ObjectiveTo observe the positional relationship between the central fixation point of the retina and the fovea in normal adults.MethodsA retrospective clinical study. From August 2019 to January 2020, 100 eyes of 100 normal adults who underwent physical examination at the Fourth People's Hospital of Shenyang were included in the study. All patients underwent BCVA, diopter, microfield, OCT examination, and axial length (AL) measurement. There were 42 males and 58 females with the average age was 46.4±14.7 years. The average diopter was －1.02±1.99 D, the average AL was 23.22±0.47 mm, the average foveal avascular zone (FAZ) area was 0.38±0.13 mm2. The MP-3 microperimetry was used for central fixation examination. After the examination, high-definition fundus images were automatically taken and the central fixation point of the retina were automatically calculated by the equipment. The Nidek Overlay functional multi-mode imaging platform was used to superimpose the images containing the central fixation point of the retina and the macular fovea, the positional relationship between the two was observed, and the distance between the two was measured. Pearson correlation analysis was performed on the distance between the fixation point of the center of the retina and the center of the fovea, age, diopter, and FAZ area of the macula.ResultsThe fixation point of the retinal center of all tested eyes was within the range of the macular fovea, which did not coincide with the center of the macular fovea. Among 100 eyes, the fixation point of the center of the retina were 53, 23, 15, and 9 eyes at the nose, lower, temporal, and upper sides, respectively. The average distance between the fixation point of the center of the retina and the center of the fovea was 158.31±71.56 μm. The distance between the fixation point of the retinal center and the center of the macular fovea and age (r=0.140), diopter (r=－0.009), FAZ area ( r=0.038) were not correlated (P=0.165, 0.932, 0.707) in correlation analysis.ConclusionThe central fixation point of normal adult retina is more common on the fovea nasal side.
Objective To summarize the clinical outcome and strategy of re-operation on adult and older children patients with congenital heart disease. Methods We retrospectively analyzed the clinical data of 339 patients underwent re-operation in our hospital from January 2010 to December 2014. There were 214 males and 125 females at the mean age of 21.6±12.4 years. According to the pathophysiological result and the difficulty level of operation, patients were divided into a simple re-operation group (n=186) and a complex re-operation group (n=153) . We compared the clinical outcomes of two groups. Results In the simple re-operation group, the rate of mortality was zero and the rate of complications was 5.9%. There was 1 patient of interoperative right atrium injury, 1 patient of extensive hemorrhage, 5 patients of postoperative secondary thoracotomy, 1 patient of hemodialysis, 3 patients of severe infection, and 2 patients of Ⅲ degree atrioventricular blockage. In the complex re-operation group, the rate of mortality was 3.3% and the rate of complication was 30.1%. There were 2 patients of intraoperative coronary artery lesion, 2 patients of aortic injury, 1 patient of pulmonary artery injury, 6 patients of extensive bleeding, 8 patients of postoperative secondary thoracotomy, 13 patients of hemodialysis, 12 patients of severe infection, 5 patients of nervous system complications, 4 patients of Ⅲ degree atrioventricular blockage. Extracorporeal membrane oxygenation (ECMO) applied in 4 patients. Conciusion Complex re-operation is still the influential factor of mortality and complications for patients with congenital heart disease and we should take measures to aviod the mortality and complications.
目的 了解成都地區非酒精性脂肪肝（NAFLD）及高尿酸血癥（HUA）患病情況及相關因素。 方法 對2010年9月－2011年3月健康體檢的36 000名18歲以上受檢者，進行病史采集、體格檢查、空腹血糖、血脂、肝功能、腎功能、血尿酸檢測以及上腹部彩色多普勒超聲檢查。 結果 高尿酸血癥（HUA）的總患病率為18.17%。NAFLD患者HUA患病率為39.41%，明顯高于總患病率（P＜0.01）。NAFLD患者的HUA患病率隨體質量指數（BMI）的增加呈遞增趨勢。BMI、舒張壓、甘油三酯、膽固醇、丙氨酸轉氨酶、門冬氨酸氨轉移酶、谷氨酰轉肽酶、血肌酐、胱抑素C均隨著血尿酸水平的升高而遞增；高密度脂蛋白隨著血尿酸水平的升高而遞減。 結論 NAFLD及HUA關系密切，且二者與代謝紊亂聯系緊密。
ObjectiveTo observe the clinical characteristics of adult patients with ocular toxoplasmosis (OT).MethodsThis study was a retrospective clinical trial. Among the 83 consecutive OT patients diagnosed in the Zhongshan Eye Center of Sun Yat-Sen University, 14 patients (16.9%, adult group) aged ≥18 years were included in the study from January 2017 to December 2019. A total of 14 OT patients (children group) aged less than 18 years who had consecutive visits from July to December 2019 were selected as controls. All patients underwent BCVA, slit lamp microscope, fundus color photography, and B-mode ultrasound examination. Eighteen cases underwent UBM examination, including 6 and 12 cases in the adult group and child group respectively; 23 cases underwent FFA examination, including 12 and 11 cases in the adult group and child group respectively. Snellen visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. We compared the two groups of patients' residence (urban or rural), history of contact with dogs and cats, main symptoms, reasons for treatment, course of disease, and clinical and imaging characteristics and so on. For measurement data conforming to normal distribution, t-test was performed for comparison between groups; for Skewness distribution measurement data, rank sum test was performed for comparison between groups.ResultsCompared with the adult group and the child group, there was no significant difference in the canine-cat contact history (Z=2.661, P=0.257) and the time from first diagnosis to diagnosis (t=?0.186, P=0.351); compared with the children group and the adult group, the patient's living environment was mainly urban, and the course of disease was significantly shorter (Z=?2.005), and the difference was statistically significant (P=0.047). The logMAR BCVA of the adult group and the child group were 0.81±1.08 and 2.08±1.30, respectively, and the difference was statistically significant (Z=?2.811, P=0.004); compared with the child group, the adult group had lighter vitreous opacities, but the difference was statistical significance (Z=7.847, P=0.048). FFA examination revealed 20 cases of "fern-like" leakage of retinal capillaries. Among them, the adult group and child group were 10 (83.3%, 10/12) and 10 (90.9%, 10/11) cases respectively.ConclusionsAdult patients account for 16.9% of OT patients. Compared with children, adult patients mostly live in towns or cities, have a short course of disease, good vision at first diagnosis, and mild inflammation or hyperplasia of the vitreous cavity. FFA is helpful for the diagnosis of adult OT.
Objective To identify proteins that have expressed in human eyes from adults and two-month old infants by proteomics approach, so as to build a two-dimensional gel electrophoresis (two-DE) reference map for human retina. The difference of proteomics between the retinas of adults and two-month old infants are also studied. Methods Human retina tissues were collected from donor eyes (nine adults and two infants). Proteins were separated by two-DE. The gels were analyzed by image software. Protein spots were excised from the gels and detected by matrix assisted laser desorption ionization time off light mass spectrometry (MALDI-TOF-MS). Results A total of 1179 spots and 1295 spots were detected respectively on two-DE gels of Coomassie-stained adults and two-month old infants retina, of which 1039 spots were matched in the position. Five spots up-regulated were successfully identified. Human serum albumin and 4 guanylate kinase 1 (GUK1) were identified in adult retina. beta;2-tubulin, transaldolase1 and alpha A-crystallin were identified in infant retina. Conclusion The two-DE reference map for retina proteomics is successfully established. This study provides an evidence of changes in retinal protein levels between adults and infants and biochemical pathways for future studies of human retina development.
ObjectiveTo compare the clinical manifestations of ocular toxoplasmosis (OT) in adult and children, and to preliminarily explore the role of intraocular fluid detection in the early diagnosis of OT.MethodsA retrospective study. From January 2018 to October 2019, 60 cases of OT patients with 60 eyes diagnosed in the Department of Ophthalmology of Beijing Chaoyang Hospital Affiliated of Capital Medical University were included in the study. The medical history information of patients was collected in parallel with slit-lamp microscopy, indirect ophthalmoscope examination, and canine toxoplasma antibody detection in aqueous or vitreous fluid. Fifty-eight cases underwent visual inspection; 2 cases did not underwent visual inspection, who were children. The visual acuity examination was carried out using the new version of the standard logarithmic visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. According to age, the patients were divided into adult group and child group, with 12 eyes in 12 cases and 48 eyes in 48 cases, respectively. The clinical characteristics and main points of diagnosis and treatment of the two groups of patients were compared and observed. The comparison among the measurement data groups conforming and the normal distribution was performed by the independent t test. The comparison between the measurement data groups of the skewed distribution was performed by the Kruskal-Wallis test. The qualitative data were compared with χ2 test.ResultsAmong the adult group and the child group, 7 (58.3%, 7/12) and 34 (70.8%, 34/48) patients with a clear history of contact with dogs and cats were in the adult group and the child group, respectively. The adult group was significantly lower than the child group, however, there was no different statistical significance (χ2=0.236, P=0.627). At the first visit, the self-reported blurred vision of the adult group and the child group was 10 (83.3%, 10/12) and 22 (45.8%, 22/48) cases, respectively. In the adult group and the child group, 3 (25.0%, 3/12) and 20 (43.5%, 20/46) eyes with logMAR visual acuity greater than 1.85, 8 (66.7%, 8/12) and 22 (45.8%, 22/46) eyes with logMAR visual acuity less than 0.3. The visual acuity of the adult group was better than that of the child group, and the difference was statistically significant (Z=2.162, P=0.031). There was no statistically significant difference in the composition ratio of different clinical types of the two groups of eyes (χ2=1.908, P=0.385). The incidence of inflammation in the anterior segment of the eye in the adult group and the child group were 25.0% (3/12) and 56.3% (27/48), respectively; there was no statistically significant difference between the two groups (χ2=3.750, P=0.053). The concentration of antibodies in the vitreous humor of the affected eye in the adult group and the child group was greater than that of aqueous humor. The antibody concentrations of vitreous humor and aqueous humor were 36.51 (22.58) and 19.94 (21.78) U/ml in the children group; 45.95 (56.44) and 32.20 (38.64) U/ml in the adult group. Comparison of antibody concentrations in the vitreous humor and aqueous humor of the affected eyes in the child group showed statistically significant differences (Z=?1.984, P=0.047).ConclusionsCompared with children with OT, adult patients with OT have better vision and mild inflammation or hyperplasia of the vitreous cavity. The detection of antibodies related to toxoplasma in the intraocular fluid is helpful for early diagnosis.