Congenital toxoplasmosis is one of the most common types of intrauterine infection, with the triad of retinal choroiditis, intracranial calcification, and hydrocephalus as the main clinical manifestations, which can lead to serious sequelae such as cerebral palsy, cognitive impairment and visual impairment. Therefore, early diagnosis and early treatment are important to improve the prognosis of patients. Recommended treatment options include pyrimethamine, sulfadiazine combined with folic acid, or new drugs such as azithromycin and atorvastatin. This article reviews the research progress of epidemiology, clinical manifestations, diagnosis and treatment of congenital toxoplasmosis, in order to provide a reference for clinicians to improve their understanding of clinical diagnosis and treatment of this disease.
ObjectiveTo investigate the relationships between the expression of integrin β1 and activated cells in a partial-thickness articular cartilage injury model of adult rats. MethodForty-five male Sprague Dawley rats (aged 10 weeks and weighing 300-400 g) were randomly divided into operated group (n=15) , sham-operated group (n=15) , and control group (n=15) . Partial-thickness articular cartilage injury model was made by scarification in operated group, direct suture after opening of the knee joint was performed in sham-operated group, and no operation was done in control group. Five rats were sacrificed at 1, 7, and 14 days after operation respectively for macroscopic evaluation, HE staining, Safranin O staining, CD105, BrdU, CD105/integrin β1 immunofluorescence and double labeling staining. The histological score of HE staining, gray value of Safranin O staining and CD105-positive cells count were compared among groups at each time point. ResultsMacroscopic evaluation showed chondromalacia and cartilage fibrosis around the linear injury with aggravating tendency with time in operated group, but no chondromalacia and cartilage fibrosis in sham-operated and control groups. HE staining demonstrated a number of activated cells accumulating around the linear injury with nonuniform distribution in operated group, and uniform size and distribution in sham-operated and control groups. The histological scores at each time point in operated group were significantly higher than those in sham-operated group and control group (P<0.05) , but no significant difference was found between different time points in 3 groups (P>0.05) . Safranin O staining was nonuniform with hypochromasia around linear injury in operated group, but the staining was uniform in sham-operated group and control group. Gray value of Safranin O staining had no significant difference among groups and among different time points in the same group (P>0.05) . BrdU-positive and CD105-positive cells distributed unevenly around the linear injury in operated group, uniform distribution was observed in sham-operated group and control group. CD105-positive cells count in operated group was significantly higher than those in sham-operated group and control group at each time point (P<0.05) ; CD105-positive cells increased significantly with time in operated group (P<0.05) . CD105/integrinβ1-positive cells were observed around the linear injury in operated group, but was not observed in sham-operated group and control group. ConclusionsThe partial-thickness articular cartilage injury model is successfully established in rats, and cartilage injury could not be repaired completely in the model. The activated cells aggregation around the linear injury can be observed, but there is no obvious relationships between activated cells and cartilage matrix. These activated cells are in proliferation and could express both CD105 and integrin β1.
ObjectiveTo observe and analyze the changes of macular choroidal thickness in children with occult high myopia and its influencing factors.MethodsA prospective, non-randomized, contemporaneous controlled trial. From September 2019 to October 2020, 56 children (110 eyes) who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. There were 33 males (64 eyes) and 23 females (46 eyes), with the average age of 8.62±1.87 years old; the age ranged from 6 to 12 years old. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group (27 cases, 52 eyes) and control group (29 cases, 58 eyes). In the 52 eyes of the occult high myopia group, the spherical equivalent refraction (SER) of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 15, 16 and 21 eyes. Among 58 eyes in the control group, the SER of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 21, 18 and 19 eyes, respectively. The macular fovea within 6 mm was divided into three concentric circles centered on the macular fovea, which included the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm, totally 9 areas. The inner ring and outer ring were divided into upper, lower, nasal and temporal areas. The changes of choroidal thickness in each macular area of children in occult high myopia group and control group were observed. The choroidal thickness in each macular area was compared between the two groups using independent sample t-test. Pearson correlation analysis was used to analyze the correlation between mean foveal choroidal thickness and gender, age, intraocular pressure, ocular axis, diopter and corneal curvature in occult high myopia group.ResultsChoroidal thickness in macular area of children in occult high myopia group was thinnest in nasal side and thickest in temporal side. Compared with the control group, the mean choroidal thickness in the 9 macular zones of children in the occult high myopia group was significantly thinner than that in the control group, and the difference was statistically significant (P＜0.05). The mean choroidal thickness in each macular region decreased with the increase of diopter in children with occult high myopia. Compared with the control group with the same spherical equivalent, there was no significant difference in the area above the inner ring and the outer ring of the macular fovea in the occult high myopia group of －0.00 to －1.00 D and the temporal side of the inner ring and the outer ring of the macular fovea in the occult high myopia group of ＞－2.00 to －3.00 D (P＞0.05), but there were significant differences among the other regions (P＜0.05). Pearson correlation analysis results showed that the average choroidal thickness of the fovea in children with occult high myopia was negatively correlated with age (r=－3.410, R2=11.630, P=0.010), eye axis (r=1.420, R2=2.016, P=0.030) and diopter (r=－2.680, R2=7.182, P=0.040), but not significantly correlated with gender (r=0.166, R2=0.028, P=0.240), intraocular pressure (r=0.330, R2=0.109, P=0.800) and corneal curvature (r=－0.260, R2=0.068, P=0.850).ConclusionsThe thickness of macular choroidal in children with occult high myopia is the thinnest on the nasal side of the macular fovea and the thickest on the temporal side of the macular fovea. The mean choroidal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean choroidal thickness of fovea is negatively correlated with age, ocular axis and diopter.
ObjectiveTo observe and analyze the changes of macular retinal thickness and related factors in children with occult myopia. MethodsA prospective longitudinal control study. From February 2021 to February 2022, 120 eyes of 60 children who first visited Department of Ophthalmology of The Affiliated Hospital of Chengde Medical College without any corresponding myopia correction treatment were included in the study. There were 32 males (64 eyes) and 28 females (56 eyes), with the age of 4-6 years. Visual acuity, medical optometry, corneal topography, spectral-domain optical coherence tomography (OCT) and axial length (AL) were measured at the first visit and 3, 6, 9 and 12 months. The children were divided into occult myopia group with 60 eyes of 30 cases and control group with 60 eyes of 30 cases according to visual acuity, equivalent spherical refraction (SE), AL and corneal curvature (CC). The macular fovea retinal thickness was measured by spectral-domain OCT enhanced deep imaging technique. According to the treatment and study of diabetic retinopathy, the retina within the 6 mm of the macular center was divided into three concentric circles with the macular fovea as the center, the central fovea of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. In the inner ring and outer ring, the retina was divided into 4 areas, upper and lower, left and right, with a total of 9 regions. The four regions of the inner ring and the outer ring were superior, inferior, nasal and temporal, respectively. The differences of AL, CC, SE, macular retinal thickness and the changes of related factors with time were compared between the occult myopia group and the control group. SE, AL, CC and retinal thickness in different macular regions of the two groups were compared by repeated measurement analysis of variance. In pairwise comparison, the minimum significant difference t test was used in different measurement time points, and the independent sample t test was used between groups at the same measurement time points. ResultsAt first diagnosis and after diagnosis, there were significant differences in SE (F=783.710), AL (F=742.192), macular fovea (F=330.292), inferior and temporal (F=158.250, 108.292) side of the outer ring retinal thickness in occult myopia group (P＜0.01). In the control group, there were significant differences in the retinal thickness of SE (F=1 793.976), AL (F=457.362), macular fovea (F=31.029), inferior and temporal (F=7.405, 77.245) side of the outer ring retinal thickness (P＜0.01). In both groups, with the prolongation of the time after the first diagnosis, the SE gradually increased, the AL gradually lengthened, and the thickness of the macular fovea, inferior and temporal side of the outer ring retinal thickness gradually thinned. Independent sample t test was performed on the data with differences between groups at the same time, and the results showed that at 3, 6, 9 and 12 months after first diagnosis, there were significant differences in SE, AL and CC between the occult myopia group and the control group (t=－4.801,－11.532, 16.276,－17.145), AL (t=24.203, 26.353, 27.057, 25.552); CC (t=－23.362,－25.382,－25.890,－24.350; P＜0.01). There were significant differences in macular fovea, inferior and temporal side of the outer ring retinal thickness at 6, 9 and 12 months, macular fovea (t=－2.596,－2.542, －2.941; P＜0.05), outer ring temporal (t =－2.285, －2.610, －2.506; P＜0.05). ConclusionThe SE and AL of the occult myopia group and the control group increase with time, and the former increase more rapidly than the latter; the macular fovea, inferior and temporal side of the outer ring retinal become thinner, and the former become thinner than the latter.
ObjectiveTo observe the characteristics of choroidal thickness in patients with macular edema secondary to superior temporal branch retinal vein occlusion (BRVO-ME). MethodsA retrospective control study. From November 2020 to September 2021, 30 patients (30 eyes) with BRVO-ME (BRVO-ME group) were diagnosed by ophthalmology examination in Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College and 14 healthy volunteers (28 eyes) were enrolled in the study. The choroidal thickness of macular area was measured by enhanced deep imaging technique of frequency domain optical coherence tomography. According to the subdivision of the diabetic retinopathy treatment group, the choroid within the 6 mm of the macular fovea was divided into three concentric circles with the macular fovea as the center, namely, the central area with the diameter of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. The inner ring area and the outer ring area are divided into upper, lower, nasal and temporal sides, respectively, which are denoted as S3, I3, N3, T3 and S6, I6, N6, T6, totaling 9 areas. To observe the distribution characteristics of choroidal thickness in different regions of two groups of eyes. The choroidal thickness of different macular regions was compared by independent sample t-test. ResultsThe choroidal thicknesses in the central area, S3, T3, I3, N3, S6, T6, I6, and N6 of the eyes in the control group and BRVO-ME group were 214.11±56.04, 207.89±57.92, 214.07±54.82, 207.14±61.54, 180.18±53.53, 204.25±59.60, 193.93±51.50, 190.54±51.21, 139.82±39.84 μm and 258.00±71.14, 256.43±68.70, 252.07±72.97, 244.37±68.49, 243.10±70.93, 247.20±68.36, 221.00±61.28, 223.77±58.64, 183.20±60.15 μm. In both groups, the choroidal thickness was the thickest in the central area, gradually thinning to the nasal side and temporal side, and the nasal choroidal thickness was thinner than other regions, and N6 area was the thinnest. Compared with the control group, the choroidal thickness of central area, S3, T3, I3, N3, S6, I6 and N6 in BRVO-ME group were significantly thicker (t=－2.899, －2.229, －2.172,－3.250, －2.543, －2.292, －3.214; P＜0.05), there was no significant difference in T6 area (t=－1.814, P=0.075). ConclusionThe choroidal thickness of macular area in patients with BRVO-ME is thicker than that in normal subjects.
ObjectivesTo systematically review the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort or case-control studies on the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies, and meta-analysis was performed by RevMan5.3 software.ResultsA total of 9 case-control studies involving 759 patients were included. The results of meta-analysis showed that, maternal factors like placental abruption (OR=6.25, 95%CI 1.47 to 26.61, P=0.01), premature rupture of fetal membranes of parturient (OR=5.62, 95%CI 2.63 to 12.00, P<0.000 01), pregnancy-induced hypertension (OR=2.04, 95%CI 1.49 to 2.80, P<0.000 01), carbapenem antibiotics used in mothers (OR=1.77, 95%CI 1.10 to 2.81, P=0.017), neonatal factors like premature delivery (OR=1.96, 95%CI 1.06 to 3.61, P=0.03), mechanical ventilation (OR=2.14, 95%CI 1.01 to 4.55, P=0.05), surgical procedure (OR=14.17, 95%CI 2.46 to 81.70, P=0.003), umbilical vein catheter (OR=1.93, 95%CI 1.20 to 3.11, P=0.007), peripherally inserted central catheter (OR=4.30, 95%CI 1.86 to 9.93, P=0.000 6), nasogastric feeding (OR=4.37, 95%CI 1.44 to 13.29, P=0.009), use of carbapenems (OR=3.04, 95%CI 1.91 to 4.84, P<0.000 01), and admission to NICU (OR=2.78, 95%CI 1.79 to 4.33, P<0.000 01) were the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Breastfeeding (OR=0.30, 95%CI 0.13 to 0.70, P=0.005) was the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.ConclusionsThe current evidence shows that maternal factors like placental abruption, premature rupture of fetal membranes, pregnancy-induced hypertension, carbapenem antibiotics used in mothers, and neonatal factors like premature delivery, mechanical ventilation, surgical procedure, umbilical vein catheter, peripherally inserted central catheter, nasogastric feeding, use of carbapenems, and admission to NICU are the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates; while breastfeeding is the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the conclusions.