (6 articles, 1.8%).ConclusionsAt present, the disease burden research are focusing more on the burden of chronic non-communicable diseases such as malignant tumors, hypertension, diabetes, cardiovascular and cerebrovascular diseases in developing countries and regions. Medical costs vary from different diseases and treatment, different demographic characteristics of patients, and the coverage medical security of different population are the primary reasons for the " expensive in medical treatment” of current residents and the heavy burden of disease. DALY and total direct medical expenses are the main evaluation indexes of epidemiological burden and economic burden of disease, respectively. Future researches should focus on strengthening the scientific nature of study design to improve the quality of research, as well as paying more attention to diseases and aspects that are rarely involved, such as major diseases caused by poverty due to illness, comprehensive analysis of multiple diseases and aspects of health investment measurement, and comprehensively use the evaluation indicators of disease burden to strengthen the research on the comparability index of disease economic burden.
Objective To establish a purified model of rat retinal ganglion cells （RGCs） cultured by serum-free medium，and provide a good cell model to investigate the damage of RGCs in glaucoma，retinal ischemia，and degenerative retinopathy. Methods Two monoclonal antibodies，anti-rat SIRP（OX-41）against rat macrophage and antibody against rat Thy-1（OX-7），were used to purify and characterize RGCs from 1-3-day old Sprague-Dawley（SD）rats by means of two-step filtration.Purified RGCs were cultured in serum-free neurobasal medium containing B27 and ciliary neurotrophic factor（CNTF） meeting the neuronal cellrsquo;s special requirements.Photomicrographs illustration，immunfluorescence staining of Thy-1，calcein-acetoxymethyl ester（calcein-AM）fluorescence images were used to observe and identify cultured retinal cells and purified RGCs. Results Among the primary cultured rat retinal cells，91% were retinal neurons.Protuberances of RGCs were seen after cultured for 24 hours.At the4th to 8th day，many cells had uniform configuration，large body，and long protuberances. At the 14th day，over 60% cells maintained viability.Immunoflurescence staining of Thy-1 showed the purity of RGCs was about 90%. The results of calcein-AM staining，which stained the living cells only，showed large cell body of RGCs and most of RGCs had a protuberance whose length was twice longer than the diameter of the cells. Conclusion RGCs cultured by serum-free medium has uniform size，good configuration，and high purity，which is adapt to the research of damage of RGCs caused by various factors and to evaluate the protective effects of neuroprotective agents. (Chin J Ocul Fundus Dis, 2006, 22: 200-203)
Objectives To investigate the disease composition and medical costs of in patients with chronic kidney disease (CKD) in People's Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2017. Methods To retrieve the records of patients with CKD, and to classify the main diagnosis of the first page of the medical record according to the International Classification of Diseases (ICD-10) standard. Data was analyzed using Excel 2010 and SPSS 19.0 software. Results A total of 11 650 CKD patients were included, with a sex ratio of 1.48 to 1. The patients were mainly young and middle-aged, accounting for 75.56%. The top 11 diseases of CKD patients were chronic glomerulonephritis, membranous nephropathy, diabetic nephropathy, IgA nephropathy, hypertensive nephropathy, minimally pathological nephritis, focal segmental glomerulosclerosis, lupus nephritis, Polycystic kidney disease, chronic interstitial nephritis and purpuric nephritis. The per capita hospitalization days of CKD patients was 11.23 days, and the per capita medical expenses was 1.51 million yuan. Significant differences were found in different genders, ethnic groups, age groups, disease composition and CKD staging. The medical expenses of CKD patients were mainly medicine and inspection fees, accounting for 71.35%. Conclusions Inpatients of CKD in the People's Hospital of Xinjiang Uygur Autonomous Region have a heavy disease burden and large difference in their conditions.
Purpose To observe the pathologic changes of retinal photic injury in mice. Methods A light damaged trunk was designed by ourselves.The mice were given an intermitent light exposure for 3 days,12 hours light exposure every day and 12 hours dark adaption before every exposure.Experimental animals were sacrificed on the 1st,6th,12th,18th and 30th day after light injury,and the eyes were enucleated for light and electronic microscopy observation. Results The early pathologic changes including disc membrance swelling,disorganization in outer segments,and mitochondrial swelling,spherical change in inner segments．Then the chromatin densification,liquefaction and margination,and the shrinkage of nuclear membrance were found in the nuclear layer.Finally the outer nuclear layer became thin and disappeared.The apical microvill of RPE cell disappeared and basic fold became flat in some samples. Conclusion The photoreceptor degeneration was the pathologic characteristic of retinal photic injury in mice. (Chin J Ocul Fundus Dis,1998,14:215-218)
OCT angiography (OCTA) is a fast, noninvasive and quantifiable new technique, which is especially suitable for long-term follow-up in patients with hereditary retinochoroidal degeneration, such as retinitis pigmentosa, Best vitelliform macular dystrophy, adult onset foveomacular vitelliform dystrophy, doyne honeycomb retinal dystrophy, choroideremia and Stargardt disease. During the follow-up, clinicians can find the subtle signs that explain disease development from the blood flow imaging, quantitatively describe the vascular density, timely detect and treat choroidal neovascularization. It is significant to explore the etiology and monitor the course of these diseases. With the development of more treatments for these diseases, OCTA parameters can also be used as indicators to evaluate and compare different therapeutic effects. In the future, more quantitative indicators of OCTA will be applied to evaluate the course of hereditary retinochoroidal degeneration, and provide valuable basis for early diagnosis and treatment.
The serum activities of 3 cytokines (TNF,IL-1 and IL-6) were observed in 23 patients admitted within 4 days of onset of acute pancreatitis (AP). The results showed that the serum level of 3 cytokines raised in all of the AP patients, significant difference between TNF and IL-1 was abserved at admission and IL-6 did after one week of admission, suggesting that proper cytokine criteria are useful in predicting severity of the disease but the relationship between cytokines and MOF had not established.