Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening

BACKGROUND Early screening and accurate staging of diabetic retinopathy(DR)can reduce blindness risk in type 2 diabetes patients.DR’s complex pathogenesis involves many factors,making ophthalmologist screening alone insufficient for prevention and treatment.Often,endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention.AIM To explore the efficacy of non-mydriatic fundus photography(NMFP)-enhanced telemedicine in assessing DR and its various stages.METHODS This retrospective study incorporated findings from an analysis of 93 diabetic patients,examining both NMFP-assisted telemedicine and fundus fluorescein angiography(FFA).It focused on assessing the concordance in DR detection between these two methodologies.Additionally,receiver operating characteristic(ROC)curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine,using FFA outcomes as the standard benchmark.RESULTS In the context of DR diagnosis and staging,the kappa coefficients for NMFPassisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively,indicating substantial intermethod agreement.Moreover,the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes,as denoted by the area under the ROC curve,was remarkably high at 0.955,within a confidence interval of 0.914 to 0.995 and a statistically significant P-value of less than 0.001.This predictive model exhibited a specificity of 100%,a sensitivity of 90.9%,and a Youden index of 0.909.CONCLUSION NMFP-assisted telemedicine represents a pragmatic,objective,and precise modality for fundus examination,particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients.Its implementation in these scenarios is of paramount significance,enhancing the clinical accuracy in the diagnosis and therapeutic management of DR.This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.

Reliability and Validity of Simplified Chinese STOP-BANG Questionnaire in Diagnosing and Screening Obstructive Sleep Apnea Hypopnea Syndrome

The main purpose of this study was to assess the reliability and validity of the simplified Chinese STOP-BANG Questionnaire(SBQ)as a diagnosing and screening tool for obstructive sleep apnea hypopnea syndrome(OSAHS).Two hundred and ten patients with suspected OSAHS were recruited in this study.The simplified Chinese SBQ was completed twice before and after polysomnography(PSG)monitoring.SPSS 20.0 was used to analyze the test-retest reliability,discriminant validity,comparative validity and predictive validity of the SBQ.Fourteen patients were excluded on account of fragmentary data,and valid 196 were divided into four groups:non-OSAHS group(n=28,14.29%),mild OSAHS group(n=28,14.29%),moderate OSAHS group(n=31,15.81%)and severe OSAHS group(n=109,55.61%).The test-retest coefficient tor the first four items was 0.810,0.679,0.775,0.963 respectively and the total score of the STOP questionnaire was 0.854.The analysis of discriminant validity revealed that there were significant differences among four groups in the total score of the SBQ and scores of item 1,3,7 and 8,which were also validated between patients with normal blood oxygen saturation and different degrees of hypoxemia.The SBQ evaluation showed low consistency with diagnostic gold standard PSG(k=0.3O3,P<0.05).When taking apnea hypopnea index(AHI)≥5/h,≥15/h and≥30/h as cut-offs to evaluate the SBQ predictive value,the areas under ROC curve were 0.77,0.81 and 0.78,the sensitivity was 90.48%,93.57%and 93.33%,and corresponding negative predictive values were 40.74%,66.67%and 85.19%,respectively.It was suggested that the simplified Chinese version of SBQ had good reliability,and could distinguish the severity of OSAHS.Despite its limited diagnostic accuracy,the SBQ can be considered as an ideal tool for screening OSAHS with superior predictive validity.

A post-classical theory of enamel biomineralization… and why we need one

Enamel crystals are unique in shape, orientation and organization. They are hundreds of thousands times longer than they are wide, run parallel to each other, are oriented with respect to the ameloblast membrane at the mineralization front and are organized into rod or interrod enamel. The classical theory of amelogenesis postulates that extracellular matrix proteins shape crystallites by specifically inhibiting ion deposition on the crystal sides, orient them by binding multiple crystallites and establish higher levels of crystal organization. Elements of the classical theory are supported in principle by in vitro studies; however, the classical theory does not explain how enamel forms in vivo. In this review, we describe how amelogenesis is highly integrated with ameloblast cell activities and how the shape, orientation and organization of enamel mineral ribbons are established by a mineralization front apparatus along the secretory surface of the ameloblast cell membrane.

CYP1A1 Ile462Val polymorphism contributes to colorectal cancer risk:A meta-analysis

AIM:To study the relation between CYP1A1 Ile462Val polymorphism and colorectal cancer risk by meta-analysis. METHODS:A meta-analysis was performed to investigate the relation between CYP1A1 Ile462Val polymorphism and colorectal cancer risk by reviewing the related studies until September 2010.Data were extracted and analyzed.Crude odds ratio(OR) with 95% confidence interval(CI) was used to assess the strength of relation between CYP1A1 Ile462Val polymorphism and colorectal cancer risk. RESULTS:Thirteen published case-control studies including 5336 cases and 6226 controls were acquired. The pooled OR with 95%CI indicated that CYP1A1 Ile462Val polymorphism was significantly related with colorectal cancer risk(Val/Val vs Ile/Ile:OR=1.47,95%CI:1.16-1.86,P=0.002;dominant model:OR= 1.33,95%CI:1.01-1.75,P=0.04;recessive model:OR=1.49,95%CI:1.18-1.88,P=0.0009) .Subgroup ethnicity analysis showed that CYP1A1 Ile462Val polymorphism was also significantly related with colorectal cancer risk in Europeans(Ile/Val vs Ile/Ile:OR=1.22,95%CI:1.05-1.42,P=0.008;dominant model:OR= 1.24,95%CI:1.07-1.43,P=0.004) and Asians(Val/ Val vs Ile/Ile:OR=1.40,95%CI:1.07-1.82,P=0.01;recessive model:OR=1.46,95%CI:1.12-1.89,P= 0.005) . CONCLUSION:CYP1A1 Ile462Val may be an increased risk factor for colorectal cancer.

Improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection

Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.

ARHGAP4 variants are associated with X-linked early-onset temporal lobe epilepsy

The ARHGAP4 gene(OMIM*300,023),also known as Rho GTPase activating protein 4,encodes a protein that has an essential role in the regulation of small GTP-binding.ARHGAP4 message RNA(mRNA)is highly expressed during the developing and adult nervous system.At the protein level,ARHGAP4 is exclusively present in certain brain regions,such as the mesial temporal lobe,specifically the stratum lucidum of the CA3 region[1].ARHGAP4 enhances the GTPase activity of Rho proteins,which modulate morphological alterations in neuron development and synaptic plasticity by interacting with the actin cytoskeleton[2].

Efficient p-doping of P3HT for hole transporting materials in perovskite solar cells

Developing hole transporting materials(HTMs)appropriate for large-area and high-performance perovskite solar cells(PSCs)is an important issue.In this work,we report using a widely used organic semiconductor P3 HT in combination with an efficient organic salt dopant trityl tetrakis(pentafluorophenyl)borate(TrTFPB)as HTM in PSCs.It is shown that the dopant can significantly enhance the conductivity of P3 HT while slightly change the film morphology.By doping P3 HT with different doping levels.

Nonideal double-slope effect in organic field-effect transistors

With the development of device engineering and molecular design,organic field effect transistors(OFETs)with high mobility over 10 cm2 V-1-s-1 have been reported.However,the nonideal doubleslope effect has been frequently observed in some of these OFETs,which makes it difficult to extract the intrinsic mobility OFETs accurately,impeding the further application of them.In this review,the origin of the nonideal double-slope effect has been discussed thoroughly,with affecting factors such as contact resistance,charge trapping,disorder effects and coulombic interactions considered.According to these discussions and the understanding of the mechanism behind double-slope effect,several strategies have been proposed to realize ideal OFETs,such as doping,molecular engineering,charge trapping reduction,and contact engineering.After that,some novel devices based on the nonideal double-slope behaviors have been also introduced.