Head and facial anthropometry of the Indian population for designing a spectacle frame

Purpose: To establish the normative data of the head and face measurements needed to design an appropriate spectacle frame for the Indian population. Methods: Indian subjects between 20 and 40 years were included in the study. Thirteen parameters were measured using the direct and indirect methods using ImageJ software. Photographs of subjects were captured in the primary gaze position, with the head turned toward the subject’s right and left by 90° from the primary gaze. Results: The mean ± standard deviation of age was 27.6 ± 5.7; 55.38% were males. An independent t?test showed a significant difference in nose width (P = 0.001), inter?pupillary distance (P = 0.032), and body mass index (P = .012) between males and females. Inner inter?canthi distance (P = .265), outer inter?canthi distance (P = .509), and frontal angles (P = .536) showed no significant difference. There is a significant difference in face width compared with the other studies. The mean head width of males (154.168 ± 9.121) was wider than that of females (145.431 ± 8.923). This suggests a smaller distance between the temples of a spectacle frame for females. Conclusion: Considering the above factors, there is a need for a customized spectacle frame design providing better optics, improved cosmesis, and comfort to the wearer

Customization of spectacle frames for individuals with facial deformities by altering conventional spectacle frames – Phase I

Purpose: Manufacturing a spectacle frame for a facially deformed individual is challenging because of facial asymmetry. One of the solutions is the customization of spectacle frames. Customization of spectacle frames for facially deformed individuals requires a better understanding of the facial anthropometry of deformed faces. This study aimed to analyze the facial anthropometry of deformed faces to understand the range of variability. The results of this study will be used to find customization methods in the future. Methods: We measured and analyzed the 12 facial parameters of individuals with facial deformities using the ImageJ software. Results: The data collected were normally distributed. Paired sample test revealed a statistically significant difference between innercanthus distances (right innercanthus distance [RICD] and left innercanthus distance [LICD]). Correlation analysis showed a positive difference between horizontal and vertical pupillary distance?innercanthus distance (PD?ICD) (0.68, 0.75, and 0.81) and pupillary distance?helix distance (PD?HD) (0.57, 0.68, and 0.59) relations. PD?ICD correlations are stronger compared to the PD?HD relation. Conclusion: Altering the frame center distance and the temple heights are the most important for asymmetric faces. Large population?based data are required to make concrete decisions to design a spectacle frame for asymmetric faces.

Design and application of a central venous pressure measurement tool / 中华危重病急救医学

Central venous pressure (CVP) reflects the comprehensive condition of effective blood volume, cardiac function and vascular tone. Clinical monitoring of CVP can indirectly understand and evaluate the dynamic changes of blood volume in patients, and provide a reference for patients to venous fluid. At present, the traditional manual measurement method is widely used for measurement, which has some shortcomings such as zero shift, cumbersome operation (requires two health care workers to cooperate). In order to overcome the above problems, the author invented a new fixable CVP measurement tool and obtained the national utility model patent (ZL 2021 2 1451705.7). The tool is mainly composed of a base plate, a movable frame and a measuring department, etc. When used, the base plate is placed into the back of the patient and pressed and fixed, the movable frame is adjusted, the zero point is found, and the measurement data is read from the measuring department. It has the advantages of simple and convenient operation, small measurement error, wide applicability (different body types) and so on, which is suitable for clinical promotion.

Clinical value of combined detection of serum IgG, TBX21 and miR-335 in diagnosis of lupus nephritis / 国际生物医学工程杂志

Objective:To investigate the clinical value of combined detection of serum immunoglobulin G (IgG), T-frame protein 21 (TBX21), and microRNA-335 (miR-335) in the diagnosis of lupus nephritis (LN).Methods:Ninety-five patients with LN treated in our hospital from January 2021 to January 2023 were selected as the observation group, while ninety-five healthy individuals were selected as the control group. Based on the systemic lupus erythematosus disease activity index (SLEDAI) score at admission, the LN patients were divided into two subgroups: the active LN group (51 cases, SLEDAI score > 4) and the stable LN group (44 cases, SLEDAI score = 0 - 4). The levels of serum IgG, TBX21, and miR-335 were compared between the two groups, and the levels of serum IgG, TBX21, miR-335, blood urea nitrogen (BUN), serum creatinine (Scr), complement C3, complement C4, and SLEDAI score were compared between the two groups. The correlations of serum IgG, PTX3, and miR-335 levels with BUN, Scr, complement C3, complement C4, and SLEDAI scores were analyzed. The diagnostic value of serum IgG, TBX21, and miR-335 in LN was evaluated.Results:Compared with the control group, the levels of serum IgG, TBX21, and miR-335 in the observation group were higher on admission (all P < 0.05). The serum levels of IgG, TBX21, and miR-335 in patients with the active stage were higher than those in patients with the stable stage on admission (all P < 0.05). On admission, the BUN, Scr, and SLEDAI scores of patients in the active stage were higher than those in the stable stage, and the levels of complement C3 and C4 were lower than those in the stable stage (all P < 0.05). The levels of serum IgG, TBX21, and miR-335 on admission were positively correlated with BUN, Scr, and SLEDAI scores and negatively correlated with complement C3 and C4 levels (all P < 0.05). The area under the curve (AUC) of the combination of serum IgG, TBX21, and miR-335 levels in the diagnosis of LN was greater than that of single detection ( P < 0.05). Conclusions:Serum IgG, TBX21, and miR-335 are closely related to disease activity and can be used as reference indicators for the diagnosis and prediction of LN in clinical practice, enabling the development of early targeted treatment plans.

Outcomes of Management of Severe Clubfoot among Children by Ilizarov External Fixator

@#Introduction: Clubfoot remains the most common birth defect involving the musculoskeletal system. There are various surgical and non-surgical treatment options available for the management of clubfoot. Using the minimally invasive Ilizarov external fixator method has been reported to have good success rates and fewer complications. Materials and methods: This study aimed at analysing the morphological and functional outcomes of treating severe clubfoot by Ilizarov external fixator among children from July 2017 to March 2020. Thirty-two children who had either failed Ponseti / surgery or neglected with 44 clubfeet of Dieglio type III and type IV were included in the study. A short-leg walking cast was applied for an additional six weeks after removing of Ilizarov frame and additionally followed by an orthosis for another six weeks. Outcomes were measured by the functional rating system by Laaveg and Ponseti and interpretation done at 1 month and 12 months after the ankle-foot arthrosis. Results: About 86.4% of the patients had good or excellent outcome scores. Pre and post-Demeglio scores and functional rating scores were statistically significant (p<0.001) by using Paired t-test. Complications included superficial pin site infections in 13 feet (29.54%), 5 feet (11.36%) had claw toes, 3 feet (6.81%) had linear skin necrosis and 2 feet (4.54%) had calcaneal fractures which were manageable with minor interventions. Conclusion: The study findings highlighted that the Ilizarov external fixator method can correct complex foot deformities of severe clubfoot with minimum morbidity. Further larger and long-term studies are needed to investigate the effects of the stiff hindfoot and possible degenerative changes on the function and symptoms of these patients as adults.

Micropeptides: origins, identification, and potential role in metabolism-related diseases / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

With the development of modern sequencing techniques and bioinformatics, genomes that were once thought to be noncoding have been found to encode abundant functional micropeptides (miPs), a kind of small polypeptides. Although miPs are difficult to analyze and identify, a number of studies have begun to focus on them. More and more miPs have been revealed as essential for energy metabolism homeostasis, immune regulation, and tumor growth and development. Many reports have shown that miPs are especially essential for regulating glucose and lipid metabolism and regulating mitochondrial function. MiPs are also involved in the progression of related diseases. This paper reviews the sources and identification of miPs, as well as the functional significance of miPs for metabolism-related diseases, with the aim of revealing their potential clinical applications.

Comparison of the effect between night-wearing orthokeratology lens and frame glasses on the treatment of juvenile myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effects of night-wearing orthokeratology lenses and frame glasses on the treatment of juvenile myopia, and provide reference for the selection of myopia treatment methods in adolescents.METHODS: A prospective study was conducted on 106 adolescent myopia patients who received treatment in our hospital from June to November 2020. According to the wishes of patients, they were divided into two groups with 53 cases in each group. The control group was given regular frame glasses after optometry, while the observation group was given night-wearing orthokeratology lenses. The uncorrected visual acuity(LogMAR), refractive index(spherical equivalent and cylindrical lens power), and ocular biological parameters(axial length, central corneal thickness, anterior chamber depth and lens thickness)were compared between the two groups.RESULTS: The uncorrected visual acuity(LogMAR)of the observation group was lower than that of the control group at 1a after treatment(0.51±0.12 vs. 0.73±0.15), and the spherical equivalent(-0.23±0.05 vs. -5.32±1.35D)and cylindrical lens power(-1.53±0.22 vs. -1.97±0.35DC)were smaller than those of the control group(P&#x0026;#x003C;0.001). The axial length of the eyes in the two groups increased at 1a after treatment and the axial length in the control group was longer(25.53±0.84 vs. 25.95±0.83 mm); the lens thickness of the observation group was increased compared with that before treatment(3.39±0.19 vs. 3.31±0.15 mm; P&#x0026;#x003C;0.05). After 1a treatment, the accommodative amplitude(14.29±1.37 vs. 12.90±1.07D), accommodative facility(11.05±2.09 vs. 7.59±1.82cpm), and total staining rate of corneal epithelium in the observation group were higher than those in the control group(15.1% vs. 1.9%), and the accommodative lag was lower than that in the control group(0.55±0.11 vs. 0.97±0.30D; P&#x0026;#x003C;0.05). There were no significant differences in corneal cell density(3197.23±249.66 vs. 3207.41±258.14 cells/mm2), corneal endothelial cell area(309.27±28.04 vs. 312.62±24.95mm2)and the incidence of complications between the two groups before and after treatment(5.7% vs. 9.4%; P&#x0026;#x003E;0.05).CONCLUSION: Night-wearing orthokeratology lenses can improve uncorrected visual acuity in adolescent patients with myopia, reduce the spherical equivalent and cylindrical lens power, and improve the accommodation-related parameters, but has no significant effect on the corneal function.

Application of computer-assisted navigation technology in the resection and reconstruction of mandibular ameloblastoma / 口腔医学

Objective@# Using computer-assisted navigation technology to guide the resection and reconstruction of mandibular ameloblastoma, evaluating its treatment effect.@*Methods @# Twelve patients were selected from the Affiliated Stomatological Hospital of Nanjing University from January 2017 to May 2022. All 12 patients accepted same surgery which included resection of mandibular ameloblastoma and reconstruction by fibula musculocutaneous flap. Among them, 6 cases were included in the navigation group; 6 cases were in the non-navigation group. Advantages and disadvantages of computer-assisted navigation technology in this operation were evaluated with these cases. @*Results@# The 12 operations were performed by the same operator. The average time for fixing the navigation bracket and performing navigation in the navigation group was about 15 minutes. Compared with the non-navigation group, the average operation time in the navigation group was shortened by about 10 minutes. In the navigation group, the mandible resection range matched the fibula musculocutaneous flap well, and the occlusal relationship recovered well. @*Conclusion @#Using the mandibular reference frame, under the guidance of computer-assisted navigation technology, the resection and reconstruction of mandibular ameloblastoma can be performed quickly and accurately.

Origin, development, and modern application value of Chinese herbal lozenges / 中国中药杂志

Lozenge is one of the traditional dosage forms of Chinese medicine. It has been recorded in traditional Chinese medical classics of all dynasties since the Eastern Han Dynasty and has been developing and evolving continuously. The unique pharmaceutical methods and application scope are the driving force of its emergence, existence, and development. Up to now, lozenge has been included in the Chinese Pharmacopoeia as an independent dosage form. Lozenge has been endowed with new meaning by modern Chinese medicine pharmaceutics, which is worth tracing origin and exploring value. The present study reviewed the origin and development of lozenge, compared lozenge with other similar dosage forms, analyzed the characteristics of modern and ancient dosage forms of lozenge, and discussed the development prospect and potential of lozenge in combination with the demand development of modern Chinese medicine preparation, so as to provide references for expanding the modern application of lozenge.

Clinical prospects and research strategies of long non-coding RNA encoding micropeptides / 浙江大学学报·医学版

Long non-coding RNAs (lncRNAs) which are usually thought to have no protein coding ability, are widely involved in cell proliferation, signal transduction and other biological activities. However, recent studies have suggested that short open reading frames (sORFs) of some lncRNAs can encode small functional peptides (micropeptides). These micropeptides appear to play important roles in calcium homeostasis, embryonic development and tumorigenesis, suggesting their potential as therapeutic targets and diagnostic biomarkers. Currently, bioinformatic tools as well as experimental methods such as ribosome mapping and in vitro translation are applied to predict the coding potential of lncRNAs. Furthermore, mass spectrometry, specific antibodies and epitope tags are used for validating the expression of micropeptides. Here, we review the physiological and pathological functions of recently identified micropeptides as well as research strategies for predicting the coding potential of lncRNAs to facilitate the further research of lncRNA encoded micropeptides.

Analysis of the supervision status of intensive countywide medical community in Fujian province based on thematic frame analysis / 中华医院管理杂志

Objective:To analyze the supervision mode and problems of intensive countywide medical communities and explore the methods and strategies to improve their supervision system.Methods:From March 2022 to May 2022, a stratified random sampling method was used and the intensive countywide medical communities in the province were selected for field study. In-depth interviews were made with the staff of the healthcare administration departments and health insurance agencies affiliated with intensive countywide medical communities, directors of general hospitals, directors of township hospitals, and heads of functional departments. These interviews mainly covered the principal entities of countywide medical community supervision, supervision measures and contents, supervision effects, supervision weaknesses, and how to improve internal and external supervision mechanisms. The interviews results were analyzed using thematic framework analysis and the data were subject to a descriptive analysis.Results:23 persons of five intensive countywide medical communities were selected for key person interview. The finalized framework of regulatory elements of intensive countywide medical communities consists of such five general themes as regulatory subjects, regulatory content, regulatory measures, regulatory effectiveness and existing problems, comprising 14 level-1 indicators and 52 level-2 indicators. The main regulatory bodies were mainly government departments (15 times), the regulatory content was focused on medical resources (10 times), the regulatory measures cover specific regulations (4 times), specific activities (4 times) and assessment and evaluation (4 times). And the regulatory effectiveness demonstrated a currently strong regulation strength of medical communities (5 times), and the existing problems were insufficient government supervision (12 times), difficulties encountered by social forces in their supervision (11 times) and internal governance (5 times).Conclusions:The supervision system of intensive countywide medical communities should be optimized by improving the governmental supervision mechanism, inviting supervision of social forces and building an effective internal governance.

The effects of Shexiang Baoxin pills combined with intracoronary injection of nicorandil on myocardial blood perfusion and short-term prognosis for STEMI patients after PPCI / 药学实践杂志

Objective To observe the effects of Shexiang Baoxin pill combined with intracoronary injection of nicorandil on myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Methods 151 patients with acute myocardial infarction after PPCI were enrolled in this study. Those patients were admitted to our hospital during January 2017 to January 2018. According to the numerical randomization method, 51 patients were selected as routine treatment group (group A), 50 patients with intracoronary injection of nicorandil (group B) and 50 patients received intracoronary injection of nicorandil plus oral Shexiang Baoxin pills (group C). Intra-operative corrected TIMI frame count (cTFC), postoperative TIMI grade 3 blood flow ratio, 2-hour ECG ST segment fallback >50% index, the incidence of major adverse cardiovascular events (MACE) during hospitalization and the incidence of angina and MACE within 3 months after surgery were evaluated. Results cTFC, 2 hours postoperative ECG ST segment fall >50% index in group B and C were better than group A (P<0.05). The results from group C were better than group B. Group C exhibited better results than group B and C in post-operative angina pectoris 3 months after surgery (P<0.05). Conclusion Shexiang Baoxin pills combined with intra-coronary injection of nicorandil can improve myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Baião de um, o outro que se retire: impasses no manejo da agressividade num grupo psicoterapêutico / Baião de um, or party of one: challenges on handling aggressiveness in a psychotherapeutic group / Baião de um: desafíos en el manejo de la agresividad en un grupo psicoterapéutico

O artigo visa discutir impasses no manejo da agressividade num grupo terapêutico, tendo a hipótese de que, em alguns momentos, a agressividade apresenta-se como uma ameaça ao enquadre do grupo. Para isso, partiremos da apresentação de um caso clínico atendido em grupo terapêutico de orientação psicanalítica em co-terapia na Clínica Escola do Instituto de Psicologia da Universidade de São Paulo. Se a partir de autores centrais na psicanálise concebemos a agressividade enquanto experiência fundamental à própria constituição psíquica (inexoravelmente presente na relação entre o eu e o outro), localizamos como condição fundamental à experiência de cuidado em um grupo terapêutico o endereçamento a um outro que se apresenta disponível. Assim, a partir das funções do enquadre propostas por Bleger e Roussillon, pensamos nas condições de constância da experiência terapêutica psicanalítica - experiência que entendemos não se dar sem alguma violência/ruptura - e nos ocupamos, no caso em questão, em evitar a potencial experiência de desamparo que a agressividade colocaria em jogo no grupo, na medida em que, com Kaës, o concebemos enquanto composto por espaços psíquicos comuns e partilhados.

The article aims to discuss challenges on handling aggressiveness in a psychotherapeutic group, from the hypothesis that, in some moments, aggressiveness presents itself as a threat to the group's environment. For this, we will start with the presentation of a clinical case treated in a therapeutic group of psychoanalytic guidance in co-therapy at the Clinical School of the Institute of Psychology of the University of São Paulo. If according to central authors in psychoanalysis we conceive aggressiveness as a fundamental experience to the psychic constitution itself (inexorably present in the relationship between the self and the other), we understand that a fundamental condition for the experience of care in a therapeutic group is being able to address to another that is available. Thus, based on the frame functions proposed by Bleger and Roussillon, we discuss the conditions of constancy of the psychoanalytic therapeutic experience - an experience that we understand does not happen without some violence / rupture. Finally, in the case presented, we aimed in avoiding the potential experience of helplessness that aggressiveness would put at stake in the group, as we conceive it, with Kaës, as composed of common and shared psychic spaces.

El artículo tiene como objetivo discutir los impases en el manejo de la agresividad en un grupo terapéutico, con la hipótesis de que, en algunos momentos, la agresividad se presenta como una amenaza para el encuadre del grupo. Para esto, comenzaremos con la presentación de un caso clínico tratado en un grupo terapéutico de orientación psicoanalítica en co-terapia en la Escuela Clínica del Instituto de Psicología de la Universidad de São Paulo. Si juntamente con autores centrales del psicoanálisis concebimos la agresividad como una experiencia fundamental para la propia constitución psíquica (inexorablemente presente en la relación entre el yo y el otro), comprendemos también ser fundamental a la experiencia del cuidado en el grupo terapeutico dirigirse a un otro que está disponible. Por lo tanto, a partir de las funciones del encuadre propuestas por Bleger y Roussillon, pensamos acerca de las condiciones constantes de la experiencia terapéutica psicoanalítica, una experiencia que entendemos que no ocurre sin cierta violencia / ruptura, y nos dedicamos, en el caso presentado, a evitar la experiencia de desamparo que la agresividad pondría en juego en el grupo, en la medida en que, con Kaës, lo concebimos como compuesto de espacios psíquicos comunes y compartidos.

O infantil¹: suas múltiplas dimensões / The infantile: its multiple aspects / Lo infantil: sus múltiples dimensiones / L'infantile: ses multiples dimensions

O objetivo deste texto é apresentar a importância fundamental do infantil para a clínica e a teoria psicanalíticas. O infantil pode ser apreendido na experiência psicanalítica como expressão princeps da realidade psíquica, da dimensão inconsciente da subjetividade humana. O infantil não concerne apenas aos analistas de crianças, pois não é assimilável à infância ou às fases de desenvolvimento. Diferente do infantilismo comportamental, o infantil obedece a uma sobredeterminação causal, não linear, de composição aberta ao acaso, ao incerto. Longe de ser uma memória fotográfica do passado ou de condutas infantis no adulto, o infantil aponta para os modos de registro e inscrição do que Freud chamou de Erlebnis, "vivência infantil". A tese nuclear é que, para o sujeito, na clínica psicanalítica e independentemente de preferências por um ou outro modelo teórico-clínico, estará sempre em jogo a eficácia dessas inscrições, sua metabolização e simbolização possível ou não, e sua força pulsional viva no presente. O infantil não emerge apenas como resistência ou testemunho do recalcamento da sexualidade infantil, mas como representante atual e vivo da busca por uma experiência criativa e reparadora (neogênese) do que não pôde ser experimentado como continuidade de ser, como expressão potencial, como impulso criativo, e que, por incapacidade ou inadequação do objeto primário, teve de ser recalcado ou clivado. Transformar a relação com o infantil não significa eliminá-lo, mas permitir um reordenamento, uma ressignificação para que o novo possa advir. Fonte de desilusão ou inspiração, nunca deixará de ser referência.

This work aims at showing the extreme importance of the infantile for the psychoanalytical clinic and theory. The infantile may be grasped during the psychoanalytical experience as the princeps expression from psychic reality, from the unconscious of the human subjectivity. The infantile does not concern only children's analysts, as it is not connected to childhood or the development phases; which is different than childish behavior patterns. The infantile follows a casual predominance, non-linear, open to chance, to the doubtful. It is not about having a photographic memory about the past or an adult having childish behavior - the infantile shows what Freud called Erlebnis, "childish perception". The thesis is that, for the subject, the impact of these registrations, their metabolization and symbology, being possible or not, and their strength, is alive in the present, being the subject in a psychoanalytical clinic and not determining preferences for this or that theory-clinical model. The infantile does not emerge only as resistance or testimonial of repressed childhood sexuality, but also as current and vivid representation of the search for a creative and restorative (neogenesis) experience of what couldn't be experimented as the continuity of being, as expression of one's potential, as creative impulse that, due to inability or inadequacy of the primary object, had to be repressed or cleaved. Transforming the relation with the infantile does not mean eliminating it. It is about allowing a reorganization, redefinition, so that something new can arise from it. It can be source of disappointment or inspiration, but it will always be a reference.

El objetivo de este texto es presentar la importancia fundamental de lo infantil para la clínica y la teoría psicoanalíticas. Lo infantil puede ser aprehendido en la experiencia psicoanalítica como expresión prínceps de la realidad psíquica, de la dimensión inconsciente de la subjetividad humana. Lo infantil no atañe solo a los analistas de niños, pues no es asimilable a la infancia o las fases de desarrollo; diferente del infantilismo comportamental, lo infantil obedece a una sobredeterminación causal, no linear, de composición abierta al acaso, a lo incierto. Lejos de una memoria fotográfica del pasado o de conductas infantiles en el adulto, lo infantil apunta a los modos de registro e inscripción de lo que Freud llamó Erlebnis, "vivencia infantil". La tesis nuclear es que, para el sujeto, en la clínica psicoanalítica e independientemente de preferencias por este o aquel modelo teórico-clínico, estará siempre en juego la eficacia de estas inscripciones, su metabolización y simbolización posible o no, y su fuerza pulsional viva en el presente. Lo infantil no emerge solo como resistencia o testimonio de la represión de la sexualidad infantil, sino como representante actual y vivo de la búsqueda por una experiencia creativa y reparadora (neogénesis) de lo que no pudo ser experimentado como continuidad de ser, como expresión potencial, como impulso creativo y que, por incapacidad o inadecuación del objeto primario, debió ser reprimido o clivado. Transformar la relación con lo infantil no significa eliminarlo, sino permitir una reordenación, una resignificación para que lo nuevo pueda advenir. Fuente de desilusión o inspiración, nunca dejará de ser referencia.

L'objectif de ce texte, c'est de présenter l'importance fondamentale de l'infantile pour la clinique et la théorie psychanalytique. L'infantile peut être appréhendé dans l'expérience psychanalytique en tant que l'expression princeps de la réalité psychique, de la dimension inconsciente de la subjectivité humaine. L'infantile ne concerne pas seulement les analystes d'enfants, car ce n'est pas assimilable à l'enfance ou aux phases de développement ; contrairement à l'infantilisme comportemental, l'infantile obéit à une surdétermination causale, non linéaire, de composition ouverte au hasard, à l'incertain. L'infantile désigne les manières d'enregistrement et d'inscription de ce que Freud a appelé Erlebnis, « vécu infantile ¼, bien qu'il ne soit pas une mémoire photographique du passé ou de conduites infantiles chez l'adulte. La thèse nucléaire, c'est que, pour le sujet, dans la clinique psychanalytique et indépendamment de préférences par l'un ou l'autre modèle théorique-clinique, il sera toujours en jeu l'efficace de ces inscriptions, sa métabolisation et symbolisation possible ou non, et sa force pulsionnelle vivante à présent. L'infantile n'émerge pas seulement en tant que résistance ou témoin du refoulement de la sexualité infantile, mais en tant que représentant actuel et vivant de la quête d'une expérience créative et réparatrice (néogenèse) de ce qui ne peut pas être expérimenté comme une continuité d'être, comme une expression potentielle, comme une impulsion créative et qui, par incapacité ou inadéquation de l'objet primaire, a dû être refoulé ou clivé. Transformer le rapport avec l'infantile ne signifie pas l'éliminer, mais permettre un reclassement, une resignification pour que le nouveau puisse advenir. Toute en étant une source de désillusion ou d'inspiration, il ne laissera jamais d'être une référence.

Morphology of endoskeleton and spination in the sea star Midgardia xandaros (Brisingida: Brisingidae) from the Gulf of Mexico / Morfología del endoesqueleto y ornamentación de la estrella de mar Midgardia xandaros (Brisingida: Brisingidae) en el Golfo de México

Introduction: The deep-sea asteroid species of Brisingida have a nearly global distribution but have remained poorly understood due to their deep bathymetric distributions and fragile skeletons. Objective: To describe the external and internal morphology of Midgardia xandaros including the skeletal arrangement, through multifocal and SEM techniques. Methods: We examined a total of 21 specimens, including 27 arm fragments, from the Gulf of Mexico and Honduras. Two specimens were dissected. Results: Detailed descriptions of pedicellariae, abactinal, intercostal, inferomarginal, adambulacral, ambulacral, odontophore, and oral ossicles, and their spines are provided, emphasizing the articulations and muscle attachments. C-shaped valves pedicellariae and small pedicellariae valves with shorter denticulation areas were recognized. Conclusions: The morphological description of M. xandaros is expanded, providing the most extensive description of abactinal, first adambulacral, first and subsequent inferomarginal ossicles, abactinal spines, and C-shaped, crossed pedicellariae, as well as the distal arm plates, for a brisingid species using SEM to date.

Introducción: Las estrellas de mar de profundidad del orden Brisingida tienen una distribución casi global, sin embargo, han sido poco estudiadas debido a su profunda distribución batimétrica y esqueleto frágil. Objetivo: Describir la morfología externa e interna de Midgardia xandaros incluyendo el arreglo de las placas del esqueleto mediante técnicas de microscopía multifocal y electrónica de barrido (MEB). Métodos: Se examinó un total de 21 ejemplares, incluyendo 27 fragmentos de brazos, provenientes del Golfo de México y Honduras. Dos de estos ejemplares fueron disectados. Resultados: Se presenta la descripción de pedicelarios; placas abactinales, intercostales, inferomarginales, adambulacrales, ambulacrales, orales y odontóforo, y sus espinas, enfatizando los sitios de articulaciones e inserción de músculos. Se reconocieron pedicelarios con valvas con forma de C, y pequeños pedicelarios cuyas valvas poseen áreas de denticulación cortas. Conclusiones: La descripción morfológica de M. xandaros es ampliada, presentado por primera vez la morfología de las placas abactinales, primera adambulacrales, primera y subsecuentes inferomarginales, espinas abactinales y pedicelarios con valvas con forma de "C", así como las placas distales de los brazos para una especie del orden Brisingida.

Ontogenetic variation of the odontophore of Luidia superba (Asteroidea: Paxillosida) and its taxonomic implications / Variación ontogenética del odontóforo de Luidia superba (Asteroidea: Paxillosida) y sus implicaciones taxonómicas

Introduction: The sea star odontophore is the structure positioned between the paired oral ossicles, with which they articulate through proximal and distal processes. The internal anatomy structures may be used as taxonomic characters for a precise differentiation between species, so it is necessary to describe the structures variation throughout growth. Objective: To describe the odontophore shape and variation of Luidia superba A. H. Clark, 1917 from specimens of the Gulf of California deposited in the Echinoderm National Collection, ICML UNAM. Methods: A total of 735 specimens were examined to describe the external characters, from which 55 selected specimens, within a range of R = 14 mm and R = 210 mm, were dissected to extract the odontophores and analyzed with geometric morphometrics. Results: Scanning electronic microscopy (SEM) images of the odontophores showing the variations in shape throughout growth are presented. Differences in shape between size groups were confirmed with a Canonical Variables Analysis (P < 0.05). Conclusions: There are three main groups in this size ranges where specialization of the stereom can be observed through the ontogenetic series; the variation in shape of the odontophore shown here is a precedent for the use of internal anatomy as new taxonomic characters of identification.

Introducción: El odontóforo es la estructura posicionada entre las placas orales pareadas con las que se articula a través de procesos proximales y distales. Las estructuras de la anatomía interna se pueden usar como caracteres taxonómicos para la diferenciación más precisa entre especies, por lo que es necesario describir la variación de las estructuras a lo largo del crecimiento. Objetivo: Describir la forma y la variación del odontóforo de Luidia superba A. H. Clark, 1917 de ejemplares del Golfo de California depositados en la Colección Nacional de Equinodermos, ICML UNAM. Métodos: Se revisaron un total de 735 ejemplares para describir los caracteres externos y de las cuales se seleccionaron 55 ejemplares, dentro de un intervalo de R = 14 mm a R = 210 mm, de los cuales se extrajeron los odontóforos y fueron analizados utilizando morfometría geométrica. Resultados: Se presentan imágenes de microscopía electrónica de barrido (MEB) de los odontóforos que muestran las variaciones de la forma durante el crecimiento. Se confirmaron diferencias significativas de la forma entre los grupos de tallas mediante un CVA (p< 0.05). Conclusiones: Se observa especialización del estereoma a lo largo de la serie ontogenética; la variación en la forma del odontóforo aquí mostrada es precedente para el uso de estructuras de la anatomía interna como nuevos caracteres de identificación.

Intraoperativeinternal stenting for preventing biliary anastomotic complications of liver transplantation / 中华器官移植杂志

Objective:To explore the role of internal stenting for preventing biliary anastomotic complications during complex duct-to-duct biliary reconstruction of orthotopic liver transplantation.Methods:From December 1, 2018 to April 30, 2020, intraductal stent was placed in 6 cases of complex biliary tract reconstruction during liver transplantation. Postoperative prognosis, recovery of bilirubin and biliary enzymes, management of intraductal stent and occurrence of postoperative biliary complications were observed.Results:All of them recovered and were discharged smoothly and bilirubin and biliary enzymes normalized before discharge. The average peak values of total bilirubin, alkaline phosphatase, total bile acid and γ-glutamyl transpeptidase were 83.8±56.4 μmol/L, 151.5±76.3 U/L, 301.7±177.0 U/L and 98.4±80.9 μmol/L and the average turning points of total bilirubin, alkaline phosphatase, total bile acid and γ-glutamyl transpeptidase 2.3±1.0, 3.0±1.1, 3.8±1.2 and 1.8±0.8 days; average time of complete recovery of total bilirubin, alkaline phosphatase, total bile acid and γ-glutamyl transpeptidase 7.7±5.1, 5.0±4.9, 23.5±7.6 and 3.8±2.4 days respectively. Intraductal stent was removed by gastroduodenoscopy ( n=3) and slipped off ( n=3). Except for one case of asymptomatic anastomotic stricture at 1 year post-operation, no biliary complications occurred during follow-ups. Conclusions:The placement of intraductal stent during complex biliary reconstruction of liver transplantation can effectively promote the recovery of postoperative liver function, enhance the quality-of-life of patients, effectively avoid the occurrence of biliary anastomotic complications and ensure the safety of patients.

Study of the accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the monocular and binocular accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children.<p>METHODS: Totally 47 children(94 eyes)with low degree myopic anisometropia(1.0D≤binocular equivalent spherical lens difference <2.5D)were involved between November 2019 and April 2020 in the retrospective clinical study. Twenty-seven cases(54 eyes)wore frame lens were used as group A and 20 cases(40 eyes)wore orthokeratology lens were used as group B. The corrected visual acuity and the accommodative parameters \〖the accommodative response(AR), the accommodative facility(AF), the accommodative amplitude(AMP)\〗 at 1mo after treatment were recorded and compared. <p>RESULTS:In two groups the results of AR were positive, and it meant accommodative lag(AL). AL of the higher myopic eyes was higher than the lower eyes in group A(0.63±0.21D <i>vs</i> 0.25±0.34D, <i>P</i><0.001), but there was no significant difference of AL in group B(<i>P</i>=0.104). Between two eyes, the difference of the corrected visual acuity and the monocular AMP in two groups were no significant(<i>P</i>>0.05). The binocular AR difference in group A was significantly higher than group B(0.38±0.36D <i>vs</i> 0.10±0.26D, <i>P</i>=0.005), and the binocular AF was lower(8.22±1.15c/min <i>vs</i> 9.95±0.89c/min, <i>P</i><0.001). There was no statistical difference in binocular AMP(<i>P</i>=0.280).<p>CONCLUSION: Low myopic anisometropia children with orthokeratology lens can obtain higher binocular AF and lower binocular AR difference than that with frame lens, so as to maintain more coordinated binocular accommodation.

Predictors of recurrent angina in patients with no need for secondary revascularization / 世界急诊医学杂志（英文）

@#BACKGROUND: Approximately 20% to 30% of patients with coronary artery disease (CAD) develop recurrent angina pectoris following successful and complete coronary revascularization utilizing percutaneous coronary intervention (PCI). We aim to investigate predictors of recurrent angina pectoris in patients who have undergone successful coronary revascularization using PCI, but on repeat coronary angiography have no need for secondary revascularization. METHODS: The study comprised 3,837 patients with CAD, who were enrolled from January 2007 to June 2019. They had undergone successful PCI; some of them redeveloped angina pectoris within one year after the procedure, but on repeat coronary angiography had no need for revascularization. Thrombolysis in myocardial infarction (TIMI) frame count was used to evaluate the velocity of coronary blood in the follow-up angiogram. Multivariate logistic regression was used to investigate risk factors for recurrent angina pectoris. Similarly, predictors of recurrent angina according to the TIMI frame count were assessed using multivariate linear regression. RESULTS: In this retrospective study, 53.5% of patients experienced recurrent angina pectoris. By multivariate logistic regression, the following characteristics were statistically identified as risk factors for recurrent angina pectoris: female sex, older age, current smoking, low-density lipoprotein cholesterol (LDL-C) ≥1.8 mmol/L, and an elevated TIMI frame count (P for all <0.05). Similarly, using multivariate linear regression, the statistical risk factors for TIMI frame count included: female sex, older age, diabetes, body mass index (BMI), post-procedural treatment without the inclusion of dual antiplatelet therapy. CONCLUSIONS: Patient characteristics of female sex, older age, diabetes, and elevated BMI are associated with an increased TIMI frame count, coronary microcirculation dysfunction, and recurrent angina pectoris after initially successful PCI. In addition, current smoking and LDL-C ≥1.8 mmol/L are risk factors for recurrent angina pectoris. In contrast, the treatment with dual antiplatelet therapy is negatively correlated with a higher TIMI frame count and the risk of recurrent angina pectoris.

Set-Up Madness: A Review

@#Psychosis can be defined as a mental disorder in which a person’s thoughts, affective response, ability to recognize reality, and ability to communicate and relate to others are sufficiently impaired to grossly interfere with his or her capacity to deal with reality. The classical characteristics of psychosis are impaired reality testing, hallucinations, delusions, and illusions. While factitious disorder and malingering are usually acknowledged as contrived psychiatric conditions for acquisition of interior or exterior profits, respectively, another alternative, also, exists that though is not manufactured individually, is enforced peripherally. Such cases, which are usually referred by the judge’s ruling, for evaluation and treatment, are more important than comparable simulated or genuine mental conditions, because incorrect diagnosis, or careless, cagily, and guarded validation of preliminary diagnosis that has been issued in the authorized or emergency department, can seriously endanger the individual’s civil rights, while it should not be overlooked that incorrect diagnosis is a kind of malpractice that may harm an individual awfully. In the present article the clinical picture of the said situation, in addition to some case histories, and recommendable hints for differential diagnosis between different types of psychoses, has been discussed.