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AIM: To compare the changes in axial length of myopic patients of different ages after wearing orthokeratology lenses with increased compression factor(ICF)or conventional compression factor(CCF)for 2 a.METHODS: Retrospective study. A total of 141 myopia patients(141 right eyes)aged 8 to 15 years who fitted with orthokeratology lenses in the General Hospital of Foshan Aier Eye Hospital from July 2020 to July 2021 were continuously included. They were divided into the CCF group(70 cases, 70 eyes)and the ICF group(71 cases, 71 eyes). The patients in the CCF group were fitted with orthokeratology lens of 0.75 DS CCF, while patients in the ICF group were fitted with orthokeratology lens of 1.25 D ICF. Taking 12 years old as a boundary, these two groups were divided into 8-11 years old and 12-15 years old group. The uncorrected visual acuity(UCVA), horizontal corneal curvature(K1)and corneal staining were recorded for all subjects after wearing lenses for 1 d, 1 wk, 1, 6 mo, 1 and 2 a. The axial length(AL)was recorded after wearing lenses for 6 mo, 1 and 2 a, and the complication and corneal epithelial staining were observed during lens wearing.RESULTS:The improvement of UCVA in the ICF group was faster than that in the CCF group, which were statistical significant after wearing lenses for 1 d, 1 wk and 1 mo, respectively(all P<0.001); however, there was no statistical significance between the two groups after 6 mo, 1 and 2 a(all P>0.05); K1 of the ICF group decreased faster than that of the CCF group, and there were statistical significance at 1 d, 1 wk, and 1 mo after wearing lenses(all P<0.05); there was no statistical significance at 6 mo, 1 and 2 a(all P>0.05). The axial length growth of patients aged 8-11 years old in the ICF group and CCF group was 0.35±0.17 and 0.48±0.26 mm, respectively(P=0.010), after wearing lenses for 2 a, and the axial length growth of patients aged 12-15 years old in the ICF group and CCF group was 0.16±0.15 and 0.31±0.29 mm, respectively(P=0.011). During the follow-up period, corneal spotting occurred in 6 eyes(8.5%)in the ICF group, and 7 eyes(10%)in the CCF group(P>0.05), all of which were grade 1 spotting.CONCLUSION:Wearing ICF orthokeratology lens is more effective than wearing CCF lenses in controlling the growth of axial length, with faster shaping and more obvious improvement in UCVA, especially for the prevention of high myopia in children under 12 years. Therefore, young children can give priority to wearing lenses that increase the compression factor, and for children over 12 years old, the compression factor of the lens can be selectively increased according to the wearer's eye habits, health status of ocular surface and visual function.
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Immune checkpoint inhibitors (ICIs) show unique advantages in the treatment of lung cancer, making the treatment of lung cancer enter the era of immunotherapy, but ICIs will also have adverse reactions, and the incidence of immune-induced hematological toxicity is not very high. Immunotherapy-induced thrombocytopenia is a rare adverse event.We report one case of thrombocytopenia induced by ICIs and review the literature on thrombocytopenia associated with ICIs and discuss the clinical features, possible mechanisms, and optimal treatment. .
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Humans , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Lung Neoplasms/drug therapy , Thrombocytopenia/chemically induced , Antibodies, Monoclonal, Humanized/adverse effectsABSTRACT
Objective:To evaluate the efficacy of ultrasound-guided bilateral erector spinae plane (ESP) block for pediatric patients undergoing Nuss procedure with general anesthesia.Methods:Thirty-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 4-15 yr, undergoing Nuss procedure with general anesthesia, were divided into ESP block plus general anesthesia group (group EG, n=16) and general anesthesia group (group G, n=16) using a random number table method.Bilateral ESP blocks were performed after anesthesia induction in group EG.Intravenous analgesia was performed postoperatively in both groups.Face Legs Activity Cry Consolability (FLACC) scores both at rest and during coughing were recorded on admission to postanesthesia care unit (PACU) and at 1, 6, 12, 24 and 48 h after operation.When FLACC score at rest >4, ibuprofen 5.0-7.5 mg/kg was taken orally according to the requirements of pediatric patients and their parents.The intraoperative amount of propofol and remifentanil used and postoperative requirement for fentanyl and ibuprofen were recorded.The development of postoperative hypoxia (SpO 2 <90%), nausea and vomiting, and urinary retention was recorded.The development of puncture site infection, hematoma and subcutaneous emphysema was recorded.The tracheal extubation time, duration in PACU and length of postoperative hospital stay were also recorded. Results:Compared with group G, FLACC scores at rest within 12 h after operation and during coughing within 6 h after operation were significantly decreased, the intraoperative consumption of remifentanil was reduced, the postoperative requirement for fentanyl and ibuprofen was decreased, the incidence of hypoxemia was decreased, the tracheal extubation time and duration in PACU were shortened ( P<0.05), and no significant change was found in the consumption of propofol, incidence of nausea and vomiting, or length of postoperative hospital stay in group EG ( P>0.05). Conclusion:Ultrasound-guided bilateral ESP block can reduce the consumption of opioids in the perioperative period and enhance the analgesic efficacy with a higher safety, which is helpful in promoting short-term outcomes for pediatric patients undergoing Nuss procedure with general anesthesia.
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Objective:To explore the effect and safety of the improved treatment of severe neonate hyperbilirubinemia by the automatic and synchronous exchange transfusion of peripheral artery and vein.Methods:From January 2016 to December 2019, 25 newborns with severe hyperbilirubinemia treated by automatic and synchronous exchange transfusion of peripheral artery and vein were selected in the research.During the operation of exchange transfusion, there were two pathways, the bloodletting one through the arteries and the transfusion one through the veins [the latter was connected to the blood-conveying leather pipeline special for Graseby 3000 syringe pump by the indwelling needle.The filter of the leather pipeline is Y-shaped and had two parallel blood transfusion plugs, one inserted into the red blood cell(RBC) bag, and the other into plasma bag.After infusion of 100 mL of RBC, clamped the RBC bag, and infused 500 mL of plasma.Then clamped the plasma bag and infused 100 mL of RBC.They were alternately operated]. The artery and the vein form a blood circuit, which was controlled by three infusion pumps (the first pump was for bloodletting, the second for transfusion, and the third for heparin sodium infusion). Hence the exchange transfusion became full-automatic.The changes of blood routine, total blood bilirubin(TBIL), blood gas analysis, blood glucose, electrolytes, blood culture and vital signs before and after transfusion were observed.Results:A total of 25 patients were studied, and the exchange transfusion time was controlled between 90-120 minutes.After transfusion, there were no statistically significant changes in breathing, heart rate, blood pressure, electrolytes and blood gas analysis(all P>0.05), while the serum TBIL and platelets(PLT) levels were significantly decreased[the amount of TBIL before and after blood transfusion: (485.8±126.5)μmol/L vs.(207.9±68.4)μmol/L; the amount of PLT before and after blood transfusion: (301.6±118.3)×10 9/L vs.(125.3±60.2)×10 9/L] ( t=-6.924, P<0.01; t=-7.986, P<0.01), and white the blood cells(WBC) was decreased [before blood transfusion: (12.57±6.11)×10 9/L, after blood transfusion: (8.98±3.24)×10 9/L, t=-2.922, P<0.05]. The trace blood glucose(TBG) was higher than normal after blood transfusion, with a significant change[before blood transfusion: (4.9±0.7)mmol/L, after blood transfusion: (7.1±1.5)mmol/L, t=3.866, P<0.01]. TBG restored within 24 h after exchange transfusion, PLT and WBC backed to normal within 72 h. Blood bacterial culture was negative in all cases after the exchange transfusion.No serious complications occurred and all patients were cured. Conclusion:It is simple, safe and reliable to treat severe neonate hyperbilirubinemia by the peripheral automatic exchange transfusion controlled by infusion pumps.The treatment is worthwhile to be recommended for clinical use in primary hospitals.
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Based on the rDNA sequence of Pichia pastoris, a multi-copy gene expression vector of transglutaminase (pPICZα-rDNA-mtg) was constructed and transformed to the host strain (pGAP9-pro/GS115) expressing pro peptide, to obtain the co-expression strain pro/rDNA-mtg (GS115). Real-time fluorescence quantitative PCR (qPCR) was used to analyze transglutaminase gene copy number in the 4 positive strains. We further studied the effect of gene copy on the enzyme production of recombinant Pichia pastoris as well as high-density fermentation of higher expression strain in a 3-L fermenter. The mtg copy numbers of the 4 positive strains were 2.21, 3.36, 5.72 and 7.62 (mtg-2c, mtg-3c, mtg-6c and mtg-8c), respectively, and the enzyme production capacity and protein expression level were mtg-3c>mtg-2c>mtg-6c>mtg-8c. Mtg-3c and mtg-6c of high-density fermentation had the highest enzymatic activity and enzymatic activity per unit wet weight in the supernatant of 3.12 U/mL, 52.1 U/g (wet weight) and 2.07 U/mL and 36.5 U/g (wet weight), respectively. In terms of enzyme activity per unit wet weight, mtg-3c is 1.4 times higher than that of mtg-6c. The activity of purified enzyme (mtg-3c) was up to 7.21 U/mL and the protein concentration was 437.2 μg/mL. By analyzing the effect of mtg copy number on the enzyme production of recombinant strains, mtg-3c is suitable for the co-expression of two genes (pro and mtg) in pro/rDNA-mtg, and its enzyme activity is related to higher protein secretion of the strain.
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Objective To investigate the therapeutic effect of double leaf flap in repairing nasal alar soft tissue defect.Methods In 25 patients with basal cell carcinoma of nasal wing skin,the defect diameter of nasal wing soft tissue between 0.5 cm and 2.0 cm was removed and the defect was repaired with double flap immediately.Results The patients in this group were all successful in surgery.The incisions were all first-stage healing,no necrosis of the skin flap,1 to 3 years of follow-up after surgery,no recurrence of cancer,and the repair of the skin flap was basically the same as the color and texture of the surrounding tissue.The scars were not obvious.The lateral nasal wing physiological radians were naturally smooth.Both sides were symmetrical and met the aesthetic standards of the nose.Conclusions With the advantages of simple design and simple operation,high survival rate and beautiful shape of nasal wing after repair,the double-leaf flap can be widely used in clinic.
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Objective To explore the application of "kite" flap in soft tissue defect of eyelid and periocular skin.Methods A triangular ("kite") flap was designed in close proximity to the defect after eyelid and periocular skin lesions.Under orbicular muscle or fascia,the flap with muscle or fascia was removed.Since 2011,we have selected 50 patients aged 16-70 years.Results All incisions were primary healing,no recurrence of the lesion and all flaps survived,Follow up for 1 to 5 years showed that the scar of the incision was not obvious,no tissue organ was displaced,and the form of the eyelid and eyebrow on both sides was naturally smooth and symmetrical.Conclusions For the soft tissue defect of the eyelid and periocular skin,not suitable for direct suture,the "kite" flap can be used for the repair,which is simple and easy,with ideal results.
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Objective To explore the application of washing fluid in the prevention of postoperative incision infection of colorectal cancer. Methods 350 patients with colorectal cancer underwent colorectal surgery from Jan. 2012 to Dec. 2015 were randomly divided into three groups: sterile saline, 0.50% metronidazole, 0.50% Povidone-iodine solution group, while part of the rinse liquid heated to 37 ~38℃ before use, then record the operation time, surgical site, postoperative incision infection, incision infection, timely delivery statistical analysis was performed by using single factor analysis and logistic multivariate regression analysis. Age, operation time, surgical site, type of irrigating fluid and temperature of flushing fluid were analyzed statistically. Results The incision infection rate of the patients ≥60 years old and the operation time ≥2 h was higher than the age <60 years, and the operation time was less than 2 h, P < 0.05, the difference was statistically significant; 0.50% metronidazole, 0.50% Povidone-iodine solution group, the infection rates of 0.50% metronidazole and 0.50% povidone-iodine group were 7.69% and 8.55%, respectively, which were significantly lower than those of the saline group 16.38% The infection rate of the rinsing fluid after heating was 7.22% and 14.71%, respectively, lower than that of the normal temperature rinsing solution (P < 0.05), the difference was statistically significant. Conclusions The risk factors of incisional infection in colorectal cancer patients with colorectal cancer were : ≥60 years of age and ≥2 h of operation, while 0.50%metronidazole, 0.50% povidone-iodine solution and heated washing fluid were protective factors. It can be applied to prevent incision infection after laparoscopic surgery.
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Studies show that heme oxygenase-1 (HO-1) can promote the tumor neovascularization via interacting with angiogenic factors,such as vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1.On the other hand,HO-1 may suppress angiogenesis in tumors via inhibiting the transcription of NF-кB.In a word,HO-1 may participate in the pathophysiological process of tumor angiogenesis,and may be a new target for cancer treatment.
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Objective To explore the application and efficacy of autogenous septal cartilage in the correction of cleft lip nasal deformity.Methods A total of 31 patients with secondary nasal deformity of cleft lip were involved in this study.After autologous nasal cartilage was released,the dislocation of nasal cartilage was corrected,nasal septum cartilage was used as substitute to raise the alar collapse,to reshape the nasal tip cartilage structure and correct the nasal deformity.Results Postoperative incision was primarily healing.For cartilage donor area there was no serious complications,and incision scar was concealed and unobvious; after 6 months to 2 years follow-up,there was no cartilage absorption deformation,the tip of the nose was flat,crack side nosewing collapses,and nasal columella skew was totally corrected,with stable rhinoplasty effects.Conclusions For secondary nasal deformity of cleft lip,the use of nasal septum cartilage to repair nose deformity can not only solve the cartilage source,but also give septal straightening and at the same time the correction effect of external nasal deformity is good.
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This paper probed into the talent training mode of two circles training,alternation of learning and training of bio-pharmaceutical technology through the reform of professional cognitive practice,professional skill training and post practice,etc.The practice teaching reforms carried out above intensify students' professional competence and professional quality.
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Objective To explore the feasibility of visually assessment of angiogenesis in a murine model of subcutaneous matrigel plugs with ultrasound molecular imaging(UMI) using microbubbles(MB)targeted to endothelial αv-integrins. Methods Matrigel angiogenesis was created by subcutaneous implantation of FGF-2 enriched matrigel in 10 mice. On day 10, UMI of the matrigel was performed in all mice at 6 minutes after intravenous injection of either αv-integrin targeting microbubbles(MBα) or isotype control microbubbles(MBc) in random with 30 min interval,and the video intensity(Ⅵ) was measured. To further test the specificity of the signal coming from MBα,antibody against αv-integrin was injected 10 min before microbubbles injection. Following UMI,all matrigels were harvested for histological analysis. Results As expected,VI of the matrigel was significantly higher ( P ＜0.05) for MBα (20. 5 ± 3.3)U as compared with MBc (4. 8 ± 1.5)U. After blocking with antibody against αv-integrin,a great decrease was observed in the MBα group [VI (4.6 ± 1.2) U, P ＜0.05] while no significant difference was noted for MBc [VI (4. 9 ±1.5)U, P ＞ 0.05 ]. Neovessels within matrigel was positive for αv-integrin. Conclusions UMI with microbubbles targeted to αv-integrins can be effective and specific in evaluating the angiogenesis in a murine model of subcutaneous matrigel plugs.