Effect of anterior capsule polishing on the visual quality after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of anterior capsule polishing on visual quality after phacoemulsification.METHODS: Prospective randomized control study. A total of 65 patients(73 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the Emergency General Hospital between November 2021 and June 2022 were included. These patients were randomly assigned to two groups, with one group(anterior polishing group)underwent anterior and posterior capsule polishing(30 cases, 35 eyes), while the other(control group)receive routine posterior capsule polishing(35 cases, 38 eyes). Best corrected visual acuity was observed at 1wk, 1, 3 and 6mo after operation. Area of anterior capsule orifice was measured at 3 and 6mo after operation. Meanwhile, posterior capsular opacification(P score), IOL tilt and decentration were recorded by Pentacam Scheimpflug system. In addition, wavefront aberration, Strehl ratio(SR)of point spread function(PSF)and modulation transfer function(MTF)were evaluated by OPD-Scan Ⅲ.RESULTS: At 1wk, 1, 3 and 6mo after operation, best corrected visual acuity in anterior polishing group is significantly better than that of control group(P<0.05). There were no significant differences in area of anterior capsule opening, P score, IOL decentration, SR of PSF and MTF between two groups at 3 and 6mo after operation(P>0.05). At 3mo follow-up, no significant differences in IOL tilt and wavefront aberration were measured between two groups either(P>0.05). However, IOL tilt [(1.65±0.60)° vs.(2.34±0.43)°, P<0.001] and wavefront aberration(0.03±0.01μm vs. 0.06±0.03μm, P<0.001)in anterior polishing group were significant lower compared to control group at 6mo after operation.CONCLUSION: 360° polishing of anterior and posterior capsule during phacoemulsification can improve best corrected visual quality, with reduced IOL tilt, lower wavefront aberration and better visual quality.

Intra-operative mapping and language protection in glioma / 中华医学杂志(英文版)

The demand for acquiring different languages has increased with increasing globalization. However, knowledge of the modification of the new language in the neural language network remains insufficient. Although many details of language function have been detected based on the awake intra-operative mapping results, the language neural network of the bilingual or multilingual remains unclear, which raises difficulties in clinical practice to preserve patients' full language ability in neurosurgery. In this review, we present a summary of the current findings regarding the structure of the language network and its evolution as the number of acquired languages increased in glioma patients. We then discuss a new insight into the awake intra-operative mapping protocol to reduce surgical risks during the preservation of language function in multilingual patients with glioma.

Meta-analysis and GRADE evidence profile of Rimegepant in the treatment of acute migraine / 四川精神卫生

ObjectiveTo systematically evaluate the efficacy and safety of Rimegepant in the treatment of acute migraine. MethodsThe databases of CNKI， Wanfang and VIP database， PubMed， Embase， Cochrane Library， ClinicalTrials were searched to collect relevant literature on the treatment of Rimegepant in acute migraine. The pain freedom and Most Bothersome Symptom （MBS） freedom 2 hours after medication were the primary outcome indicators， and the other 11 indicators including pain relief 2 hours after medication were the secondary outcome indicators. The Meta-analysis was performed using RevMan 5.3， and the quality of evidence was evaluated using GRADE Profiler 3.6 for outcome indicators. ResultsA total of 4 randomized controlled studies involving 3 827 patients， including 1 840 patients in the experimental group and 1 987 patients in the control group. Meta-analysis results showed that， in terms of effectiveness， compared with the control group， the proportion of patients in the Rimegepant group who were painless 2 hours after medication （RR=1.67， 95 % CI： 1.44~1.94， P<0.01）， MBS free 2 hours after medication （RR=1.37， 95% CI： 1.24~1.51， P<0.01） and pain relief （RR=1.33， 95% CI： 1.25~1.41， P<0.01）， pain relief lasting 2~24 hours after medication （RR=1.59， 95% CI： 1.46~1.74， P<0.01）， pain relief lasting 2~48 hours after medication （RR=1.57， 95% CI： 1.42~1.74， P<0.01）， painless 2~24 hours after medication （RR=2.27， 95% CI： 1.62~3.20， P<0.01）， painless 2~48 hours after medication （RR=2.14， 95% CI： 1.52~3.02， P<0.01）， and no fear of light （RR=1.47， 95% CI： 1.32~1.64， P<0.01） and no fear of sound 2 hours after medication （RR=1.40， 95% CI： 1.19~1.64， P<0.01） was higher， the differences were statistically significant. In terms of safety， the proportion of patients with nausea （RR=1.70， 95% CI： 0.95~3.02， P=0.07）， urinary tract infection （RR=1.81， 95% CI： 0.84~3.91， P=0.13）， dizziness （RR=1.14， 95% CI： 0.49~2.63， P=0.77） or elevated transaminase （RR=0.76， 95% CI： 0.45~1.27， P=0.29） showed no statistically significant differences between the Rimegepant group and the control group. Based on GRADE criteria， evidence for Rimegepant in the treatment of acute migraine was of high or moderate quality. ConclusionRimegepant is effective for acute migraine， and the toxic effects are tolerable.

Concordant systemic and local eosinophilia relates to poorer disease control in patients with nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective: To explore whether blood and polyp tissue eosinophil numbers are independent risk factors for poor disease control in patients with nasal polyp. Methods: By using the electronic medical records database and manual evaluation, 183 nasal polyp patients who had undergone endoscopic sinus surgery at least one year prior to the study with complete data of tissue specimens, baseline blood routine test, nasal endoscopy and sinus computed tomography, were identified and recruited to assess disease control based on the criteria of a European Position Paper on Rhinosinusitis and Nasal Polyps 2012 (EPOS 2012). Multiple logistic regression model was used to determine the association between blood and tissue eosinophil numbers and risk of poor disease control by adjusting for demographics and comorbidities. Results: We broke down the cohort into 4 groups according to blood (0.3×109/L) and tissue (10%) eosinophils. The patients without eosinophilic inflammation represented the largest group (41.5%). The group with concordant blood and tissue eosinophilia represented the second largest (31.2%), and the patients with isolated tissue (15.3%) or blood (12.0%) eosinophilia were relatively rare. Multiple logistic regression models found blood eosinophil count and tissue eosinophil percentage were independently associated with increased risk for poor disease control after adjustments for covariates related to poor treatment outcome. Furthermore, subjects with concordant blood and tissue eosinophilia had a higher risk for poor disease control than those with isolated blood or tissue eosinophilia. Conclusion: Concordant blood and tissue eosinophilia relates to a higher likelihood of poor disease control than isolated blood or tissue eosinophilia after adjustment of potential confounders in nasal polyp patients.

Primary experience and discussion on the treatment of esthesioneuroblastoma / 中华耳鼻咽喉头颈外科杂志

Objective: To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. Methods: The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with P<0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Conclusions: Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.

Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs.@*OBJECTIVE@#This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions.@*SEARCH STRATEGY@#PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020.@*INCLUSION CRITERIA@#Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included.@*DATA EXTRACTION AND ANALYSIS@#Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity.@*RESULTS@#A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I@*CONCLUSION@#Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.

Effect of Sanhuang Xiexintang in Inhibiting 7-Ketocholesterol-induced Endothelial Disfunctional by NIRP3 Inflammasome Pathway / 中国实验方剂学杂志

<b>Objective::To study whether Sanhuang Xiexintang (SHXXT) can restore endothelial function by inhibiting the activation of NOD-like receptor protein 3 (NIRP3) induced by 7-ketocholesterol (7-keto) in vascular endothelial cells. <b>Method::The aortic rings of mice were cultured in normal group, model (7-keto) group, SHXXT groups (1%, 2% and 5% drug-containing serum). Vasodilation function of mice was observed. Microvascular endothelial cells were cultured according to the above experimental groups, and NIRP3 inhibitor isoglycyrrhizin (ISO) group, was also set. Western blot was used to detect the expressions of endothelial nitric oxide synthase (eNOS), NIRP3, cysteinyl aspartate specific proteinase-1 (Caspase-1), interleukin-1<italic>β</italic> (IL-1<italic>β</italic>) protein. In addition, nitric oxide (NO) quantitative kit was used to detect the concentration of NO. <b>Result::Compared with the normal group, the endothelium-dependent vasodilation function of vascular rings was significantly reduced in model group (<italic>P</italic><0.01), and the drug group significantly restored the endothelium-dependent vasodilation function in a concentration-dependent manner (<italic>P</italic><0.05, <italic>P</italic><0.01). Meanwhile, microvascular endothelial cells were also studied. Compared with the normal group, the content of eNOS protein in the model group decreased (<italic>P</italic><0.05), while the concentration of NO decreased significantly (<italic>P</italic><0.01). After treatment with SHXXT serum, eNOS and NO could be restored, with significant differences in the concentration of NO with 5% (<italic>P</italic><0.05) and 10% (<italic>P</italic><0.01) SHXXT serum. At the same time, the expressions of NIRP3 (<italic>P</italic><0.05), cle-Caspase-1 activation (<italic>P</italic><0.01) and IL-1<italic>β</italic> production (<italic>P</italic><0.01) in endothelium were significantly increased under 7-keto stimulation, and the SHXXT serum could significantly inhibit the expression and activation of relevant proteins. Subsequently, endothelial cells were treated with NIRP3 inhibitor ISO. Compared with the model group, eNOS expression increased, and NO concentration increased significantly (<italic>P</italic><0.01) after treatment with ISO, but ISO had no synergistic effect on SHXXT serum. <b>Conclusion::SHXXT can improve endothelium-dependent vascular dysfunction induced by 7-keto, which is achieved by NO signaling pathway mediated by inhibiting the activation of endothelial NIRP3-related proteins.

Intravitreal injection of C3F8 in the treatment of vitreomacular traction syndrome / 中华眼底病杂志

Objective To evaluate the efficacy of single intravitreal injection of C3F8 in treating vitremacular traction (VMT) syndrome.Methods A retrospective case series of 38 eyes of 36 patients affected with VMT syndrome in Department of Ophthalmology,Central Theater Command General Hospital from March 2016 to June 2017 were enrolled in this study.There were 16 males (16 eyes) and 20 females (22 eyes),with the mean age of 64.1 1 ± 9.49 years and the mean courses of 151.55 ± 127.87 days.All the patients received an intravitreal injection of 0.3 ml of 100％ C3F8 within one week.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.The severity of metamorphopsia was detected using M-charts.The extent of vitreomacular adhesion (VMA),central macular thickness (CMT) and the status of ellipsoid zone (EZ) were assessed with spectral-domain OCT at baseline and each month after treatment.The average BCVA was 0.58± 0.22.The mean horizontal metamorphopsia (MH)and vertical metamorphopsia (MV) were 0.34±0.30 and 0.50±0.42,respectively.The mean CMT was 415.15 ± 89.59 μm.The mean horizontal VMA was 1168.68± 400.61 μm (30 eyes with VMA ≤ 1500 μtm and 8 eyes with VMA＞ 1500 μm).The mean vertical VMA was 976.89±295.92 μtm.There were 22 eyes with integrity EZ and 16 eyes without integrity EZ,33 eyes with crystalline lens and 5 eyes with IOL.The mean follow-up time was 10.7 months.The differences in BCVA,MH,MV,CMT,the integrity of EZ before and after treatment were analyzed.The VMT release rates were assessed.The Spearman rank correlation analysis was performed to investigate the relationship of VMT release rates with the data at baseline.Results Vitreomacular traction release occurred in 29 of 38 eyes by the final follow-up visit,the VMT release rate was 76.3％.VMT release occurred and the average time of VMT release occurred was 2.2 weeks.VMT persisted in 7 eyes,in the rest two eyes,one eye developed a retinal detachment and another eye formed macular hole,both eyes responded to vitrectomy.At 6 months after treatment,the average logMAR BCVA was 0.43±0.23,the mean MH and MV were 0.25± 0.23 and 0.24± 0.23,the mean CMT was 310.61 ± 63.10 pm.Among 16 eyes without integrity EZ before treatment,there were 9 eyes with integrity EZ at 6 months after treatment.There were 16 eyes with integrity EZ and 9 Compared with baseline,the mean BCVA at 6 months after treatment was significantly increased (F=3.779,P=0.037),but the MV (F=4.958,P =0.003) and CMT (F=13.419,P＜0.001) were significantly decreased,the integrity of EZ was improved significantly (22=5.050,P=0.025).The VMT release correlated inversely with the extent of horizontal VMA,BCVA,and CMT at baseline (r=-0.514,-0.348,-0.429;P=0.009,0.001,0.038).Conclusion Intravitreal injection of C3F8 can induce a posterior vitreous detachment and release vitreomacular traction,it is an efficient and safe treatment for VMT syndrome.It can improve the visual acuity,metamorphopsia and foveal morphology in patients with VMT syndrome.

Correlation between foveal avascular zone size and foveal morphology in patients with idiopathic macular epiretinal membrane / 中华眼底病杂志

Objective To analyze the correlation between foveal avascular zone (FAZ) size and foveal morphology in patients with idiopathic macular epiretinal membrane (IMEM) using OCT angiography (OCTA).Methods A retrospective case series study contained of 54 eyes of 54 patients affected with IMEM (IEM group) and 50 eyes of 50 normal persons as the control group.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logMAR visual acuity.The FAZ areas were evaluated with OCTA in both the superficial and deep capillary plexus layers by using 3 mm × 3 mm images of the macular.The central macular thickness (CMT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),subfoveal choroidal thickness (SFCT),and the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography.The differences of FAZ areas between the two groups were analyzed.The correlative analysis was performed to investigate the relationship between areas and foveal morphology.Results Compared with control group,the FAZ area in superficial and deep capillary plexus in the IMEM group were significantly smaller (t=-29.095,-28.743;P＜0.001,＜0.001);the mean CMT,IRT,ORT and SFCT were significantly thickening in the IMEM group (Z=-8.784,-8.524,-7.709,-7.535;P＜0.001,＜0.001,＜0.001,＜0.001).In the IMEM group,the FAZ area in superficial capillary plexus correlated inversely with the CMT,IRT,and the integrity of EZ (r=-0.464,-0.536,-0.293;P＜ 0.001,＜ 0.001,0.039),no significant correlation of superficial plexus FAZ areas with ORT and SFCT (r=-0.218,-0.165;P=0.172,0.157).The FAZ area in deep capillary plexus correlated inversely with the CMT,IRT,and the integrity of EZ (r=-0.306,-0.694,-0.468;P=0.037,＜0.001,＜0.001),no significant correlation with ORT and SFCT (r=-0.242,-0.227;P=-0.079,0.094).Conclusions The FAZ areas is significantly decreased in IMEM eyes compared with normal eyes.Both superficial and deep FAZ area are correlated with the CMT,IRT,and the integrity of EZ.

Relationship between Serum Lipid Levels and Parkinson's Disease / 中国康复理论与实践

Objective:To investigate the relationship between serum lipids and Parkinson's disease, and its predictive value for Parkinson's disease. Methods:From January, 2016 to November, 2018, 145 patients with Parkinson's disease and other 122 healthy subjects were selected. They were measured the various lipid indexes. Results:Total cholesterol, low density lipoprotein cholesterol, Apolipoprotein A1 (ApoA1) and Apolipoprotein B (ApoB) were less in the patients than in the controls (t > 2.089, P < 0.05). ApoA1 was an independent protective factor from Logistic regression (OR = 0.081, P < 0.01). The most optimal cut-off threshold of ApoA1 was 1.38 mmol/L, with the sensitivity of 0.72 and the specificity of 0.68. Conclusion:The lipid decreased in patients with Parkinson's disease. Low ApoA1 may be a potential independent risk factor for Parkinson's disease, which may be a predictor for it.

Monitoring Value of Multimodal Magnetic Resonance Imaging in Disease Progression of Amyotrophic Lateral Sclerosis: A Prospective Observational Study / 中华医学杂志(英文版)

Background@#Ongoing efforts have been made to identify new neuroimaging markers to track amyotrophic lateral sclerosis (ALS) progression. This study aimed to explore the monitoring value of multimodal magnetic resonance imaging (MRI) in the disease progression of ALS.@*Methods@#From September 2015 to March 2017, ten patients diagnosed with ALS in Peking Union Medical College Hospital completed head MRI scans at baseline and during follow-up. Multimodal MRI analyses, including gray matter (GM) volume measured by voxel-based morphometry; cerebral blood flow (CBF) evaluated by arterial spin labeling; functional connectivity, including low-frequency fluctuation (fALFF) and regional homogeneity (ReHo), measured by resting-state functional MRI; and integrity of white-matter (WM) fiber tracts evaluated by diffusion tensor imaging, were performed in these patients. Comparisons of imaging metrics were made between baseline and follow-up using paired t-test.@*Results@#In the longitudinal comparisons, the brain structure (GM volume of the right precentral gyri, left postcentral gyri, and right thalami) and perfusion (CBF of the bilateral temporal poles, left precentral gyri, postcentral gyri, and right middle temporal gyri) in both motor and extramotor areas at follow-up were impaired to different extents when compared with those at baseline (all P < 0.05, false discovery rate adjusted). Functional connectivity was increased in the motor areas (fALFF of the right precentral gyri and superior frontal gyri, and ReHo of right precentral gyri) and decreased in the extramotor areas (fALFF of the bilateral middle frontal gyri and ReHo of the right precuneus and cingulate gyri) (all P < 0.001, unadjusted). No significant changes were detected in terms of brain WM measures.@*Conclusion@#Multimodal MRI could be used to monitor short-term brain changes in ALS patients.

Inductively Coupled Plasma Mass Spectrometry as a Reference Method to Evaluate Serum Calcium Measurement Bias and the Commutability of Processed Materials during Routine Measurements / 中华医学杂志(英文版)

<p><b>Background</b>Measuring total serum calcium is important for the diagnosis of diseases. Currently, results from commercial kits for calcium measurement are variable. Generally, the performance of serum calcium measurements is monitored by external quality assessment (EQA) or proficiency testing schemes. However, the commutability of the EQA samples and calibrators is often unknown, which limits the effectiveness of EQA schemes. The aim of this study was to evaluate the bias of serum calcium measurements and the commutability of processed materials.</p><p><b>Methods</b>Inductively coupled plasma mass spectrometry was applied as a comparative method, and 14 routine methods were chosen as test methods. Forty-eight serum samples from individual patients and 25 processed materials were quantified. A scatter plot was generated from patient samples, and 95% prediction intervals were calculated to evaluate the commutability of the processed materials and measurement bias at three concentration levels was used to determine the accuracy of routine assays.</p><p><b>Results</b>All assays showed high precision (total coefficient of variation [CV] <2.26%) and correlation coefficients (r > 0.99). For all assays, the mean bias for the 48 patient samples ranged from -0.13 mmol/L to 0.00 mmol/L (-5.61-0.01%), and the ranges for the three concentrations were -0.10-0.04 mmol/L (-5.71-2.35%), -0.14--0.01 mmol/L (-5.80--0.30%), and -0.19-0.04 mmol/L (-6.24-1.22%). The EQA samples, calibrators, and animal sera exhibited matrix effects in some assays; human serum pools were commutable in all assays; certificate reference materials were commutable in most assays, and only GBW09152 exhibited a matrix effect in one assay; and aqueous reference materials exhibited matrix effects in most assays.</p><p><b>Conclusions</b>Biases for most assays were within the acceptable range, although the accuracy of some assays needs improvement. Human serum pools prepared from patient samples were commutable, and the other tested materials exhibited a matrix effect.</p>

Evaluation of the ocular surface in the patients after strabismus surgery / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To evaluate the ocular surface in the patients after strabismus surgery. ·METHODS: One hundred and eighty-eight hospitalized patients (240 eyes) with strabismus from May 2015 to October 2016 in Aier Hospital were divided into 3 groups according to the type of incision:85 cases(100 eyes) with the corneal limbus incision in Group A;35 cases(50 eyes) with the cross-muscle incision in Group B; 68 cases (90 eyes) with the adjacent-fornix incision (including Parks incisions and improved Parks incisions) in Group C. And 75 eyes with single extraoeular muscle surgery, 110 eyes with 2 extraoeular muscle surgery, 55 cases with 3 extraoeular muscle surgery. The first noninvasive tear film break-up time (NITBUTf) and the tear meniscus height (TMH) were tested by Oculus anterior segment analyzer preoperatively and 1d, 1, 2 and 4wk postoperatively. The data were studied by statistics. · RESULTS: Comparing with preoperative, TMH increased significantly at post-operatively 1d in all group, NIKBUTf reduced significantly(P<0.05). NIKBUTf was recovered in Group A at post-operative 2wk. NIKBUTf were recovered in Group B and C at post-operative 1wk. TMH were recovered in Group A and B at post-operative 2wk. TMH was recovered in Group C at post-operative 1wk. NIKBUTf and TMH were recovered with the single extraoeular muscle surgery at post-operative 1wk. They were recovered at post-operative 2wk with the 2 and 3 extraoeular muscle surgery. ·CONCLUSION: Surgical incision and surgical muscle number may affect the ocular surface of the people after strabismus surgery. The adjacent fornix conjunctival incision has less effect. The less number of muscles in strabismus surgery,the less effect on ocular surface.

External quality assessment for measurement of serum cystatin C in China / 临床检验杂志

Objective To understand the current status of the measurement quality of serum Cystatin C (CysC) in China.Methods The external quality assessment (EQA) data in 2017 were collected from the network platform of National Center for Clinical Laboratories.The EQA data were classified into 8 groups according to different types of diagnostic reagents,each of which was employed by at least 18 users.The robust mean value and robust coefficients of variation (CV) were calculated according to ISO 13528 document in each group.The robust mean value was set as the target value.The total error derived from biological variation was used as the fine (3.8％),moderate (7.6％) and weak (11.4％) criteria in evaluating the pass rates,respectively.The reagents which were employed by more than 50 users were classified into subgroups named as " reagent-analyzer" group according to the used analyzer.The median values and differentials between maximum and minimum value were calculated for each reagent-analyzer subgroup.Results A total number of 710 laboratories submitted their results of CysC measurement during 2017.The fine,moderate and weak pass rates according to the setting criteria were 25.9％ (184/710),55.5 ％ (394/710) and 75.2％ (534/710),respectively.The variations of CysC measurement results of among different reagent-analyzer groups ranged from 1.62％ to 12.27％.Conclusion The quality of CysC measurement of should be improved with nationwide attention.

Correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling in idiopathic macular epiretinal membrane eyes / 中华眼底病杂志

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

Nutritional Status of Under-five Children from Urban Low-income Families in Xiangtan and Jilin in China / 华中科技大学学报（医学）（英德文版）

There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China,whereas researches on children from urban low-income families are scarce.This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China.There were 169 children aged 25-60 months recruited from Xiangtan and Jilin,two cities with a population of 2.81 million and 4.26 million respectively,in China in this cluster cross-sectional study.Data were collected on demographic and socioeconomic characteristics,the feeding practices and the incidence of anemia and diarrhea.The results showed that the prevalence of low birth weight and macrosomia was 7.l％ and 9.5％ for the two cities,respectively,which was higher than that for other cities in China (1.5％ and 5.9％).Of all the sampled children,14.6％ and 8.2％ suffered anemia and diarrhea,respectively.Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia (OR=4.9).Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence (OR=1.4).In conclusion,the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high.The growth and nutritional status of these children is greatly affected by feeding practices.A series of measures should be taken by relevant government departments to improve the health of these children.

Prostate-specific Antigen Density Variation Rate as a Potential Guideline Parameter for Second Prostate Cancer Detection Biopsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The diagnostic value of current prostate-specific antigen (PSA) tests is challenged by the poor detection rate of prostate cancer (PCa) in repeat prostate biopsy. In this study, we proposed a novel PSA-related parameter named PSA density variation rate (PSADVR) and designed a clinical trial to evaluate its potential diagnostic value for detecting PCa on a second prostate biopsy.</p><p><b>METHODS</b>Data from 184 males who underwent second ultrasound-guided prostate biopsy 6 months after the first biopsy were included in the study. The subjects were divided into PCa and non-PCa groups according to the second biopsy pathological results. Prostate volume, PSA density (PSAD), free-total PSA ratio, and PSADVR were calculated according to corresponding formulas at the second biopsy. These parameters were compared using t-test or Mann-Whitney U-test between PCa and non-PCa groups, and receiver operating characteristic analysis were used to evaluate their predictability on PCa detection.</p><p><b>RESULTS</b>PCa was detected in 24 patients on the second biopsy. Mean values of PSA, PSAD, and PSADVR were greater in the PCa group than in the non-PCa group (8.39 μg/L vs. 7.16 μg/L, 0.20 vs. 0.16, 14.15% vs. -1.36%, respectively). PSADVR had the largest area under the curve, with 0.667 sensitivity and 0.824 specificity when the cutoff was 10%. The PCa detection rate was significantly greater in subjects with PSADVR >10% than PSADVR ≤10% (28.6% vs. 6.5%, P< 0.001). In addition, PSADVR was the only parameter in this study that showed a significant correlation with mid-to-high-risk PCa (r = 0.63, P = 0.03).</p><p><b>CONCLUSIONS</b>Our results demonstrated that PSADVR improved the PCa detection rate on second biopsies, especially for mid-to-high-risk cancers requiring prompt treatment.</p>

Study on leaf transpiration and stomatal structure of medicinal plant Tetrastigma hemsleyanum / 中草药

Objective: Taking annual Tetrastigma hemsleyanum (Tetrastigma Radix) from three habitats, Taizhou, Minhou, and Shunchang, as materials to study the effects of different light intensity stress on the stomatal shape and leaf transpiration. Methods: The stomata, leaf transpiration rate, net photosynthetic rate, and stomal structure of T. hemsleyanum were observed using a scanning [0-2000 μmol/(m2·s)] to explore the optimal light intensity. Results: The stomata with surround and parallel distribution types were only distributed in the lower epidermis in the leaves of T. hemsleyanum; The transpiration rate, stomatal conductance, and net photosynthetic rate of T. hemsleyanum from the two habitat regions (Minhou and Taizhou) by rising after falling with the 30℃ stress, which suggested the stress could make the light intensity heavier. At the same time, the transpiration rate, stomatal conductance, and net photosynthetic rate of T. hemsleyanum from the habitat region Shunchang were rising. The stomatal type of leaves was 600 μmol/(m2·s) in Minhou, and 1900 μmol/(m2·s) in Shunchang, when the water utilization ratio of T. hemsleyanum leaves from the three habitats was higher. Conclusion: Different habitats and light intensity are the important factors of leaves transpiration in natural world, which is more beneficial to the growth of the root crops and suitable for the accumulation of flavonoids in plants.

Clinical effect of cyclopentolate hydrochloride on cycloplegia in children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the application of 10g/L cyclopentolate chloride eye drops in children, and to compare the different effectiveness of cycloplegia between 10g/L cyclopentolate chloride and atropine in Chinese children.METHODS:A total of 236 eyes of 118 children aged 3~12 years old were enrolled in this study including 80 eyes of 40 children with myopia, 156 eyes of 78 children with hyperopia and 146 eyes of 73 children combined with astigmatism. 10g/L cyclopentolate chloride eye drops were used once per 5min for 3 times and refractive diopter was obtained 1h after the last drop of cyclopentolate. Three days after that, 10g/L atropine was then used 1 time per night for 1wk and optometry was performed again. The children were divided into 3 groups ( myopia, hyperopia and astigmatism group ) according to the refractive status, in which astigmatism was independent of the degree of separation of cylinder statistics. The results of retinoscope refraction were then compared between 10g/L cyclopentolate and 10g/L atropine. RESULTS:The refractive diopter was -2. 25±1. 31D after 10g/L cyclopentolate eye drops and -2. 23±1. 32D after 10g/L atropine in myopic group. The refractive diopter was 1. 35±1. 19D and 1. 38±2. 00D in astigmastic group. No significant difference was found in myopic group and astigmastic group (P= 0. 109, P= 0. 374). While in the hyperopic group, the refractive diopter was 3. 76±2. 4D after 10g/L cyclopentolate eye drops, which was lower than that after 10g/L atropine 4. 39±2. 6D (P=0. 000). CONCLUSION: The results of this study suggest that 10g/L cyclopentolate chloride eye drops can be used in myopia and astigmatism children, and 10g/L atropine should be used in hyperopia children.

Chinese medicine single-walled carbon nanotube targeting compound for antitumor therapy: a feasible way? / 中国结合医学杂志

Malignant cancer is the leading cause of death in man, exceeding cerebrovascular disease and heart disease. More than half of the total mortality due to malignant cancer is from lung, liver, intestinal and gastric cancer. Chemotherapy is one of the effective treatments for cancer. However, the great majority of Western anticancer medicines have considerable side effects. Herbal medicines offer many more advantages than synthesized compounds because they are made from purely natural compounds and have less adverse effects. However, the single administration methods used as standard in herbal medicine, and deficient drug targeting, severely limit their anticancer activity. Single-walled carbon nanotubes (SWNTs) can be used as drug carriers. They have been modified to form Chinese anticancer medicine-SWNT compounds which can specifically target tumors, thereby significantly increasing the therapeutic effectiveness of these medicines. Water-soluble SWNTs have high stability. As a drug carrier, SWNTs functional modification of the anticancer medicine may improve the targeting and killing of tumor cells. SWNTs have been attached to the Chinese antitumor medicines paclitaxel and plumbagin and have achieved excellent therapeutic effects. Furthermore, choosing the best administration methods such as internal iliac arterial infusion, intravesical infusion and embedment of a hypodermic chemotherapeutic pump, may also improve the anticancer effects of Chinese medicine.