Surgical decisions and outcomes of rhegmatogenous retinal detachment during the coronavirus disease 2019 pandemic: Data from a tertiary referral center in Taiwan

Purpose: To assess changes in surgical decisions and outcomes of rhegmatogenous retinal detachment (RRD) during the COVID?19 pandemic at a tertiary center in Taiwan. Methods: Patients undergoing pars plana vitrectomy (PPV) or scleral buckling (SB) for primary RRD during Taiwan’s first wave of domestic COVID?19 cases surge between May and July 2021 (COVID cohort, n = 100) were compared to controls in the closest pre?COVID year, 2019 (pre?COVID cohort, n = 121). Results: The COVID cohort had significantly worse RRD presentation, received more PPV (alone or combined with SB (PPV + SB)) and less SB alone, and had comparable single?surgery anatomic success (SSAS) rates. In patients who underwent PPV, more underwent PPV + SB instead of PPV alone. The decision to combine SB in PPV surgery was significantly affected by the COVID pandemic (odds ratio [OR], 3.1860 [95% confidence interval (CI), 1.1487–8.8361]). However, a shorter duration of symptoms before the first presentation (0.9857 [95% CI, 0.9720–0.9997]) was the only factor related to SSAS, whereas the surgical method had no association. The SSAS rate remained close to or over 90% in patients with a duration of symptoms before surgery ?4 weeks but dropped to 83.3% in patients with duration >4 weeks. Conclusion: During the COVID?19 pandemic, worse RRD presentations led to a shift in preference for PPV over SB alone as the primary surgery. The pandemic affected surgeons’ decision to combine SB during PPV. Nevertheless, SSAS was only associated with the duration of symptoms but not with surgical methods.

Pinpointing Synechococcus Rubisco large subunit sections involved in heterologous holoenzyme formation in Escherichia coli

Aims@#Heterologous holoenzyme formation of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) has been a challenge due to a limited understanding of its biogenesis. Unlike bacterial Rubiscos, eukaryotic Rubiscos are incompatible with the Escherichia coli (E. coli) chaperone system to fold and assemble into the functional hexadecameric conformation (L8S8), which comprises eight large subunits (RbcL) and eight small subunits (RbcS). Our previous study reported three sections (residues 248-297, 348-397 and 398-447) within the RbcL of Synechococcus elongatus PCC6301, which may be important for the formation of L8S8 in E. coli. The present study further examined these three sections separately, dividing them into six sections of 25 residues (i.e., residues 248-272, 273-297, 348-372, 373-397, 398-422 and 423-447).@*Methodology and results@#Six chimeric Rubiscos with each section within the RbcL from Synechococcus replaced by their respective counterpart sequence from Chlamydomonas reinhardtii were constructed and checked for their effect on holoenzyme formation in E. coli. The present study shows that Section 1 (residues 248-272; section of Synechococcus RbcL replaced by corresponding Chlamydomonas sequence), Section 2 (residues 273-297), Section 3 (residues 348-372) and Section 6 (residues 423-447) chimeras failed to fold and assemble despite successful expression of both RbcL and RbcS. Only Section 4 (residues 373-397) and 5 (residues 398-422) chimeras could form L8S8 in E. coli.@*Conclusion, significance and impact of study@#GroEL chaperonin mediates the folding of bacterial RbcL in E. coli. Therefore, residues 248-297, 348-372 and 423-447 of Synechococcus RbcL may be important for interacting with the GroEL chaperonin for successful holoenzyme formation in E. coli.

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Background@#To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care. @*Methods@#This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR. @*Results@#There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70). @*Conclusion@#Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.

Guidelines for the application of the fundus autofluorescence in age-related macular degeneration(2023) / 国际眼科杂志(Guoji Yanke Zazhi)

Fundus autofluorescence(FAF)imaging is based on the fluorescence excited by the endogenous fluorophores in the retinal pigment epithelium and choroid, mainly referring to lipofuscin(LF)and melanin. The non-invasive examination method can imply the function of retinal pigment epithelium by observing the spatial distribution of LF or melanin. This technique has unique advantages in the diagnosis and differentiation of age-related macular degeneration(ARMD). This guideline is to standardize and interpret the application of FAF in different stages and classifications of ARMD.

Impact of bicuspid aortic valve or tricuspid aortic valve on hemodynamics and left ventricular reverse remodeling in patients after transcatheter aortic valve replacement / 中华心血管病杂志

Objective: To compare the impact of bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) on hemodynamics and left ventricular reverse remodeling after transcatheter aortic valve replacement (TAVR). Methods: We retrospectively analyzed the clinical data of patients who underwent TAVR in our hospital from January 2019 to March 2021. Patients were divided into BAV group and TAV group according to aortic contrast-enhanced CT. Each patient was followed up by N-terminal pro B-type natriuretic peptide (NT-proBNP) and echocardiography at four time points, namely before TAVR, 24 hours, 1 month and 6 months after TAVR. Echocardiographic data, including mean pressure gradient (MPG), aortic valve area (AVA), left ventricular ejection fraction (LVEF), left ventricle mass (LVM) and LV mass index (LVMi) were evaluated. Results: A total of 41 patients were included. The age was (75.0±8.6) years, and male patients accounted for 53.7%. There were 19 BAV patients and 22 TAV patients in this cohort. All patients undergoing TAVR using a self-expandable prosthesis Venus-A valve. MPG was (54.16±21.22) mmHg(1 mmHg=0.133 kPa) before TAVR, (21.11±9.04) mmHg at 24 hours after TAVR, (18.84±7.37) mmHg at 1 month after TAVR, (17.68±6.04) mmHg at 6 months after TAVR in BAV group. LVEF was (50.42±13.30)% before TAVR, (53.84±10.59)% at 24 hours after TAVR, (55.68±8.71)% at 1 month after TAVR and (57.42±7.78)% at 6 months after TAVR in BAV group. MPG and LVEF substantially improved at each time point after operation, and the difference was statistically significant (all P<0.05) in BAV group. MPG in TAV group improved at each time point after operation, and the difference was statistically significant (all P<0.05). LVMi was (164.13±49.53), (156.37±39.11), (146.65±38.84) and (134.13±39.83) g/m2 at the 4 time points and the value was significantly reduced at 1 and 6 months post TAVR compared to preoperative level(both P<0.05). LVEF in the TAV group remained unchanged at 24 hours after operation, but it was improved at 1 month and 6 months after operation, and the difference was statistically significant (all P<0.05). LVMi in TAV group substantially improved at each time point after operation, and the difference was statistically significant (all P<0.05). NT-proBNP in both two groups improved after operation, at 1 month and 6 months after operation, and the difference was statistically significant (all P<0.05). MPG in TAV group improved better than in BAV group during the postoperative follow-up (24 hours after TAVR: (11.68±5.09) mmHg vs. (21.11±9.04) mmHg, P<0.001, 1 month after TAVR: (10.82±3.71) mmHg vs. (18.84±7.37) mmHg, P<0.001, 6 months after TAVR: (12.36±4.42) mmHg vs. (17.68±6.04) mmHg, P=0.003). There was no significant difference in NT-proBNP between BAV group and TAV group at each time point after operation (all P>0.05). There was no significant difference in paravalvular regurgitation and second prosthesis implantation between the two groups (all P>0.05). Conclusions: AS patients with BAV or TAV experience hemodynamic improvement and obvious left ventricular reverse remodeling after TAVR, and the therapeutic effects of TAVR are similar between BAV and TAV AS patients in the short-term post TAVR.

Prognostic value of age in patients with inoperable stage Ⅲ non-small cell lung cancer after radiotherapy: a competing risk analysis based on the Surveillance, Epidemiology, and End Results database / 肿瘤研究与临床

Objective:To explore the data of patients with inoperable stage Ⅲ non-small cell lung cancer (NSCLC) after radiotherapy from the Surveillance, Epidemiology, and End Results (SEER) database, and to evaluate the effect of age on prognosis.Methods:The data of patients with inoperable stage Ⅲ A and Ⅲ B NSCLC according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging standard who had been treated with radiotherapy from 2010 to 2016 were collected in the SEER database. A total of 17 117 cases were included in the analysis. According to the maximally selected test, the best cut-off value of age was 72 years old. According to the best cut-off value of age, patients were divided into the young group (< 72 years old, 11 008 cases) and the elderly group (≥ 72 years old, 6 109 cases). The basic clinical characteristics were compared between the two groups. Kaplan-Meier method was used to analyze the overall survival (OS) and log-rank test was performed. The multivariate Cox proportional hazards regression model was used to analyze the influencing factors for OS. The cumulative incidence function (CIF) was used to calculate the lung cancer-specific death rate and death rate from other causes in the different age groups, and the difference between the two groups was compared by Fine-Gray competing risk model, and the influencing factors of lung cancer-specific death were analyzed. Results:The proportion of squamous cell carcinoma in the elderly group was higher than that in the young group [51.1% (3 123/6 109) vs. 46.8% (5 154/11 008), P < 0.01], and the proportion of stage Ⅲ A was also higher than that in the young group [67.4% (4 120/6 109) vs. 60.1% (6 615/11 008), P < 0.01]; the proportion of patients receiving chemotherapy in the elderly group was lower than that in the young group [69.2% (4 226/6 109) vs. 88.6% (9 748/11 008), P < 0.01]. The 2-year and 5-year OS rates of the young group were 39.2% and 18.0%, and the elderly group were 32.4% and 12.5% (both P < 0.01). The multivariate Cox regression analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, reason for non-operation and chemotherapy were independent influencing factors for patients' OS after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.13 (95% CI 1.09-1.18) ( P <0.01). The 2-year and 5-year cumulative incidence rate of lung cancer-specific death in the elderly group were 60.3% and 75.7%, which were higher than the corresponding values of 55.9% and 74.0% in the young group, and the difference of cumulative incidence rate of lung cancer-specific death between the two groups was statistically significant ( P < 0.01). The 2-year and 5-year cumulative incidence rate of death from other causes in the elderly group were 7.3% and 11.8%, which were higher than the corresponding values of 4.9% and 8.0% in the young group, and the difference of death from other causes between the two groups was statistically significant ( P < 0.01). The competing risk model analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, and with or without chemotherapy were independent influencing factors for lung cancer-specific death in patients with inoperable stage Ⅲ NSCLC after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.07 (95% CI 1.02-1.12) ( P =0.002). Conclusions:Age is an independent prognostic factor for patients with inoperable stage Ⅲ NSCLC after radiotherapy. The prognosis of elderly patients is poor, and they have high risks of lung cancer-specific death and death from other causes.

Assessment of two-site blood cultures practice in pediatric patients / 中华实用儿科临床杂志

Objective To evaluate the effect of two-site blood cultures on detection rate in pediatric patients.Methods The data were retrospectively analyzed of 1 985 hospitalized children with blood cultures from January 2013 to February 2015 in Department of Infectious Diseases,Beijing Children's Hospital,Capital Medical University,including blood culture collection,the administration of antibiotics prior to obtaining blood cultures and positive condition of blood culture.It was divided into 3 stages according to blood culture collection.Blood culture of a single bottle referred to the blood culture in an aerobic bottle.Double bottles transition stage referred to two blood samples taken from the same skin puncture point and the aerobic bottle culture was carried out at the same time.Two-site blood cultures referred to two blood samples taken from the different skin puncture point and the aerobic bottle culture was carried out at the same time.The interval time between the two blood cultures should be less than 5 minutes.The positive rates of three stages were analyzed by Pearson x2 test.The change tendency of positive rates in three stages were analyzed by Cochran-Armitage test.Bilateral P ＜ 0.05 was considered as statistically significant difference in all test analysis.Results More than 80％ of the children in the three stages were given antibiotics.There was no significant difference in the true positive rate (x2 =1.343,P ＞ 0.05).There was no significant difference in the change tendency of positive rates (P ＞ 0.05).False-positive strains were common for coagulase-negative staphylococci.In terms of false positive rate,blood culture of single bottle was higher than two-site blood culture (x2 =6.051,P ＜ 0.05).Conclusion For children (non-neonates),two-site blood cultures can reduce the false positive rate of blood culture and play a role in distinguishing between true positives and false positives in blood culture.

Pathological grading analysis of liver biopsies in chronic hepatitis B virus carriers of different age ranges / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the best time of taking liver biopsy for chronic HBV carriers of age ranges and then guiding antiretroviral treatment.</p><p><b>METHOD</b>The liver biopsy pathologic results of 292 cases of chronic HBV carriers were collected from the First Affiliated Hospital of Kunming Medical College. The patients were divided into three groups according to ages. The differences between groups were compared by calculating the ratio of inflammation above G2 or fibrosis staging above S2.</p><p><b>RESULT</b>The percentages of the chronic HBV carriers with liver histopathology inflammation graded above G2 or fibrosis staging above S2 were 26.5% (36/136) in 11 to 29 year-old group, 39.4% (37/94) in 30-39 year-old group and 58.1% (36/62) in 40-60 year-old group. Significant difference existed among groups in general (P less than 0.01). 39.4% (37/94) of chronic HBV carriers were found with inflammation graded above G2 or fibrosis staging above S2 in 30-39 year-old group, no statistically significant difference found between group 30-39 years old and group and 40-60 years old 58.1% (36/62) (P less than 0.01). 26.5% (36/136) of chronic HBV carriers under 30 years old were with inflammation graded above G2 or fibrosis staging above S2 as compared with the percentage of 46.8% (73/156) in the chronic HBV carriers over 30 years old group, and significant difference existed between the two groups (P less than 0.01).</p><p><b>CONCLUSION</b>The best time choice of taking liver biopsy should be at the ages elder than or equal to 30.</p>

Indwelling the anterior urethral stent: a good treatment option for anterior urethral stricture / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of indwelling the anterior urethral stent in the treatment of anterior urethral stricture.</p><p><b>METHODS</b>We included 38 patients with anterior urethral stricture in the treatment group, and another 38 in the control, the former treated by indwelling the anterior urethral stent, and the latter by urethral dilatation. Then we analyzed the clinical results by comparing the Qmax, urinary hesitancy and numbers of urethral dilations between the two groups.</p><p><b>RESULTS</b>Compared with the controls, the patients of the treatment group showed an obvious increase in Qmax, a significant decrease in the number of urethral dilatations, and a marked improvement of the quality of life. Six months after the stent removal, there were significantly more patients with Qmax > 15 ml/s in the treatment group than in the control (P < 0.05).</p><p><b>CONCLUSION</b>Indwelling the anterior urethral stent is a desirable option for the treatment of anterior urethral stricture, which is simple, safe, effective and reliable, and can be applied to general clinical practice.</p>

Application of evidence- based nursing in nasopharyngeal carcinoma patients undergoing radiotherapy / 中国实用护理杂志

Objective To discuss application of evidence-based nursing in nasopharyngeal carcinoma patients undergoing radiotherapy. Methods Evidence-based nursing was used in 33 nasopharyngeal carcinoma patients undergoing radiotherapy. Results After evidence-based nursing, all the patients actively cooperated with the doctors and nurses, lived through the treatment process smoothly, and radiotherapy complications were reduced or avoided. Conclusions Evidence-based nursing is an idealized nursing method which could reduce or avoid the complications and alleviate the pain of patients and improve the quality of nursing.

Association of NRAMP1 gene polymorphisms with the susceptibility to tuberculosis in ethnic Han Chinese children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Tuberculosis is still a public health problem. Host genetic factors, such as polymorphisms in NRAMP1 gene, may play a role in the development of tuberculosis. To clarify the effect of NRAMP1 gene polymorphisms on the development of childhood tuberculosis, the association of NRAMP1 gene polymorphisms with susceptibility to tuberculosis in the ethnic Han Chinese children was investigated.</p><p><b>METHODS</b>From January 2005 to March 2008, 130 ethnic Han children with tuberculosis (TB group) were enrolled. Three hundred and ninety hospitalized ethnic Han children for physical examination in the surgery department were used as the control group. The controls were matched with tuberculosis children by age, sex and area. PCR-RFLP analysis was performed on DNA samples to identify allele genotypes of INT4 and D543N in NRAMP1 gene. Genotype frequency differences between tuberculosis patients and controls were analyzed using x2 test.</p><p><b>RESULTS</b>No statistical difference was found in the genotype frequency of variants G/C and C/C at the INT4 locus between the TB and the control groups. At the D543N locus, the frequency of genotype variants (G/A and A/A) was significantly higher in the TB group (34/130) than that in the control group (66/390) (x2=5.349, P<0.05; OR=1.74, 95%CI=1.08-2.79). When stratified by sex, differences in the genotype distribution were observed only in females at the D543N locus, which the variant genotypes were higher in the TB group (16/52) than in the control group (21/155) (x2=7.866, P<0.05; OR=2.84, 95%CI=1.34-5.99). For males, there was no difference between the TB and the control groups. At the INT4 locus, no difference was observed between the two groups in boys and girls.</p><p><b>CONCLUSIONS</b>Genotypic variation at the D543N locus in NRAMP1 gene may be associated with susceptibility to tuberculosis in ethnic Han Chinese children. Variant genotypes in NRAMP1 gene (G/A and A/A) may be susceptible genotypes to tuberculosis in ethnic Han Chinese children. Girls with variant genotypes were more susceptible to tuberculosis.</p>

Identification of a novel mutation in the ATP2C1 gene in a Chinese pedigree with Hailey-Hailey disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study a Chinese pedigree with Hailey-Hailey disease (HHD) and examine the ATP2C1 gene mutation in this family.</p><p><b>METHOD</b>All exons of ATP2C1 gene were analyzed with polymerase chain reaction and DNA sequencing in all patients of this family and 100 unrelated population-match controls.</p><p><b>RESULTS</b>We identified a novel heterozygous nucleotide A --> G transition at position 235 - 2 in intron 3 of ATP2C1 gene. This splice site mutation was not found in the healthy members of this pedigree and in the controls.</p><p><b>CONCLUSION</b>The splicing mutation can affect the result of transcription and translation, and it is a specific novel mutation of ATP2C1 gene.</p>

CXCL12 Chemokine Mediates Mesenchymal Stem Cell Adhesion and Proliferation Through ?_V and ?_3 Integrins / 中国生物工程杂志

Background The identification of mesenchymal stem cells(MSCs) have provided exciting prospects for cell-based regeneration after myocardic infraction.However cell therapy have inherent limitations such as low survival rate of transplanted cells and insufficient cell number.It is known that cell-matrix adhesion plays a key role in cell proliferation,differentiation and survival,and chemokine CXCL12 may involved in these prcesses.Transfected mesenchymalstem cells with CXCL12 for local secretion of CXCL12 and then explored CXCL12 triggered adhesion of mesenchymal stem cells to extracellular matrix proteins.Mesenchymal stem cells was transfected with CXCL12.?V and ?3 integrins content was evaluated by Western blot analysis.Cell adhesion to extracellular matrix was examined in vitro and cell prolife-ration after transplantation in vivo.Transfection of CXCL12 resulted increased CXCL12 in situ.Increased CXCL12 induced elevated adhesion to fibronectin in vitro and higher survival in vivo.CXCL12 mediated adhesion and proliferation was established by ?V and ?3 integrin subunits.Chemoattractive mechanisms are involved in adhesion processes of mesenchymal stem cells.Increased CXCL12 leads to enhanced expression of ?V and ?3 integrins,which may augment cell survival,proliferation and differrentiation.