Efficiency of pulsed electromagnetic field and neuromuscular electrical stimulation on painful shoulder following stroke / Eficiência do campo eletromagnético pulsado e da estimulação elétrica neuromuscular em ombro doloroso após acidente vascular cerebral

INTRODUCTION: Shoulder pain after stroke, a complication with a prevalence of up to 16­84% usually occurs after 2­3 months and leads to patients withdrawing from rehabilitation programs, staying in the hospital longer, having less limb function and having a great negative impact on their quality of life. The aim of the present study was to determine the effect of PEMF and NMES in reducing shoulder pain in patients with stroke. MATERIAL AND METHODS: A prospective, randomized controlled trial included 51 patients with shoulder pain following stroke. The patients were randomly assigned to three groups (17 people in each group): Pulsed Electromagnetic Field (PEMF), Neuromuscular Electrical Stimulation (NMES) and Control group. The outcome measures were Visual Analogue Scale (VAS), Modified Ashworth Scale (MAS) and Fugl Meyer Assessment­Upper Extremity (FMA-UE), Active and Passive Range of Motion (AROM/PROM) assessed at the baseline, six weeks into the intervention, and one week into the follow-up. RESULTS: VAS score for pain showed a mean change of 1.60, 1.60 and 4.94 in PEMF, NMES, and control respectively after 20 sessions. It showed pain was significantly improved in all the groups (p<0.001), but the effectiveness of the PEMF and NMES groups was superior to the control group. CONCLUSION: The current literature showed that PEMF & NMES are effective in improving post-stroke shoulder pain, spasticity, range of motion and motor function and a novel method for stroke patients undergoing rehabilitation.

INTRODUÇÃO: Dor no ombro após acidente vascular cerebral com prevalência de 16­84% geralmente ocorre após 2­3 meses e pode resultar na suspensão de programas de reabilitação, internações hospitalares mais longas e redução da função dos membros, prejudicando qualidade de vida dos pacientes com AVC. O objetivo do presente estudo foi determinar o efeito da PEMF e da EENM na redução da dor no ombro em pacientes com acidente vascular cerebral. MATERIAL E MÉTODOS: Um estudo prospectivo, randomizado e controlado incluiu 51 pacientes com dor no ombro pós-AVC. Os pacientes foram divididos aleatoriamente em três grupos (17 pessoas em cada grupo): grupo Campo Eletromagnético Pulsado (PEMF), grupo Estimulação Elétrica Neuromuscular (EENM) e grupo Controle. As medidas de resultados foram na Escala Visual Analógica (VAS), Escala de Ashworth Modificada (MAS) e Avaliação de Fugl Meyer ­ Extremidade Superior (FMA-UE), Amplitude de Movimento (AROM/PROM) foram avaliadas no início do estudo, após seis semanas de tratamento, e após um acompanhamento semanal. RESULTADOS: A pontuação VAS para dor mostrada uma alteração média de 1,60, 1,60 e 4,94 na PEMF, EENM e Controle, respectivamente, após 20 sessões. Mostrou melhora significativa entre os três grupos (p<0,001), mas a eficácia do grupo PEMF e EENM foi superior ao grupo Controle. CONCLUSÃO: O presente estudo mostrou que PEMF e EENM são eficazes na melhora da dor no ombro pós-AVC, espasticidade, amplitude de movimento e função motora e um novo método para pacientes com AVC em reabilitação. Nossas descobertas indicam que a eficácia da EENM é claramente superior à do PEMF na manutenção da analgesia a longo prazo.

A randomized controlled study evaluating outcomes of intense pulsed light and low-level light therapy for treating meibomian gland dysfunction and evaporative dry eye

Purpose: This randomized, controlled, blinded study evaluates the efficacy of intense pulsed light (IPL) therapy with low?level light therapy (LLLT) in the treatment of meibomian gland dysfunction (MGD) and evaporative dry eye (EDE) compared to a control group. Methods: Hundred patients with MGD and EDE were randomized into control (50 subjects, 100 eyes) and study group (50 subjects, 100 eyes). The study group underwent three sittings of IPL with LLLT 15 days apart and were followed up 1 month and 2 months after the last treatment sitting. The control group underwent sham treatment and was followed up at the same intervals. The patients were evaluated at baseline and 1 month and 3 months (post 1st treatment) for dry eye. Schirmer's test and tear breakup time (TBUT), OSDI, meibomian gland expression, and meibography. Results: The study group showed significant improvement in OSDI scores (P < 0.0001) compared to the control group and a significant improvement in TBUT (P < 0.005) compared to the control group. There was no change in schirmer's test and an improvement in the meibomian gland expression but not significant. Conclusion: The results show that a combined therapy of IPL with LLT is effective in treating MGD with EDE compared to controls, and repeated treatment sessions have a cumulative effect on the disease outcomes

Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review

This study reviewed the efficacy and safety of intense pulsed light (IPL) for the treatment of dry eye disease (DED). The PubMed database was used to conduct the literature search, which used the keywords “intense pulsed light” and “dry eye disease”. After the authors evaluated the articles for relevancy, 49 articles were reviewed. In general, all treatment modalities were proven to be clinically effective in reducing dry eye (DE) signs and symptoms; however, the level of improvement and persistence of outcomes differed amongst them. Meta-analysis indicated significant improvement in the Ocular Surface Disease Index (OSDI) scores post-treatment with a standardized mean difference (SMD) = ?1.63; confidence interval (CI): ?2.42 to ?0.84. Moreover, a meta-analysis indicated a significant improvement in tear break-up time (TBUT) test values with SMD = 1.77; CI: 0.49 to 3.05. Research suggests that additive therapies, such as meibomian gland expression (MGX), sodium hyaluronate eye drops, heated eye mask, warm compress, lid hygiene, lid margin scrub, eyelid massage, antibiotic drops, cyclosporine drops, omega-3 supplements, steroid drops, and warm compresses along with IPL, have been found to work in tandem for greater effectiveness; however, in clinical practice, its feasibility and cost-effectiveness have to be taken into consideration. Current findings suggest that IPL therapy is suitable when lifestyle modifications such as reducing or eliminating the use of contact lenses, lubricating eye drops/gels, and warm compresses/eye masks fail to improve signs and symptoms of DE. Moreover, patients with compliance issues have been shown to benefit well as the effects of IPL therapy is sustained for over several months. DED is a multifactorial disorder, and IPL therapy has been found to be safe and efficient in reducing its signs and symptoms of meibomian gland dysfunction (MGD)-related DE. Although the treatment protocol varies among authors, current findings suggest that IPL has a positive effect on the signs and symptoms of MGD-related DE. However, patients in the early stages can benefit more from IPL therapy. Moreover, IPL has a better maintenance impact when used in conjunction with other traditional therapies. Further research is needed to assess cost-utility analysis for IPL.

Diquafosol sodium combined with intense pulsed light in the treatment of meibomian gland dysfunction dry eye after corneal refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.

Efficacy of low-intensity pulsed ultrasound therapy in elderly patients with coronary heart disease and angina pectoris / 中华老年医学杂志

Objective:To investigate the practical efficacy of low-intensity pulsed ultrasound(LIPUS)and its effects on hemodynamics in patients with coronary heart disease and angina pectoris.Methods:As a single-center randomized controlled study, 66 elderly patients with coronary heart disease and angina pectoris treated at Qilu Hospital of Shandong University between November 2021 and August 2022 were consecutively recruited.Participants were divided into an ultrasound group and a control group via the random number table method, with 33 in each group.Both groups were given conventional drug treatment, and the ultrasound group was supplemented with LIPUS treatment.After 20 sessions of treatment, the clinical efficacy, blood lipid levels, inflammatory factors and hemodynamics from noninvasive monitoring before and after treatment were compared.Results:There were no statistically significant differences in baseline data between the two groups( P>0.05). After treatment, marked effectiveness was seen in 12 cases(36.4%), effectiveness in 18 cases(54.5%), ineffectiveness in 2 cases(6.1%)and aggravation in 1 case(3%)in the ultrasound group, with a total effectiveness rate of 90.9 %.In the control group, marked effectiveness was seen 2 cases(6.1%), effectiveness in 19 cases(57.6%)and ineffectiveness in 9 cases(27.3%), with a total effectiveness rate of 63.6%.Statistically significant favorable results were achieved in the ultrasound treatment group, compared with the control group( P<0.05). Also, compared with the control group, patients in the ultrasound group showed lower total cholesterol[(2.31±1.03)mmol/L vs.(4.36±0.76)mmol/L, P<0.01], decreased low-density lipoprotein cholesterol[(1.24±0.70)mmol/L vs.(1.74±0.44)mmol/L, P<0.01], decreased triglycerides[(1.04±0.40)mmol/L vs.(1.28±0.49)mmol/L, P<0.05], decreased apolipoprotein B[(0.67±0.25)g/L vs.(0.90±0.14)g/L, P<0.01], decreased interleukin-6[(2.87±2.52)ng/L vs.(4.66±3.30)ng/L, P<0.05], and decreased high-sensitivity C-reactive protein[(1.04±1.41)mg/L vs.(3.80±5.78)mg/L, P<0.05]. Concerning hemodynamics, there was an increase in cardiac output[(4.92±1.05)L/min vs.(4.39±0.97)L/min, P<0.05], stroke volume[(75.85±17.50)ml/beat vs.(66.97±15.57)ml/beat, P<0.05], cardiac index[(37.50±7.14)ml·beat -1·m -2vs.(43.29±7.96)ml·beat -1·m -2, P<0.01], and stroke volume index[(3.05±0.45)L/min 2vs.(2.51±0.43)L/min 2, P<0.01], but a decrease in systemic vascular resistance[(1 358.29±325.23)dyne·s -1·cm -5vs.(1 617.94±526.27)dyne·s -1·cm -5, P<0.05], total vascular resistance[(4.07±24.30)% vs.(21.32±31.94)%, P<0.05], and average heart rate[(63.43±7.42)beats/min vs.(69.11±10.89)beats/min, P<0.05]. Conclusions:LIPUS treatment can improve symptoms, blood lipid profiles, inflammatory factors and hemodynamics in patients with coronary heart disease and angina pectoris.It is a safe and effective adjuvant therapy for elderly patients with coronary heart disease and angina pectoris.

Microbial detection and analysis of a foodborne disease caused by Staphylococcus aureus infection / 中国基层医药

Objective:To identify the cause of a suspected foodborne disease caused by bacterial food poisoning using multiple detection methods.Methods:At 9:35 a.m. on August 9, 2022, a suspected foodborne disease incident was handled by the Hefei Center for Disease Control and Prevention. The preliminary laboratory test results showed that the foodborne disease was caused by Staphylococcus aureus infection. Sixteen strains of Staphylococcus aureus were isolated, cultured, and identified using real-time fluorescent polymerase chain reaction. At the same time, the 16 strains of Staphylococcus aureus isolated from different sources were analyzed by pulsed-field gel electrophoresis to determine the correlation between strains. Results:The distribution of 16 strains of Staphylococcus aureus enterotoxins isolated was that the anal swab and chopping board (inner) smear samples from a salesperson surnamed Li showed SEB type, and the remaining 14 strains all carried type A, C, and E enterotoxin genes simultaneously. Pulsed-field gel electrophoresis typing results showed that there were two types of strains; except the anal swab and chopping board (inner) smear samples from the salesperson surnamed Li, the other 14 strains were all of the same type, with a similarity of 100%. The similarity between the anal swab and the chopping board (inner) smear samples from the salesperson surnamed Li was 80.65%, and the similarity with another type was 59.26%. This result was consistent with the detection results of Staphylococcus aureus enterotoxins. Conclusion:The foodborne disease in this case was caused by mixed contamination of two or three different sources of Staphylococcus aureus with enterotoxins.

Efficacy of ultrasound guided intercostal nerve pulse radiofrequency combined with nerve block in the treatment of post-herpetic neuralgia / 中国基层医药

Objective:To analyze the efficacy and safety of ultrasound-guided intercostal nerve pulse radiofrequency combined with nerve block in the treatment of post-herpetic neuralgia.Methods:The clinical data of 62 patients with post-herpetic neuralgia who received treatment in The Affiliated Hospital of Southwest Medical University from May 2017 to May 2021 were retrospectively analyzed. These patients underwent nerve block (NB group, n = 30) or pulsed radiofrequency plus nerve block (PRF + NB group, n = 32). Before and after treatment, The Numerical Rating Scale (NRS) score and Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups. After treatment, the occurrence of complications including pneumothorax, infection, and skin numbness was evaluated in each group. Results:Before treatment, there were no significant differences in NRS and PSQI scores between the two groups (all P > 0.05). Immediately, 1 week and 1 month after treatment, there was no significant difference in PSQI score between the two groups (all P > 0.05). At 3 and 6 months after treatment, the NRS score in the NB +PRF group was (1.71 ± 0.35) points and (1.68 ± 0.36) points, which were significantly lower than (2.72 ± 0.68) points and (3.26 ± 0.76) points in the NB group ( t = 54.40, 78.18, both P < 0.05). There were no treatment-related complications such as pneumothorax, infection, nerve numbness, or muscle weakness in the two groups. Conclusion:Ultrasound-guided pulsed radiofrequency combined with nerve block has a definite curative effect on post-herpetic neuralgia and is highly safe. The medium- and long-term efficacy of the combined therapy is superior to that of nerve block alone.

Research on effect of pulsatile external auditory canal irrigation on foreign bodies in children / 中国实用护理杂志

Objective:To explore the methods to improve the success rate of external canal foreign body washing and reduce the incidence of adverse reaction in children (≤14 years old).Methods:This study was a randomized controlled trial. A total of 60 pediatric patients with ear canal foreign bodies who were admitted to the otolaryngology-head and neck surgery clinic of Shengjing Hospital Affiliated to China Medical University from January 2021 to May 2022 were selected. The patients were divided into the experimental group and the control group by the random number table method, with 30 cases in each group. The experimental group were treated with pulsatile external auditory canal irrigation method, while the control group were treated with the conventional ear canal flushing method. The success rate of flushing, the flushing time, the incidence of adverse reactions and satisfaction of the patient's family were compared between the two groups.Results:The success rate of flushing was 80.0% (24/30) in the experimental group and 46.7% (14/30) in the control group, with statistically significant difference ( χ2= 7.18, P <0.05). The flushing time was (140.80 ± 44.48) s in the experimental group and (296.60 ± 82.79) s in the control group, with statistically significant difference ( t=9.08, P <0.05). The incidence of adverse reactions was 23.3% (7/30) in the experimental group and 63.3% (19/30) in the control group, with statistically significant difference ( χ2=9.77, P<0.05). The satisfaction of the patient's family was 93.9% (28/30) in the experimental group and 36.7% (11/30) in the control group, with statistically significant difference ( χ2=21.17, P<0.05). Conclusions:The pulsatile external auditory canal irrigation method can improve the success rate of ear canal foreign body flushing, shorten the flushing time and reduce the adverse reactions. The need for surgery and hospitalization due to ear canal foreign body, the suffering of patients and the corresponding cost can be decreased accordingly. The new treatment showed clear advantages clinically and should be widely applied.

Diquafosol sodium combined with intense pulsed light in the treatment of meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of 3% diquafosol sodium eye drops combined with intense pulsed light on the treatment of meibomian gland dysfunction and the change of meibomian glands.METHODS: Prospective study. A total of 141 patients(282 eyes)who were diagnosed with meibomian gland dysfunction from January 2021 to May 2022 in our hospital were selected and they were randomly divided into the control group(73 cases, 146 eyes)and the observation group(68 cases, 136 eyes)according to random number table. The control group was given 0.3% sodium hyaluronate eye drops combined with intense pulsed light, and the observation group was treated with 3% diquafosol sodium eye drops combined with intense pulsed light. The subjective symptom score, physical sign score, non-invasive tear break-up time, tear meniscus height, lipid layer thickness, and meibomian gland density before and after the treatment were compared between the two groups at 2wk after the end of treatment.RESULTS: There were no differences in the subjective symptom score, physical sign score, non-invasive tear break-up time, tear meniscus height, lipid layer thickness, and meibomian gland density between the two groups of patients before treatment(P&#x003E;0.05). After 2wk of treatment, the symptom scores and physical sign scores of patients in the two groups continued to decrease, non-invasive tear break-up time and lipid layer thickness continued to increase, and the meibomian gland density also increased. The tear meniscus height in the observation group increased, while the control group showed no significant changes. The observation group had better clinical indicators than the control group(P&#x003C;0.05). No obvious complications were observed in all patients.CONCLUSION: The combination of diquafosol sodium eye drops and intense pulsed light is synergistic in the treatment of meibomian gland dysfunction, with significant therapeutic effects and improvement of meibomian gland repair, which is significantly superior to simple intense pulsed light therapy.

The Effect of Intense Pulsed Light Treatment for Chronic Hordeolum / 生物医学与环境科学（英文）

OBJECTIVE@#To evaluate the effect of intense pulsed light (IPL) in the treatment of chronic hordeolum.@*METHODS@#Patients with chronic hordeolum who underwent IPL treatment were enrolled in this study. According to the severity of hordeolum, the patients were treated with IPL 3 to 5 times. Patients' satisfaction and visual analog scale scores for ocular discomfort symptoms before and after treatment were collected. The number, congestion, long diameter, short diameter and area of nodules were also recorded and measured. Finally, eyelid margin signs, meibum quality, meibomian gland expressibility, meibomian gland dropout, tear meniscus height, and corneal fluorescein staining were scored.@*RESULTS@#20 patients were enrolled in this study. The eyelid margins were congestive and swollen, with blunt rounding or irregularity. The meibum was cloudy or toothpaste-like. The meibomian gland expressibility, meibomian gland dropout and tear meniscus height were reduced. The cornea showed scattered fluorescein staining. After treatment, score of visual analog scale, congestion and size of nodules were significantly reduced. Eyelid margin signs, meibum quality, meibomian gland expressibility, tear meniscus height and corneal fluorescein staining scores were improved. Meibomian gland dropout had no significant change. No side effects occurred during treatment.@*CONCLUSIONS@#IPL is beneficial for the treatment of chronic hordeolum.

An in vitro study of temperature variation of super-pulsed thulium fiber laser in ureter / 现代泌尿外科杂志

【Objective】 The thermal effects of super-pulsed thulium fiber laser (TFL) at different powers,lithotripsy modes and irrigation rates were studied using a 3D kidney model to simulate ureteral lithotripsy in vivo. 【Methods】 A thermal effect model was established in vitro. Under the same conditions of laboratory temperature and equipment,the temperature around the optical fiber was measured and compared when different optical fiber diameters,powers,lithotripsy modes and irrigation rates were used to simulate lithotripsy by TFL. 【Results】 There was significant difference in the temperature around the optical fiber caused by two fibers with different diameters under the same conditions (P<0.05). Under the same conditions,different lithotripsic modes produced different temperatures,and the temperature of "high energy and low frequency" was lower than that of "low energy and high frequency" (P<0.05). When the power was 10 W and the minimum irrigation rate was 10 mL/min,the plateau temperature did not reach the safety threshold (43 ℃). When the power was 20 W and the minimum irrigation rate was 10 mL/min,the platform temperature exceeded the safety threshold. When the irrigation rate was 20 mL/min,the platform temperature did not reach the safety threshold. 【Conclusion】 In the study of ureteral lithotripsy in vitro,the power,mode,irrigation rate and optical fiber diameter are factors affecting the thermal effects of TFL. No matter what kind of lithotripsy mode and fiber diameter,the temperature around the fiber is safe when the lithotripsy power is ≤10 W and the irrigation rate is ≥10 mL/min;when the lithotripsy power is ≤20 W and the irrigation rate is ≥20 mL/min,the temperature around the fiber is safe.

Efficacy of low intensity pulsed ultrasound in the treatment of erectile dysfunction / 现代泌尿外科杂志

【Objective】 To investigate the efficacy of low intensity pulsed ultrasound (LIPUS) in the treatment of erectile dysfunction (ED). 【Methods】 A total of 121 ED patients treated during June 2020 and June 2022 were selected as the research objects. According to the International Erectile Index Score (IIEF-EF), the patients were divided into three subgroups:mild (17-25 points), moderate (11-16 points), and severe (0-10 points). The total effective rate, erectile hardness scale (EHS), sex life log questions (SEP), general assessment questionnaire (GAQ), peak systolic velocity (PSV), end diastolic velocity (EDV), and adverse reactions of the three groups before treatment, 4 weeks and 12 weeks after treatment were analyzed. 【Results】 A total of 119 patients completed the follow-up. There were significant increases in IIEF-EF and EHS at week 4 and 12 (P<0.05), and the total effective rate was 69.75% and 76.47%, respectively. The total effective rate was significantly higher in the mild and moderate groups than in the severe group at week 4 and 12 (P<0.05). The patients who answered "yes" to SEP2 and SEP3 accounted for 91.60% and 71.43%, respectively at week 4, and 92.44% and 78.15% at week 12, both significantly higher than the rates before treatment (52.10% and 27.73%, P<0.05). The proportion of patients who answered "yes" to GAQl and GAQ2 at week 4 were 84.87% and 71.43%, respectively, and were 82.35% and 70.59% respectively at week 12, with no significant difference. The PSV level significantly increased at week 12 compared to that before treatment [(48.85±14.11) cm/s vs. (41.42±14.90) cm/s] (P<0.05), while the EDV level significantly decreased [(-0.57±7.01) cm/s vs. (2.25± 5.68)cm/s] (P<0.05). 【Conclusion】 LIPUS can improve erectile function in ED patients without obvious adverse reactions.

Efficacy evaluation of radiofrequency thermocoagulation and pulse radiofrequency for the ganglion impar in treating primary perineal pain / 西安交通大学学报(医学版)

【Objective】 To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain. 【Methods】 We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation (group A) and pulsed radiofrequency (group B) in the ganglion impar from January 2020 to March 2022. VAS, excellent and good rates, sleep quality, postoperative medication usage, complications, and recurrence were evaluated before and 24 h, 1 W, 1 M, 3 M and 6 M after operation. The differences between the two groups were compared. 【Results】 The VAS score of group A gradually decreased at each level after operation, and the VAS score of group B gradually increased after 24 hours of operation. The differences between the two groups began to appear 1 week after operation, and the differences further increased with the extension of time (P<0.001). In six months after follow-up, the excellent and good rates of group A (86%) was significantly higher than that of group B (22%). In addition to postoperative perineal skin numbness, group A was superior to group B in improving sleep, postoperative oral medication (pregabalin and opioids), and disease recurrence (P<0.05). 【Conclusion】 Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain, improving the excellent and good rates, improving sleep, and reducing recurrence a medication. The effect is better than that of pulsed radiofrequency.

Intense pulsed light combined with meibomian gland massage and diquafosol sodium eye drops in the treatment of lipid deficiency / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the efficacy of intense pulsed light combined with meibomian gland massage and diquafosol eye drops in lipid deficiency dry eye disease and related cytokines.METHODS: A total of 511 patients(1 022 eyes)with lipid deficiency dry eye diagnosed in the ophthalmology clinic of our hospital from January to December 2021 were selected as the research objects. They were divided into two groups according to the patient's wishes: 294 cases(588 eyes)in the study group were treated with diquafosol sodium eye drops combined with intense pulsed light and meibomian gland massage, while 217 cases(434 eyes)in the control group were treated with artificial tears combined with intense pulsed light and meibomian gland massage. The levels of tear tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β)and lactoferrin(LF)before and after treatment were detected, the corneal fluorescein staining(CFS)score, tear film break-up time(BUT), and Schirmer Ⅰ(SⅠt)under no surface anesthesia, ocular surface disease index(OSDI)were compared, the correlation between TNF-α, IL-1β, LF levels and CFS, BUT, SⅠt, OSDI before treatment was analyzed, and the occurrence of adverse reactions was observed.RESULTS: There was no significant difference in preoperative OSDI, SⅠt, BUT, CFS and levels of TNF-α, IL-1β and LF between the two groups(P&#x003E;0.05). The SⅠt, BUT, CFS and levels of TNF-α, IL-1β and LF in the study group at 3, 6 and 9wk after treatment were better than those of control group(P&#x003C;0.05). There were no differences in OSDI score of both groups at 9wk after treatment(P&#x003E;0.05). The TNF-α and IL-1β were negatively correlated with SⅠt and BUT, while they were positively correlated with CFS and OSDI; LF and SⅠt were positively correlated with SⅠt and BUT, while they were negatively correlated with CFS and OSDI(all P&#x003C;0.01); The adverse reaction rate of the study group(5.78%)was significantly lower than that of the control group(11.52%; P&#x003C;0.05).CONCLUSION: Intense pulsed light combined with meibomian gland massage and diquafosol sodium eye drops is effective and well tolerated in the treatment of lipid deficiency dry eye.

Efficacy of different frequency of intense pulsed light in the treatment of meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy and safety of frequency of intense pulsed light(IPL)in the treatment of meibomian gland dysfunction.METHODS: In this retrospective study, a total of 108 patients(216 eyes)with meibomian gland dysfunction admitted to our hospital from January 2021 to June 2022 were included. They were divided into two groups, with 54 cases(108 eyes)IPL group(energy density 13.0J/cm2, pulse width 6ms, delay time 50ms), and 54 cases(108 eyes)in advanced optimal pulsed technology(AOPT)group(energy density 10.0-16.0J/cm2, pulse width 7-4-4 ms in unequal-division mode). The clinical effects of the two groups were observed and compared, including ocular surface symptoms, corneal fluorescein staining score(FL), tear film lipid layer thickness(LLT), ocular surface disease index(OSDI)score, mean non-invasive tear film break-up time(NIBUTav)and first non-invasive tear film break-up time(NIBUTf), tear meniscus height, score of meibomian gland secretion and its secretion traits, and the incidence of adverse effects was also calculated.RESULTS: The effective rate of the AOPT group(106 eyes, 98.1%)was higher than that of the IPL group(90 eyes, 83.3%, P&#x003C;0.05), as well as OSDI score, FL score, score of meibomian gland secretion and its secretion traits, LLT NIBUTav, NIBUTf and tear meniscus height(all P&#x003C;0.001). However, the incidence of adverse effects of the AOPT group(18 eyes, 16.7%)was higher than that of the IPL group(4 eyes, 3.7%; P&#x003C;0.05).CONCLUSION: With significant improvement in the ocular surface symptoms and function, AOPT has a better therapeutic effect on the treatment of meibomian gland dysfunction, but it has more adverse reactions. Therefore, optimal treatment plan should be fully selected in combination with the actual clinical situation.

Etiologic identification and drug susceptibility analysis of a Citrobacter freundii food poisoning event / 中国热带医学

@#Abstract: Objective　In order to provide reference for emergency treatment of a sudden food poisoning incident, pathogen detection and drug resistance analysis were carried out. Methods　Diarrheal stool and surplus food samples were detected by GB 4789 and the isolates were identified by VITEK2 and matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), at the same time, the bacterial drug sensitivity test was carried out by using the method of microbroth dilution, and the isolates from different sources were molecularly classified by pulsed field gel electrophoresis (PFGE), and the correlation between the strains was analyzed by BioNumerics software. Results　Totaly 13 leftovers and 3 diarrhea patients were isolated and identified, The total number of colonies and coliforms in 7 leftovers samples all exceeded the standard, and Citrobacter freundii was detected in 5 leftovers and 2 stools. The results of drug sensitivity test showed that seven strains of Citrobacter freundii were sensitive to ciprofloxacin, tetracycline, chloramphenicol, gentamicin, amikacin, cefotaxime and meropenem, but completely resistant to ampicillin, and there was no multiple drug resistance. The results of pulsed field gel electrophoresis (PFGE) showed that 7 strains of Citrobacter freundii had the same PFGE bands and 100% homology, showing the same clone. Conclusions　This food poisoning incident was caused by Citrobacter freundii. The pathogen of food poisoning can be quickly and accurately determined by MALDI-TOF MS, which is beneficial to the early diagnosis and treatment of infectious diseases. It is suggested to strengthen the corresponding management, improve food safety awareness and prevent similar incidents.

Contamination status and molecular typing of Legionella pneumophila in artificial water environment in Shanghai hospitals from 2019 to 2020 / 环境与职业医学

Background The incidence of Legionnaires' disease is increasing globally and artificial water environment is becoming a common source of outbreaks. Molecular typing techniques can help prevent and control Legionella. Objective To understand the molecular epidemiological characteristics of Legionella pneumophila in artificial water environment of Shanghai hospitals, and provide a scientific basis for the prevention and control of Legionnaires' disease. Methods Water samples were collected from artificial water environment in 14 hospitals from May to October each year from 2019 to 2020 in Shanghai. A total of 984 water samples were collected from 8 Grade-A tertiary hospitals and 6 non-Grade-A tertiary hospitals, including 312 samples of cooling water, 72 samples of chilled water, and 600 samples of tap water. The water samples were isolated and serotyped for Legionella pneumophila and preserved, and the positive rate of Legionella pneumophila in the samples was used as an indicator of contamination. The preserved strains were resuscitated and 81 surviving strains were obtained for pulsed field gel electrophoresis (PFGE) typing analysis. Results A total of 124 Legionella pneumophila positive water samples were detected, with a positive rate of 12.60%. The positive rate was higher in the Grade-A tertiary hospitals (16.54%, 87/526) than in the non-Grade-A tertiary hospitals (8.08%, 37/458) (χ2=15.91, P<0.001). The positive rate of cooling water (23.40%) was the highest among different types of water samples, and the difference was statistically significant (χ2=61.19, P<0.001). The difference in positive rate of tap water was statistically significant among different hospital departments (χ2=11.37, P<0.05). The positive rate in 2019 (15.06%) was higher than that in 2020 (9.84%) (χ2=6.23, P<0.05). From May to October, August had the highest annual average positive rate (16.46%) and October had the lowest (8.54%), but the difference in positive rates among months was not statistically significant (χ2=5.39, P=0.37). The difference in positive rate among districts was statistically significant (χ2=24.88, P<0.001). A total of 131 strains of Legionella pneumophila were isolated, with serotype 1 (80.15%, 105/131) predominating. Among the 81 surviving strains of Legionella pneumophila subjected to PFGE typing, the band-based similarity coefficients ranged from 41.30% to 100%. Among the 29 PFGE band types (S1-S29) recorded, each band type included 1-10 strains, and S28 was the dominant band type. Four clusters (I-IV) of PFGE band types were identified, accounting for 66.67% (54/81) of all strains and containing 13 band types. Conclusion Legionella pneumophila contamination is present in the artificial water environment of hospitals in Shanghai from 2019 to 2020, and the contamination in tap water deserves attention. The detected serotype of Legionella pneumophila is predominantly type 1, and PFGE typing reveals the presence of genetic polymorphism. Therefore, the monitoring and control of Legionella pneumophila in hospital artificial water environment should be strengthened.

Etiological characteristics of Vibrio parahaemolyticus strains isolated from foodborne outbreaks in Zhongshan in 2019 - 2021 / 公共卫生与预防医学

Objective To investigate the etiological characteristics of food poisoning isolates of Vibrio parahaemolyticus (VP) from 2019 to 2021 in Zhongshan City. Methods A total of 37 strains of Vibrio parahaemolyticus isolated from 8 food poisoning incidents in Zhongshan City from 2019 to 2021 were collected, including 1 residual food isolate and 36 human isolates. The genetic correlation of Vibrio parahaemolyticus food poisoning isolates in this region was analyzed by serological typing, virulence gene detection (TLH, TDH, and TRH), drug sensitivity test, pulsed field gel electrophoresis (PFGE) and multipoint sequence typing (MLST). Results The 37 strains of Vibrio parahaemolyticus were divided into 4 serotypes: O3:K6, O10:K4, O4:K8, and O4:KUT. The tdh+ and trh- were the main virulence genotypes, accounting for 97.30% (36/37). The drug resistance rate of cefazolin was 40.54% (15 strains R, 22 strains I), and no multidrug-resistant strains were found. The 37 VP strains were divided into 23 PFGE types and 6 cluster groups, with correlation coefficients ranging from 60.4%-100%. The multipoint sequencing typing showed that the 37 VP strains were divided into 9 ST types and 3 complex groups, of which ST3 type was the main type (23 strains, 62.1%). Conclusion This study has found that the dominant virulence types of Vibrio parahaemolyticus food poisoning isolates in Zhongshan City from 2019 to 2021 are tdh+ and trh-, and 37 representative strains can be divided into 6 PFGE clusters and 9 ST types with MLST type being mainly ST3. This study has identified the rare serotype O10:K4 which has caused an increase in the proportion of food poisoning events, suggesting that we should strengthen detection and be alert to the risk of continued local epidemics of new rare serotype strains.

Safety and efficacy of intense pulsed light in the treatment of severe chronic ocular graft-versus-host disease / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the safety and efficacy of intense pulsed light in the treatment of severe chronic ocular graft-versus-host disease.METHODS: Prospective randomized controlled study. A total of 35 cases(35 eyes), who had a history of allogenic hematopoietic stem cell transplantation(allo-HSCT), admitted to the Affiliated Hospital of Xuzhou Medical University from January to September 2022 and were diagnosed by our hospital's hematology and ophthalmology departments with severe chronic ocular graft-versus-host disease(coGVHD)were selected. One eye was randomly selected for inclusion in the study if both eyes met the enrollment criteria, and the eye was selected if a single eye met the enrollment criteria. All patients were administrated with Dextran and Hypromellose eye drops 4 times a day and Cyclosporine eye drops twice a day. The experimental group was additionally treated with intense pulsed light, once every two weeks a week, for 4 times in total. The evaluation indicators were evaluated before treatment and 2wk, 1 and 2mo after treatment. The evaluation indicators include ocular surface disease index(OSDI)score, best corrected visual acuity(BCVA), intraocular pressure(IOP), tear meniscus height(TMH), non-invasive break-up time(NIBUT), conjunctival injection score(CIS), meibomian gland area proportion(MGAP), meibomian gland evaluation(MGE), cornea fluorescein staining(CFS), conjunctival lissamine green staining(CLGS), lid margin abnormality score(LMAS), and Schirmer's Ⅰ test(SⅠt).RESULTS: After treatment, OSDI score, TMH, NIBUT, BCVA, CFS, CLGS, and CIS improved in both groups compared with those before treatment(all P&#x003C;0.05), with NIBUT, CFS and CLGS showing more significant improvements in the test group. In the control group, MGAP, MGE of the upper and lower eyelids and LMAS did not change significantly before and after treatment(P&#x003E;0.05), while in the experimental group, MGAP of the lower eyelids, MGE of upper and lower eyelids and LMAS improved compared with those before treatment(P&#x003C;0.05), except for MGAP of the upper eyelids, which did not differ from that before treatment(P&#x003E;0.05). There was no difference in SⅠt and IOP between the two groups before and after treatment(P&#x003E;0.05). Patients did not experience adverse reactions such as skin burns, redness and swelling in the treated area and eyelash loss during the follow-up period.CONCLUSION: Intense pulsed light is safe and effective in the treatment of severe coGVHD, which can significantly improve the symptoms and signs of patients and enhance the stability of tear film.

Effect of pulsed electromagnetic fields on mesenchymal stem cell-derived exosomes in inhibiting chondrocyte apoptosis / 生物医学工程学杂志

The study aims to explore the effect of mesenchymal stem cells-derived exosomes (MSCs-Exo) on staurosporine (STS)-induced chondrocyte apoptosis before and after exposure to pulsed electromagnetic field (PEMF) at different frequencies. The AMSCs were extracted from the epididymal fat of healthy rats before and after exposure to the PEMF at 1 mT amplitude and a frequency of 15, 45, and 75 Hz, respectively, in an incubator. MSCs-Exo was extracted and identified. Exosomes were labeled with DiO fluorescent dye, and then co-cultured with STS-induced chondrocytes for 24 h. Cellular uptake of MSC-Exo, apoptosis, and the protein and mRNA expression of aggrecan, caspase-3 and collagenⅡA in chondrocytes were observed. The study demonstrated that the exposure of 75 Hz PEMF was superior to 15 and 45 Hz PEMF in enhancing the effect of exosomes in alleviating chondrocyte apoptosis and promoting cell matrix synthesis. This study lays a foundation for the regulatory mechanism of PEMF stimulation on MSCs-Exo in inhibiting chondrocyte apoptosis, and opens up a new direction for the prevention and treatment of osteoarthritis.