Objective To guide blood glucose management during pregnancy and reduce the incidence of long-term complications of the fetus by exploring the long-term growth condition of offspring of pregnant women with gestational diabetes mellitus. Methods A total of 180 cases full-term newborns of pregnant women with gestational diabetes mellitus from December 25th, 2011 to December 25th, 2012 were selected as the diabetes group. Another 200 newborns of pregnant women without any complications were randomly collected as the control group. Birth weight, gestational age, sex, blood glucose, and 24-, 48-, 72- and 120-hour transcutaneous bilirubin value after the birth of the newborns were recorded; weight, height, body mass index (BMI), triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein, blood pressure and fasting plasma glucose quota between the two groups were contrasted when the children were three years old. Results There were no significant difference in the birth weight, gestational age and sex between the diabetic and the control group. The blood glucose levels of the newborns in the diabetic group was significantly lower than that in the control group (P<0.05). The 24-, 48-, 72- and 120-hour transcutaneous bilirubin values of the newborns in the diabetic group were significantly higher than those of the control group (P<0.05). The weight, height and BMI of the three years old offspring in the diabetic group were significantly higher than those in the control group (P<0.05). There were no significant difference in triglycerides, total cholesterol, HDL, Low density lipoprotein, fasting plasma glucose quota, and systolic blood pressure between the diabetic group and the control group (P>0.05), but the diastolic blood pressure in the diabetic group was much higher than that in the control group (P<0.05). Conclusion The impact of gestational diabetes mellitus on offspring of pregnant women was not only in the fetus and newborn period, but also in the future, which should be timely intervened.
ObjectiveTo evaluate the correlation between macular microstructure changes and visual outcome before and after scleral buckling for macular-off primary rhegmatogenous retinal detachment (RRD). MethodsA total of 43 eyes in 43 patients with RRD were enrolled in this retrospective study. All patients underwent scleral buckling and the retina was successfully reattached. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT) were measured for all patients before and at 3 days, 1, 3 and 6 months after surgery. The height of subretinal fluids (SRF), the thickness of retinal neurosensory layer in foveal, and the thickness of outer nuclear layer (ONL) were measured. The microstructure changes of external limiting membrane (ELM), junction line and intermediate line of photoreceptor inner segment/outer segment (IS/OS) were observed. The correlation between morphologic changes in the macular foveal and BCVA on 6 months after surgery were also analyzed. ResultsThe mean preoperative BCVA was 1.18±0.93. The detached retinas had 3 types of SD-OCT images, including normal foveal contour without edema, diffuse edema with ONL cystoids cavities, diffuse edema with ONL cystoids cavities and wave-like ONL. The mean preoperative SRF height was (885.05±493.28) μm. The preoperative mean thickness of retinal neurosensory layer in foveal and ONL in the RRD eyes were thinner than the healthy fellow eyes (t=2.642, 1.895;P < 0.05). The fluids and cystoids cavities were absorbed, retina reattached in all the RRD eyes at 3 days after surgery. SRF had been detected in 100.0%, 93.0%, 77.8%, 46.5% RRD eyes on 3 days, 1 month, 3 months and 6 months after surgery, with heights of (219.00±117.02), (163.51±72.83), (101.27±64.47), (55.69±21.15) μm respectively. There were 3 patterns of residual SRF: diffuse, subfoveal multi-bleb, subfoveal single bleb. Compared with the healthy fellow eyes, there were significant differences in the mean thickness of foveal neurosensory layer (t=-10.658, -8.550, -6.955) and ONL thickness (t=-6.240, -5.424, -3.326, -3.323) at 3 days, 1 month, 3 months and 6 months after surgery(P < 0.05), except for the thickness of foveal neurosensory layer at 6 months after surgery (t=-2.186, P=0.570). The reattached retinas had 4 types of SD-OCT images, including: (1) disrupted ELM, IS/OS line and intermediate line; (2) intact ELM with disrupted IS/OS line and intermediate line; (3) intact ELM and IS/OS line with disrupted intermediate line; (4) intact ELM, IS/OS line and intermediate line. The mean postoperative BCVA at different time points were better than preoperative BCVA (t=-3.12, -4.89, -5.03, -4.53; P < 0.05). The postoperative BCVA of eyes with intact IS/OS was different from that of eyes with disrupted IS/OS at 6 months after surgery (t=2.609, P < 0.05). The preoperative SRF height, thickness of foveal neurosensory layer and ONL were correlated with the BCVA at 6 months after surgery (r=0.817, 0.028, 0.521; P < 0.05). ConclusionsMacular-off RRD eyes had SRF, thinner foveal neurosensory layer and ONL before and after scleral buckling. The disruption of ELM, IS/OS junction line and intermediate line can be seen in most of RRD patients. The thinner foveal neurosensory layer and ONL were correlated with the slow recovery of postoperative BCVA.
ObjectiveTo observe the effect of intravitreal injection of anti-vascular endothelial growth factor drugs on the subfoveal choroid thickness (SFCT) of patients with retinal vein occlusion (RVO) and macular edema (ME). MethodsA prospective clinical study. From January 2017 to January 2019, 59 monocular RVO-ME patients with 59 eyes diagnosed in the eye examination of The First Central Hospital of Baoding were included in the study. Among them, there were 31 males with 31 eyes and 28 females with 28 eyes; the average age was 57.4±10.3 years old. The course of the disease was 5 days to 1 month, all of whom had the first-onset disease. Branch retinal vein occlusion (BRVO) was found in 35 eyes (BRVO-ME group); non-ischemic central retinal vein occlusion (CRVO) was found in 24 eyes (CRVO-ME group). Best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (OCT) were performed. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. The Cirrus HD-OCT 5000 instrument from Carl Zeiss company of Germany was used to measure the central macular thickness (CMT) and SFCT. All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs. The follow-up time after treatment was 6 months, and the changes of BCVA, CMT and SFCT of eyes before treatment and 2 weeks after treatment were compared and observed, as well as the occurrence of treatment-related complications. The comparison of BCVA, CMT, and SFCT at different times before and after treatment were adopted repeated measures analysis of variance; pairwise comparison of differences at different time points adopts the least significant difference t test. ResultsBefore treatment, the average logMAR BCVA and CMT of RVO-ME eyes were 0.92±0.46 and 604.71±169.35 μm, respectively. At 2 weeks, 1, 3, and 6 months after treatment, the average logMAR BCVA of the affected eye was significantly improved compared with that before treatment, and the CMT was significantly decreased. The difference was statistically significant (F=55.664, 59.518; P＜0.05). Before treatment, the average SFCT of the affected eye and the contralateral eye of RVO-ME patients were 306.3±65.8 and 241.3±59.8 μm, respectively. The SFCT of the affected eye was significantly thicker than that of the contralateral healthy eye, and the difference was statistically significant (t=25.772, P＜0.05). At 2 weeks, 1, 3, and 6 months after treatment, the average SFCT of the eyes were 267.7±81.4, 252.3±57.3, 239.2±46.5, 240.6±48.3 μm, respectively. Compared with before treatment, treatment SFCT decreased significantly at different times afterwards, and the difference was statistically significant (F=924.341, P＜0.001). There was no significant difference in SFCT between CRVO-ME group and BRVO-ME group at 2 weeks, 1, 3, and 6 months after treatment (P＞0.05). No complications such as endophthalmitis, cataract progression and neovascular glaucoma occurred during the follow-up period of all eyes. ConclusionThe SFCT of eyes with short course of disease and first-onset RVO-ME is thickened; anti-VEGF drug treatment can effectively reduce SFCT, improve ME, and increase BCVA.
Objective To explore how to differentiate the epilepsy and syncope in order to minimize the misdiagnosis. Methods Retrospectively analyzed the medical record of 6 cases which were misdiagnosed as epilepsy or syncope during April 2008 to September 2012 and reviewed the literatures about the differential diagnosis. Results Among the clinical characteristics, the ictal positional tone and loss of consciousness as well as the duration of postictal confusion are very important to the differential diagnosis. The ictal EEG shows highly rhythmic abnormal discharges when epileptic seizures occur. However, the ictal EEG would become slower and flatler during syncope. Conclusions When the automomic disorder and signs such as chest distress, arrhythmia. appear, the causes should not be limited in the cardiac diseases, the functional or structural abnormalities of the nervous system innervating the heart should also be considered; on the contrary, convulsions might not only due to the abnormal electrical activity in the brain, but syncope.