Objective To investigate the characteristics and possibility of using an image analyzer-aided method to count axotomized retinal ganglion cells (RGCs). Methods The left optic nerves of 18 rats were transected intraorbitally and a piece of gelform soaked in 5% fluorogold was applied to the ocular stump to retrogradely label the surviving RGCs. All animals were executed 2, 7 or 14 d ays after the operation (n=6 for each time point), respectively. The left retinae were removed, post-fixed and whole-mounted on the slides. The numbers of labeled RGCs were counted using both the conventional sampling method and image analysis, and compared statistically between the two methods.Results The number of surviving RGCs decreased sharply［(12 0663±9 089), (59 285±17 071) and (17 802±19 8 4) cells/mm2 for image analyzer-aided method, and (118 237±7 898), (57 648±14 533) and (18 070±1 461) cells/mm2 for conventional sampling method］when the survival time increased from 2 to 7 and 14 days. No significant difference was detected between the two groups at any corresponding time points.Conclusion The image analyzer-aided method is convenient, objective and reproducible, which can be used in the studies where counting RGCs is needed. (Chin J Ocul Fundus Dis，2003，19：333-404)
ObjectiveTo study the clinical value of procalcitonin (PCT), WBC count, and C-reactive protein (CRP) in diagnosis of common bile duct stones with acute bile duct infection and systemic inflammatory response syndrome (SIRS).MethodsA total of 80 patients with bile duct stones were retrospectively analyzed, which were divided into two groups, SIRS group (n=40) and non-SIRS group (n=40). The numerical value of PCT, WBC count, and CRP were detected on 1, 4, and 7 day after admission, and calculated the score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) on 1 day after admission. Then analyzed the clinical value of PCT, WBC count, and CRP in diagnosis of common bile duct stones with acute bile duct infection and SIRS.ResultsEach area under the ROC curve of PCT, CRP, and WBC count were 0.81, 0.78, and 0.72, respectively, with significant difference (P<0.05). The PCT, CRP, and WBC count had a certain accuracy in diagnosis of common bile duct stones with acute bile duct infection and SIRS. The positive-relationship between PCT, CRP, WBC count and APACHE Ⅱ score was significant (r=0.91, P<0.01; r=0.88, P<0.01; r=0.69, P<0.01).ConclusionTo detect the numerical value of PCT, WBC count, and CRP had significant clinical value in diagnosis of common bile duct stones with acute bile duct infection and SIRS.
【摘要】 目的 研究人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合症(AIDS)患者CD4+T淋巴细胞数变化(ΔCD4+T)和外周血淋巴细胞总数变化(ΔTLC)的相关性。探讨用ΔTLC预测ΔCD4+T在监测HIV/AIDS患者疾病进展以及高效抗逆转录病毒治疗(HAART)疗效的价值。 方法 回顾性分析2005〖CD3/5〗2008年确诊的91例HIV/AIDS患者的临床资料。 结果 ΔTLC与ΔCD4+T呈直线正相关(r=0809,Plt;001),好于TLC与CD4+T的相关性(r=0712,Plt;001)。分别用ΔTLC 170、330、630、910个/μL细胞预测ΔCD4+T 50、100、200、300个/μL细胞时具有较好的预测价值,各项评价指标符合率基本达到90%以上,显著高于相同时间下用TLC预测CD4+T计数的价值。 结论 应用ΔTLC预测ΔCD4+T,可比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。【Abstract 】Objective To assess the utility of total lymphocyte count (TLC) changes (ΔTLC) in place of TLC to predict the development of HIV/AIDS. To investigate the monitoring value of ΔCD4+T on progress of HIV/AIDS and HAART which predicted by ΔTLC. Methods Clinical data of 91 patiens with HIV/AIDS diagnosed from 2005 to 2009 were retrospectively analyzed. Results A linear correlation was found between the value of ΔTLC and the value of CD4+T changes(ΔCD4+T)(r=0809,Plt;001),which was better than the correlation between TLC and CD4+T (r=0712,Plt;001).Using ΔTLC as 170,330,630,910 cells/μL,respectively for forecasting ΔCD4+T as 50,100,200,300 cells/μL,respectively,had a better predictive value with the area under ROC curve near to 09,significantly higher than using TLC for predicting CD4+T counts. Conclusion ΔTLC is more accurate than TLC to reflect the development of HIV/AIDS.
Objective To investigate the relationship between systemic inflammation response index (SIRI) and early neurological deterioration (END) and 3-month prognosis in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke treated at West China Hospital of Sichuan University and Deyang People’s Hospital between April 2020 and October 2020 were collected. Clinical data were collected using a unified case form and outcomes were followed up for 3 months. According to the poor prognosis, the patients were divided into END group and non-END group. The multivariate logistic regression analysis was used to explore the relationship of SIRI, END and 3-month prognosis. We drew receiver operating characteristic curve to evaluate the value of related factors in predicting the occurrence of END and poor prognosis after 3 months. Results A total of 242 patients were included, of which 47 (19.42%) were in the END group. There were statistically significant differences between the two groups in National Institutes of Health stroke Scale (NIHSS) score on admission, hypertension, creatinine, urea nitrogen, neutrophils count, lymphocyte count, neutrophil count/lymphocyte count ratio (NLR), lymphocyte count/monocyte count ratio, platelet count/lymphocyte count ratio, complications (besides cerebral edema) and SIRI (P<0.05). Logistic regression analysis showed that NIHSS score on admission, hypertension, SIRI and NLR were independent risk factors for END (P<0.05). SIRI had better predictive value for the occurrence of END than NLR (P<0.05). Compared with the non-END group, the patients in the END group had worse prognosis at 3-month [44.7%(21/47) vs. 17.4% (34/195), P<0.05]. NIHSS score on admission had predictive value for clinical prognosis of acute ischemic stroke patients at 3-month. Conclusion SIRI is an independent risk factor for END in patients with acute ischemic stroke, and there is no independent correlation with the 3-month prognosis.
ObjectiveTo compare the clinical characteristics of inpatients with different influenza subtypes, so as to identify the subtypes at an early stage.MethodsA retrospective case study was conducted, using influenza surveillance data from January 1st, 2016 to December 31st, 2018 at a tertiary surveillance outpost hospital in Chengdu. Patients diagnosed with different subtypes of influenza by nucleic acid testing or virus isolation and culture were investigated, and their clinical characteristics, laboratory test results, and prognosis were analyzed and compared among the four subtypes including H1N1, H3N2, Victoria (BV), and Yamagata (BY).ResultsThere were 127 inpatients with laboratory-confirmed influenza. Among the confirmed influenza patients, 85.8% (109/127) had low or normal white blood cell counts, and 78.8% (89/113) had abnormally high procalcitonin levels. Among the patients with different subtypes, statistical differences existed in age (P<0.001), low or normal white blood cell count (P=0.041), positive bacteria/fungus/mycoplasma/chlamydia culture (P=0.001), kidney damage (P=0.013), outcome at discharge (P<0.001), and hospitalization expenses (P=0.016). However, there was no statistical difference in gender, clinical symptoms, liver damage, cardiac damage, or length of hospital stay (P>0.05).ConclusionThe infection of influenza can lead to severe clinical complications or even death. The outcomes of patients with influenza A may be more severe. An elevated procalcitonin level can be detected in quite a few patients with influenza.
Objective To observe the distribution of human photoreceptor cells at the posterior pole, detect the change of density of the cells affected by eccentricity, and analyze the relationship between the density distribution and the visual sensitivity. Methods Twenty human eye cups with the cornea removed were fixed in 4% polyformaldehyde for 1-4 weeks, and the retinal mounts were observed by differential interference contrast microscope to reveal the retinal cellular configuration and density. The inner segments of photoreceptor cells were first observed from the center to the temporal peripheral part of the retinal mounts. Results The highest density of visual cone cells was at the central fovea (134 000-267 000/mm2, mean 198 090/mm2; CV value:18.2%). The density and individual variation decreased rapidly in the peripheral area. The high density area of rod cells was at the 4 mm of the eccentricity, with the highest value of 72 610-182 350/mm2 and with the high density between 3 and 5 mm. Conclusions The inner segment of photoreceptor cells was monolayer, which may tell the cellular absolute value. The high density of retinal cone cells at the central fovea provide the basis of sensitive central visual acuity, which relates to the individual variation and development. The rod cells have the peak density at the eccentricity with 4 mm, and this area has the greatest sensitivity of dim vision.
Objective To explore the correlation and diagnostic value of neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in peripheral blood of patients with exacerbation of chronic obstructive pulmonary disease (COPD). Methods One hundred patients with acute exacerbation of COPD who were hospitalized in the hospital between January 2019 and October 2020 were selected as exacerbation group, and another 100 patients with stable COPD who received treatment during the same time period were enrolled as stable group. The general data of patients were collected, and blood samples were collected to detect hemoglobin (Hb), platelet count (PLT), white blood cell count (WBC), neutrophil count, lymphocyte count and RDW, and the NLR was calculated. The correlation between the detection indicators was analyzed and receiver operating characteristic (ROC) curve was drawn to analyze the detection significance of related indicators. Results There were no statistical differences in the levels of Hb and PLT between the exacerbation group and the stable group (P>0.05). The levels of WBC, NLR, RDW and high-sensitivity C-reactive protein (hs-CRP) in the exacerbation group were significantly higher than those in the stable group (all P<0.05). NLR in the patients with acute exacerbation of COPD was positively correlated with serological indicators of WBC and hs-CRP (all P<0.05). ROC curve showed that the sensitivity and specificity of NLR in the diagnosis of acute exacerbation of COPD were 92.0% and 68.0% respectively, those of RDW were 91.0% and 58.0% respectively, those of hs-CRP were 77.0% and 71.0% respectively, and those of NLR+RDW were 90.0% and 73.0% respectively. NLR had the highest diagnostic specificity, RDW had the highest diagnostic sensitivity, and NLR+RDW had the best diagnostic efficiency. Conclusions Serological indicators of WBC, hs-CRP, NLR and RDW in patients with acute exacerbation of COPD will be abnormally increased, and NLR has a positive correlation with WBC and hs-CRP. NLR and RDW have high specificity and high sensitivity respectively in the diagnosis of patients with exacerbation of COPD, and their detection can strengthen the diagnosis and mastery of disease in patients.
ObjectivesTo assess the predictive value of neutrophils-to-lymphocytes ratio (NLR) in the diagnosis of children complicated appendicitis.MethodsThe clinical data of patients with acute appendicitis treated in Department of Pediatric Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University from January 2014 to June 2017 were analyzed retrospectively. Based on the pathology results, patients were divided into two groups: simple appendicitis and complicated appendicitis. The differences of age, gender, disease time, fever, highest temperature, emesis, right lower abdominal pain, blood indicators, and ultrasound results between the two groups were analyzed. Useful parameters to aid in the diagnosis of children complicated appendicitis were screened through single-factor and multiple-factor analysis. The predictive value of the parameters was evaluated by ROC analysis, sensitivity and specificity.ResultsA total of 235 patients was evaluated and divided into simple appendicitis group (179 patients) and complicated appendicitis group (56 patients). Logistic regression analysis revealed that NLR was the independent risk factor for diagnosis of children complicated appendicitis. When NLR>11.74, the Youden index for predictive complicated appendicitis was the biggest, reaching 0.325, and the sensitivity and specificity were 47.8% and 84.7%, respectively (OR=3.121, 95%CI 2.036 to 4.783).ConclusionsThe preoperative NLR is a certain indicator for predicting children complicated appendicitis, and can be used as reference to whether or not receive an operation.
ObjectiveTo investigate the ultrasonic changes of hepatic veins and splenic veins during various immune stages with different CD4+T lymphocyte count. MethodsFifty AIDS/HIV patients with chronic viral hepatitis treated between January 2010 and October 2013 were designated as the case group, and another 50 patients with simple chronic viral hepatitis were regarded as the controls. For patients in the case group, we observed their ultrasonic changes of hepatic and splenic veins during various immune stages with different CD4+T lymphocyte count. The results of observation and clinical laboratory analysis were compared. ResultsAbnormal ultrasonic changes were detected in the liver in various immune stages based on the CD4+T lymphocyte count, and the main manifestations of these changes included unclear portal and splenic vein distal direction, wide diameter, slowed blood flow velocity, and disappearance of fluctuations of blood flow spectrum; and unclear hepatic vein distal direction, low and three-phase, and negative blood flow spectrum with the disappearance of windows were also detected. There were no statistical differences between the case group and the control group when the CD4+T cell count was over 300/mm3, and a few indexes were significantly different when the CD4+T cell count was between 100 and 200/mm3. However, the differences of almost all indexes were significant when the CD4+T cell count was below 100/mm3. ConclusionPatients with HIV/AIDS combined with chronic viral hepatitis have ultrasonographic abnormalities of intrahepatic and splenic veins, which is more obvious as the CD4+T cell count declines. Overall consideration of intrahepatic vein and splenic vein ultrasonic indicators helps clinical assessment of disease development in patients with HIV/AIDS combined with chronic viral hepatitis.
Objective To investigate the response of retinal ganglion cells （RGC）in detached and reattached retina in adult rats, and the effect of IL-1beta antibody and IL-1Ra on the loss of RGC. Methods A total of 73 Sprague-Dawley (SD) rats were subretinally injected with healon GV（1.4% hyaluronate）and retrograde labeled with fluorogold (FG), and 10 ng IL-1 Ra and 500 ng IL-1beta antibody were injected into the subretinal space combined with healon GV. The retinal flakes were observed under the fluoroscope and the number of RGC was counted 2 hours, 1, 3, 5, 7, 10, 20, 50, and 90 days after deta chment; 10 days after detachment and 30 days after reattachement; 90 days after detachment and 20 days after reattachement, and 1 and 10 days after injection with IL-1beta antibody and IL-1Ra,respectively. And the control group was only developed an intraocular injection of the same valume of healon GV. Result Two hours after detachment, the RGC loss was found, reached the peak at first day, and decreased gradually. RGC loss was also found in the non-detached area. The reattachment 10 days after detachment (early reattachment) stopped the loss of RGC, and the reattachment 90 days after detachment (late reattachment) promoted the loss, which rested on a certain level. Subretinal space injection of IL-1Ra and IL-1beta antibody decreased the loss of RGCs in the detached retina. Conclusion The RGCs loss were found both in the detached and attached retina. Early reattachment may stop the loss of RGC, and late reattachment may promote the loss. Both IL-1beta antibody and IL-1Ra have neuro protective effect on RGC. (Chin J Ocul Fundus Dis，2004，20：233-236)