[In Press] Optical coherence tomography with or without enhanced depth imaging for peripapillary retinal nerve fiber layer and choroidal thickness

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference(P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P＜0.001). Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI (103.25±9.42 μm vs 101.87±8.78 μm, P=0.010). The ICC of the two protocols was excellent with the value of 0.867 to 0.924, the 95% LoA of global RNFL thickness was between -10.0 to 7.4 μm. Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI (147.23±51.04 μm vs 150.90±51.84 μm, P＜0.001). The ICC was also excellent with the value of 0.960 to 0.987, the 95% LoA of global choroidal thickness was between -12.5 to 19.8 μm. CONCLUSION: Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.     

Expert consensus on treating esophageal stenosis in children by magnetic recanalization

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IgG4 and IgE co-positive group found in idiopathic orbital inflammatory disease

AIM: To reveal the cytokines involved in idiopathic orbital inflammatory disease (IOID) and the relationship between Th17 cells, IgE and IOID pathogenesis. METHODS: Whole blood samples were processed immediately after collection and serological IgG4, IgG, and IgE antibodies were tested using ELISA. IOID and orbital cavernous hemangioma (CH) tissue samples underwent Bio-Plex multiplex cytokine detection. Hematoxylin-Eosin (HE) staining of all paraffin samples suggested the histological features of IOIDs, and expressions of IgG4 and IL-17A in affected tissues were detected by immunohistochemistry. RESULTS: Among 40 IOID plasma samples, 52.5% (21/40) were positive for IgG4 and 25% (10/40) were positive for IgE. Overlapped IgG4 or IgE positive samples accounted for 22.5% (9/40). Therefore, IOID samples were separated into three groups. The IgE+/IgG4+ group had a relevantly lower level of pro-inflammatory cytokine expression. IL-4 (Th2 cell related), IL-10 and TGF-β1 (Treg cell immunity related) were elevated in all three groups. Some of the Th17 cell related cytokines (i.e. IL-17A/F, IL-25, IL-23, and IL-33) displayed higher expression levels in the IgE-/IgG4- group compared to the other two groups. CONCLUSION: We discovered an IgG4-IgE co-positive group as well as Th17 cell immune involvement in IgG4-IgE co-negative subgtroup in IOID for the first time. The pathogenesis of IOID could differ from different subgroups according to the IgG4 and IgE detection. Therefore, we recommend that, Treatment stratagy should be made according to the clinical assessment of IgG4-IgE and Th17 profile detection.     

正交试验优选利胆排石胶囊的水煎提取制备工艺

摘 要 目的： 优选利胆排石胶囊的水煎提取制备工艺。 方法: 以浸膏得率、大黄素含量和大黄酚含量作为考察指标,采用L₉(3⁴)正交试验优选利胆排石胶囊最佳水煎提取制备工艺。结果:最佳制备工艺条件为加14倍量的水、煎煮4次、每次2 h。结论: 水煎提取制备工艺易于操作,合理可行。     

婴儿胆汁淤积性肝病的病因学研究进展

目的：分析芜湖市第一人民医院儿童药品不良反应（ADR）发生的特点和规律,为儿童临床合理用药提供参考。方法：对2012-2018年我院收集的144例儿童ADR进行回顾性分析。结果：144例ADR患儿中,男81例（56.25%）,女63例（43.75%）;学龄前期发生的ADR最多（29.86%）;抗感染药引发的ADR居首位,涉及17个药物品种,共64例（44.44%）,其中以头孢菌素类为主,共26例（40.63%）;ADR主要累及皮肤及其附件,共74例（48.37%）,主要临床表现为皮疹、瘙痒。结论：儿童ADR的发生与药物类型、品种等多种因素相关,临床应加强重视,减少ADR的发生。     

重症监护室日记对生存患者及家属心理状态和生活质量影响的meta分析

目的评价重症监护室(intensive care unit, ICU)日记对生存患者及家属心理状态和生活质量的影响。方法计算机检索PubMed、MEDLINE、EBSCO、OVID、The Cochrane Library、Proquest、中国知网、万方、维普等数据库ICU日记文献,检索时段为建库至2021年3月。由两名研究者进行文献筛选、资料提取和质量评价,应用RevMan 5.3统计软件进行meta分析。结果共纳入21篇文献,2 056例患者,797名家属。Meta分析结果显示,ICU日记能减少重症患者创伤后应激障碍(post traumatic stress disorder, PTSD)(OR=0.55,95%CI:0.41～0.74,P<0.01)和家属PTSD阳性症状(OR=0.34,95%CI:0.18～0.63,P<0.01),改善患者的抑郁程度(OR=0.58,95%CI:0.38～0.90,P=0.01),但对患者的生活质量和焦虑程度改善效果不明显(P>0.05)。ICU日记对减轻家属焦虑和抑郁状况的效果不明确(P>0.05)。结论 ICU...     

水甘油通道蛋白7与原发性肝细胞癌的相关性研究

目的：检测水甘油通道蛋白7（aquaglyceroporin,AQP7）是否在肝组织中有表达,并观察其在原发性肝细胞癌（human hepatocellular carcinoma,HCC）组织及其配对癌旁肝脏（non-tumourigenic liver,NTL）组织,以及正常肝脏（normal liver,NL）组织中的表达差异,并结合临床病理探讨AQP7与HCC发生发展的相关性。方法：收集34例HCC患者的HCC组织及其配对NTL组织和4例NL组织,分别应用real-time PCR法、蛋白免疫印迹（Western blot）法、免疫组织化学技术,在基因与蛋白、定性及定位层面检测HCC及NTL、NL组织中AQP7的表达情况。收集临床病理资料,分析AQP7的差异表达与患者临床病理参数的相关性。结果：（1）AQP7在所有HCC及NTL、NL组织中均有表达,免疫组化结果显示其主要表达于肝细胞胞膜及胞浆。（2）在HCC组织中AQP7的表达量无论在基因还是蛋白水平明显低于NTL与NL组织,NTL与NL组织中AQP7的表达量无明显差异：mRNA水平,NL组表达量与NTL组相比,无统计学差异（P=0.072）,HCC组表达量明显低于NTL组（t=3.841,P=0.000）及NL组（P=0.001）;蛋白水平,NL组与NTL组无明显统计学差异（t=0.264,P=0.798）,HCC组表达量明显低于NTL组（t=7.333,P=0.000）及NL组（t=5.648,P=0.011）。（3）应用多元线性回归分析法分析患者HCC组织中AQP7降低的差值与临床参数的相关性分析,发现有淋巴结转移的患者降低幅度更大（t=-2.837,P=0.008）。回归方程为：Y=1.612-0.472 X7（F=8.048,P=0.008）。结论：AQP7在人肝脏组织上有大量表达,主要表达于肝细胞胞膜及胞浆,且在ＨＣＣ组织上表达较其配对ＮＴＬ组织及ＮＬ组织表达明显降低,有淋巴结转移的患者降低幅度更大。     

中国10个地区成年人共病流行特征分析

目的:描述中国成年人的共病流行情况及其长期变化,以及常见的共病模式。方法:本研究纳入参与中国慢性病前瞻性研究第二次重复调查的25 033人,利用研究对象参加2004-2008年基线调查和2013-2014年第二次重复调查时采集的信息进行分析。根据自报疾病史、现场体格检查及血液样本检测等信息定义了13种慢性病或健康问题,...     

经颅直流电刺激对精神分裂症伴迟发性运动障碍患者空间工作记忆的影响

目的探讨经颅直流电刺激(tDCS)对精神分裂症伴迟发性运动障碍(TD)患者空间工作记忆的影响。方法选取2017年6月至2018年1月来源于苏州市广济医院、苏州市社会福利总院、太仓市精神卫生中心、南充市第六人民医院四家精神专科医院的38例住院精神分裂症伴TD患者,随机分为试验组(21例)和对照组(17例)。研究期间,两组患者均接受常规药物治疗,试验组予以tDCS治疗,采用的电流为2 mA,刺激部位为左侧背外侧前额叶皮质及对侧眶上缘;对照组相应地予以伪tDCS治疗。在基线期、治疗15次结束后及2周后进行随访,采用剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)模块分别对两组患者进行认知测评。结果在完成15次治疗后,试验组SWM指标分析中的总错误数[31.00(28.50,49.00)]、平均第一次响应时间(4盒子)[3289.500(1871.750,5018.000)ms]、平均第一次响应时间(6盒子)[2862.500(2128.500,4672.250)ms]、平均第一次响应时间(8盒子)[3328.500(2611.250,5120.750)ms]与对照组比较,差异无统计学意义(P>0.05);试验组SWM指标分析中的策略分[19.00(17.00,20.00)]低于对照组[21.00(19.50,23.00)],差异有统计学意义(P<0.05)。在2周后的随访中,两组的SWM各指标比较,差异均无统计学意义(P>0.05)。结论tDCS可能对精神分裂症患者使用策略的能力有即刻改善效应。