Advances in the study of the pathogenesis of ophthalmic surgery-related dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

With the rapid development and widespread implementation of all types of ophthalmic surgery, more attention is being paid to the quality of post-operative vision. Dry eye is a common complication after ophthalmic surgery, often causing eye discomfort, blurred vision and other dry eye symptoms. Ophthalmic surgery-related dry eye is a common type of dry eye and is usually caused by a combination of surgical injury to the conjunctival tissue and nerves, destabilisation of the tear film, postoperative inflammatory reaction and perioperative topical medication. This article reviews the risk factors for ophthalmic surgery-related dry eye, the pathogenesis of dry eye due to different ophthalmic surgeries and the prevention of this type of dry eye, with the aim of reducing the occurrence and development of ophthalmic surgery-related dry eye and improving the quality of vision and life after ophthalmic surgery in the clinical setting.

Effects of intravascular hypothermia combined with early post-pyloric feeding on neurological function and prognosis in patients with first severe ischemic stroke / 中国实用护理杂志

Objective:To investigate the effects of intravascular hypothermia combined with early post-pyloric feeding on the neurological function and prognosis in patients with severe ischemic stroke, and to provide a theoretical basis for clinical decision-making on the optimal nutritional support strategy for patients with severe ischemic stroke during intravascular hypothermia treatment.Methods:This was a retrospective, non-randomized, controlled study. A total of 78 patients with first severe ischemic stroke who were admitted to the ICU of Neurology Department, Xuanwu Hospital, Capital Medical University from January 2018 to December 2021 were selected. General information and clinical data of the patients were collected and grouped according to intrvascular hypothermia combined with nutritional support. Patients were divided into early post-pyloric feeding group of 52 cases and early parenteral nutrition group of 26 cases. The neurological prognosis, disease prognosis, nutritional status and complications related to nutritional support of the two groups were retrospectively analyzed.Results:The Glasgow score at 30th day after intravascular hypothermia in the early postpyloric feeding group was (11.25 ± 4.92) points, which was higher than that in the early parenteral nutrition group (8.40 ± 5.53), and the difference was statistically significant ( t=-2.45, P<0.05). After treatment, the serum total protein and hemoglobin of early postpyloric feeding group were (59.56 ± 5.09) g/L and (131.06 ± 19.58) g/L, respectively, which were higher than those of early parenteral nutrition group (56.52 ± 7.94) g/L and (122.07 ± 17.72) g/L. The difference was statistically significant ( t=-2.03, -1.91, P<0.05). The clinical pulmonary infection score of the early postpyloric feeding group was (7.33 ± 0.96) points, which was lower than that of the early parenteral nutrition group (9.42 ± 2.11). The mechanical ventilation time and ICU stay time were (17.46 ± 10.47) days and (28.89 ± 12.59) days, respectively. Compared with the early parenteral nutrition group (25.77 ± 15.20) days and (37.07 ± 17.15) days, the differences were statistically significant ( t=3.28, 2.83, 2.52, all P<0.05). There were no significant differences in catheter-associated bloodstream infection and ICU hospitalization mortality between the two groups (both P>0.05). Conclusions:Intravascular hypothermia combined with early post-pyloric feeding can improve the nutritional status of patients with severe ischemic stroke, effectively control pulmonary infection, shorten mechanical ventilation and hospital stay, and promote neurological repair.

Comparison of 17β-estradiol against retinal light damage in BALB/c or C57BL/6 mice / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the neuroprotective effect of 17β-estradiol(E2)on retina light damage in BALB/c and C57BL/6 mice and provide experimental data for the successful construction of a research model for E2 against retinal light damage.METHODS:Totally 40～45 adult female BALB/c or C57BL/6 mice were divided into six groups, 6 for each group: normal control, ovariectomized control, ovariectomized light(mice were stimulated with continuous white light at 10000 lx for 4, 8, 12, 16, and 24h after 14d of ovariectomy), intravitreal administration sham operation, saline and E2 pre-treatment groups(2μL saline or 10-5mol/L E2 were intravitreal injected respectively after 14d of ovariectomy operation and 24h of dark adaptation). The morphological and functional changes of the retina were detected by paraffin section HE staining, TUNEL staining and electroretinogram.RESULTS:In the ovariectomized light group, the thickness of the inner/outer nuclear layer decreased significantly from the 4h stimulation of 10000 lx white light group. Intravitreal administration of E2 significantly inhibited the apoptosis of retinal cells in the two strains of mice(P&#x003C;0.01)and the decrease of amplitudes of a- and b-waves in max-ERG of C57BL/6 mice(P&#x003C;0.05).CONCLUSION:The light loss sensitivity of two strains of mice was different under the same light stimulation. E2 had a protective effect on both morphology and function of the retina in BALB/c mice, and had a significant protective effect on retina function in C57BL/6 mice.

Current status and prospect of supermicrosurgery in maxillofacial reconstruction / 中华显微外科杂志

Supermicrosurgery is a hot topic in the field of microsurgery and reconstruction. The core concept of supermicrosurgery is precision and minimally invasive, which coincides with the concept of maxillofacial reconstruction. Oral and maxillofacial regions play an important role in aesthetics and function, and the structure of oral and maxillofacial tissues is complex. Various types of flaps, especially vascularised free flaps, are required for the repair of various complex maxillofacial defects. However, at present, conventional microsurgery does meet the requirement of mandibular reconstruction in special cases. Super microsurgical technique can further supplement the deficiency of conventional methods of repair and reconstruction in maxillofacial reconstruction. Under the guidance, many new methods of maxillofacial surgery have inevitably emerged. The application of supermicrosurgery in maxillofacial head and neck is still in its early stage, and there are still many difficulties to overcome and many technical issues to be furtherresolved. Supermicrosurgery is not only an advanced technique, but also an advanced concept in surgery. Supermicrosurgery is expected to show its clinical value in oral and maxillofacial reconstruction. In this paper, the application of supermicrosurgery in maxillofacial reconstruction is reviewed and its application prospect is prospected.

DDB1- and CUL4-associated factor 8 plays a critical role in spermatogenesis / 医学前沿

Cullin-RING E3 ubiquitin ligase (CRL)-4 is a member of the large CRL family in eukaryotes. It plays important roles in a wide range of cellular processes, organismal development, and physiological and pathological conditions. DDB1- and CUL4-associated factor 8 (DCAF8) is a WD40 repeat-containing protein, which serves as a substrate receptor for CRL4. The physiological role of DCAF8 is unknown. In this study, we constructed Dcaf8 knockout mice. Homozygous mice were viable with no noticeable abnormalities. However, the fertility of Dcaf8-deficient male mice was markedly impaired, consistent with the high expression of DCAF8 in adult mouse testis. Sperm movement characteristics, including progressive motility, path velocity, progressive velocity, and track speed, were significantly lower in Dcaf8 knockout mice than in wild-type (WT) mice. However, the total motility was similar between WT and Dcaf8 knockout sperm. More than 40% of spermatids in Dcaf8 knockout mice showed pronounced morphological abnormalities with typical bent head malformation. The acrosome and nucleus of Dcaf8 knockout sperm looked similar to those of WT sperm. In vitro tests showed that the fertilization rate of Dcaf8 knockout mice was significantly reduced. The results demonstrated that DCAF8 plays a critical role in spermatogenesis, and DCAF8 is a key component of CRL4 function in the reproductive system.

Effect of the regulator of G-protein signaling 2 on the proliferation and invasion of oral squamous cell carcinoma cells and its molecular mechanism / 华西口腔医学杂志

OBJECTIVES@#This study aims to investigate the effect of the regulator of G-protein signaling 2 (RGS2) on the proliferation and invasion of oral squamous cell carcinoma (OSCC) cells and its potential molecular mechanism. Metho⁃ds The expression status and clinical significance of RGS2 in head and neck squamous cell carcinomas and matched adjacent normal tissues were evaluated using TCGA database. Three OSCC cell lines (i.e., SCC-9, Cal27, and Fadu) were overexpressed with RGS2, and the effect of RGS2 on cell proliferation and invasion was determined using the Transwell, clone formation, and cell counting kit (CCK)-8 assays. Moreover, the yeast two-hybrid scree-ning and co-immunoprecipitation (Co-IP) assays were conducted to detect the correlation of RGS2, four and a half LIM domains protein 1 (FHL1), and damage DNA-binding protein 1 (DDB1).@*RESULTS@#The expression level of RGS2 in OSCC was significantly lower than that in matched adjacent normal tissues (@*CONCLUSIONS@#RGS2 plays an important role in the inhibition of OSCC proliferation and invasion. The structure stability of RGS2 is competitively regulated by FHL1 and DDB1.

Hypoalbuminemia and Central Venous Catheter as Risk Factors for Multidrug-resistant Healthcare-associated Pneumonia in an Intensive Care Setting

The rapid emergence of antibiotic­resistant bacteria is a threat to global health particularly in the area of healthcare­associate pneumonia (HCAP) where there is high rate of mortality. In general, guidelines should serve as a framework that needs to be complemented by local antibiogram data due to multiple factors influencing the development of multidrug­resistant (MDR) HCAP. Failure to administer prompt and appropriate empirical therapy would often result in a high mortality rate. Based on these concerns, the aim of the study was to evaluate the appropriate empirical use of antibiotic and risk factors of MDR HCAP based on local pathogen resistant pattern. This was a retrospective analysis on HCAP in critical care of a tertiary­care hospital with data fromJanuary 2016 to December 2018. Patients diagnosed with HCAP: hospital­associated pneumonia (HAP) and ventilator­associated pneumonia (VAP), with positive bacterial cultures were included into the study. Of the 269 patients and isolates included, 160 (59.5%) had MDR strains. The top causative pathogens isolated were Acinetobacter baumannii(n=104, 38.7%), Pseudomonas aeruginosa(n=66, 24.5%), Klebsiella spp(n==55, 20.4%), and Staphylococcus aureus(n=16, 5.9%). The incidence of inappropriate empirical antibiotic was significantly higher in patients with MDR HCAP (n=135, 84.4%) compared to those with non­MDR HCAP (n=34, 31.2%) (p < 0.001). Mortality was significantly higher in patients receiving inappropriate empirical therapy (n = 118, 72.4%) compared to those receiving appropriate empirical antibiotic (n = 36, 54.5%) (P = 0.009). The independent risk factors for MDR HCAP identified in this study were hypoalbuminemia (odds ratio [OR] 3.43, 95% confidence interval [CI] 1.08 –10.87, p = 0.036) and indwelling central venous catheter (OR 5.65, 95% CI 1.13 –28.18, p = 0.035). This work serves as a basis for a center­specific guideline to improve antibiotic use among HCAP patients in intensive care setting.

Prevention and treatment strategies for sarcopenic obesity in the elderly / 中华老年医学杂志

Sarcopenic obesity(SO)has been a hot issue in the field of geriatrics.SO is associated with major adverse health consequences such as falls, disability, fractures, cardiometabolic diseases, cancer and death.The pathogenesis of SO is still unclear, mainly involving age-related changes in body composition, chronic low-grade inflammation, insulin resistance and sex-specific hormonal changes.Lifestyle interventions, including rational nutrition, physical activity, and especially aerobic exercise and resistance training, are the cornerstones of SO treatment.Emerging therapies include testosterone supplements, selective androgen receptor modulators, myostatin inhibitors, whole body vibration therapy, vitamin K and mesenchymal stem cell therapy.There is an urgent need for researchers and clinicians to have an in-depth understanding of the pathogenesis of SO and carry out effective prevention and treatment.

Clinical observation and analysis of BLB implant system over 10 years / 医学研究生学报

Objective The lack of observation on domestic BLB implant affect its longterm maintenance. The long-term clinical effect of domestic BLB implant system was evaluated by a 10-year follow-up.Methods A total of 179 implants were placed in 120 patients from January 2004 to December 2005 in Nanjing Stomatological Hospital. Patients accepted implant pattern of stage Ⅰ implantation and stage Ⅱ delayed exposure and prostheses were completed. Upper crowns were either screw-retained or cemented. Follow-up observation includes post-operation immediately, pre-secondary operation, 3 months and annually.Results Until December 2017, the rate of loss of follow-up was 6% and the overall survival rate was 95.2%. Implant failures were mainly due to the looseing of implant system caused by bone resorption and infection. Prosthetic complications include abutment loose, central screw loose, food impaction and porcelain fracture. There were no significant differences of failure cases comparing maxillary and mandible (P>0.05); neither comparing anterior teeth, pre-molars and molars (P>0.05)Conclusion When clinical indication is strictly controlled, BLB implant system is suitable for partially edentulous patients.

Status of Secondary Prevention and Control of Risk Factors in Elderly Patients With Coronary Heart Disease in Guangzhou / 中国循环杂志

Objectives: To investigate the status of secondary prevention, treatment and risk factors of retired elderly patients (≥80 years old) with coronary heart disease in Guangzhou. Methods: A total of 752 questionnaires were collected from the elderly patients with coronary heart disease who underwent routine cardiovascular checkup in our hospital from March to May in 2016. The questionnaire included basic situation, complications, weight, blood pressure, low density lipoprotein, glucose level and secondary prevention medications based on evidence-based medicine. Results: Antiplatelet drugs, beta blockers, statins, ACEI/ARB use rate was 55.72%, 30.98%, 25.13%, 42.69% for the secondary prevention; 21.94% patients did not take secondary prevention drugs, the combined use rate of the four drugs was 4.92%. In elderly patients with coronary heart disease, the control rate of blood pressure (<150/90 mmHg), fasting blood glucose (<7mmol/L), 2-hour postprandial blood glucose (<10 mmol/L), body mass index (<24 kg/m2) were 81.17% (470/579 cases), 77.61% (253/326 cases), 55.21% (180/326 cases) and 54.73% (266/486 cases), respectively. With LDL-C<1.8 mmol/L as the standard, percent with normal LDL-C value was 14.06% (63/448 cases). Conclusions: In this survey population, use rate of the four types of drugs for secondary prevention and the control rate of known risk factors for coronary artery disease are very low. Efforts are needed to improve rational use of the secondary prevention drugs, minimize the gaps between promote the guidelines and clinical practice, and reduce the recurrence rate of coronary heart disease in elderly patients with coronary artery disease.

Yizhi Congming Decoction attenuates learning and memory deficits through reducing tau hyperphosphorylation in Aβ-induced AD mice / 中成药

AIM To study the effects of Yizhi Congming Decoction (Ginseng Radix et Rhizoma,Poria,Polygoni multiflori Radix praeparata,etc.) on learning and memory deficits through reducing tau hyperphosphorylation in Aβ-induced AD mice and its mechanism of action.METHODS Sixty ICR mice were randomly and equally assigned into six groups.Sham group (injection of 3 μL normal saline into left hippocampus),model group,donepezil group and each group of Yizhi Congming Decoction (injection of 3 μL Aβ25-35 into left hippocampus).Donepezil group and three treatment groups were gavaged with donepezil and Yizhi Congming Decoction.After 15 days of administration,immunohistochemistry was used to observe the expressions of Ser404 and Thr231.Western blot was performed to evaluate the levels of phosphatidylinositol-3-kinase (PI3K),threonine/serine protein kinase B (AKT) and glycogen synthase kinase 3β (GSK3β).RESULTS Yizhi Congming Decoction attenuated the levels of phosphorylated tau at the Thr231 and Ser404 sites in the hippocampus and increased the phosphorylation levels of PI3K,AKT and GSK3β.CONCLUSION Yizhi Congming Decoction effectively provides protection against learning and memory deficits and inhibits hyperphosphorylated tau protein expression in the hippocampus.The possible mechanism may occur via the PI3 K/Akt-dependent GSK3 β signalling pathway.

Yizhi Congming Decoction attenuates learning and memory deficits through reducing tau hyperphosphorylation in Aβ-induced AD mice / 中成药

AIM To study the effects of Yizhi Congming Decoction (Ginseng Radix et Rhizoma,Poria,Polygoni multiflori Radix praeparata,etc.) on learning and memory deficits through reducing tau hyperphosphorylation in Aβ-induced AD mice and its mechanism of action.METHODS Sixty ICR mice were randomly and equally assigned into six groups.Sham group (injection of 3 μL normal saline into left hippocampus),model group,donepezil group and each group of Yizhi Congming Decoction (injection of 3 μL Aβ25-35 into left hippocampus).Donepezil group and three treatment groups were gavaged with donepezil and Yizhi Congming Decoction.After 15 days of administration,immunohistochemistry was used to observe the expressions of Ser404 and Thr231.Western blot was performed to evaluate the levels of phosphatidylinositol-3-kinase (PI3K),threonine/serine protein kinase B (AKT) and glycogen synthase kinase 3β (GSK3β).RESULTS Yizhi Congming Decoction attenuated the levels of phosphorylated tau at the Thr231 and Ser404 sites in the hippocampus and increased the phosphorylation levels of PI3K,AKT and GSK3β.CONCLUSION Yizhi Congming Decoction effectively provides protection against learning and memory deficits and inhibits hyperphosphorylated tau protein expression in the hippocampus.The possible mechanism may occur via the PI3 K/Akt-dependent GSK3 β signalling pathway.

The clinical application of modified adams clasp / 实用口腔医学杂志

The disadvantages of Admas clasp include inconvenient manual adjustment and being unsuitable to the deciduous molars.The modified Admas clasp can overcome the shortcomings.

Prognostic and clinical value of Sirt1 expression in gastric cancer: A systematic meta-analysis / 华中科技大学学报（医学）（英德文版）

Many studies have reported that the expression of silent information regulator 1 (Sirt1) is associated with the clinical features and prognosis of patients with gastric cancer, but the exact function remains controversial. We conducted this study to illustrate the clinical and prognostic value of Sirt1 in gastric cancer. The related publications before December 2015 were searched in the databases including Pubmed, Cochrane Library, Embase and China National Knowledge Infrastructure (CNKI). The studies were included and excluded according to the inclusion criteria and exclusion criteria. The 3- and 5-year overall survival (OS) and clinical features such as age, T stage, N stage and differentiation were analyzed by software RevMan 5.3. A total of 1650 patients in 7 studies were included according to the inclusion criteria and exclusion criteria. The high expression of Sirt1 was found in 58.4% cases by immunohistochemistry. High expression of Sirt1 was closely linked with the 3-year OS (OR=0.25, 95% CI: 0.16-0.39, P<0.00001, fixed), patient's age (≥60 years old vs. <60 years old; OR=1.43, 95% CI: 1.06-1.93, P=0.02, fixed), T stage (T3+T4 vs. T1+T2; OR=1.45, 95% CI: 1.08-1.94, P=0.01, fixed), N stage (N1+N2+N3 vs. N0; OR=3.47, 95% CI: 2.39-5.05, P<0.00001, fixed) and tumor differentiation (G1+G2 vs. G3; OR=0.50, 95% CI: 0.35-0.69, P<0.0001, fixed). Nevertheless, it seemed that high expression of Sirt1 was not associated with 5-year OS (OR=0.44, 95% CI: 0.15-1.28, P=0.13, random). It was suggested that the high expression of Sirt1 implies a poor prognosis of gastric cancer patients in a relatively short period (3 years), but not in a long time (≥5 years). The expression of Sirt1 is also linked with patients' age, T stage, N stage and tumor differentiation.

The treatment of mesially impacted mandibular second molar / 实用口腔医学杂志

The mesially impacted of mandibular second molar is one kind of common malocclusion in clinic.It can lead to damages to stomatognathic system.The looped uprightor is an effective tool in the treatment of this kind of malocclusion.

Prognostic and clinical value of Sirt1 expression in gastric cancer: A systematic meta-analysis / 华中科技大学学报（医学）（英德文版）

Many studies have reported that the expression of silent information regulator 1 (Sirt1) is associated with the clinical features and prognosis of patients with gastric cancer, but the exact function remains controversial. We conducted this study to illustrate the clinical and prognostic value of Sirt1 in gastric cancer. The related publications before December 2015 were searched in the databases including Pubmed, Cochrane Library, Embase and China National Knowledge Infrastructure (CNKI). The studies were included and excluded according to the inclusion criteria and exclusion criteria. The 3- and 5-year overall survival (OS) and clinical features such as age, T stage, N stage and differentiation were analyzed by software RevMan 5.3. A total of 1650 patients in 7 studies were included according to the inclusion criteria and exclusion criteria. The high expression of Sirt1 was found in 58.4% cases by immunohistochemistry. High expression of Sirt1 was closely linked with the 3-year OS (OR=0.25, 95% CI: 0.16-0.39, P<0.00001, fixed), patient's age (≥60 years old vs. <60 years old; OR=1.43, 95% CI: 1.06-1.93, P=0.02, fixed), T stage (T3+T4 vs. T1+T2; OR=1.45, 95% CI: 1.08-1.94, P=0.01, fixed), N stage (N1+N2+N3 vs. N0; OR=3.47, 95% CI: 2.39-5.05, P<0.00001, fixed) and tumor differentiation (G1+G2 vs. G3; OR=0.50, 95% CI: 0.35-0.69, P<0.0001, fixed). Nevertheless, it seemed that high expression of Sirt1 was not associated with 5-year OS (OR=0.44, 95% CI: 0.15-1.28, P=0.13, random). It was suggested that the high expression of Sirt1 implies a poor prognosis of gastric cancer patients in a relatively short period (3 years), but not in a long time (≥5 years). The expression of Sirt1 is also linked with patients' age, T stage, N stage and tumor differentiation.

Survival analysis of 256 patients with oral cancer / 中国肿瘤临床

Objective:To analyze survival in patients with advanced oral cancer from prospective clinical trials. Methods:From 2008 to 2010, 256 patients with oral cancer at clinical stage III/IVA were randomly categorized into two groups. Patients in the experi-mental group received neo-adjuvant chemotherapy, surgery, and post-operative radiation, and patients in the control group underwent surgery and post-operative radiation. All patients were routinely followed-up after treatments. Survival was analyzed using Kaplan–Meier method and log-rank test, and differences were considered statistically significant at P value lower than 0.05. Results: Each group was composed of 128 patients. With the median follow-up period of 60 months, the 5-year overall survival rate was 61.7%and the disease-free survival rate was 53.9%. The overall survival rate (P=0.350) and the disease-free survival rate (P=0.160) were not sig-nificantly different between the experimental and control groups. Patients with positive pathological response to neo-adjuvant chemo-therapy exhibited significantly improved overall survival (P＜0.05). Conclusion:Radical surgery should be emphasized to improve the prognosis of oral cancer. Functional reconstruction could also improve the quality of life and survival of patients. Despite that neo-adju-vant chemotherapy could not improve the survival of patients with advanced oral cancer in entirety, it could benefit patients exhibiting positive treatment responses.

Clinical significance of perineural invasion among patients with early squamous cell carcinoma of the tongue / 中国肿瘤临床

Objective:To investigate the effect of perineural invasion (PNI) on patients with early squamous cell carcinoma of the tongue (ESCCT) and the controversial issues related to PNI's effect on loco-regional recurrence, cervical lymph node metastases, and prognosis. Methods:Data of 156 patients with ESCCT were analyzed. Two subgroups comprising 40 patients each were investigated. One was PNI-positive subgroup, and the other subgroup was consisted of patients with PNI-negative carcinomas. These patients had similar histopathological characteristics and were randomly selected from the total number of cases. The relationship among the prevalence of PNI, loco-regional recurrence, cervical lymph node metastases, and prognosis was analyzed. Results:PNI was significantly correlated with high cervical lymph node metastases and poor 5-year survival rates (P=0.045 and P=0.034, respectively) but not with local recurrence (P=0.531). Elective neck dissection was considerably associated with a low risk of regional recurrence among the PNI-positive ESCCT patients (P=0.001). Conclusion:PNI should be considered as a predictor for high cervical lymph node metastases and poor 5-year survival of early tongue squamous cell carcinoma. Elective neck lymph node dissection should be performed among patients with PNI-positive early tongue squamous cell carcinoma.

The early treatment of buccoversion malpositon of maxillary second molars / 实用口腔医学杂志

The buccoversion malpositon of maxillary second molars is one kind of common malocclusion.It can lead to damages to stoma-tognathic system.The adjustable maxillary molar retractor is an effective tool in the early treatment of this kind of malposition.

Neurobiology of head-neck squamous cell carcinoma / 国际肿瘤学杂志

Neonatal nerves exist in tumor tissues,and tumor cells can invade nerve by neurogenesis.Current research shows that cancer cells can secrete cytokines to promote the differentiation and growth of nerve cells,in turn,the differentiation and growth of nerve cells can stimulate tumor development and metastasis.Neurogenesis is one way of interaction bettween tumor cells and microenvironment similar to angiogenesis and lymphangiogcnesis,which has a major impact on biological behavior of tumor cells and prognosis.