Unilateral branch retinal artery occlusion in a patient with systemic lupus erythematosus: A case report

Rationale:Ocular involvements in systemic lupus erythematosus (SLE) are not rare but extremely varied. Here we present a very meaningful case with unilateral branch retinal artery occlusion (BRAO) secondary to undetected SLE, for which immunotherapy showed significant effect, which led to complete resolution of macular edema.Patient concerns:A 31-year-old female patient, so far without any previous illnesses, presented with a sudden onset of painless diminution of vision in left eye for 5 days. Diagnosis: Signs of branch retinal artery occlusion and macular ischemic edema were observed on the left fundus, which was further confirmed by Fundus fluorescein angiography and OCT. BRAO was initially proposed. However, after ophthalmological treatment for BRAO, visual acuity and macular edema improvement was limited. Physical examination revealed erythema on the hands and feet, together with her experience of hair loss and joint pain. The patient was diagnosed with SLE.Interventions and outcomes:The patient received systemic immunotherapy, which resulted in visual improvement to 20/20.Lessons:This is a rare monocular vaso-occlusive retinopathy in SLE with mainly diffuse nonperfusion and small arterial and arteriolar occlusion in the retina, as distinct from more common vasculitis. Even without intravitreal injection of anti-VEGF, systemic immunotherapy can be effective for the treatment of macular edema.     

CR与屏(铜)-片成像在头颈部肿瘤放疗射野影像验证中的比较应用

目的 评价计算机X线摄影(CR)与屏(铜)-片成像在头颈部肿瘤放疗射野影像验证中的应用价值.资料与方法 40张验证片中,20张采用传统屏(铜)-片摄影,20张采用CR摄影.由4名观察者分别对其进行评价,评价标准参照欧共体提供的影像标准,分"可见"、"再现"及"清晰再现"三级,取其平均百分比.采用SPSS 11.0统计软件包对观察者之间的一致性作方差分析.结果 CR的"可见"率为18.75%,"再现"率为71.25%,"清晰再现"率为10%;屏(铜)-片的"可见"率为71.25%,"再现"率为28.75%,"清晰再现"率为0.对比分析有意义的"再现"率与"清晰再现"率之和,CR组为81.25%,而屏(铜)-片组仅为28.75%.单因素方差分析结果显示观察者之间的一致性无统计学意义(P＞0.05).结论 CR成像在头颈部肿瘤放疗射野影像验证中较屏(铜)-片成像具有更好的显示效果.     

左侧乳腺癌保乳术后ABC与Catalyst呼吸门控系统动态调强放疗的剂量学分析

目的 对比自主呼吸门控系统(ABC)和Catalyst呼吸门控系统在左侧乳腺癌保乳术后的剂量学差异。方法 回顾性选取深圳市人民医院放疗科2020年11月至2021年8月收治的左侧乳腺癌保乳术后女性患者48例,分成ABC和Catalyst组,设计动态调强放疗(IMRT)计划。分析2组计划的靶区和危及器官的剂量学差异。结果 2组呼吸门控IMRT计划在胸壁靶区的D_90%、D_98%、D_max、D_mean、适形指数、均匀性指数及机器跳数方面差异无统计学意义(P＞0.05)。2种呼吸门控深吸气屏气(DIBH)模式IMRT计划在患侧肺、心脏方面差异无统计学意义(P＞0.05)。ABC组和Catalyst组冠状动脉左前降支D_mean、D_max、D_2%依次为(1 047.72±1 401.84)vs.(454.48±206.26)、(1 619.28±809.05)vs.(1 068.53±419.63)、(1 405.85±798.30)vs.(1 016.54±592.00) cGy,Catalyst优于ABC呼吸门控组,差异有统计学意义(t=-2.07、-3.18、-2.07,P＜0.05)。结论 ABC和Catalyst呼吸门控系统均满足临床治疗要求,Catalyst较ABC呼吸门控可进一步降低冠状动脉左前降支受照射剂量。     

Clinical Characteristics and Long-term Outcomes of Pediatric Ulcerative Colitis: A Single-Center Experience in Korea

Background/AimsAlthough pediatric ulcerative colitis (UC) has a different phenotype and clinical course than adult UC, its clinical features and outcomes are poorly defined, especially in Asian populations. This study investigated the clinical features and long-term outcomes of pediatric UC in a Korean population.MethodsWe retrospectively analyzed 208 patients aged <18 years diagnosed with UC between 1987 and 2013. The patient characteristics at diagnosis according to the Paris classification and the clinical course were analyzed.ResultsThe male-to-female ratio was 1.31, and the median patient age was 15.5 years. At diagnosis, 28.8% of patients had proctitis (E1), 27.8%, left-sided colitis (E2); 5.2%, extensive colitis (E3); and 38.2%, pancolitis (E4). The cumulative probabilities of extension after 5, 10, 15, and 20 years were 32.7%, 40.4%, 52.5%, and 65.8%, respectively. Eighteen patients underwent colectomy, and three patients had colorectal cancer. The cumulative probabilities of colectomy after 5, 10, 15, and 20 years were 7.1%, 8.9%, 12.6%, and 15.6%, and those of colorectal cancer after 10, 15, and 20 years were 0%, 2.1%, and 12.0%, respectively. The disease extent, Pediatric Ulcerative Colitis Activity Index severity, and systemic corticosteroid therapy were significant risk factors for colectomy. The development of primary sclerosing cholangitis was significantly associated with colorectal cancer.ConclusionsThis study provides detailed information on the disease phenotype and long-term clinical outcomes in a large cohort of Korean children with UC. They have extensive disease at diagnosis, a high rate of disease extension, and a low rate of cumulative colectomy.     

Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study

Background/AimsThe long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the long-term prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort.MethodsOutcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015.ResultsDuring a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68).ConclusionsThe long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades.     

A Tug of War: Pseudorabies Virus and Host Antiviral Innate Immunity

The non-specific innate immunity can initiate host antiviral innate immune responses within minutes to hours after the invasion of pathogenic microorganisms. Therefore, the natural immune response is the first line of defense for the host to resist the invaders, including viruses, bacteria, fungi. Host pattern recognition receptors (PRRs) in the infected cells or bystander cells recognize pathogen-associated molecular patterns (PAMPs) of invading pathogens and initiate a series of signal cascades, resulting in the expression of type I interferons (IFN-I) and inflammatory cytokines to antagonize the infection of microorganisms. In contrast, the invading pathogens take a variety of mechanisms to inhibit the induction of IFN-I production from avoiding being cleared. Pseudorabies virus (PRV) belongs to the family Herpesviridae, subfamily Alphaherpesvirinae, genus Varicellovirus. PRV is the causative agent of Aujeszky’s disease (AD, pseudorabies). Although the natural host of PRV is swine, it can infect a wide variety of mammals, such as cattle, sheep, cats, and dogs. The disease is usually fatal to these hosts. PRV mainly infects the peripheral nervous system (PNS) in swine. For other species, PRV mainly invades the PNS first and then progresses to the central nervous system (CNS), which leads to acute death of the host with serious clinical and neurological symptoms. In recent years, new PRV variant strains have appeared in some areas, and sporadic cases of PRV infection in humans have also been reported, suggesting that PRV is still an important emerging and re-emerging infectious disease. This review summarizes the strategies of PRV evading host innate immunity and new targets for inhibition of PRV replication, which will provide more information for the development of effective inactivated vaccines and drugs for PRV.     

Irradiated microvascular endothelial cells may induce bystander effects in neural stem cells leading to neurogenesis inhibition

Radiation-induced neurocognitive dysfunction (RIND) has attracted a lot of attention lately due to the significant improvement of the survival of cancer patients after receiving cranial radiotherapy. The detailed mechanisms are not completely understood, but extensive evidence supports an involvement of the inhibition of hippocampal neurogenesis, which may result from radiation-induced depletion of neural stem cells (NSCs) as well as the damage to neurogenic niches. As an important component of neurogenic niches, vascular cells interact with NSCs through different signaling mechanisms, which is similar to the characteristics of radiation-induced bystander effect (RIBE). But whether RIBE is involved in neurogenesis inhibition contributed by the damaged vascular cells is unknown. Thus, the purpose of the present study was to investigate the occurrence of RIBEs in non-irradiated bystander NSCs induced by irradiated bEnd.3 vascular endothelial cells in a co-culture system. The results show that compared with the NSCs cultured alone, the properties of NSCs were significantly affected after co-culture with bEnd.3 cells, and further change was induced without obvious oxidative stress and apoptosis when bEnd.3 cells were irradiated, manifesting as a reduction in the proliferation, neurosphere-forming capability and differentiation potential of NSCs. All these results suggest that the damaged vascular endothelial cells may contribute to neurogenesis inhibition via inducing RIBEs in NSCs, thus leading to RIND.     

雷贝拉唑钠肠溶片的制备及溶出度考察

目的制备雷贝拉唑钠肠溶片并考察其溶出度。方法应用3因素3水平的正交试验设计进行片心处方筛选,采用高效液相色谱法对肠溶片进行溶出度(释放度)测定。结果所制得的片剂外观洁白,硬度达到40 N以上,30 min内溶出度达到80%以上。结论该工艺条件稳定,用所筛选的处方制备的肠溶片达到设计要求,适于工业化生产。     

涎腺腺泡细胞癌的临床病理分析

目的:探讨涎腺腺泡细胞癌(AciCC)的临床病理特征及与生物学行为相关的病理因素。方法 :收集1988—2011年,四川大学华西口腔医院的腺泡细胞癌病例68例,进行临床病理学分析和随访调查。结果:平均发病年龄为44.4岁,20岁以下4例(5.9%),男女比例为1∶1.13;就诊平均病程为45.2个月。肿瘤发生于腮腺为57例(83.8%)、腭部为4例(5.9%)、颊部为3例(4.4%)、颌下腺为2例(2.9%)。68例AciCC中,56例获随访信息,随访率为82.4%。复发率为26.5%,颈部淋巴结转移率为8.82%,5年生存率为98.21%。肿瘤间质中有大量淋巴样细胞浸润的患者,复发率较低(P<0.05)。结论:AciCC肿瘤间质中大量淋巴样细胞浸润,是提示患者预后较好的一个病理指标。     

微孔钛网应用于犬牙槽骨增量术中的实验研究

目的探究微孔钛网在犬下颌牙槽骨增量术中的作用效果。方法选择6只成年健康杂种犬,建立双侧下颌牙槽骨缺损动物模型。将每只犬的左侧下颌牙槽骨缺损区作为第Ⅰ组,右侧作为第Ⅱ组。两组均采用GBR+自体骨修复牙槽骨缺损,第Ⅰ组采用微孔钛网,第Ⅱ组采用海奥口腔修复膜。观察植骨术后4周、8周、12周时两组大体标本、Masson染色、HE染色、荧光素标记、CT三维重建后骨微结构参数的结果。结果术后12周第Ⅰ组及第Ⅱ组植骨区域表面均形成明显新生软骨组织,移植骨与原骨之间界限模糊,其中第I组新生成骨面积略大于第Ⅱ组,新生成骨形态略优于第Ⅱ组,其它方面大体标本上肉眼观察结果差异不明显,两组牙槽嵴高度比较也无显著差异(P>0.05)。Masson染色及HE染色显示两组均有明显新生骨组织、骨小梁生成。术后12周两组骨矿化率比较无显著差异(P>0.05)。术后12周两组骨小梁数量、骨小梁厚度、骨体积比较也无显著差异(P>0.05)。结论微孔钛网在犬下颌牙槽骨缺损的GBR手术中能获得良好成骨效果,临床中可根据患者具体情况,合理应用。