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Objective:To explore the relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.
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Objectives To develop a multi-stage and multi-epitope vaccine, which consists of epitopes from the early secretory and latency-associated antigens of Mycobacterium tuberculosis (MTB). Methods The B-cell, cytotoxic T-lymphocyte (CTL) and helper T-lymphocyte (HTL) epitopes of 12 proteins were predicted using an immunoinformatics. The epitopes with antigenicity, without cytotoxicity and sensitization, were further screened to construct the multi-epitope vaccine. Furthermore, the proposed vaccine underwent physicochemical properties analysis and secondary structure prediction as well as 3D structure modeling, refinement and validation. Then the refined model was docked with TLR4. Finally, an immune simulation of the vaccine was carried out. Results The proposed vaccine, which consists of 12 B-cell, 11 CTL and 12 HTL epitopes, had a flexible and stable globular conformation as well as a thermostable and hydrophilic structure. A stable interaction of the vaccine with TLR4 was confirmed by molecular docking. The efficiency of the candidate vaccine to trigger effective cellular and humoral immune responses was assessed by immune simulation. Conclusion A multi-stage multi-epitope MTB vaccine construction strategy based on immunoinformatics is proposed, which is expected to prevent both active and latent MTB infection.
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Mycobacterium tuberculosis/metabolism , Molecular Docking Simulation , Toll-Like Receptor 4 , Epitopes, T-Lymphocyte/chemistry , Epitopes, B-Lymphocyte/chemistry , Vaccines, Subunit/chemistry , Computational Biology/methodsABSTRACT
Objective@#To investigate the association between parenting style and sleep problems among school aged children with autism spectrum disorder (ASD).@*Methods@#A total of 98 children with ASD aged 6-10 years old and 98 age and gender matched typically developing (TD) children from mainstream schools were recruited. Parenting style and sleep problems were measured via Parent Behavior Inventory (PBI) and Children s Sleep Habits Questionnaire(CSHQ), respectively. The symptom severity and intelligence level were also evaluated. Generalized linear model was used to analyze the relationship between parenting style and sleep problems.@*Results@#There was no statistically significant difference in the parenting style of the two groups of children( P > 0.05 ); weekend sleep time of children with ASD was significantly shorter than that of the TD group [(9.1±0.7)(9.5±0.8)h, P < 0.01 ], and the score of sleep onset delay was significantly higher than that of the TD group[(1.8±0.7)(1.5±0.7), P <0.01]. However, there was no statistically significant difference in the incidence of total sleep problems and various problems between the two groups of children( P >0.05). The parental support/engagement of children with ASD was negatively associated with the total score of sleep problems( β=-2.68, 95%CI =-4.88--0.47), bedtime resistance ( β=-1.65, 95%CI =-2.54--0.77) and sleep anxiety( β=-1.01, 95%CI =-1.70--0.32). The parental hostility/coercion was positively correlated with score of daytime sleepiness( β=1.41, 95%CI =0.53-2.29)( P <0.05).@*Conclusion@#Parenting style of support/engagement is associated with lower sleep problems in children with ASD, while hostile/coercion is associated with higher sleep problems. It should be improve parental style to reduce the sleep problems in children with ASD.
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Objective To investigate the basic situation of radiodiagnosis and radiotherapy institutions and the frequency of medical exposure in Fangshan District, Beijing, China. Methods A general survey using the questionnaire was conducted online to obtain the basic situation of the radiodiagnosis and radiotherapy institutions, the number of people in each type of radiodiagnosis and radiotherapy project, and the number of the usually resident population in the whole district in 2019, thus obtaining the frequency of medical exposure in each type of radiodiagnosis and radiotherapy project. Results There were 60 radiodiagnosis and radiotherapy institutions, 565 radiology staff, and 199 sets of radiodiagnosis and radiotherapy equipment in the whole district in 2019. The frequency of medical exposure was 521.29 per 1000 people, among which conventional medical diagnostic X-ray workers accounted for 301.79 per 1000 people (57.89%) and computed tomography workers accounted for 207.56 per 1000 people (39.82%). The number of tertiary hospitals accounted for 6.67% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed tomedical radiation in tertiary hospitals accounted for 52.25% of the total. The number of secondary hospitals accounted for 5.00% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed to medical radiation in secondary hospitals accounted for 27.83% of the total. Conclusion The distribution of medical exposure in Fangshan District is uneven. The radiodiagnosis and radiotherapy technology used is relatively single. Relevant departments should strengthen macroscopic readjustment and control, and formulate reasonable policies, so as to rationally allocate and effectively utilize medical and health resources.
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Objective:To analyze the value of minute ventilation to carbon dioxide production slope (VE/VCO 2 slope) combined with peak systolic blood pressure (SBP) in predicting prognosis for patients with chronic heart failure (CHF). Methods:A total of 170 patients with CHF who visited the Cardiac Rehabilitation Center of Tongji Hospital Affiliated to Tongji University and completed cardiopulmonary exercise test from March 2007 to December 2018 were enrolled in the study. The clinical data, cardiopulmonary exercise testing results and follow-up information of patients were collected to explore the predictors of all-cause mortality in patients with CHF.Results:The median follow-up time was 647 (182-1 764) days. All-cause death occurred in 34 patients. Compared with surviving patients, the proportion of diabetes and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) use in fatal patients was significantly higher ( P<0.01). The VE/VCO 2 slope and peak SBP*VE/VCO 2 in the fatal patients were significantly higher, and the peak oxygen consumption (peak VO 2) was lower than those in the surviving patients ( P<0.01). The areas under the receiver operating characteristic curve (AUC) of VE/VCO 2 slope and peak SBP*VE/VCO 2 in predicting all-cause mortality in patients with CHF were 0.648 ( P=0.008) and 0.681 ( P=0.001), respectively; the optimal thresholds were >40.95 ( P=0.008) and > 5 423.50 mmHg (1 mmHg=0.133 kPa, P=0.006), the sensitivity was 0.559 and 0.588, and the specificity was 0.728 and 0.735, respectively. Multivariate Cox regression analysis showed that after adjusting for age, gender, diabetes and ACEI/ARB use, VE/VCO 2 slope ( HR=2.12, P=0.036) and peak SBP*VE/VCO 2 ( HR=2.42, P=0.016) were independent risk factors for all-cause mortality in patients with CHF. Conclusion:Compared to the traditional index VE/VCO 2 slope, a novel index peak SBP* VE/VCO 2 provides a relatively better predictive value for all-cause death of CHF patients.
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Objective:To study the effect of heating skin disinfectant during peripherally inserted central catheter (PICC) in preterm infants.Methods:Premature infants were retrospectively analyzed who received PICC catheterization during hospitalization in the Department of Neonatology of the Affiliated Hospital of Southwest Medical University from April 2020 to March 2021. They were divided into the control and heating groups according to different disinfection methods in two different periods. The skin of premature infants in the heating group was disinfected with disinfectant at 37℃, and the control group was disinfected with room temperature disinfectant. The rate of successful primary catheterization, operation duration, and catheter-associated infection were compared between the two groups.Results:The rate of successful primary catheterization in the heating group was higher than that of the control group [80.2% (65/81) vs. 66.7% (56/84)], and the operation time was shorter than that of the control group [(45.0±9.0) min vs. (48.4±11.9) min] ( P<0.05). There was no statistical difference in catheter keeping time, unplanned extubation rate, the rate of positive catheter tip cultures, and the blood cultures. Conclusions:During PICC puncture in premature infants, heating skin disinfectant can increase the success rate of one-time PICC catheterization, reduce the operation duration, and not increase the risk of catheter-associated infection.
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Objective:To evaluate the efficacy of compound chamomile and lidocaine hydrochloride gel in prevention of complications related to laryngeal mask airway (LMA) insertion.Methods:Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-60 yr, undergoing elective surgery with ventilation using LMA under general anesthesia, were divided into 3 groups ( n=30 each) using a random number table method: paraffin oil group (group A), compound lidocaine cream group (group B), and compound chamomile and lidocaine hydrochloride gel group (group C). The paraffin oil, compound lidocaine cream, and compound chamomile and lidocaine hydrochloride gel were evenly applied on the front, shoulder and back of the LMA before inserting the LMA in A, B and C groups, respectively.The severity of sore throat, oropharyngeal mucositis score, hoarseness score and occurrence in each time period (0-1 h, >1-6 h, >6-24 h, > 24-48 h) were recorded at 1, 6, 24 and 48 h after removal of the laryngeal mask.The stress responses during removal of the LMA and occurrence of drug-related adverse reactions within 48 h after removal of LMA were recorded. Results:Twenty-nine cases in group A, 28 cases in group B and 27 cases in group C completed the trial.Compared with group A, the severity of sore throat at each time point after removal of the LMA and incidence of sore throat in each time period were significantly decreased, the oropharyngeal mucositis score at 6, 24 and 48 h after removal of the LMA and the incidence of oropharyngeal mucositis in the time period >1-48 h were decreased, and the incidence of drug-related adverse reactions was increased in group C ( P<0.05). Compared with group B, the severity of sore throat at 6 h after removal of the LMA and incidence of sore throat > 1-48 h after removal of the LMA were significantly decreased, the oropharyngeal mucositis score at 6, 24 and 48 h after removal of the LMA and incidence of oropharyngeal mucositis in the time period >1-48 h after LMA removal were reduced, and the incidence of drug-related adverse reactions was decreased in group C ( P<0.05). There was no significant difference in the hoarseness score and incidence of hoarseness after removal of the LMA and incidence of stress responses during removal of the LMA among the three groups ( P>0.05). Conclusions:Compound chamomile and lidocaine hydrochloride gel has a certain efficacy in preventing complications related to LMA placement.
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Objective:To investigate the correlation between serum ceruloplasmin level and elevated impulsivity in elderly patients with Parkinson′s disease (PD).Methods:227 elderly PD patients treated in Jinhua People′s Hospital from October 2019 to June 2021 were selected as the research objects. They were grouped according to the 75th percentile of serum ceruloplasmin. 0-75th percentile was defined as normal and >75th percentile was defined as high level. The differences of second-order and first-order factor scores of Barratt′s Impulsivity Scale Version 11 (BIS-11) between the two groups were observed. After balancing the general characteristics, the third part of Parkinson′s Disease Rating Scale (MDS-UPDRS), Hoehn&Yahr Scale, Addenbrooke Cognitive Examination Revised Edition (ACE-R), clinical treatment plan and other data, the correlation between ceruloplasmin and BIS-11 was observed.Results:According to the 75th percentile level of ceruloplasmin, 56 patients were included in the high-level group and 171 patients were included in the normal group. The level of ceruloplasmin, the ratio of female patients, MDS-UPDRS Ⅲ, Hoehn&Yahr Scale and ACE-R score in the high-level group were significantly higher than those in the normal group (all P<0.05). The second-order unplanned and corresponding first-order self-control and first-order self-knowledge complexity in the high-level group were higher than those in the normal group (all P<0.05). There was no significant difference in second-order attention, first-order attention, first-order cognitive instability, second-order motivation, first-order motivation, first-order stability and BIS-11 score between the two groups (all P>0.05). After removing the confounding factors by multifactor logistic analysis, ceruloplasmin was correlated with second-order unplanned and its corresponding first-order factors (self-control and self-knowledge complexity) (all P<0.05). Conclusions:The serum ceruloplasmin level in elderly PD patients is related to the elevated level of BIS-11 unplanned impulse.
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Objective To establish a high performance liquid chromatography(HPLC) method for simultaneous determination of the contents of 7 components of chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein, and wogonin in Piqin oral liquid. Methods A double-wavelength HPLC method was performed. The column was Agilent Zorbax SB-C18 (250 mm × 4.6 mm, 5 μm). The mobile phase was 0.02% phosphoric acid aqueous solution (A)-acetonitrile (B) gradient elution; Flow rate: 1.0 ml/min; Column temperature: 35℃; Injection volume: 20 μl; Detection wavelength: 0-18.0 min, 325 nm (detect chlorogenic acid, caffeic acid); 18.0-65.0 min, 280 nm (detect paeoniflorin, baicalin, baicalein, ammonium glycyrrhizinate, wogonin). Results The chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein and wogonin were completely separated. Seven components have a good linear relationship between the peak area and concentration, with the recoveries between 96.41% and 99.70%. Conclusion This method is simple, accurate and reproducible, and can be used for the quality control of Piqin oral liquid.
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Objective:To observe the effect of local retinal laser photocoagulation (local photocoagulation) on Coats disease.Methods:A retrospective clinical study. From January 1, 2006 to August 1, 2020, 48 patients (48 eyes) who were diagnosed as Coats disease and received focal photocoagulation at The Eye Hospital Affiliated to Wenzhou Medical University were included in the study. Among them, there were 40 males (40 eyes) and 8 females (8 eyes). The average age was 32.46±22.41 years old. Nine eyes were in stage 2A, and 39 eyes were in stage 2B. All affected eyes underwent best corrected visual acuity (BCVA), color fundus photography and fluorescein fundus angiography (FFA).The BCVA was carried out using a standard logarithmic visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. According to age, patients were divided into the adolescent group (age≤ 20 years old) and the adult group (age> 21 years old), with 18 eyes in 18 cases and 30 eyes in 30 cases, respectively. In the adolescent group, 18 eyes of 18 cases were all male; the average age was 11.17±3.31 years; the average logMAR BCVA was 0.83±0.60. Among the 30 patients in the adult group, 22 patients were male and 8 patients were female. the average age was 49.26±15.26 years old; the average logMAR BCVA was 0.82±0.59. All the affected eyes were treated with focal photocoagulation. Laser parameters were as followed: wavelength 577 nm, spot diameter 500 μm, exposure time 0.5 to 0.7 s, spot intensity level Ⅲ. FFA was FFA was performed 3 to 4 months after the first laser photocoagulation, and laser treatment was repeated as needed. The average follow-up after first treatment was 36.88±36.92 months. The changes in BCVA, abnormal blood vessels in the fundus, and hard exudation were observed.Results:Among 48 eyes, 36 eyes (75.00%, 36/48) received multiple local photocoagulation treatments. At the last follow-up, 36 eyes (75.00%, 36/48) had an improved or stable vision, and 17 eyes (35.42%, 17/48) had BCVA ≤ 0.32 logMAR units (≥ 0.5). The average logMAR BCVA of eyes in the adolescent group was 0.66±0.54, which was higher than the baseline, but the difference was not statistically significant ( Z=-1.126, P=0.260). The average logMAR BCVA of the eyes in the adult group was 0.96±0.79, which was lower than the baseline, but the difference was not statistically significant ( Z=-0.482, P=0.630). Among 48 eyes, abnormal blood vessels were completely or partially occluded in 42 eyes (87.50%, 42/48); of which, 29 eyes were completely occluded (60.42%, 29/48), and 13 eyes were partially occluded (27.08%, 13/48)). The hard exudation at macula or peripheral retina were completely absorbed or obviously absorbed in 40 eyes (83.33%, 40/48); among them, the complete and obvious absorption were 11 (22.92%, 11/48) and 29 (60.42%, 29/48) eyes. Conclusion:The treatment of focal photocoagulation with a larger spot, long exposure and weak level Ⅲ spot can effectively seal abnormal blood vessels in the eyes of Coats disease,reduce hard exudation and improve or stabilize vision.
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Objective:To evaluate the efficacy of auricular acupoint pressure therapy combined with intranasal dexmedetomidine for transthoracic echocardiography in pediatric patients.Methods:A total of 117 pediatric patients with congenital heart disease, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, aged 3-36 months, weighing 5-20 kg, scheduled for elective transthoracic echocardiography under outpatient sedation, were selected.Transthoracic echocardiography was performed under sedation using intranasally administered dexmedetomidine or using auricular acupoint pressure therapy combined with intranasal dexmedetomidine.The interval between the two sedation methods was at least 1 week.Intranasal dexmedetomidine: Dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.Intranasal dexmedetomidine combined with auricular acupoint pressure: auricular acupressure with Wang Bu Liu Xing (semen vaccariae) seeds was used at the auricular acupoints.After each acupoint was rubbed for about 1 min, dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.After the examination, auricular acupoint pressure therapy was continued at home, and pressing-rubbing at the acupoints was manipulated for 3 times daily, one of which was performed at 30 min before going to bed, for 3 consecutive days.When the University of Michigan Sedation Scale score≥2 and body movement score ≥2 within 30 min after giving dexmedetomidine, sedation was considered to be successful.The onset time of sedation, examination time, waiting time, recovery time and the success of sedation were recorded.The incidence of adverse reactions such as bradycardia, hypotension, hypertension, hypoxemia, nausea and vomiting, respiratory depression, restlessness, hyperactivity, action imbalances and allergic reaction were recorded within 24 h after administration of dexmedetomidine.Time to recovery and improvement of sleep quality at night were recorded.Results:Compared with intranasal dexmedetomidine, the successful rate of sedation and incidence of improvement of sleep quality at night were significantly increased ( P<0.05), and no significant change was found in adverse reactions using intranasal dexmedetomidine combined with auricular acupoint pressure ( P>0.05). Conclusion:Intranasal dexmedetomidine combined with auricular acupoint pressure therapy can increase the successful rate of sedation and improve the sleep quality at night in pediatric patients undergoing transthoracic echocardiography when compared to intranasal dexmedetomidine.
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Objective To establish an UV spectrophotometry method for the determination of total flavonoids in Oxytropis falcata Bunge. Methods Using rutin as comparison，three coloration methods were used to find the optimal assay method, optimize the color conditions and take a systematic methodological investigation. Results The best color development method is aluminum chloride-sodium acetate color method. Using the test product without adding color reagent as a reference, 0.3 mol/L aluminum chloride solution 3.0 ml, 1.0 mol/L sodium acetate 4.0 ml, placed for 16 min, the sample was detected at 277 nm wavelength by AlCl3-CH3COONa reaction by using rutin as reference. The rutin content had a good liner relationship in the range of 8.8 to 44 μg/ml (r=0.9996), and the average recovery rate was 100.91% with RSD of 2.426%. Conclusion This method is simple, rapid, accurate and sensitive and can be used as a method for the determination of total flavonoids from Oxytropis falcata Bunge.
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Objective:To investigate the clinical efficacy of plasma exchange combined with dual plasma molecular adsorption system (PE+ DPMAS) in treating patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods:A total of 114 HBV-ACLF patients admitted to The Affiliated Hospital of Southwest Medical University in Luzhou City and treated with PE+ DPMAS from June 2014 to January 2018 were included. According to different basis of liver diseases, there were type A, type B and type C. The laboratory data and model for end-stage liver disease (MELD) of patients before PE+ DPMAS and 48 h after treatment, and the prognosis of patients at 90 d were retrospectively analyzed. Independent sample t test, paired sample t test, nonparametric test, variance analysis and chi-square test were used for statistical analysis. Results:The clinical stages among patients with type A (22 cases), type B (39 cases) and type C (53 cases) were mainly early (seven, 17, 22 cases) and mid-stages (eight, 14, 20 cases). Before PE+ DPMAS, alanine aminotransferase (ALT), prealbumin (pAlb), albumin (Alb), creatinine (Cr), total bilirubin (TBil), prothrombin time (PT), international normalized ratio (INR), prothrombin activity (PTA), and MELD were all not statistically different among the patients in the three groups (all P>0.05). After PE+ DPMAS treatment, ALT, TBil, PT, INR, MELD, pAlb, Alb, and PTA in patients with type A were statistically different compared with those before treatment ( Z=5.104, t=5.555, 4.974, 4.481, 7.984, -5.396, -2.784 and -6.752, respectively, all P<0.05). ALT, TBil, PT, INR and MELD in patients with type B were significantly decreased, while pAlb and PTA were significantly increased after treatment ( Z=-5.428, t=4.867, 4.405, 4.179, 6.186, -6.290 and -4.533, respectively, all P<0.01). ALT, pAlb and TBil in patients with type C after PE+ DPMAS treatment were significantly different from those before treatment ( Z=-5.723, t=-2.525 and 2.462, respectively, all P<0.05). There was no statistically significant difference in Cr of the three groups before and after treatment (all P>0.05). The patients with type A had the shortest hospital stay ((17.95±5.92) d), while the patients with type C had the longest stay ((25.77±7.02) d). The hospital stay of patients with type B was (21.79±6.72) d. The difference was statistically significant ( F=11.317, P<0.01). After 90 d follow-up, four patients (18.18%) with type A died, nine patients (23.08%) with type B died, and 25 patients (47.17%)with type C died. The difference was statistically significant ( χ2=8.615, P=0.013). Conclusion:HBV-ACLF patients with type A and type B have better prognosis after PE+ DPMAS treatment compared to patients with type C who are in the decompensated stage of liver cirrhosis.
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Objective@#To understand the concern of freshmen with different characteristics on sexual knowledge in Sichuan province and to provide evidence for comprenensive sex education in colleges.@*Methods@#A survey was conducted among 2 532 freshmen from 13 universities in Sichuan Province in September 2018. Attention to specific sexual knowledge among students with different characteristics was analyzed.@*Results@#Sexual knowledge that the freshmen concerned included partner communication (39.25%~55.10%), STD and AIDS (37.78%~44.85%) and gender equality (33.33%~43.34%). Logistic regression results showed that male students payed more attention to partner communication(OR=0.77,95%CI=0.65-0.91), masturbation (OR=0.36，95%CI=0.27-0.47) and sexual minorities (OR=0.61,95%CI=0.41-0.90), while female students payed more attention to gender equality (OR=1.31,95%CI=1.10-1.57), sexual harassment and violence (OR=1.65,95%CI=1.37-1.98). Rural students pay. more attention to partner communication (OR=0.79,95%CI=0.65-0.94), while urban students pay. more attention to masturbation (OR=1.50,95%CI=1.08-2.08), sexual harassment and sexual violence (OR=1.30,95%CI=1.07-1.58). Students who had sex were more concerned about contraception and unwanted pregnancy than those who had not (OR=0.53,95%CI=0.39-0.72). Sexual minority students were more concerned about topic of sexual minorities than heterosexual students (OR=3.50,95%CI=2.30-5.33).@*Conclusion@#College freshmen with different characteristics varied in their concern on sexual knowledge, which is related to their needs. It is suggested that schools set up comprehensive education courses according to the needs of students, the content of sex education knowledge can be focused, and carry out comprehensive and targeted sex education.
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Diabetic retinopathy (DR) is a major and irreversible blinding eye disease in working aged adults. Diabetic macular edema (DME) is a complication of the further development of DR, and it is one of the main causes of vision loss in DR patients. The emergence of anti-VEGF drugs has changed the treatment model of DR and DME. Firstly, for the treatment of DME, the previous focal/grid-like laser photocoagulation is converted to anti-VEGF drugs as the first-line treatment. Secondly, for the treatment of proliferative DR (PDR), panretinal photocoagulation (PRP) was the gold standard in the past, and now anti-VEGF drugs have become an alternative treatment for some PDR patients. In varying degrees of DR and DME, the option of treatment, anti-VEGF drug therapy replacing PRP, and the era of anti-VEGF drug therapy on DR treatment modes are worthy questions for consideration by clinicians. In-depth study of the clinical study of PRP and anti-VEGF drugs in the treatment of DR, the changes attention in clinical guidelines and expert consensus, the gradual establishment of treatment of DR and DME suitable, and the personalized treatment of DR patients may help improve the level of DR treatment in China.
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Objective:To investigate the value of pattern reversal visual evoked potential (PRVEP) and sweep pattern visual evoked potential (SPVEP) in evaluating the visual function of patients with central serous chorioretinopathy (CSC).Methods:A retrospective clinical trial. A total of 38 monocular CSC patients were enrolled from March 2016 to December2018 in Heping Hospital Affiliated Changzhi Medical College. There were 34 males and 4 females with the mean age of 40.0±5.2 years. All patients undergo PRVEP detection in both the acute phase (disease course ≤ 3 months) and the clinical cure phase (disease course ≤ 6 months) using the German Roland electrophysiological RETIport system.The stimulation pattern adopted a checkerboard with 1.00° and 0.25° stimulation angles. The P 100 peak amplitude and peak time were observed. SPVEP inspection equipment and methods were the same as PRVEP, and the spatial frequency was 1, 2, 4, 6, 8, 12, 16, 22 cpd. The difference between SPVEP vision and subjective vision were compared. The PRVEP peak amplitude, peak time and SPVEP amplitude and phase of the affected eye and the contralateral eye were compared by paired t test; the subjective vision and SPVEP visual acuity of the affected eye and the contralateral eye were compared by Wilcoxon paired rank test; Pearson product-moment correlation analysis was performed on SPVEP vision. Results:In the acute phase, the peak amplitude of P100 in the affected eye was lower than that in the contralateral eye ( t=30.26, 13.59), and the peak time was prolonged ( t=-19.89, -29.41). The difference was statistically significant ( P<0.01); in clinically cured period, the P100 peak amplitude ( t=1.49, -0.57) and peak time ( t=-1.22, -1.84) of the affected eye and the contralateral eye showed no significant difference ( P>0.05). In the acute phase, the difference in SPVEP amplitude between the affected eye and the contralateral eye with different spatial frequencies was statistically significant ( P<0.01); the phase of the affected eye and the contralateral eye were compared about the spatial frequency 1, 2, 4, 6, 8, 12 cpd, the difference was statistically significant ( P<0.01). During the clinical cure period, the spatial frequency of 6, 8, 12, 16 cpd, the SPVEP amplitude of the affected eye and the contralateral eye, the difference was statistically significant ( P<0.01); on the spatial frequency of 6, 8, 12 cpd, the phase of SPVEP was compared between the affected eye and the contralateral eye, the difference was statistically significant ( P<0.01). During the acute phase and the clinical cure phase, the SPVEP visual acuity of the affected eye was lower than that of the contralateral eye, and the difference was statistically significant ( P<0.01); during the acute phase and clinical cure phase, the SPVEP visual acuity of the affected eye and the contralateral eye were lower than the subjective vision. The difference was statistically significant (acute phase: Z =-5.38, -3.00; P<0.001, 0.003; clinical cure phase: Z=-5.36,-5.38; P<0.001,<0.001). In the acute phase, the subjective visual acuity of the affected eye was positively correlated with SPVEP visual acuity ( r=0.847, P<0.001). Conclusions:PRVEP and SPVEP are useful for objectively assessing the visual function of the patients with CSC. Especially, the slight and potential visual impairment in CSC can been detected by SPVEP.
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Objective:To observe the short-term efficacy of sub-Tenon’s triamcinolone acetonide (TA) in the treatment of cystoid macular edema (CME) after cataract surgery.Methods:A retrospective study. From October 1, 2013 to October 1, 2018, 21 patients (21 eyes) with CME after cataract surgery diagnosed at The Affiliated Eye Hospital of Wenzhou Medical University were included in this study. All eyes underwent BCVA, intraocular pressure, frequency domain OCT examination. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity when recorded. A frequency domain OCT instrument was used to measure the foveal retinal thickness (CRT). Among 21 eyes of 21 patients, 9 eyes were male and 12 eyes were female; the average age was 66.38±10.88 years. The average logMAR BCVA was 0.46±0.23; the average CRT was 519.90±131.59 μm; the average intraocular pressure was 11.01±3.97 mmHg (1 mmHg=0.133 kPa). All eyes underwent a single treatment of 100 mg/ml TA suspension 0.4 ml (containing TA 40 mg) under Tenon's capsule. The average follow-up time after treatment was 32.86±20.2 days. The changes of BCVA, CRT and intraocular pressure were observed 1 month after treatment. The BCVA, CRT and intraocular pressure before and after treatment were compared by paired t test. Results:One month after treatment, the average logMAR BCVA, CRT, and intraocular pressure of the CME eyes were 0.29±0.22, 307.71±35.82 μm and 14.19±6.30 mmHg, respectively. Compared with those before treatment, the differences were statistically significant ( t=5.252, 8.166, 4.128; P=0.000, 0.000, 0.001). Among 21 eyes, 13 eyes (61.90%) of the retinal cysts in the macular area completely disappeared; 8 eyes (38.1%) were still visible between the retinal layers. Three eyes with intraocular pressure over than 21 mmHg were treated with lowering intraocular pressure and returned to normal. Conclusion:Sub-Tenon’s capsular injection of TA to treat CME after cataract surgery can reduce CRT and improve vision in a short time.
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Objective To analyze the clinical characteristics and drug resistance of 57 patients with Salmonella infection, and to understand the sensitivity of Salmonella to commonly used antibiotics. Methods Clinical data of 57 Salmonella infection patients admitted in our hospital from January 2016 to February 2019 were collected. After hospitalization, routine examinations such as hematuria and stool were carried out, and fecal bacterial culture and drug sensitivity tests were performed. Results Among the 57 patients, the highest incidence of clinical symptoms was abdominal pain and diarrhea (57 cases, 100%), with an average of 7.46±2.03 times. The others were nausea and vomiting (45 cases, 78.95%), fever (43 cases, 75.44%), headache (34 cases, 59.65%), tenesmus (26 cases, 45.61%) and dehydration (25 cases, 43.86%). The results of stool routine examination showed that 51 cases (89.47%) were positive for fecal leukocytes and 45 cases (78.95%) were positive for fecal occult blood test. The results of urine routine test showed that 45 cases (78.95%) were positive for proteinuria and 38 cases (66.67%) for occult blood test. The results of blood routine examination showed that the average value of leukocyte count was (9.98±4.22)×109/L, neutrophils accounted for 79%, and C-reactive protein was (60.15±32.48)mg/L. The results of drug sensitivity showed that the resistant strains to cephalosporins and quinolones accounted for a large proportion of the total strains. Conclusion The main symptoms of Salmonella infection in this area were abdominal pain and diarrhea. Fecal examination and routine urine examination were more valuable for diagnosis. The detection of resistance to quinolone and cephalosporin antibiotics should be strengthened to provide a basis for rational use of drugs.
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Objective To investigate the shear rate and VWF-A1-mediated platelets calcium response. Methods Flou-4 AM was used as the fluorescent indicator of intracellular calcium, and the intracellular calcium concentrations of adherent platelets on VWF-A1 with different concentrations at different shear rates were detected by parallel plate flow chamber system combined with fluorescence microscope. The effect of shear stress and chemical signaling on intensity and speed of calcium response was also analyzed. Results VWF-A1 specifically mediated platelet adhesion and calcium response under flow. The shear rate and molecular concentrations had positive regulation of platelets activation ratio and negative regulation of delay time of calcium response. Compared with static conditions, the activation ratio was increased by 37 times at shear rate of 500 s-1. When the concentration of VWF-A1 was increased from 60 mg/L to 240 mg/L, the delay time of calcium response was shortened by 10 s. Conclusions The shear rate could modulate the calcium response of platelets in cooperation with VWF-A1. The result of this study will be helpful to deepen the understanding about the process of hemostatic reaction of platelet coagulation in bloodstream.
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Objective To observe the changes and significance of the protein expression levels of nuclear factor-κB p65 (NF-κB p65), transforming long factor-β1 (TGF-β1) and apoptosis-related factors Bcl-2 and Bax in myocardial tissue of Bama miniature pig model of diabetic cardiomyopathy (DCM). Methods Ten healthy male Guangxi Bama miniature pigs, aged 4 to 5 months old, were selected and divided into control group and model group according to the random number table method, with 5 pigs in each group. After 12 hours of fasting in the two groups, the DCM model was replicated by intravenous injection of streptozotocin (STZ) 150 mg/kg; for the Bama miniature pigs in the control group, citric acid-sodium citrate buffer 150 mg/kg was injected intravenously. After 10 months of modeling, the basic conditions of the two groups of animals were observed and their fasting blood glucose (FPG) levels were detected. The protein expression levels of NF-κB p65, TGF-β1, Bcl-2 and Bax in myocardial tissue of two groups were detected by Western Blot and the pathological changes of myocardial tissue were observed under electron microscope. Results In the model group, 4 models were successfully established, and 1 died. The model pigs had symptoms such as polydipsia, polyphagia, polyuria and decreased body weight. The FPG level in the model group was significantly higher than that in the control group (mmol/L: 25.53±3.75 vs. 4.68±0.77, P < 0.01). Compared with the control group, the protein expression levels of NF-κB p65, Bax and TGF-β1 in the myocardial tissue of model group were significantly increased (NF-κB p65/GAPDH: 0.46±0.05 vs. 0.38±0.02, Bax/GAPDH: 0.46±0.01 vs. 0.35±0.01, TGF-β1/GAPDH: 0.39±0.01 vs. 0.33±0.01, all P < 0.05) and the expression level of Bcl-2 protein was significantly decreased (Bcl-2/GAPDH: 0.33±0.01 vs. 0.42±0.01, P < 0.01). Electron microscopy results showed that the myofibrils of myocardial tissue in the DCM model group were disordered, and the number of mitochondria in the gap was significantly reduced. A large number of mitochondria with vacuolar degeneration were observed. Conclusions The DCM model of Bama miniature pigs can be successfully replicated after 10 months of high-dose STZ disposable ear vein injection. The DCM model miniature pigs have obvious glucose metabolism disorder, and their myocardial tissue has inflammatory reaction, cardiomyocyte apoptosis and fibrosis.