Efficacy and safety of modified four-point fixed IOL suspension implantation in aphakic eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the efficacy and safety of modified four-point fixed intraocular lens suspension implantation in aphakic eyes.METHODS:A prospective study. A total of 32 aphakic patients(32 eyes)with an average age of(44.56±8.48)years who underwent modified four-point fixed intraocular lens suspension implantation in our hospital from October 2020 to May 2021 were selected. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), corneal astigmatism, intraoperative and postoperative complications were observed before and after operation.RESULTS:The mean follow-up of all patients was(4.84±0.64)mo. The preoperative UCVA(LogMAR)was 1.25±0.42 and the last follow-up was 0.5±0.25(P<0.001). The preoperative BCVA(LogMAR)was 0.41±0.19 and the last follow-up was 0.42±0.19,(P >0.05). The preoperative corneal astigmatism was(1.17±0.64)D and the last follow-up was(1.20±0.59)D(P>0.05). There were no intraoperative complications, but 2 eyes had low intraocular pressure, 1 eye had high intraocular pressure and 2 eyes had corneal edema occurred after operation. There were no complications of hyphema, vitreous hemorrhage, macular cystoid edema, corneal endothelial decompensation, inclination or eccentricity of intraocular lens and exposure of suture.CONCLUSION:The modified four-point fixed intraocular lens suspension implantation can significantly improve the postoperative visual acuity of aphakic patients without additional corneal astigmatism,and with fewer complications.

Effects of internal limiting membrane peeling on post-vitrectomy epiretinal membrane and visual prognosis of rhegmatogenous retinal detachment / 中华实验眼科杂志

Objective:To analyze the effect of vitrectomy combined with internal limiting membrane (ILM) peeling on the prevention of post-vitrectomy epiretinal membrane (ERM) in macular-off rhegmatogenous retinal detachment (RRD) and its influence on visual outcomes.Methods:A cohort study was conducted.Seventy-four patients (74 eyes) with macular-off RRD, who realized retinal reattachment after vitrectomy and silicone oil tamponade from January 2015 to January 2018 in Baoding NO.1 Central Hospital, were enrolled.The patients were divided into the non-ILM peeling group (36 cases, 36 eyes) and ILM peeling group (38 cases, 38 eyes) according to whether they received ILM peeling or not.The patients underwent silicone oil removal within 3 to 5 months after the surgery.Best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscopy, fundus photography and optical coherence tomography (OCT) were examined before and at 1, 6 and 12 months after the surgery.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Baoding NO.1 Central Hospital (No.[2019]042). Written informed consent was obtained from each patient.Results:There was no ERM found in the two groups at 1 month after the operation.There were 3 eyes (8.33%) with ERM in the non-ILM peeling group and 2 eyes (5.26%) in the ILM peeling group at 6 months after the operation, with no statistically significant difference between them ( P=0.067). There were 9 eyes (25.00%) with ERM in the non-ILM peeling group and 4 eyes (10.53%) in the ILM peeling group at 12 months postoperatively, with no statistically significant difference between them ( χ2=2.674, P=0.102). There was a significant difference in BCVA between before and after the operation in the two groups ( Ftime=31.692, P<0.001). Postoperative 1-, 6-and 12-month BCVA were all significantly better than the preoperative BCVA in the two groups (all at P<0.05). There was no significant difference in BCVA between the two groups ( Fgroup=0.117, P=0.773). OCT images showed that there were 25 eyes (77.78%) and 30 eyes (78.95%) with the intact ellipsoid zone in the non-ILM peeling group and ILM peeling group at 12 months after the operation, respectively, with no statistically significant difference between them ( χ2=0.875, P=0.350). Conclusions:Compared with vitrectomy alone, the vitrectomy combined with ILM peeling does not show better efficacy in the prevention of ERM occurrence in macula-off RRD patients and has no obvious influence on postoperative visual acuity.

Analysis of factors of metamorphopsia after vitrectomy for rhegmatogenous retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To identify factors associated with metamorphopsia in patients with rhegmatogenous retinal detachment(RRD)who underwent primary vitrectomy(PPV). <p>METHODS:This retrospective study included 94 patients(94 eyes)who underwent 23G PPV for repair of RRD between January, 2017 and January, 2019. Each patient were examined both eyes preoperatively and postoperatively(at 1, 6, 12mo and last visits). At each time-point, patients received a complete ophthalmological examination, including best corrected visual acuity(BCVA), intraocular pressure, slit-lamp biomicroscopy, optical coherence tomography(OCT), and M-chart examination.<p>RESULTS: One month after surgery, metamorphopsia occurred in 53%(<i>n</i>=50), the mean M value was 0.68±0.28. The metamorphopsia rate differed significantly between macula-off and macula-on RRD(<i>P</i><0.01). There was significant difference in M-chart among the different time(<i>F</i>=26.442, <i>P</i><0.01). Univariate analysis demonstrated that the macula status, location of retinal breaks, and disrupted EZ was a risk factor that was significantly associated with metamorphopsia. In multivariate analysis, macula-involving retinal detachment(<i>OR</i>=9.020, 95% <i>CI</i>:1.808-45.011, <i>P</i>=0.007)and disrupted EZ(<i>OR</i>=10.570, 95% <i>CI</i>:2.909-38.400, <i>P</i><0.01)was a significant predictors of metamorphopsia.<p>CONCLUSION: The metamorphopsia was improved after anatomically successful RRD surgery. Macular involvement retinal detachment and disrupted EZ were more likely to develop metamorphopsia.

Management of ablation techniques for liver cancer and establishment of a diverse team for liver cancer ablation / 临床肝胆病杂志

Ablation is one of the important treatment methods for liver cancer, and standard ablation techniques, scientific and rational therapeutic strategy, and close teamwork are important premises for a good clinical effect. Although the efficacy of ablation therapy for liver cancer has gradually increased with the continuous improvement of ablation techniques, there remains a high tumor recurrence rate, and therefore, there is an urgent need for the therapeutic strategies that can improve the efficacy of ablation therapy for liver cancer and the prognosis of patients. Establishment of a diverse team for liver cancer ablation is a new concept put forward on the basis of a conventional team for liver cancer ablation to meet the requirements of ablation therapy for liver cancer. Since a diverse team for liver cancer ablation has potential advantages over a conventional team, it may be a promising mode for establishing a team for liver cancer ablation.

NCTD Retards AML HL60 Cell Proliferation via Targeting Hedgehog/SOX2 axis / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of norcantharidin (NCTD) to proliferation of leukemia cells through disrupting key regulators of sonic Hedgehog (SHH) pathway and its downstream transcription factor SOX2.@*METHODS@#CCK8 was used to detected the HL60 and NB4 cells after inhibited by NCTD, SMO and GLI1 inhibitor for 24 hours. Expression level of SMO, GLI1 and SOX2 in HL60 cells with NCTD treatment was detected by immunoblot. HL60 cells were transfected with pcDNA3.1 plasmid expressing GLI1 or SOX2. Empty vector and pcDNA3. 1-EGFP were divided into negative and positive control group, respectively. The expression of exogenous GLI1 or SOX2 in HL60 cells was confirmed by immunoblot, and growth curve of HL60 cell was checked by CCK8. Proliferation of genetic modified HL60 cells treated by various dose of NCTD was detected.@*RESULTS@#NCTD, SMO/GLI1 inhibitors could inhibit the proliferation of NB4 and HL60 cells in a dose-dependent manner. Compared with solvent (DMSO)-treated control group, NCTD remarkably decreased protein level of SMO, GLI1 and SOX2. GLI1 and SOX2 were overexpressed in HL60 cells as compared with pcDNA3.1 empty vector-transfected group. Growth curve demonstrated significant proliferative advantage of GLI1/SOX2-transfected cells. CCK8 assay indicated that GLI1/SOX2-overexpressed HL60 cells were more resistant to NCTD treatment.@*CONCLUSION@#NCTD attenuates HL60 proliferation via targeting the Hedgehog/SOX2 axis.

The influence of the choroidal thickness of the affected eye about anti-vascular endothelial growth factor drug treatment for retinal vein occlusion with macular edema / 中华眼底病杂志

Objective:To observe the effect of intravitreal injection of anti-vascular endothelial growth factor drugs on the subfoveal choroid thickness (SFCT) of patients with retinal vein occlusion (RVO) and macular edema (ME).Methods:A prospective clinical study. From January 2017 to January 2019, 59 monocular RVO-ME patients with 59 eyes diagnosed in the eye examination of The First Central Hospital of Baoding were included in the study. Among them, there were 31 males with 31 eyes and 28 females with 28 eyes; the average age was 57.4±10.3 years old. The course of the disease was 5 days to 1 month, all of whom had the first-onset disease. Branch retinal vein occlusion (BRVO) was found in 35 eyes (BRVO-ME group); non-ischemic central retinal vein occlusion (CRVO) was found in 24 eyes (CRVO-ME group). Best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (OCT) were performed. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. The Cirrus HD-OCT 5000 instrument from Carl Zeiss company of Germany was used to measure the central macular thickness (CMT) and SFCT. All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs. The follow-up time after treatment was 6 months, and the changes of BCVA, CMT and SFCT of eyes before treatment and 2 weeks after treatment were compared and observed, as well as the occurrence of treatment-related complications. The comparison of BCVA, CMT, and SFCT at different times before and after treatment were adopted repeated measures analysis of variance; pairwise comparison of differences at different time points adopts the least significant difference t test. Results:Before treatment, the average logMAR BCVA and CMT of RVO-ME eyes were 0.92±0.46 and 604.71±169.35 μm, respectively. At 2 weeks, 1, 3, and 6 months after treatment, the average logMAR BCVA of the affected eye was significantly improved compared with that before treatment, and the CMT was significantly decreased. The difference was statistically significant ( F=55.664, 59.518; P<0.05). Before treatment, the average SFCT of the affected eye and the contralateral eye of RVO-ME patients were 306.3±65.8 and 241.3±59.8 μm, respectively. The SFCT of the affected eye was significantly thicker than that of the contralateral healthy eye, and the difference was statistically significant ( t=25.772, P<0.05). At 2 weeks, 1, 3, and 6 months after treatment, the average SFCT of the eyes were 267.7±81.4, 252.3±57.3, 239.2±46.5, 240.6±48.3 μm, respectively. Compared with before treatment, treatment SFCT decreased significantly at different times afterwards, and the difference was statistically significant ( F=924.341, P<0.001). There was no significant difference in SFCT between CRVO-ME group and BRVO-ME group at 2 weeks, 1, 3, and 6 months after treatment ( P>0.05). No complications such as endophthalmitis, cataract progression and neovascular glaucoma occurred during the follow-up period of all eyes. Conclusion:The SFCT of eyes with short course of disease and first-onset RVO-ME is thickened; anti-VEGF drug treatment can effectively reduce SFCT, improve ME, and increase BCVA.

Protective effect of Renqing Changjue on acute respiratory distress syndrome in rabbits / 中国药理学与毒理学杂志

OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory dis?tress syndrome (ARDS) induced by endotoxin lipopolysaccharide (LPS) in rabbits. METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups: normal control group, model group, dexamethasone group, Renqing Changjue high, middle and low dose group, with six rabbits in each group. LPS was used to replicate the ARDS model after five consecutive days of gavage. Arterial pressure, respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0, 0.5, 1, 2 and 4 h, respectively. At the end of the four-hour experiment, rab?bits were killed by bloodletting, and the lung tissue was quickly removed to determine the cytokines, SOD, MDA and pathological examination of rabbit lung. RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group. The expression of AQP1 and MPO in rabbit lung was significantly decreased by immuno?histochemistry (P<0.05) ,reduce the lung wet/dry weight ratio, increase the ratio of PaO2/FiO2, inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects. CONCLUSION Renqing Changjue can effec?tively protect rabbits with acute respiratory distress syndrome induced by LPS, and may protect the lung by inhibiting the release of cytokines and anti-oxidation.

Clinical study of intraperitoneal infusion of bevacizumab combined with albumin paclitaxel and carboplatin in carcinomatous peritoneal adhesion from ovarian cancer / 国际肿瘤学杂志

Objective:To observe the clinical effects of intraperitoneal perfusion of bevacizumab combined with albumin paclitaxel and carboplatin in the treatment of malignant peritoneal adhesion caused by ovarian cancer.Methods:From January 2016 to December 2020, 54 patients treated in our hospital with malignant peritoneal adhesions caused by ovarian cancer were enrolled in this study. They were randomly divided into experimental group ( n=27) and control group ( n=27) according to the random number table method. The treatment regimen of the experimental group was intravenous infusion of albumin paclitaxel plus intraperitoneal infusion of carboplatin and bevacizumab. The treatment regimen of the control group was intra-venous infusion of albumin paclitaxel plus intraperitoneal infusion of carboplatin. The treatment was repeated every 21 days, and the therapeutic effect was evaluated every two cycles. The treatment lasted for six cycles. The efficacy and incidence of adverse reactions were compared between the two groups. Results:The remission rate of incomplete malignant bowel obstruction of the experimental group was higher than that of the control group [85.19% (23/27) vs. 59.26% (16/27)], the total effective rate of the experimental group was higher than that of the control group [74.07% (20/27) vs. 44.44% (12/27)], and there were statistically significant differences ( χ2=4.523, P=0.033; χ2=4.909, P=0.027). After treatment, the levels of vascular endothelial growth factor (VEGF) in ascites of the experimental group and the control group were significantly lower than those before treatment [(80.33±1.41) pg/ml vs. (310.45±3.35) pg/ml, t=449.884, P<0.001; (135.68±1.60) pg/ml vs. (310.46±3.09) pg/ml, t=499.281, P<0.001], and after treatment, the VEGF level in the experimental group decreased more significantly than that in the control group ( t=-134.907, P<0.001). Patients in the experimental group and the control group tolerated the treatment well, and there were no significant differences in the incidences of adverse reactions such as hypertension (11.11% vs. 3.70%, χ2=0.270, P=0.603), neutropenia (14.81% vs. 11.11%, χ2<0.001, P>0.999), peripheral neuropathy (3.70% vs. 0, χ2<0.001, P>0.999), diarrhea (7.41% vs. 3.70%, χ2<0.001, P>0.999), nausea (3.70% vs. 0, χ2<0.001, P>0.999), epistaxis (7.41% vs. 0, χ2=0.519, P=0.471) or albuminuria (3.70% vs. 0, χ2<0.001, P>0.999) between the two groups. Conclusion:Intraperitoneal perfusion of bevacizumab combined with chemotherapy is superior to simple chemotherapy in the treatment of malignant peritoneal adhesion caused by ovarian cancer.

Correlation of Chemical Components in Periploca forrestii with Ecological and Soil Factors / 中国实验方剂学杂志

Objective:To study the correlation of eight chemical components in Miao medicine <italic>Periploca forrestii</italic> from different producing areas with the ecological and soil factors. Method:The contents of neochlorogenic acid， chlorogenic acid， cryptochlorogenic acid， isochlorogenic acid B， isochlorogenic acid A， isochlorogenic acid C， procyanidin A₂， and periplocin were simultaneously determined by ultra-performance liquid chromatography （UPLC）. The root soil samples from various producing areas were collected for testing various soil factors， followed by climate data extraction with ArcGIS and topographic data recording using GPS. SPSS 24.0 was employed to conduct the bivariate analysis and stepwise regression analysis of the eight chemical components in <italic>P. forrestii</italic> from different producing areas with the ecological and soil factors. Result:Stepwise regression equations of the content of eight chemical components against ecological and soil factors were established. The findings demonstrated that neochlorogenic acid was negatively correlated with precipitation in the coldest season and chlorogenic acid negatively correlated with precipitation in the driest month. Cryptochlorogenic acid was negatively correlated with precipitation in the coldest season and average temperature in the warmest season， but positively with selenium. Isochlorogenic acid B was mainly affected by soil factors. Specifically， it was positively correlated with available iron and molybdenum but negatively with total phosphorus and available phosphorus. Isochlorogenic acid A was positively correlated with molybdenum but negatively with the coefficient of variation of precipitation. Isochlorogenic acid C showed a positive correlation with exchangeable magnesium. Procyanidin A₂ exhibited a positive correlation with molybdenum and a negative correlation with available potassium. Periplocin was negatively correlated with the coefficient of variation of precipitation. Conclusion:The correlation between the eight chemical components of <italic>P. forrestii</italic> and the ecological and soil factors has been clarified， which will provide reference for the introduction， cultivation， and standardized planting of <italic>P. forrestii </italic>and also a theoretical basis for further research on its ecological and soil factors and quality formation mechanism.

Long-term outcomes and independent predictors of mortality in patients presenting to emergency departments with acute heart failure in Beijing: a multicenter cohort study with a 5-year follow-up / 中华医学杂志(英文版)

BACKGROUND@#Acute heart failure (AHF) is the most common disease in emergency departments (EDs). However, clinical data exploring the outcomes of patients presenting AHF in EDs are limited, especially the long-term outcomes. The purposes of this study were to describe the long-term outcomes of patients with AHF in the EDs and further analyze their prognostic factors.@*METHODS@#This prospective, multicenter, cohort study consecutively enrolled 3335 patients with AHF who were admitted to EDs of 14 hospitals from Beijing between January 1, 2011 and September 23, 2012. Kaplan-Meier and Cox regression analysis were adopted to evaluate 5-year outcomes and associated predictors.@*RESULTS@#The 5-year mortality and cardiovascular death rates were 55.4% and 49.6%, respectively. The median overall survival was 34 months. Independent predictors of 5-year mortality were patient age (hazard ratio [HR]: 1.027, 95 confidence interval [CI]: 1.023-1.030), body mass index (BMI) (HR: 0.971, 95% CI: 0.958-0.983), fatigue (HR: 1.127, 95% CI: 1.009-1.258), ascites (HR: 1.190, 95% CI: 1.057-1.340), hepatic jugular reflux (HR: 1.339, 95% CI: 1.140-1.572), New York Heart Association (NYHA) class III to IV (HR: 1.511, 95% CI: 1.291-1.769), heart rate (HR: 1.003, 95% CI: 1.001-1.005), diastolic blood pressure (DBP) (HR: 0.996, 95% CI: 0.993-0.999), blood urea nitrogen (BUN) (HR: 1.014, 95% CI: 1.008-1.020), B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in the third (HR: 1.426, 95% CI: 1.220-1.668) or fourth quartile (HR: 1.437, 95% CI: 1.223-1.690), serum sodium (HR: 0.980, 95% CI: 0.972-0.988), serum albumin (HR: 0.981, 95% CI: 0.971-0.992), ischemic heart diseases (HR: 1.195, 95% CI: 1.073-1.331), primary cardiomyopathy (HR: 1.382, 95% CI: 1.183-1.614), diabetes (HR: 1.118, 95% CI: 1.010-1.237), stroke (HR: 1.252, 95% CI: 1.121-1.397), and the use of diuretics (HR: 0.714, 95% CI: 0.626-0.814), β-blockers (HR: 0.673, 95% CI: 0.588-0.769), angiotensin-converting enzyme inhibitors (ACEIs) (HR: 0.714, 95% CI: 0.604-0.845), angiotensin-II receptor blockers (ARBs) (HR: 0.790, 95% CI: 0.646-0.965), spironolactone (HR: 0.814, 95% CI: 0.663-0.999), calcium antagonists (HR: 0.624, 95% CI: 0.531-0.733), nitrates (HR: 0.715, 95% CI: 0.631-0.811), and digoxin (HR: 0.579, 95% CI: 0.465-0.721).@*CONCLUSIONS@#The results of our study demonstrate poor 5-year outcomes of patients presenting to EDs with AHF. Age, BMI, fatigue, ascites, hepatic jugular reflux, NYHA class III to IV, heart rate, DBP, BUN, BNP/NT-proBNP level in the third or fourth quartile, serum sodium, serum albumin, ischemic heart diseases, primary cardiomyopathy, diabetes, stroke, and the use of diuretics, β-blockers, ACEIs, ARBs, spironolactone, calcium antagonists, nitrates, and digoxin were independently associated with 5-year all-cause mortality.

Correlation between metamorphopsia and foveal microstructure changes in patients with rhegmatogenous retinal detachment after vitrectomy / 中华眼底病杂志

Objective:To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods:It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results:The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant ( F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation ( F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant ( F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation ( r/ rs=0.672, 0.385, 0.932; P<0.05). There was no correlation between M value and BCVA ( r/ rs=0.503), EZ and ELM integrity ( r/ rs=0.497, 0.472), SRF ( r/ rs=0.416), CME ( r/ rs=0.821) and ERM ( r/ rs=0.632) after operation ( P>0.05). Conclusions:The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.

Pirfenidone suppressing esophageal stent-related restenosis after stent placement: an animal experimental study / 中华放射学杂志

Objective:To investigate the preventive efficacy of pirfenidone in esophageal stent-related restenosis and the related underlying mechanisms.Methods:Twenty-four rats underwent esophageal stent placement were included in this study. The rats were randomly assigned to three groups, with 8 rats in each group. The three groups were set to receive placebo, 150 mg/kg pirfenidone and 300 mg/kg pirfenidone daily by oral administration for 28 days, respectively. Twenty-eight days after stent placement, the stented esophagi were harvested for histological examinations. The number of epithelial layers, the thickness of submucosal fibrosis, the percentage of granulation tissue area, the degree of inflammatory cell infiltration, the degree of collagen deposition, and the α-SMA staining scores were evaluated. One-way ANOVA was performed for the statistical comparison of the number of epithelial layers, the degree of inflammatory cell infiltration, the degree of collagen deposition and the α-SMA staining scores among these three groups. The Kruskal-Wallis H test was used for comparison of the thickness of submucosal fibrosis and the percentage of granulation tissue area among the three groups. Results:Gross pathological findings showed that both pirfenidone groups had significantly less luminal fibrotic tissue formation and restenosis than placebo group. The percentage of granulation tissue areas in placebo group, 150 mg/kg and 300 mg/kg pirfenidone groups were 57.23%±25.68%, 21.80%±6.65% and 12.18%±6.37%, respectively. Both pirfenidone groups showed significantly less granulation tissue areas than placebo group ( P<0.01). The degree of inflammatory cell infiltration, the degree of collagen deposition and the α-SMA staining scores were 3.28±0.55, 3.38±0.63 and 2.75±0.38 in placebo group, 2.30±0.46, 2.36±0.58 and 2.00±0.42 in 150 mg/kg pirfenidone group, and 1.86±0.38, 1.91±0.41 and 1.57±0.28 in 300 mg/kg pirfenidone group, respectively. Both pirfenidone groups showed significantly less inflammatory cell infiltration, collagen deposition and α-SMA staining scores than placebo group ( P<0.01). Conclusion:Pirfenidone can suppress esophageal stent-related restenosis in rats by significantly inhibiting inflammation, myofibroblast activation and proliferation, and fibrotic tissue formation.

Clinical features, diagnosis, and treatment of Chinese children with Shwachman-Diamond syndrome / 中国当代儿科杂志

In order to clearly define the features of Shwachman-Diamond syndrome (SDS) in Chinese children, this article analyzes and summarizes the epidemiology, clinical features, and key points in the diagnosis and treatment of SDS in Chinese children with review of the clinical data of 27 children with SDS from related articles published previously. A comparative analysis was made between the Chinese and international data related to childhood SDS. The results showed a male/female ratio of about 2:1 in the Chinese children with SDS, with an age of onset of <1 month to 5 years (median 1 month) and an age of 3 months to 12 years (median 12 months) at the time of confirmed diagnosis. Reductions in peripheral blood cells due to myelopoiesis inhibition were observed in all 27 children with SDS, among whom 93% had neutropenia. Chronic diarrhea (85%), liver damage (78%), and short stature (83%) were the three main clinical features of SDS. Supplementation of pancreatin and component blood transfusion may temporarily alleviate the disease, while allogeneic hematopoietic stem cell transplantation is still an effective radical treatment. The comparative analysis of the Chinese and oversea data showed that compared with those in the European and American countries, the children with SDS in China had significantly higher incidence rates of chronic diarrhea, reductions in peripheral blood cells (three lineages), and liver damage, and there were also differences in the type of mutant genes.

Etiology and epidemiological characteristics of gastroenteritis virus in food-borne diarrhea from three cities in Shandong Province, 2017 / 中华预防医学杂志

To analyze the etiology and epidemiological characteristics of gastroenteritis virus in foodborne diseases from three cities in Shandong. From January to December 2017, six sentinel hospitals in Jinan, Yantai and Linyi city of Shandong Province were selected as the research sites. Stool samples of 1 397 diarrhea patients were collected, as well as basic information and clinical symptoms. Duplex quantitative RT-PCR was used to detect Norovirus genogroupⅠ (Nov GⅠ) and genogroupⅡ (Nov GⅡ), Sapovirus (SAV) and Human astrovirus (HAstV), respectively, quantitative RT-PCR was used to detect group A Rotavirus (RVA), and quantitative PCR was used to detect Enteric adenovirus (EAdV). The specific gene of the virus were sequenced and typed. It was compared that the gastroenteritis virus rate in cases with different characteristics and the clinical symptoms difference between the virus positive and negative cases. The median age ((25), (75)) was 23 (1, 42) , mainly male, 57.48% with 803 cased and children under 5 years old, 36.36% with 508 cases. The positive rate of gastroenteritis virus was 33.93% (474 cases), and that of Jinan, Linyi and Yantai City were 32.03% (147/459), 41.54% (189/455) and 28.57% (138/483), respectively (0.001). Nov GⅡ had the highest positive rate, 16.54% (231 cases), which, mainly GⅡ.P16/GⅡ.2 (48.28%, 56/116), peaked in May (24.75%, 50/202) and June (19.59%, 38/194). In patients of gastroenteritis virus positive, 44.51% (211/474) had vomiting symptoms, higher than that of patients of gastroenteritis virus negative (34.13%, 315/923). The difference was statistically significant (0.001). In Shandong Province, the majority of gastroenteritis patients were male and children under 5 years old. Nov GⅡ possessed highest epidemic intensity, and peaked in spring and summer. Viral gastroenteritis had atypical clinical symptoms.

Effect of Bletillae Rhizoma Polysaccharide on PI3K/Akt in Gastric Tissue of GU Model Rats / 中国实验方剂学杂志

Objective::To investigate the effect of Bletillae Rhizoma polysaccharide on the expressions of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) gene protein and its mediated cytokines interleukin-2 receptor (IL-2R) and interleukin-4 (IL-4) in gastric tissue of rats with gastric ulcer (GU). Method::Sixty SPF Wistar rats were randomly divided into blank group and model group.The GU model was replicated by direct acetic acid cauterization in model group.The GU model rats were randomly divided into five groups: model group, positive control group, and large, medium and small-dose Bletillae Rhizoma polysaccharide groups, with 10 rats in each group.Rats in blank group and GU model group were given 10 mL·kg-1·d-1 distilled water by gavage, rats in large, medium and small-dose groups were given 0.5, 0.25, 0.125 g·kg-1·d-1 Bletillae Rhizoma polysaccharide by gavage, while rats in positive control group were given 0.3 g·kg-1·d-1 ranitidine by gavage for 15 days.Serum nitric oxide (NO) content, pepsinase activity and cytokines IL-2R and IL-4 levels in rats of each group were measured by enzyme-linked immunosorbent assay (ELISA), PI3K and Akt mRNA expressions were detected by Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), and PI3K and Akt protein expressions were detected by Western blot. Result::Compared with the blank group, the contents and gene expressions of cytokines IL-2R and IL-4 in gastric tissue were significantly increased, and the PI3K and Akt genes and protein expressions were significantly increased, with statistical significance (P<0.01). Compared with GU model group, the content and gene expressions of IL-2R and IL-4 in large, medium and small-dose Bletillae Rhizoma polysaccharide groups were decreased significantly, and the PI3K and Akt gene and protein expressions were decreased significantly in large-dose Bletillae Rhizoma polysaccharide group, while those in large and medium-dose Bletillae Rhizoma polysaccharide groups were decreased significantly (P<0.05, P<0.01). Conclusion::Bletillae Rhizoma polysaccharide can protect gastric mucosa by down-regulating PI3K and Akt gene and protein expressions and inhibiting abnormal secretion of cytokines IL-2R and IL-4.

The changes and correlation between foveal avascular zone size and visual acuity in patients with rhegmatogenous retinal detachment / 中华眼底病杂志

Objective:To evaluate the changes in foveal avascular zone (FAZ) size and foveal microstructures in patients with rhegmatogenous retinal detachment (RRD) and to analyze the correlation between FAZ size, foveal microstructure changes and visual outcomes.Methods:A retrospective study. From January 2017 to January 2019, 79 RRD patients (79 eyes) diagnosed in Department of Ophthalmology in Baoding First Central Hospital were included in the study. The patients were divided into macula-off group (51 eyes), macula-on group (28 eyes). The unaffected fellow eyes were used as a control group. The retinas were reattachment in all eyes after first standard 23G PPV combined with silicone oil filling. Before and 3 months after surgery, all patients underwent a comprehensive ophthalmologic examination, including the measurement of BCVA and OCT angiography (OCTA) examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The FAZ areas were evaluated with OCTA in the superficial capillary plexus layers by using 3 mm×3 mm images of the macular.The following postoperative foveal microstructures were evaluated:epiretinal membranes, macular edema, subretinal fluids, integrity of ellipsoidal zone and external limiting membrane. Pearson correlation analysis was used to analyze the correlation between FAZ area and BCVA. The correlation between macular microstructures and BCVA was analyzed by Spearman correlation analysis.Results:At 3 months after the removal of silicone oil, the FAZ area in the macula-off group, macula-on group and the control group were 0.447±0.041, 0.409±0.034, 0.335±0.027 mm 2, respectively. Compared with the control group, the FAZ area in the macula-off group and macula-on group were enlarged, the difference was statistically significant ( F=184.148, P<0.05). The logMAR BCVA in the macula-off group and macula-on group were 0.800±0.180 and 0.386±0.160, respectively. There was significant difference in ellipsoidal zone rupture between the two groups ( χ 2=7.577, P=0.006). The results of correlation analysis showed that the area of FAZ and the incidence of ellipsoidal zone fracture after surgery were positively correlated with BCVA after surgery ( r=0.329, 0.290; P=0.003, 0.010). Conclusions:The FAZ area of RRD is enlarged after surgery. FAZ area and ellipsoid zone fracture are positively correlated with BCVA after surgery.

Correlation between Spike and Gamma rhythm of local field potential in Alzheimer's disease mice during fear memory activity / 中华行为医学与脑科学杂志

Objective:To explore the relationship between the Spike and the Gamma rhythm of the local field potential (LFP) in Alzheimer's disease (AD) transgenic mice during fear memory activity.Methods:Six-month-old APP/PS1/tau three transgenic (3xTg) mice and wild-type (WT) mice were divided into 3xTg group and WT group, with 10 mice in each group. The electrodes were embedded into the hippocampus of mice under sterile conditions, and the behavioral experiment of conditioned fear box test was carried out two weeks later. The changes of Gamma rhythm, Spike and Burst firing were recorded and analyzed by the wireless telemetry device which embedded in the mouse head. Finally, the correlation between Gamma rhythm and Spike was calculated by entropy value.Results:(1) In behavioral experiments, the freezing ratio caused by conditioned stimulation (CS) in 3xTg mice was ((54.07±2.32)%), which was significantly lower than that of WT mice ((76.21±2.88)%) ( t=4.796, P<0.01). (2) Simultaneously recorded the average power of the Gamma oscillation in the Pre-CS period of the WT mice was ((11.574±1.147) dB), which increased to ((18.108±1.177) dB) after CS ( t=3.386, P<0.01). After CS administration, the average power of Gamma in 3xTg group((12.346±1.345) dB) was significantly lower than that of WT group ( t=3.423, P<0.01). (3) The frequency of Spike release in WT mice during the Pre-CS period was ((5.667±1.475)times/s), significantly increased to ((11.008±1.335) times/s) after CS ( t=3.542, P<0.01). The frequency of Spike release of 3xTg mice after CS ((5.249±1.033) times/s) was significantly lower than that of WT group ( t=4.788, P<0.01). (4) The Burst duration of WT group in pre-CS and CS period were ((0.550±0.043)s) and ((1.075±0.034)s), respectively. It suggested that the Burst firing frequency of WT group increased significantly after conditional stimulation ( t=5.188, P<0.01). However, the release interval of 3xTg group after CS ((0.619±0.033)s) was significantly lower than that of WT group ( t=3.352, P<0.01). (5) After CS, the Spike-Gamma entropy curve of WT mice was always higher than that of 3xTg mice. The maximum correlation of WT group and 3xTG group were (0.403±0.031) and (0.314±0.028), respectively. The Spike-Gamma correlation of the 3xTg group was significantly lower than WT mice ( t=3.372, P<0.01). Conclusion:The defect of fear memory in Alzheimer's disease may be caused by the disharmony of Spike-LFP (Gamma) distribution.

Effect of advanced airway establishment on prognostic evaluation of cardiopulmonary resuscitation quality index during cardiopulmonary resuscitation / 中华急诊医学杂志

Objective:Cardiopulmonary resuscitation quality index (CQI) is based on pulse oximetry plethysmographic waveform (POP), which have been proved able to reflect the peripheral circulation state as good as the quality of chest compression during cardiopulmonary resuscitation (CPR). It has been confirmed that CQI is as good as the partial pressure of end-tidal carbon dioxide (P ETCO 2) in prognostic evaluation of CPR patients. The purpose of this study was to explore whether advanced airway establishment affects the prognostic value of CQI during CPR. Methods:This was a prospective descriptive study. 376 patients receiving CPR were divided into advanced airway group and non-advanced airway group according to whether advanced airway was established, each of which was divided into ROSC (return of spontaneous circulation) group and non-ROSC group according to whether they got ROSC. The changes of CQI and P ETCO 2 during CPR were collected, and the relation of these parameters and the prognosis of patients was analyzed. Results:In advanced airway group, both CQI [(63.3±20.7) vs (49.7±23.8)] and P ETCO 2 [(19.8 (11.4, 31.6) vs 8.8 (3.3, 15.8)] mmHg were statistically different between ROSC group and non-ROSC group ( P <0.05). The cut-off value for these two parameters were 60.4 and 16.3 mmHg respectively. There was no significant difference between the two curves ( P>0.05). In the non-advanced airway group, CQI [(63.0±21.8) vs (42.2±29.0)] were also statistically different between the ROSC group and the non-ROSC group ( P <0.05). The cut-off value of CQI in advanced airway group and non-advanced airway group were 60.4 and 61.1, respectively. And there was no statistical difference between the two curves ( P>0.05). Conclusions:During CPR, CQI can be used to evaluate the prognosis of patients, which is as good as that of P ETCO 2. Establishment of advanced airway does not affect the prognostic evaluation of CQI during CPR.

Bench Treadmill Training for Lower Limbs Severe Burn / 中国康复理论与实践

Objective:To explore the clinical effect of bench treadmill training on functional recovery for patients with severely burnt on lower limbs. Methods:From October, 2016 to December, 2017, 30 patients with severe lower limb burn were divided into control group (n = 15) and observation group (n = 15). The control group accepted routine comprehensive rehabilitation, while the observation group accepted the bench treadmill training in addition. They were assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Numerical Rating scale (NRS) of pain, Berg Balance Scale (BBS) and 6-minute walking test (6MWT) before and after six weeks of treatement. Results:The scores of SAS, SDS and NRS decreased in both groups (t > 3.636, P < 0.01), and they were less in the observation group than in the control group (t > 2.319, P < 0.05). The score of BBS and distance of 6MWT increased in the observation group compared with those in the control group (t > 2.541, P < 0.05). Conclusion:Early training with bench treadmill may promote the functional recovery for patients with severe lower limbs burns.

Salvianolic acid B decreases interleukin-1β-induced colitis recurrence in mice / 中华医学杂志(英文版)

BACKGROUND@#Degree of mucosal recovery is an important indicator for evaluating the therapeutic effects of drugs in treatment of inflammatory bowel disease (IBD). Increasing evidences has proved that tight junction (TJ) barrier dysfunction is one of the pathological mechanisms of IBD. The aim of this study was to observe whether enhancement of TJ can decrease colitis recurrence.@*METHODS@#Eighty C57BL/6 mice were randomly divided into four groups including normal group, colitis group, sulfasalazine (SASP) treated group, and traditional Chinese drug salvianolic acid B (Sal B) treated group. Colitis was established in mice by free drinking water containing dextran sulfate sodium, after treatments by SASP and Sal B, recombinant human interleukin-1β (IL-1β) was injected intraperitoneally to induce colitis recurrence.@*RESULTS@#Compared with sham control, cell apoptosis in colitis group was increased from 100.85 ± 3.46% to 162.89 ± 11.45% (P = 0.0038), and TJ dysfunction marker myosin light chain kinase (MLCK) was also significantly increased from 99.70 ± 9.29% to 296.23 ± 30.78% (P = 0.0025). The increased cell apoptosis was reversed by both SASP (125.99 ± 8.45% vs. 162.89 ± 11.45%, P = 0.0059) and Sal B (104.27 ± 6.09% vs. 162.89 ± 11.45%, P = 0.0044). High MLCK expression in colitis group was reversed by Sal B (182.44 ± 89.42% vs. 296.23 ± 30.78%, P = 0.0028) but not influenced by SASP (285.23 ± 41.04% vs. 296.23 ± 30.78%, P > 0.05). The recurrence rate induced by recombinant human IL-1β in Sal B-treated group was significantly lower than that in SASP-treated group.@*CONCLUSIONS@#These results suggested a link between intestinal mucosal barrier dysfunction, especially TJ barrier dysfunction, and colitis recurrence. The TJ barrier dysfunction in remission stage of colitis increased the colitis recurrence. This study might provide potential treatment strategies for IBD recurrence.