Application of MPVR and TL-VR with 64-row MDCT in neonates with congenital EA and distal TEF

AIM:To assess the application of multiple planar volume reconstruction(MPVR) and three-dimensional (3D) transparency lung volume rendering(TL-VR) with 64-row multidetector-row computed tomography (MDCT) in neonates with congenital esophageal atresia (EA) and distal tracheoesophageal fistula(TEF).METHODS:Twenty neonates(17 boys,3 girls) with EA and distal TEF at a mean age of 4.6 d(range 1-16 d) were enrolled in this study.A helical scan of 64-row MDCT was performed at the 64 mm×0.625 mm collimation.EA and TEF were reconstructed with MPVR and TL-VR,respectively.Initial diagnosis of EA was made by chest radiography showing the inserted catheter in the proximal blind-ended esophageal pouch.Manifestations of MDCT images were compared with the findings at surgery.RESULTS:MDCT showed the proximal and distal esophageal pouches in 20 cases.No significant difference was observed in gaps between the proximal and distal esophageal pouches detected by MPVR and TLVR.The lengths of gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR correlated well with the findings at surgery(R=0.87,P<0.001).The images of MPVR revealed the orifice of TEF in 13 cases,while TL-VR images showed the orifice of TEF in 4 cases.CONCLUSION:EA and distal TEF can be reconstructed using MPVR and TL-VR of 64-row MDCT,which is a noninvasive technique to demonstrate the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

Melanin change of retinal pigment epithelium and choroid in the convalescent stage of Vogt-Koyanagi-Harada disease

AIM:To observe the melanin change of the retinal pigment epithelium(RPE)and choroid in the convalescent stage of Vogt-Koyanagi-Harada(VKH).METHODS:A retrospective study was performed on 40 eyes of 20 patients in the convalescent stage of VKH.Fundus photography(FP),multi-spectral imaging(MSI),and optical coherence tomography(OCT)were performed.RESULTS:In the VKH convalescent stage,focal RPE melanin accumulation(FRMA)was detected in 34 eyes(85%)on MSI and in 7 eyes(17.5%)on FP.FRMA was limited to the previous retinal detachment area in all 28 eyes(FRMA was detected in 34 eyes on MSI,which were enrolled,and 6 eyes lacked data in the acute stage).Sunset-glow fundus was detected in 20 eyes(50%)on FP.The mean density of FRMA in a 1-mm-diameter circular area of the fovea was 0.04±0.07 on MSI,which was significantly correlated with sunset-glow fundus(ρ=0.467,P=0.02).CONCLUSION:In the VKH convalescent stage,FRMA is derived from the RPE melanin change,and sunset-glow fundus is derived from the choroid melanin change.A higher density of FRMA in the fovea and sunset-glow fundus represents more serious depigmentation of melanin.

Retinal laser photocoagulation and intravitreal injection of anti-VEGF for hemorrhagic retinal arterial microaneurysm

AIM:To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF)for hemorrhagic retinal arterial macroaneurysm(RAM).METHODS:This was a retrospective clinical study.Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments:a retinal laser photocoagulation therapy monotherapy group,an anti-VEGF intravitreal injection monotherapy group,a laser and anti-VEGF combination therapy group,and an observation group.Visual acuity(VA),central macular thickness(CMT),and retinal hemorrhage area(RHA)were collected.RESULTS:Forty-seven eyes of 47 patients were enrolled.VA improved and had a significant difference between baseline and final in each treatment group(logMAR;laser group:1.90±0.53 vs 1.05±0.63,P<0.001;anti-VEGF group:1.75±0.63 vs 1.12±0.54,P=0.009;combination group:1.76±0.38 vs 1.01±0.52,P<0.001);however,VA decreased and had no significant difference in observation group(1.63±0.51 vs 1.76±0.61,P=0.660).CMT decreased and had a significant difference between baseline and final in each group(laser group:815.16±310.83 vs 252.05±83.90μm,P<0.001;anti-VEGF group:725.00±290.79 vs 203.56±69.89μm,P=0.001;combination group:595.50±186.51 vs 253.13±55.06μm,P=0.001;observation group:758.88±195.65 vs 267.00±120.90μm,P=0.001).RHA were 28.99±28.15,25.94±11.58,19.64±8.97,and 27.45±13.76 mm^(2) in laser group,anti-VEGF group,combination group and observation group,respectively.RHA was statistically correlated with final VA(P=0.032)in the observation group.CONCLUSION:Both laser and anti-VEGF treatments are effective for hemorrhagic RAM.Combination therapy reduces the number of injections of anti-VEGF.RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.

Meta-analysis on Treatment of Chronic Hepatitis B with Telbivudine and Entecavir

Objective To evaluate the therapeutic effects of telbivudine and entecavir on patients with chronic hepatitis B by meta-analysis method. Methods Databases including the Cochrane Library, PubMed, EMBASE and HighWire were searched from January 2008 to October 2012. Randomized controlled trials on treatment of chronic hepatitis B with telbivudine and entecavir were included. According to the Cochrane systematic reviews, the methodological quality of the included studies was evaluated and effective data was extracted from these studies and analyzed. Results Six studies were included eventually. The telbivudine group included 417 cases and the entecavir group included 396 cases. For 12-week antiviral treatment of chronic hepatitis B, the rate of undetectable HBV DNA was 39.1% with telbivudine and 38.6% with entecavir [OR = 1.04, 95% CI(0.62, 1.73), P > 0.05]; for treatment of HBeAg(+) hepatitis B, the HBeAg clearance rate was 23.8% with telbivudine and 3.8% with entecavir [OR= 8.07, 95% CI(2.69, 24.21), P < 0.05], and the HBeAg seroconversion rate was 6.7% with telbivudine and 3.8% with entecavir [OR = 4.95, 95% CI(1.60, 15.31), P < 0.05]; the ALT normalization rate was 54.3% with telbivudine and 58.5% with entecavir [OR = 0.84, 95% CI(0.49, 1.45), P > 0.05]; and for early-stage treatment, the incidence of adverse events was 17.2% with telbivudine and 22.0% with entecavir [OR = 0.66, 95% CI(0.33, 1.32), P > 0.05]. For 1-year antiviral treatment of chronic hepatitis B, the rate of undetectable HBV DNA was 79.4% with telbivudine and 89.7% with entecavir [OR = 0.46, 95% CI(0.28, 0.74), P < 0.05]; for treatment of HBeAg(+) hepatitis B, the HBeAg clearance rate was 28.9% with telbivudine and 15.6% with entecavir [OR = 2.21, 95% CI(1.06, 4.58), P < 0.05], and the HBeAg seroconversion rate was 31.2% with telbivudine and 18.5% with entecavir [OR = 2.31, 95% CI(1.23, 4.31), P < 0.05]; the ALT normalization rate was 85.8% with telbivudine and 84.9% with entecavir [OR = 0.90, 95% CI(0.29, 2.84), P > 0.05]; and the resistance rate was 6.0% with telbivudine and 0.76% with entecavir [OR = 5.71, 95% CI(1.67, 19.47), P < 0.05]. Conclusions For 1-year treatment of chronic hepatitis B, the difference in ALT normalization between telbivudine and entecavir was not statistically significant; and telbivudine was superior over entecavir in terms of HBeAg undetectable and HBeAg seroconversion; entecavir was superior over telbivudine in terms of HBV DNA undetectable and resistance; and both drugs had similar rates of adverse events in early-stage treatment and no severe adverse event was noted. Both telbivudine and entecavir are effective antiviral drugs against hepatitis B.

Identification of an immune-related signature for the prognosis of uveal melanoma

AIM:To construct an immune-related prognostic signature(IPS)that can distinguish and predict prognosis in uveal melanoma(UM).METHODS:The transcriptomic data and clinicopathological information of 80 UM patients were extracted from the TCGA database.These patients were randomly assigned to a training and a testing set.RESULTS:Lasso Cox analysis was performed for the prognostic immune-related genes to develop an IPS for UM in the training set.The signature was validated in both the testing set and entire cohort.We confirmed the prognostic value of our IPS in distinct subgroups and found its association with the T stage and basal diameter of the tumor.Tumor Immune Estimation Resource database analysis revealed that the IPS was negatively correlated with the infiltration of neutrophils and dendritic cells,but positively correlated with the infiltration level of CD8+T cells.In addition,we demonstrated that immune checkpoints containing PD-1,CTLA-4,IDO,and TIGIT were moderately associated with the IPS.CONCLUSION:This is the first study to develop and validate an immune-related signature with the ability of predicting prognosis for UM patients.Further studies are needed to validate its prediction accuracy.

Forecast of Power Generation for Grid-Connected Photo-voltaic System Based on Grey Theory and Verification Model

Being photovoltaic power generation affected by radiation strength, wind speed, clouds cover and environment temperature, the generating in each moment is fluctuating. The operational characteristics of grid-connected PV systems are coincided with gray theory application conditions. A gray theory model has been applied in short-term forecast of grid-connected photovoltaic system. The verification model of the probability of small error will help to check the accuracy of the gray forecast results. The calculated result shows that the ?model accuracy has been greatly enhanced.