Correlation between ocular surface status and blood lipids in patients with meibomian gland dysfunction during pregnancy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.

Echinatin down-regulates ASKl-JNK signaling pathway against FFA induced non-alcoholic fatty liver disease / 中国药理学通报

Aim To investigate the effect of echinatin on the non-alcoholic fatty liver disease model of free fatty acids ( FFA) -induced HepG2 cells and its mechanism. Methods The experimental groups were divided into control group, FFA model group and echinatin group (0.3 , 1, 3 μmol • L

Clinical characteristics and diagnostic indicators of macrophage activation syndrome in patients with systemic lupus erythematosus and adult-onset Still's disease / 北京大学学报(医学版)

OBJECTIVE@#To analyze and compare the clinical and laboratory characteristics of macrophage activation syndrome (MAS) in patients with systemic lupus erythematosus (SLE) and adult-onset Still's disease (AOSD), and to evaluate the applicability of the 2016 European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organization classification criteria for MAS complicating systemic juvenile idiopathic arthritis (sJIA) in different auto-immune diseases contexts and to propose new diagnostic predictive indicators.@*METHODS@#A retrospective analysis was conducted on the clinical and laboratory data of 24 SLE patients with MAS (SLE-MAS) and 24 AOSD patients with MAS (AOSD-MAS) who were hospitalized at Peking University People's Hospital between 2000 and 2018. Age- and sex-matched SLE (50 patients) and AOSD (50 patients) diagnosed in the same period without MAS episodes were selected as controls. The cutoff values for laboratory indicators predicting SLE-MAS and AOSD-MAS were determined using receiver operating characteristic (ROC) curves. Furthermore, the laboratory diagnostic predictive values for AOSD-MAS were used to improve the classification criteria for systemic juvenile idiopathic arthritis-associated MAS (sJIA-MAS), and the applicability of the revised criteria for AOSD-MAS was explored.@*RESULTS@#Approximately 60% of SLE-MAS and 40% of AOSD-MAS occurred within three months after the diagnosis of the underlying diseases. The most frequent clinical feature was fever. In addition to the indicators mentioned in the diagnosis criteria for hemophagocytic syndrome revised by the International Society for Stem Cell Research, the MAS patients also exhibited significantly elevated levels of aspartate aminotransferase and lactate dehydrogenase, along with a significant decrease in albumin. Hemophagocytosis was observed in only about half of the MAS patients. ROC curve analysis demonstrated that the optimal discriminative values for diagnosing MAS was achieved when SLE patients had ferritin level≥1 010 μg/L and lactate dehydroge-nase levels≥359 U/L, while AOSD patients had fibrinogen levels≤225.5 mg/dL and triglyceride levels≥2.0 mmol/L. Applying the 2016 sJIA-MAS classification criteria to AOSD-MAS yielded a diagnostic sensitivity of 100% and specificity of 62%. By replacing the less specific markers ferritin and fibrinogen in the 2016 sJIA-MAS classification criteria with new cutoff values, the revised criteria for classifying AOSD-MAS had a notable increased specificity of 86%.@*CONCLUSION@#Secondary MAS commonly occurs in the early stages following the diagnosis of SLE and AOSD. There are notable variations in laboratory indicators among different underlying diseases, which may lead to misdiagnosis or missed diagnosis when using uniform classification criteria for MAS. The 2016 sJIA-MAS classification criteria exhibit high sensitivity but low specificity in diagnosing AOSD-MAS. Modification of the criteria can enhance its specificity.

Suture guided gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in the treatment of primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.

Guidelines for diagnosis and treatment of glucocorticoid-induced osteoporosis / 中华内科杂志

Glucocorticoid-induced osteoporosis (GIOP) is a skeletal disease characterized by decreased bone strength and increased fracture risk associated with long-term glucocorticoid use. GIOP is the most common secondary osteoporosis that critically affects the quality of life of patients. Currently, the incidence of GIOP in China remains high, with insufficient awareness and lack of prevention and treatment norms. Therefore, the Chinese Rheumatology Association has established this standard based on domestic and international experience, with the aim of raising awareness of prevention and treatment among clinicians, guiding the standardized diagnosis and treatment of this disease, and improving the overall prognosis of patients with GIOP.

Acteoside promotes autophagy and apoptosis of hepatoma cells by regulating JNK signaling pathway / 中国中药杂志

This study explored the molecular mechanism of acteoside against hepatoma 22(H22) tumor in mice through c-Jun N-terminal kinase(JNK) signaling pathway. H22 cells were subcutaneously inoculated in 50 male BALB/c mice, and then the model mice were classified into model group, low-dose, medium-dose, and high-dose acteoside groups, and cisplatin group. The administration lasted 2 weeks for each group(5 consecutive days/week). The general conditions of mice in each group, such as mental status, diet intake, water intake, activity, and fur were observed. The body weight, tumor volume, tumor weight, and tumor-inhibiting rate were compared before and after administration. Morphological changes of liver cancer tissues were observed based on hematoxylin and eosin(HE) staining, and the expression of phosphorylated(p)-JNK, JNK, B-cell lymphoma-2(Bcl-2), Beclin-1, and light chain 3(LC3) in each tissue was detected by immunohistochemistry and Western blot. qRT-PCR was performed to detect the mRNA expression of JNK, Bcl-2, Beclin-1, and LC3. The general conditions of mice in model and low-dose acteoside groups were poor, while the general conditions of mice in the remaining three groups were improved. The body weight of mice in medium-dose acteoside group, high-dose acteoside group, and cisplatin group was smaller than that in model group(P<0.01). The tumor volume in model group was insignificantly different from that in low-dose acteoside group, and the volume in cisplatin group showed no significant difference from that in high-dose acteoside group. Tumor volume and weight in medium-dose and high-dose acteoside groups and cisplatin group were lower than those in the model group(P<0.001). The tumor-inhibiting rates were 10.72%, 40.32%, 53.79%, and 56.44% in the low-dose, medium-dose, and high-dose acteoside groups and cisplatin group, respectively. HE staining showed gradual decrease in the count of hepatoma cells and increasing sign of cell necrosis in the acteoside and cisplatin groups, and the necrosis was particularly obvious in the high-dose acteoside group and cisplatin group. Immunohistochemical results suggested that the expression of Beclin-1, LC3, p-JNK, and JNK was up-regulated in acteoside and cisplatin groups(P<0.05). The results of immunohistochemistry, Western blot, and qRT-PCR indicated that the expression of Bcl-2 was down-regulated in the medium-dose and high-dose acteoside groups and cisplatin group(P<0.01). Western blot showed that the expression of Beclin-1, LC3, and p-JNK was up-regulated in acteoside and cisplatin groups(P<0.01), and there was no difference in the expression of JNK among groups. qRT-PCR results showed that the levels of Beclin-1 and LC3 mRNA were up-regulated in the acteoside and cisplatin groups(P<0.05), and the level of JNK mRNA was up-regulated in medium-dose and high-dose acteoside groups and cisplatin group(P<0.001). Acteoside promotes apoptosis and autophagy of H22 cells in mice hepatoma cells by up-regulating the JNK signaling pathway, thus inhibiting tumor growth.

Evaluation of the efficacy and safety of Nocardia rubra cell wall skeleton immunotherapy for cervical high-risk HPV persistent infection / 中华妇产科杂志

Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ2=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ2=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.

Clinical analysis of 31 cases of fetal umbilical artery thrombosis / 中华妇产科杂志

Objective: To analyze the ultrasonic manifestations, clinical features, high risk factors and key points of pregnancy management in prenatal diagnosis of umbilical artery thrombosis (UAT). Methods: The data of 31 pregnant women of UAT diagnosed by prenatal ultrasonography and confirmed after birth from July 2017 to July 2022 at the Women's Hospital, Zhejiang University School of Medicine were retrospectively analyzed, including the maternal characteristics, pregnancy outcomes and fetal complications. In addition, the baseline data and pregnancy outcomes were compared in 21 patients who continued pregnancy after diagnosis of UAT. Of the 21 UAT cases that continued pregnancy, 10 cases were treated with low molecular weight heparin (LMWH; LMWH treatment group), while the other 11 patients had expectant treatment(expectant treatment group). Results: The age of the 31 pregnant women was (30.2±4.7) years, of which 5 cases (16%,5/31) were advanced age pregnant women. The gestational age at diagnosis was (32.9±4.0) weeks, and the gestational age at termination of pregnancy was (35.6±2.9) weeks. In 31 fetuses with UAT, 15 cases (48%) had fetal distress, 11 cases (35%) had fetal growth restriction, and 3 cases (10%) had intrauterine stillbirth. There were 28 cases of live births, including 26 cases by cesarean section and 2 cases by vaginal delivery. There were also 3 stillbirths, all delivered vaginally. Four neonates had mild asphyxia and two newborns had severe asphyxia. Among the 31 cases, 10 cases were terminated immediately after diagnosis, the gestational age at diagnosis was (35.9±2.9) weeks. Another 21 pregnancies continued, and their gestational age at diagnosis was (31.4±3.7) weeks. The median prolonged gestational age in LMWH treatment group was 7.9 weeks (4.6-9.4 weeks), and all were live births. The median prolonged gestational age in the expectant treatment group was 0.6 weeks (0.0-1.0 weeks), and 2 cases were stillbirths. There was a statistically significant difference in prolonged gestational age (P=0.002). Conclusions: Ultrasound is the preferred method for prenatal detection of UAT. Clinicians need to be vigilant for UAT when a newly identified single umbilical artery is detected by ultrasound in the second or third trimesters. The decision to continue or terminate the pregnancy depends on the gestational age and the condition of fetus. Attention should be paid to fetal movements as the pregnancy continues. The treatment of LMWH as soon as possible after diagnosis of UAT may improve the pregnancy outcome.

Application of Optical Genome Mapping Technology in Detecting Complex Chromosomal Rearrangement / 中山大学学报(医学科学版)

ObjectiveTo investigate the application of optical genome mapping （OGM） technology in detecting complex chromosomal rearrangement. MethodsWe recruited five patients who were diagnosed as complex chromosomal rearrangement at the Reproductive Medicine Center of the Sixth Affiliated Hospital of Sun Yat-sen University from January 2022 to June 2023. They underwent OGM， nanopore sequencing and pre-implantation genetic testing （PGT）. The results were compared with the results of karyotype and chromosomal microarray analysis （CMA）/ copy number variation sequencing （CNV-Seq）. ResultsOGM could detect translocation， invert inversion， and triplet translocation， which were consistent with the results of OGM and CMA/ CNV-Seq. But OGM could not detect Robertsonian translocation. ConclusionBecause of its ultra-long reads， OGM realizes the detection across repetitive regions， and it has great advantages when applied in patients with complex chromosome rearrangement or uncertain karyotype analysis. It can accurately locate breakpoints.

Clinical value of 1, 3-β-D glucan and mannan IgM/IgG antibodies in the early diagnosis of invasive candidiasis / 中华微生物学和免疫学杂志

Objective:To evaluate the diagnostic value of 1, 3-β-D glucan (BDG), mannan IgM antibody (Mn-IgM) and mannan IgG antibody (Mn-IgG) in invasive candidiasis and to compare the differences in the diagnostic capability of serological markers used alone or in combination.Methods:Serum samples of 126 patients with invasive candidiasis and 104 healthy people who took physical examination during the same period were collected. BDG was detected by dynamic chromogenic method, and Mn-IgM and Mn-IgG were detected by ELISA. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, coincidence rate and Kappa value of the three serological markers used alone or in combination in the diagnosis of invasive candidiasis were analyzed and compared. The receiver operating characteristic (ROC) curves were drawn and the areas under the curves (AUCs) were calculated.Results:The levels of BDG, Mn-IgM and Mn-IgG in patients with invasive candidiasis were significantly higher than those in healthy people ( P<0.01). The sensitivity, specificity, Kappa value and AUC of BDG were 48.41%, 92.31%, 0.389 and 0.842. The sensitivity, specificity, Kappa value and AUC of Mn-IgM were 64.29%, 91.35%, 0.540 and 0.829. The sensitivity, specificity, Kappa value and AUC of Mn-IgG were 27.78%, 95.19%, 0.214 and 0.737. The sensitivity, specificity, Kappa value and AUC of BDG+ Mn-IgM were 76.19%, 88.46%, 0.637 and 0.921. The sensitivity, specificity, Kappa value and AUC of BDG+ Mn-IgG were 59.52%, 91.35%, 0.491 and 0.856. The sensitivity, specificity, Kappa value and AUC of Mn-IgM+ Mn-IgG were 69.84%, 90.38%, 0.588 and 0.891. The sensitivity, specificity, Kappa value and AUC of BDG+ Mn-IgM+ Mn-IgG were 80.16%, 88.46%, 0.679 and 0.922. Conclusions:The sensitivity of Mn-IgM was higher than that of BDG and Mn-IgG in the diagnosis of invasive candidiasis. When the serological biomarkers were used in combination, BDG+ Mn-IgM and BDG+ Mn-IgM+ Mn-IgG had relatively high Kappa value and AUC, showing high accuracy. The clinical diagnostic value of multiple serological biomarkers used in combination was significantly higher than that of any serological biomarkers used alone. Early combined detection and continuous monitoring of multiple serological biomarkers in patients with high risk of invasive candidiasis could be used clinically to adjust antifungal treatment strategies timely.

Clinical features of POEMS syndrome initially diagnosed as pulmonary hypertension / 中华全科医师杂志

Objective:To analyze the clinical characteristics, diagnosis and treatments of patients with POEMS syndrome initially diagnosed as pulmonary hypertension (PH).Methods:Clinical data of 7 patients who were initially diagnosed as PH and finally diagnosed as POEMS syndrome in Shanghai Pulmonary Hospital from May 2013 to November 2021 were retrospectively reviewed. Clinical manifestations, laboratory tests, echocardiography, hemodynamic findings, treatment and prognosis of patients were analyzed.Results:Seven patients, including 4 males and 3 female, aged (55±9) (44-62) years were presented with elevated pulmonary artery pressure by echocardiography at admission. Chest tightness and shortness of breath (7/7), fatigue (6/7) and lower limb edema (4/7) were the most common symptoms in the first-episode. Meanwhile, patients also presented symptoms associated with POEMS syndrome, including multiple peripheral neuropathy (7/7), multiserosal cavity effusion (6/7), organomegaly (5/7), skin changes (5/7), and endocrine lesions (4/7). Serum levels of vascular endothelial growth factor (VEGF) were significantly increased in all patients. The pulmonary arterial systolic blood pressure was (66±21)mmHg (1 mmHg=0.133 kPa) estimated by echocardiography. Six patients underwent right heart catheterization and significantly increased mean pulmonary artery pressure((35±9) mmHg) was confirmed; and their pulmonary vascular resistance was (4.00±2.10) Wood U. All patients received corresponding treatment for POEMS syndrome. The excise tolerance was improved in 5 patients after successful treatment with stable or reversed WHO functional class. One patient received hemodialysis treatment for uncontrolled POEMS. One patient died during follow-up. The echocardiography was followed up in 4 patients, and 2 of whom had a complete reversal of PH, 1 had a partial reversal, and 1 had not yet reversed.Conclusions:In patients with PH who have multisystem manifestations, such as multiple peripheral neuropathy, multiserosal cavity effusion, organomegaly and skin changes, POEMS syndrome should be considered, and proper and active treatment of POEMS may reverse PH and improve the prognosis of patients.

Influential factors of the efficacy of tinnitus multivariate integrated sound therapy for the treatment of subjective tinnitus / 中国基层医药

Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.

Correlation between sputum culture results and serum levels of C-reactive protein, amyloid A and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective:To investigate the correlation between sputum culture results and serum levels of C-reactive protein, amyloid A, and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 131 older adult patients with AECOPD who received treatment in the Affiliated Hospital of Shaoxing University between January 2019 and January 2021 were retrospectively analyzed. According to sputum culture results, these patients were divided into a sputum culture positive group ( n = 52) and a sputum culture negative group ( n = 79). The sputum of patients was collected aseptically for isolation and identification of pathogens. The general data [age, gender, history of smoking, underlying diseases (hypertension, diabetes mellitus, coronary heart disease), albumin level, mechanical ventilation, method of sputum suction, duration of antibiotics medication, length of hospital stay] were recorded for each group. The risk factors for positive sputum culture were analyzed using binary logistic regression techniques. The efficiency of serum levels of C-reactive protein, amyloid A, and procalcitonin for predicting positive sputum culture was analyzed using the receiver operating characteristic curve. Results:There were 67 strains of pathogens isolated from 52 older adult patients with positive sputum culture of AECOPD. The main pathogens were Gram-negative bacteria (67.16%) [Klebsiella pneumonia (31.34%)], followed by Gram-positive bacteria (25.37%) and fungi (7.47%). Logistic regression analysis showed that mechanical ventilation ( OR = 2.75, P = 0.020), usage of broad-spectrum antibiotics ( OR = 2.95, P = 0.012), serum C-reactive protein level ≥ 20.96 mg/L ( OR = 2.44, P = 0.007), serum amyloid A level ≥ 18.03 mg/L ( OR = 2.67, P = 0.016) and serum procalcitonin level ≥ 2.08 μg/L ( OR = 2.51, P = 0.013) were independent risk factors of positive sputum culture in older adult patients with AECOPD. The receiver operating characteristic curve analysis showed that the area under the receiver operating characteristic curve depicting serum levels of C-reactive protein, amyloid A, and procalcitonin in combination for predicting AECOPD was 0.896, which is of predictive efficiency for positive sputum culture ( P < 0.05). Conclusion:The sputum culture pathogens in older adult patients with AECOPD are mainly Gram-negative bacteria. Increased serum levels of C-reactive protein, amyloid A, and procalcitonin are independent risk factors for Gram-positive bacteria. Combined detection of serum levels of C-reactive protein, amyloid A, and procalcitonin is highly efficient in the diagnosis of AECOPD and can be used to evaluate the sputum culture results in older adult patients with AECOPD.

Application of narrative therapy theory implanted games into bowel preparation in children / 中国实用护理杂志

Objective:To investigate the effect of applying narrative therapy theory into game on improving the quality of bowel preparation in children, and to provide a basis for selecting nursing intervention methods before bowel preparation.Methods:This study was a quasi experimental study. Totally 62 children who took polyethylene glycol electrolyte dispersion for bowel preparation in Gansu Maternal and Child Health Hospital from January to December 2021 were included in this retrospective study. They were divided into control group with 28 cases and experimental group with 34 cases according to random number table method. The control group was given conventional bowel preparation and medication guidance, and the experimental group was given the intervention during bowel preparation by applying narrative therapy theory implanted games. The bowel preparation adequacy rate, complete medication taking rate and parental satisfaction of the two groups were observed and compared.Results:The bowel preparation adequacy rate and complete medication taking rate in the experimental group were 94.12% (32/34) and 52.94% (18/34), respectively, which were higher than 46.43% (13/28) and 10.71% (3/28) in the control group, and the differences were statistically significant ( χ2 = 15.23, 10.41, both P<0.01). According to the average BBPS score, the experimental group had better intestinal cleanliness compared to the control group (7.65 ± 1.07 vs 6.07 ± 1.41, t = -4.87, P<0.01), the difference was statistically significant. 97.06% (33/34) of the parents in the experimental group expressed satisfaction, which was higher than 64.29% (18/28) in the control group, and the difference was statistically significant ( χ2 = 12.74, P<0.05). Conclusions:By applying the narrative therapy theory implanted games, the complete taking of high-dose bowel cleasing agent can be promoted and the quality of bowel preparation can be improved, which is worth suggesting as a nursing intervention method for bowel preparation.

Correlation between family support and health literacy in elderly patients with knee osteoarthritis / 中国实用护理杂志

Objective:To investigate the level of family support and health literacy in elderly patients with knee osteoarthritis, and to analyze the correlation.Methods:This study was a cross-sectional study. Totally 172 knee osteoarthritis patients were recruited by convenience sampling method from the department of Orthopaedics in Honghui Hospital, Xi ′an Jiaotong University from July to December, 2021. General data questionnaire,Chronic Disease Health Literacy Scale and Family Support Scale were used for questionnaire survey. Results:The total score of family support in elderly patients with knee osteoarthritis was (10.20 ± 2.61), and the total score of health literacy was (93.62 ± 12.68). The results of single factor analysis showed that family support and health literacy in elderly patients with knee osteoarthritis were affected by gender, education level, marital status, residence, family income per capita and other factors. The results of correlation analysis showed that family support was positively correlated with the level of health literacy ( r=0.730, P<0.05). Conclusions:The family support of elderly knee osteoarthritis patients is medium level, and health literacy needs to be strengthened. Therefore, when formulating the health management plan of patients′ health literacy and the related support of family support, targeted attention should be paid to the influencing factors and intervention measures should be implemented.

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.

Cone-beam CT analysis of occlusal planes between different vertical skeletal types of adult class Ⅱ malocclusions in Shandong province / 解剖学报

[Abstract] Objective To investigate the cant of the occlusal planes in Chinese adult class Ⅱ malocclusions with hypodivergent, normodivergent, and hyperdivergent facial vertical patterns using cone-beam CT. Methods The descriptive, cross-sectional study evaluated 123 cephalogram from CBCT(CCB) of patients in Department of Orthodontics, the Affiliated Hospital of Qingdao University. According to cephalometric analysis, 89 Chinese adult class Ⅱ patients were divided into three groups according to the angle between FH-MP and the angle between SN-MP. In comparison, 34 Class I normodivergent malocclusions individuals were selected as the control group. Comparing the cephalometric result between 4 groups. Results As expected,the hyperdivergent group had steeper anterior occlusal planes(14. 73±3. 76) . and posterior occlusal planes(21. 42±5. 77)., there was a significant statistical difference between the hyperdivergent group and other 2 groups in class Ⅱ patients (P<0. 05). The height of maxillary second molar increased from high angle group to low angle group (P<0. 01). Conclusion There are different characters of the occlusal planes in varied vertical facial pattern. The inclinations of anterior and posterior occlusal planes in Chinese class Ⅱ hyperdivergent group were steeper than other 3 groups. The difference of posterior occlusal plane inclination is mainly caused by the height of maxillary second molar.

Clinical Characterization of Patients with Ovarian Mass Combined with Dysplasia of Secondary Sexual Characteristics / 中国医学科学院学报

Objective To investigate the clinical characteristics of preadolescent and adolescent female patients with ovarian mass combined with dysplasia of secondary sexual characteristics. Methods This study retrospectively analyzed 18 cases of ovarian mass combined with dysplasia of secondary sexual characteristics aged 0-19 years admitted to Peking Union Medical College Hospital from January 2012 to November 2019.By analyzing the clinical manifestations,surgical methods,postoperative pathology,therapies and prognosis of the cases,we summarized the diagnosis and treatment ideas. Results Among the 18 cases,7(7/18,38.9%)developed secondary sex signs before puberty,including 5 cases showing precocity(including 2 cases of juvenile granulosa cell tumor,1 case of gonadoblastoma,1 case of ovarian follicular cyst,and 1 case of 46,XY simple gonadal dysplasia combined with dysgerminoma)and 2 cases presenting masculine manifestations(1 case of steroid cell tumor and 1 case of sclerosing stromal tumor).The rest 11(11/18,61.1%)cases showed abnormal development of secondary sexual characteristics during puberty,including 8 cases with masculine manifestations or abnormal menstruation after menarche(7 cases with sex cord stromal cell tumor and 1 case with cystic granulosa cell tumor),2 cases with primary amenorrhea(1 case with androgen insensitivity syndrome combined with testicular sertoli cell tumor and 1 case with endometriosis cyst combined with reproductive tract malformation),and 1 case diagnosed as 46,XX gonadal dysplasia with serous cystadenoma and no secondary sexual development during puberty. Conclusions Sex hormone levels should be actively tested in the case of prepubertal secondary sexual characteristics appearing early,pubertal secondary sexual characteristics being abnormal(underdevelopment),and/or menstrual abnormalities.Imaging examination should be performed to exclude ovarian organic lesions,and chromosome karyotype analysis should be performed if necessary.The diagnosis of ovarian mass in preadolescent and adolescent females with related symptoms should first be alerted to cord stromal cell tumor.It is recommended to rule out the possibility of combined reproductive tract malformation in the adolescent patients with primary amenorrhea.Chromosome examination should be conducted to rule out the possibility of gonadal dysplasia in the adolescent patients with primary amenorrhea and/or no development of secondary sexual characteristics.

Clinical characteristics of subjective cognitive decline in patients with Parkinson′s disease and its relationship with affective symptoms: a preliminary study / 中华神经科杂志

Objective:To investigate the characteristics and clinical related factors of Parkinson′s disease (PD) patients with subjective cognitive decline (SCD).Methods:Ninety-nine PD patients with normal cognitive function enrolled in Beijing Hospital from January to December 2018 were collected for the study. Patients with PD were divided into groups with ( n=57) and without ( n=42) SCD using the first question in Part 1 of the Unified Parkinson′s Disease Rating Scale (UPDRS). All patients were assessed by Montreal Cognitive Assessment (MoCA), modified Hoehn-Yahr grading, UPDRS, Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), Parkinson′s Disease Sleep Scale, Ability of Daily Living Scale and 39-item Parkinson′s Disease Questionnaire (PDQ-39). Levodopa equivalent dose conversion was performed for patients taking anti-PD drugs. Patients′ self-reported years of formal education were collected. Results:The proportion of PD with SCD in this group was 57.58% (57/99). There were statistically significant differences in MoCA [28.00 (27.00, 29.00) vs 28.00 (27.00, 29.00) ,Z=-2.28, P=0.023], HAMD [6.00 (5.00, 8.50) vs 5.00 (2.00, 8.00), Z=-2.23, P=0.026], HAMA [7.00 (6.00, 11.00) vs 6.00 (3.00, 8.25) , Z=-2.70, P=0.007], PDQ-39-emotional health [2.00 (0, 5.00) vs 1.00 (0, 3.00), Z=-2.03, P=0.042] and PDQ-39-cognitive scores [4.00 (2.00, 5.00) vs 2.00 (0, 4.00), Z=-3.42, P=0.001] between PD with and without SCD groups. SCD was correlated with MoCA ( r=-0.23, P=0.022), HAMD ( r=0.23, P=0.025) and HAMA ( r=0.27, P=0.006) scores to varying degrees. When controlling for HAMD and HAMA scores, the correlation between SCD and MoCA scores ( r′=-0.18, P=0.084) was no longer existed. Conclusions:SCD is common in PD patients with normal cognitive function and is associated with poorer cognitive performance and more severe symptoms of depression and anxiety. In this group of patients, the relationship between SCD and affective symptoms may be greater than that of objective overall cognitive function, which is worthy of further studies.

Risk factor of the growth rate of cerebral infarction and its effects on the prognosis in elderly patients with acute ischemic stroke / 中华老年医学杂志

Objective:To investigate the risk factors of infarct growth rate of elderly acute ischemic stroke(AIS)patients with endovascular treatment(EVT)and its influence on prognosis.Methods:Elderly AIS patients who underwent EVT at Beijing hospital from June 2016 to October 2020 were retrospectively included.Infarct growth rate(ml/h)=infarct core volume(ml)/time from stroke onset to CTP examination(h).Based on the rate of infarct growth and the patient's clinical severity, ROC curve was established, and the cut-off value of the ROC curve was obtained.By the cut-off value of the rate of infarct growth, the patients were divided into cerebral infarct slow-growth group and rapid-growth group.Predictors of rapid growth in infarct were analyzed by univariate and multivariate analysis.The patients were divided into good prognosis group(mRS score 0-2)and poor prognosis group(mRS score 3-6)according to the mRS score at the day 90 and the predictors of poor prognosis were analyzed separately.Results:A total of 67 elderly AIS patients were included with age ranging from 65-96 years and an average of(78.8±7.6)years.(1)The cut-off value of the optimal infarct growth rate for patients with good and poor prognosis was 8.89 ml/h.The patients were divided into fast-growth group(26 patients)and slow-growth group(41 patients)according the cut-off value.(2)Multivariate logistic regression showed that only poor collateral circulation was an independent predictor for fast infarct growth( OR=0.162, 95% CI: 0.053-0.489).(3)Faster infarct growth rate( OR=1.173, 95% CI: 1.044-1.318)and high NIHSS score( OR=1.146, 95% CI: 1.018-1.291)were predictors of poor prognosis. Conclusions:Collateral circulation status is a major influencing factor for the infarct growth rate, and a faster infarct growth rate is a predictor of poor prognosis for elderly AIS patients after endovascular treatment.