Visual field analysis in idiopathic demyelinating optic neuritis, non-arteritic anterior ischemic optic neuropathy and papillaedema

AIM: To compare the visual field characteristics of patients with idiopathic demyelinating optic neuritis(IDON), non-arteritic anterior ischemic optic neuropathy(NAION)and papilledema(PE), and analyze their occurrence mechanism.<p>METHODS: It was a retrospective case series study. Visual field data of patients with IDON, NAION, and PE who were treated in Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University from March 2011 to May 2012 were collected. Ages, gender, best-corrected visual acuities(BCVA), pupil sizes, the visual field testing duration, types of visual field defect, the defect locations, mean deviation(MD)and pattern standard deviation(PSD)of the patients were compared and the reasons of these differences were analyzed by SPSS 12.0.<p>RESULTS: There were 17 cases(20 eyes)with IDON, 21 cases(26 eyes)with NAION, 11 cases(22 eyes)with PE included in this study. All differences from mean age, gender composition, BCVA, pupil size, visual field testing duration, MD and PSD among three groups had statistical significance(<i>P</i><0.05).<p>CONCLUSION: Although these visual fields of patients with IDON, NAION and PE are complex, they have different features closely related with the pathogenesis of disease. These features can provide important evidence for differential diagnosis among optic nerve diseases

cis-Tetra­aqua­bis­{5-[4-(1H-imidazol-1-yl-κN 3)phen­yl]tetra­zolido}manganese(II) dihydrate

In the title compound, [Mn(C10H7N6)2(H2O)4]·2H2O, the complex unit comprises an Mn2+ ion, coordinated by two imidazole N atoms from cis-related monodentate 5-[4-(imidazol-1-yl)phen­yl]tetra­zolide ligands and four water mol­ecules, together with two water mol­ecules of solvation. The Mn2+ ion lies on a twofold rotation axis and has a slightly distorted octa­hedral geometry. The mol­ecules are connected by O—H⋯N and O—H⋯O hydrogen bonds involving both coordinated and solvent water mol­ecules, generating a three-dimensional structure. Two C atoms of the imidazole ring of the ligand are each disordered over two sites with occupancy factors of 0.75 and 0.25

Application of problem based learning steered by constructivism in Ophthalmologic teaching

AIM: To investigate the application of problem based learning(PBL)steered by constructivism. <p>METHODS: The 120 students were appointed as the routine teaching group and the PBL steered by constructivism group separately, who were coming from the department of clinical medicine and clinical pharmacy in grade 94, China Medical University. They were divided into PBL steered by constructivism group(60 students)and the routine teaching group(60 students). The students' feedbacks and teaching effects were compared by the questionnaire after teaching. <p>RESULTS: The feedback of the students in the PBL steered by constructivism group were significant better than that in the routine teaching group, including interest, referring data, self-study, thought process, obtaining and spreading knowledge, computer utilization, studying independently, concerted struggling, appreciating and magnanimous ability, discussion and communication(<i>P</i><0.05).<p>CONCLUSION: Application of problem based learning steered by constructivism interests the students in Ophthalmologic teaching and is helpful in their self-study, which is benefit to elevate the teaching level and train the qualified scientists

Sleep-disordered breathing is associated with depletion of circulating endothelial progenitor cells and elevation in pulmonary arterial pressure in patients with decompensated systolic heart failure

BACKGROUND: Sleep-disordered breathing (SDB) is known to occur frequently in and may predict worsening progression of patients with congestive heart failure (CHF). SDB is also known to play an important role in the development of idiopathic pulmonary arterial hypertension (PAH) via inducing endothelial dysfunction and vascular remodeling, a pathological process that can be significantly influenced by factors such as osteoprotegerin (OPG) and endothelial progenitor cells (EPCs). The objective of this study is to determine if CHF with SDB is associated with changes in OPG, EPCs, and PAH. METHODS: EPCs were isolated, cultured, and quantified from CHF patients with SDB (n = 52), or without SDB (n = 68). OPG and N-terminal pro-brain natriuretic peptide (NT-proBNP) from each group was analyzed and correlated with EPCs and the mean pulmonary artery pressure (mPAP) measured by right heart catheterization. RESULTS: A significant decrease in circulating EPCs (29.30 ± 9.01 vs. 45.17 ± 10.51 EPCs/× 200 field; P < 0.05) was found in CHF patients with SDB compared to those without SDB. Both OPG (789.83 ± 89.38 vs. 551.29 ± 42.12 pg/mL; P < 0.05) and NT-proBNP (5946.50 ± 1434.50 vs. 3028.60 ± 811.90 ng/mL; P < 0.05) were also significantly elevated in SDB CHF patients who also had significantly elevated mPAP (50.2 ± 9.5 vs. 36.4 ± 4.1 mm Hg; P < 0.05). EPC numbers correlated inversely with the episodes of apnea and hypopnea per hour (RDI, r = -0.45, P = 0.037) and blood level of OPG (r = -0.53, P = 0.011). Although NT-proBNP was also increased significantly in patients with SDB, it had no correlation with either EPCs or RDI. CONCLUSIONS: SDB due to hypoxemia from decompensated CHF is associated with (1) OPG elevation, (2) EPC depletion, and (3) mPAP elevation. The inverse relationship of circulating OPG with EPCs suggests a likely mechanism for hypoxemia and OPG in the development of pulmonary vascular dysfunction via depleting EPCs, thus worsening prognosis of CHF