Changed trends of major causes of visual impairment in Sichuan,China from 1987 to 2006

AIM: To study the trends of major causes of visual impairment(VI) in adults in Sichuan,China and evaluate the effect of aging on the trends. ·METHODS: We used data from the National Sample Survey on Disabilities(NSSD) in Sichuan province conducted in 1987 and 2006. The age-adjusted prevalence of major causes of VI and the prevalence stratified by age in each cause were calculated and compared. The association between age and each cause of VI was also analyzed.·RESULTS: Retinal disease increased and became the second leading cause of VI in 2006 while blinding trachoma decreased markedly. Cataract and non-trachomatous corneal diseases were among the leading causes of VI in both years. We found associations between age and causes of VI,with age showing the strongest association with cataract and relatively lower associations with other causes. · CONCLUSION: In the last two decades,dramatic changes occurred in the major causes of VI with significantly increased retinal disease and decreased blinding trachoma. Aging of the population might be an important factor accounting for the changed trends of VI. Understanding the prevalence of VI,its major causes and trends over time can assist in prioritizing and developing effective interventional strategies and monitoring their impact.

Lung injury after cardiopulmonary bypass:Alternative treatment prospects

Although the lung injury caused by cardiopulmonary bypass(CPB)has been extensively investigated,the incidence and mortality of lung injury after CPB remain a prominent clinical problem.The poor outcome has been attributed to multifactorial etiology,including the systemic inflammatory response and ischemia reperfusion(I/R)injury during CPB.Lung injury after CPB is a complex pathophysiological process and has many clinical manifestations of mild to severe disease.Which is associated with prognosis.To alleviate this lung injury,interventions that address the pathogenesis are particularly important.This review summarizes the pathogenesis,mechanism and treatment options of lung injury after CPB,such as lung protection with intralipid.

Correlation between Survivin Expression and Laryngeal Carcinoma:A Meta-analysis

In order to provide evidence for evidence-based medicine in the treatment and prognosis of laryngeal cancer in China, the meta-analysis electronically retrieved the case-control studies published in China about the Survivin expression and its association with clinical pathological features in the tissues of laryngeal carcinoma. The results showed that a total of 25 case-control studies were finally included with 1333 cases of laryngeal cancer and 528 cases of controls. The difference in the expression of Survivin between the two groups was statistically significant [OR=18.34, 95% CI（11.82, 28.47）, P〈0.00001]. The difference in the expression of Survivin between laryngeal carcinoma patients with lymph node metastasis or not was statistically significant [OR=0.25, 95% CI（0.17, 0.37）, P〈0.00001]. The expression of Survivin in clinical Ⅰ–Ⅱ stage group was significantly lower than in the clinical stage Ⅲ–Ⅳ group [OR=0.24, 95% CI（0.18, 0.32）, P〈0.00001]. The expression of Survivin in patients with low/medium differentiation was significantly lower than that in those with high differentiation [OR=0.33, 95% CI（0.26, 0.43）, P〈0.00001]. The difference in the expression of Survivin among different T stages of laryngeal carcinoma was statistically significant [OR=0.35, 95% CI（0.21, 0.58）, P〈0.00001]. In conclusion, Survivin may play an important role in the occurrence and development of laryngeal carcinoma, and its high expression is related to the poor prognosis of patients with laryngeal cancer.

Superficial esophageal lesions detected by endoscopic ultrasound enhanced with submucosal edema

AIM:To determine if there is consistency between endoscopic ultrasound(EUS)findings and pathological results for detecting lesions of different depth in the esophageal mucosa.METHODS:A canine(Beagle)model was established in which lesions of different depths were created in the esophageal mucosa by thermal burning.Seventy-two hours later,these lesions and adjacent tissue in the esophagus were examined by EUS.EUS findings including infiltrating depth,strength of echogenicity and homogeneity were recorded.Dogs were sacrificed and tissue specimens were obtained.We then compared the EUS findings with the pathology reports.RESULTS:Thermal burns created at different power settings caused lesions of different depth in the esophageal mucosa.When the echo strength was shifted from high,medium,to low echogenicity,an increase in the infiltrating depth of the lesion was noted,which coincided with results of the pathology examination.Obvious submucosal edema visualized by EUS was also detected by pathology.Furthermore,because of the enhancement caused by the submucosal edema,the lesions invading into the submucosa were easily visualized by EUS.CONCLUSION:There is consistency between EUS findings and pathological results of esophageal lesions with different depths.Submucosal edema can serve as an ultrasonic contrast agent.

Extraesophageal saline enhances endoscopic ultrasonography to differentiate esophagus and adjacent organs

AIM:To distinguish between the esophagus and adjacent organs using extraesophageal saline injection(ESI) in a canine model.METHODS:ESI was performed through the esophagus under the guidance of linear-array endoscopic ultrasonography(EUS).Approximately 15 mL of methylene blue saline(0.5%) was then injected through each of the extraesophageal puncture points using a 22 G needle.Radial EUS examinations were conducted before and after ESI.EUS images of the trachea,tracheal bifurcation,arcus aortae and thoracic aorta were recorded.Vital signs were monitored during the ESI procedure and EUS examination.The dogs were then sacrificed for exploratory thoracotomy.RESULTS:No obvious fluctuation in vital signs or serious adverse events occurred during the ESI procedure.On EUS imaging,an apparent hypoechoic area outside the esophagus,which separated the esophagus and adjacent organs,was visualized.The adventitious of the esophagus and adjacent organs were easily distinguished.The findings of subsequent exploratory thoracotomy confirmed the EUS findings:obvious accumulation of a blue liquid in the extraesophageal tissues,as well as in the esophageal-thoracic aorta space,esophageal-arcus aortae space and esophageal-tracheal space.CONCLUSION:The esophagus and adjacent organs were successfully separated by ESI,and extraesophageal saline acted as an effective ultrasonic contrast agent.

Large cystic-solid pulmonary hamartoma:A case report

BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.