Diabetic kidney disease, as a common complication of diabetes, is one of the main causes of end-stage renal disease. Because of the rapid progress of its course and the limited means of treatment, it is of great clinical significance to seek biomarkers from early diagnosis for the treatment of diabetic kidney disease. At present, there are limited methods for early diagnosis of diabetic kidney disease. As a widely used research method, metabonomics can detect metabolites in diseases and provide biomarkers for disease diagnosis and prognosis. This article summarizes the changes of amino acids, lipids, organic acids and other metabolites in blood or urine of patients with diabetic kidney disease.
Objective To analyse the causes of missed diagnosis in colorectal cancers and improve the early diagnosis. Methods A retrospective analysis was made to investigate the cause of missed diagnosis in 380 cases suffering from colorectal cancers.Results Of the 1 020 patients treated in our hospital in the past ten years (1984-1993), 380 patients were missed diagnosed, with the missed diagnosis rate of 37.3%. The main causes included: ①lacking attention to the early symptoms of colorectal cancers, neglecting the need to conduct certain tests such digital rectal examination and stool occult blood examination, ②delaying of seeking medical advice on the part of the patients, ③being satisfied with the diagnosis and treatment of benign disease, and ④neglecting certain special tests such as enteroscopy and barium enema examination of colon.Conclusion Routine use of rectal touch, occult blood examination and necessary use of special tests such as enteroscopy, barium enema examination of colon in patients suffering from stool change will increase the rate of accurate diagnosis of colorectal cancer.
Objective To compare the characteristics of the results of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in patients with classic choroidal neovasculazation (CNV). Methods The data of FFA and ICGA of 34 patients (36 eyes) with classic CNV were analyzed retrospectively and the results of the two examinations were analyzed contrastively. Results The results of FFA revealed the clew or cartheel-tike configuration of classic CNV at the early phase in 3 out of 15 eyes (20%) with age-related macular degeneration (AMD); in 5 out of 7 eyes with pathological myopia(71.4%); and in 9 out of 14 eyes with central exudative chorioretinopathy (CEC),(64.3%),In 36 eyes with classic CNV, the images of ICGA indicated CNV distinctly in 20 (55.6%) and indistinctly in 15 (41.6%); CNV was not detected by ICGA in 1 eye (2.8%); feeding blood vessels in 6 eyes (16.7%) were detected by ICGA but none by FFA. Conclusions At the early phase of FFA, the configuration of classic CNV is clew-like in eyes with pathological myopia and CEC, and erose in eyes with AMD. The image of ICGA which indicated the outline of classic CNV is not as clear as the one of FFA, but it can reveal the feeding vessels which FFA can not. (Chin J Ocul Fundus Dis, 2006, 22: 217-209)
Objective To investigate the MRI characteristics of the tumor of optic pathway and damage degree of visual function. Methods Analysis of 119 cases surgically and pathologically proved tumor suffering from optic pathway was carried out retrospectively. The patients included:36 ones with tumors in anterior segment of optic pathway,70 ones in middle segment of optic pathway,and 13 ones in posterior segment of optic pathway. The MRI examination series were transverse T-1WI SE,transverse and coronal T-2WI TSE,coronal T-2WI SPIR,and transverse,sagittal,coronal T-1WI SE after Gd-DTPA enhancement. Results The tumors of optic pathway included:the primary tumors of the optic pathway and the tumors of any other part of the body which invaded the optic pathway. There was a special MRI feature on the each tumor suffering from optic pathway,but the pituitary adenoma which affects visual function was the most common tumor. Conclusion MRI is an effective method in the diagnosis of optic-pathway tumor. (Chin J Ocul Fundus Dis, 2002, 18: 101-103)
PURPOSE:To discuss the clinical characteristics and differential diagnosis of peripapillary subretinal hemorrhage(PPSRH). METHOD:Retrospective analysis of the clinical documents including mainly the ocular manifestations and the findings of fundus fluorescein angiography(FFA)of 37 patients (38 eyes)with PPSRH. RESULTS:In all of these 37 patients,36 were myopes, 31 were young persons ,the average age was 21 years old,and 36 were affected unilaterally. The subretinal hemorrhage revealed itself in 4 types :PPSRH (5 eyes),PPSRH with disc iaemorrhage (21 eyes),PPSRH with vitreous hemorrhage (2 eyes), and PPSRH with disc hemorrhage and vitreous hemorrhage (10 eyes). In the FFA, the hemorrhages showed blocked fluorescence and the optic discs showed irregular hyperfluorescence at the late phase. All of the hemorrhages were absorbed within 3 weeks to 3 months without any treatment. CONCLUSIONS:According to the manifestation of the optic discs in FFA PPSRH might be complicatton of the buried optic disc drusen. （Chin J Ocul Fundus Dis,1997,13: 143-145 ）
Objective To evaluate the diagnosis value of purified protein derivative (PPD) antibody tests in childhood tuberculosis. Methods We reviewed 126 cases of hospitalization children tested body fluid PPD antibody by Enzyme-Linked Immunosorbent Assay (ELISA). Twenty-two them were diagnosed with tuberculosis. We determined the sensitivity, specificity, diagnostic likelihood ratio, positive prognostic value, negative prognostic value, post-test probability, respectively. Results The following accuracy statistics for the PPD body liquid antibody tests in this study: sensitivity, 45.45%; specificity, 91.35%; diagnostic likelihood ratio positive, 5.25; diagnostic likelihood ratio negative, 0.597; positive predictive value, 52.63%; negative predictive value, 88.79% and post-test probability, 48.09% in 15% of prevalence. Conclusion This study shows that body fluid PPD tests have limited value for diagnosis of tuberculosis in pediatric tuberculosis. Clinic physicians should be wary of the positive results of body fluid PPD antibody tests. The value of diagnosis is related to prevalence of tuberculosis in the specific hospital.
Noninfectious uveitis refers to a category of inflammatory diseases involving the uvea, with the exception of infectious factors or masquerade syndrome. The diagnosis and follow-up of noninfectious uveitis that involving retina or choroid require fundus imaging techniques. Fundus autofluorescence is a noninvasive imaging technique. Compared with fundus colorized photography, fundus fluorescein angiography and indocyanine green angiography, fundus autofluorescence indicates the functional status of retinal pigment epithelium and photoreceptor cells in a better way, thus playing a role in the pathophysiological mechanisms investigating, early diagnosis, disease progression monitoring and prognosis estimating of noninfectious uveitis, such as Vogt-Koyanagi-Harada disease, Behçet disease, multifocal choroiditis, punctate inner choroidopathy, birdshot chorioretinopathy, multiple evanescent white dot syndrome, acute zonal occult outer retinopathy, acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis.
Objective To evaluate the diagnosis of blue-on-yellow perimetry and macular threshold perimetry in early primary glaucoma. Methods Humphrey II 750 automatic perimetry was used to test 60 eyes of 60 cases in normal control group and 63 eyes of 63 cases in early primary glaucoma group with white-on-white perimetry (W/W), blue-on-yellow perimetry (B/Y)，and macular threshold perimetry (M TP). The results of the visual field defects detected by the three perimetries were compared and analyzed.Results The differences of mean sensibility of W/W, B/Y and MTP between the two groups had statistical significance［t=-3 .01, P=0.0054 (W/W); t=-2.95, P=0.006 3 (B/Y); t=-2.59,P=0. 0150 (MTP)］. In the diagnosis of early primary glaucoma, the sensitivity of MTP was the highest (83%), B/Y was the second (65%), and W/W was the lowest (48%). When B/Y and MTP were combined, the sensitivity was improved to 94% using parallel testing, and the specificity was improved to 87% using serial testing.Conclusions B/Y and MTP are valuable in diagnosis of early primary glaucoma, and the sensitivity and specificity of the diagnosis can be improved when B/Y and MTP are combined. (Chin J Ocul Fundus Dis，2003，19：102-105)
Objective To investigate the current situation, problems of medicinal biotechnology in China, and to provide the relevant countermeasures for its development. Methods We surveyed the units which could carry out medicinal biotechnology projects in 30 provinces except Tibet, and compared the results with that in America.Results The questionnaire were returned from 25 provinces (83.4%), and there were 1 477 medicinal biotechnology projects carried out by 149 units in the past 10 years. These projects ranged from basic biotechnology to regenerative medicine and stem cell researches. The basic research projects constituted quite large percentage among all the projects. But the development levels in different areas were imbalanced, cross correlation with the development levels of economy. An echelon team of talents has been developed, most of them were trained in China. The invested capital differed considerably among units, in general the amounts were insufficient. Most invested capital came from the government. The number of patent application for projects based on independent-developed technology was small. This showed that project principals had a poor understanding of patents. More than half of units did not have a Bioethics Committee. From the search result for documents, the number of articles on stem research of China was close to that in America; and the number of articles on gene treatment and tissue engineering has already exceeded that of America. However, research on gene diagnosis of China was lagging far behind America. Conclusions An echelon team of talents has been developed, most of them are trained in China.We should give full play to the advantage of the distribution of qualified personal resources in developed economical areas so as to promote the applicability and popularity of medicinal biotechnology in less developed areas.Regarding to applicability and development, we should first develop applied technology to form the core competetiveness of basic research, technology development and application; we should also strengthen the training in ethics and regulation to establish a set of scientific assessment of medicinal biotechnology and management system.
ObjectiveTo observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with vitreomacular traction syndrome and its clinical significance.MethodsThe clinical data of 25 patients with vitreomacular traction syndrome diagnosed by OCT, fundus fluorescein angiography, and B-scan ultrasonography and confirmed by surgical treatment were retrospectively analyzed. The features of images of OCT in vitreomacular traction syndrome were observed.ResultsFive types were found in the images of OCT in the patients with vetreomacular traction syndrome. The main characteristic of the images of OCT in the patients with vitreomacular traction was the highly reflective band of the vitreous posterior cortex inservion at fovea. In 25 patients, vitreomacular traction associated with macular edema was found in 10, macular hole in 3, macular epiretinal membrane in 6, retinoschisis in 1, and retinal detachment in 5.ConclusionOCT is a potential powerful toll for detecting and monitoring vitreomacular traction syndrome. (Chin J Ocul Fundus Dis, 2005,21:86-89)