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ObjectiveTo investigate the effect of chorionicity， gestational age at birth and birth weight discordance on neonatal outcomes in twin pregnancies. MethodsWe conducted a population-based retrospective study of monochorionic diamniotic （MCDA） twin pregnancies and dichorionic diamniotic （DCDA） twin pregnancies who were admitted in the First Affiliated Hospital， Sun Yat-sen University from January 2015 to December 2020. A total of 1504 live-born twins were included， with 386 cases in MCDA group and 1118 cases in DCDA groups， respectively. The comparison of neonatal outcomes between MCDA and DCDA twins was performed using t-test， Wilcoxon rank sum test， Chi-square test or Fisher’s exact test. Logistic regression was performed to evaluate the effects of chorionicity， gestational age at birth， birth weight discordance and sex on neonatal outcomes. There were 168 live-born twins affected by inter-twin birth weight discordance≥25%， with 96 cases in MCDA group and 72 cases in DCDA groups， respectively. Logistic regression was performed to evaluate the effects of chorionicity， gestational age at birth， birth weight light or heavy （small twin or large twin） of the twin and sex on neonatal outcomes. ResultsAmong the 1 504 newborns， gestational age at birth was lower in MCDA group compared with DCDA group （P = 0.000）， and the degree of birth weight discordance was higher in MCDA group than that of the DCDA group （P = 0.001）. Birth asphyxia， respiratory distress syndrome （RDS）， bronchopulmonary dysplasia （BPD）， and sepsis were more frequency in MCDA group compared with DCDA group （P = 0.000， P = 0.000， P = 0.000， P = 0.000）. Low gestational age at birth was an independent risk factor for birth asphyxia， RDS， BPD， sepsis， necrotizing enterocolitis （NEC）≥stageⅡ， acute kidney injury （AKI）， retinopathy of prematurity （ROP）， and neonatal death respectively （P = 0.000， P = 0.000， P = 0.000， P = 0.000， P = 0.011， P = 0.000， P = 0.000， P = 0.000）. High degree of birth weight discordance was an independent risk factor for birth asphyxia， RDS， BPD， sepsis and ROP respectively （P = 0.045， P = 0.000， P = 0.000， P = 0.004， P = 0.017 ）. Chorionicity was not an independent risk factor for neonatal morbidity and death （P > 0.05）. Among the 168 twins with birth weight discordance ≥25%， low gestational age at birth was an independent risk factor for birth asphyxia， RDS， BPD， sepsis and ROP， respectively （P = 0.000， P = 0.000， P = 0.000， P = 0.000， P = 0.000）； small twin was an independent risk factor for birth asphyxia and BPD， respectively （ P = 0.013， P = 0.001）； chorionicity was not an independent risk factor for neonatal morbidity （P > 0.05）. ConclusionChorionicity was not an independent risk factor for adverse neonatal outcome in twin births. Low gestational age at birth and high degree of birth weight discordance were independent risk factor for adverse neonatal outcome in twin births. Small twins had increased risk of adverse neonatal outcome in twins with birth weight discordance ≥25%.
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Ionic liquids (ILs) are liquid mixtures formed by anions and cations in a certain stoichiometric ratio under certain conditions. They are widely used in various fields because of their simple preparation process, low volatility, high stability, high conductivity and non-flammability. Here, we firstly introduce their formation principles, classification, and physical and chemical properties in detail. Then, we summarize their functions in pharmaceutical preparations, such as improving the solubility of insoluble drugs, enhancing the stability of drugs, and promoting the permeability of drugs, as well as their role as active pharmaceutical ingredients (API) to fabricate new drug delivery systems of API-ILs. Finally, we reviewed the applications of ILs in different administration routes, including oral, transdermal, mucosal, and injection routes, and meanwhile offer perspectives for the further use of ILs.
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·AIM:To investigate the clinical efficacy of Ranibizumab combined with laser photocoagulation in the treatment of proliferative diabetic retinopathy (PDR). ·METHODS: Totally 80 patients (101 eyes) with PDR admitted to our hospital from October 2014 and October 2016 were selected and divided into the observation group and the control group, with 50 eyes and 51 eyes respectively. The patients in the control group (50 eyes) were treated with panretinal photocoagulation (PRP), and the patients in observation group (51 eyes) were treated with ranibizumab on the basis of PRP treatment. Best corrected visual acuity(BCVA) was compared before and after surgery 1, 3, and 6mo. Optical coherence tomography (OCT) was used to examine the central macular thickness ( CMT ) and the area of neovascularization at each timepoints. Then the laser spot number,laser energy and energy density were compared between the two groups and the adverse reactions were recorded. · RESULTS: Postoperative BCVA of the two groups significantly increased, and the BCVA of observation group were significantly higher than that of the control group after surgery 1, 3, 6mo, the difference was statistically significant (P<0. 05). After treatment, the CMT and neovascularization area of the two groups significantly decreased, and those of the observation group were significantly lower than those of the control group after surgery 1, 3, 6mo, the difference was statistically significant (P<0.05). The laser spot number, laser energy and energy density of the observation group were significantly lower than those of the control group, the difference was statistically significant(P<0.05). There were 2 cases (2 eyes) in the observation group and 1 cases (1 eye) in the control group, whose intraocular pressure exceeded 28mmHg, while relieved rapidly after the treatment, and no obvious complications occurred in two groups. ·CONCLUSION:Ranibizumab combined with laser in the treatment of PDR is an effective and safe way to improve BCVA, reduce CMT, and eliminate new blood vessels with less required laser energy.
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AIM: To investigate the clinical safety and effectiveness of the two kind of bandage contact lenses: Senofilcon A (Johnson & Johnson Acuvue Oasys) and Balafilcon A ( Bausch& Lomb pure vision ) after laser - assisted subepithelial keratectomy (LASEK). METHODS: Thirty - eight patients (76 eyes) who had undergone the LASEK were divided into two groups. One group of patients wore Balafilcon A, the other group of patients fitted with Senofilcon A. The lenses were worn continuously for 7d. This was a seven - day experience and the patients scored for the symptom of the eyes (sore eyes, foreign body sensation and tearing) on the third day and the seventh day. Both of the two groups of patients taken off the soft contact lens on the seventh day and let their vision and corneal staining checked. RESULTS: The symptoms of eye sore and tearing of the two groups patients were different. The patients who wore the Senofilcon A were better. The pain of eyes were also different at 3 and 7d after surgeries(Z = - 4. 146, P =0. 000; Z= - 2. 814, P = 0. 005). The difference on tearing between the two groups at 3 and 7d after surgeries were significant ( Z = -2. 309, P = 0. 021; Z= -3. 276, P= 0. 001). There was no difference on sensation of dryness between the two groups at 3 and 7d after surgeries (Z= -0. 447, P=0. 655; Z= -0. 966, P = 0. 334). After the lenses were taken off, the visual acuity of patients wearing Senofilcon A was better ( t = 3. 800, P = 0. 001 ); corneal staining showed limited spots in 1- 2 quadrants with significant difference (Z= -2. 384,P= 0. 017). CONCLUSION: The Senofilcon A ( Johnson &Johnson Acuvue Oasys ) and Balafilcon A ( Bausch& Lomb pure vision) bandage contact lenses are safe and effective after LASEK, and the former is better than the latter in epithelial regeneration.