Li Rui

ObjectiveWe aim to investigate the feasibility of using diffusion tensor imaging to evaluate changes in extraocular muscles and lacrimal gland in patients with thyroid-associated ophthalmopathy and to evaluate disease severity.Materials and MethodsA total of 74 participants, including 17 healthy controls, 22 patients with mild TAO, and 35 patients with moderate-severe TAO, underwent 3-Tesla DTI to measure fractional anisotropy and mean diffusivity of the EOMs and LG. Ophthalmological examinations, including visual acuity, exophthalmos, intraocular pressure, and fundoscopy, were performed. FA and MD values were compared among patients with different disease severity. Multiple linear regression was adopted to predict the impact of clinical variables on DTI parameters of orbital soft tissue.ResultsTAO patients’ EOMs and LG showed significantly lower FA values and higher MD compared to HCs’. Moderate-severe TAO patients’ EOMs and LG had dramatically lower FA and higher MD compared with HCs. In addition, only the DTI parameters of the medial rectus were considerably different between mild and moderate-severe TAO patients. Multiple linear regression showed that disease severity had a significant impact on the DTI parameters of orbital soft tissue.ConclusionDTI is a useful tool for detecting microstructural changes in TAO patients’ orbital soft tissue. DTI findings, especially medial rectus DTI parameters, can help to indicate the disease severity in TAO patients.

The cosmology elaborated in the Hengxian is eclectic. Its most salient point is the notion of self–generation which most probably stems from some other independent source no longer extant today. Apart from the cosmology of self–generation, there existed three other types of cosmology in ancient China: ‘nonpresence to presence’ cosmology, numerological cosmology, and mythological cosmology. Interestingly, the pursuit of the cosmological problematic led ancient Chinese thought to two antinomies. The first one revolved around the issue of whether the world and the myriad things have a beginning. The latter antinomy regarded the question of whether the generation and transformation of the world and the myriad things is caused by ‘some agency’ or whether there is ‘no maker’ involved in the cosmological process. These two antinomies have their close counterparts in two of the four antinomies introduced by Immanuel Kant, which attests to the depth of philosophical reasoning in ancient China.