Genetically predicted waist circumference and risk of atrial fibrillation / 中华医学杂志(英文版)

INTRODUCTION@#Observational studies have revealed an association between waist circumference (WC) and atrial fibrillation (AF). However, it is difficult to infer a causal relationship from observational studies because the observed associations could be confounded by unknown risk factors. Therefore, the causal role of WC in AF is unclear. This study was designed to investigate the causal association between WC and AF using a two-sample Mendelian randomization (MR) analysis.@*METHODS@#In our two-sample MR analysis, the genetic variation used as an instrumental variable for MR was acquired from a genome-wide association study (GWAS) of WC (42 single nucleotide polymorphisms with a genetic significance of P <5 × 10 -8 ). The data of WC (from the Genetic Investigation of ANthropometric Traits consortium, containing 232,101 participants) and the data of AF (from the European Bioinformatics Institute database, containing 55,114 AF cases and 482,295 controls) were used to assess the causal role of WC on AF. Three different approaches (inverse variance weighted [IVW], MR-Egger, and weighted median regression) were used to ensure that our results more reliable.@*RESULTS@#All three MR analyses provided evidence of a positive causal association between high WC and AF. High WC was suggested to increase the risk of AF based on the IVW method (odds ratio [OR] = 1.43, 95% confidence interval [CI], 1.30-1.58, P = 2.51 × 10 -13 ). The results of MR-Egger and weighted median regression exhibited similar trends (MR-Egger OR = 1.40 [95% CI, 1.08-1.81], P = 1.61 × 10 -2 ; weighted median OR = 1.39 [95% CI, 1.21-1.61], P = 1.62 × 10 -6 ). MR-Egger intercepts and funnel plots showed no directional pleiotropic effects between high WC and AF.@*CONCLUSIONS@#Our findings suggest that greater WC is associated with an increased risk of AF. Taking measures to reduce WC may help prevent the occurrence of AF.

Exploring Modern Mechanism of Treating Diabetic Retinopathy and Coronary Heart Disease from Perspective of Blood Stasis Under Viewpoint of Treating Different Diseases with the Same Method / 中国实验方剂学杂志

Diabetic retinopathy（DR） and coronary heart disease（CHD） are both major chronic vascular complications that seriously jeopardize the health of the population and often occur together in clinical practice， it is of great clinical value to actively explore the association between the two in the process of disease development and methods of prevention and treatment of modern medicine and traditional Chinese medicine（TCM）. According to TCM， the heart and eyes physiologically communicate with each other by taking Qi， blood and veins as bridges， blood stasis obstructing collaterals is the common TCM etiology of DR and CHD， whose mechanism involves inflammation， oxidative stress and endothelial dysfunction. Promoting blood circulation and removing blood stasis plays an important role in the same treatment for different diseases and prevention and treatment of comorbidities， possibly by inhibiting the expression of interleukin-1β（IL-1β）， endothelin-1（ET-1） and hypoxia inducible factor-1α/vascular endothelial growth factor（HIF-1α/VEGF）， regulating phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） pathway， initiating adenosine monophosphate（AMP）-activated protein kinase/silent information regulator 1（AMPK/SIRT1） and nuclear transcription factor erythroid 2-related factor 2/heme oxygenase-1（Nrf2/HO-1） signaling pathways， inhibiting Hippo/Yes-associated protein（Hippo/YAP） signaling pathway， inhibiting mitochondrial permeability transition pore and anti-platelet agglutination for treating DR and CHD， which provides a multi-component， multi-pathway and multi-target selection strategies and ideas for the prevention and treatment of DR and CHD by TCM from a biological perspective. Based on this， subsequent studies should focus on constructing clinically relevant comorbidity models， conducting multicenter prospective studies， and fully utilizing artificial intelligence technology to gain a deeper understanding of the relationship between the two diseases， so as to elucidate the mechanism of promoting blood circulation and removing blood stasis in preventing and treating panvascular diseases.

Pathogenesis and Traditional Chinese Medicine Prevention and Treatment Strategy of Diabetic Vascular Calcification Based on Theory of Stasis-toxin-deficiency / 中国实验方剂学杂志

Vascular complications are the primary cause of the high disability and mortality in diabetic patients. Vascular calcification is a pathological basis of diabetic vascular complications and increases the risk of adverse cardiovascular events and the difficulty of revascularization in diabetic patients. It is of great clinical value to explore the measures for prevention and treatment of diabetic vascular calcification with integrated traditional Chinese and Western medicine. This paper explores the intrinsic association of stasis， toxin， and deficiency with diabetic vascular calcification to reveal the pathogenesis of diabetic vascular calcification. Stasis and toxin are causally affected by and combined with each other； deficiency refers to the deficiency of healthy Qi and the loss of Qi and blood. The three elements are associated with the occurrence and development of blood vessel diseases. This paper proposes the evolutional law of stasis， toxin， and deficiency in traditional Chinese medicine （TCM） for diabetic vascular calcification. Specifically， diabetic vascular calcification is rooted in the stasis of meridians and collaterals， develops due to the combination of stasis and toxin， and is aggravated by middle Qi deficiency. Furthermore， this paper proposes the TCM intervention principle of activating blood， removing toxin， tonifying deficiency， and dredging collaterals for the prevention and treatment of diabetic vascular calcification. The aim is to provide a theoretical basis for clinical and translational research on the prevention and treatment of diabetic vascular calcification with integrated Chinese and Western medicine.

Dietary Patterns for Prevention and Treatment of Cardiometabolic Disease： Interpretation and Thinking Based on Traditional Chinese Medicine Theory / 中国实验方剂学杂志

Cardiometabolic disease （CMD） is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic （Huang Di Nei Jing） to the widespread application of modern dietary patterns such as dietary restriction， plant-based diets， and Jiangnan cuisine， dietary regulation plays a significant role in preventing diseases， early treatment of existing diseases， and recovery. This article systematically reviewed the traditional Chinese medicine （TCM） theory related to dietary patterns， elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD， and explored the strategy of integrating TCM theory with dietary patterns， aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.

Effect of maxillary expansion combined with orofacial myofunctional therapy on the position of the tongue of children with mouth breathing / 临床耳鼻咽喉头颈外科杂志

Objective:This study aimed to investigate the change of the position of the tongue before and after combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion. Methods:A total of 30 children with skeletal class Ⅱ malocclusion and unobstructed upper airway were selected. The 30 children were divided into mouth-breathing group（n=15） and nasal-breathing group（n=15） and CBCT was taken. The images were measured by Invivo5 software. The measurement results of the tongue position of the two groups were analyzed by independent samples t-test. 15 mouth-breathing children with skeletal class Ⅱ malocclusion were selected for maxillary expansion and orofacial myofunctional therapy. CBCT was taken before and after treatment, the measurements were analyzed by paired sample t test with SPSS 27.0 software package. Results:The measurement of the tongue position of the mouth-breathing and nasal-breathing groups were compared, the differences were statistically significant（P<0.05）. The measurement of the tongue position showed significant difference after the combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion（P<0.05）. Conclusion:Skeletal class Ⅱ malocclusion children with mouth-breathing have low tongue posture. The combined treatment of maxillary expansion and orofacial myofunctional therapy can change the position of the tongue.

Spatial Distribution of Parvalbumin-Positive Fibers in the Mouse Brain and Their Alterations in Mouse Models of Temporal Lobe Epilepsy and Parkinson's Disease / 神经科学通报·英文版

Parvalbumin interneurons belong to the major types of GABAergic interneurons. Although the distribution and pathological alterations of parvalbumin interneuron somata have been widely studied, the distribution and vulnerability of the neurites and fibers extending from parvalbumin interneurons have not been detailly interrogated. Through the Cre recombinase-reporter system, we visualized parvalbumin-positive fibers and thoroughly investigated their spatial distribution in the mouse brain. We found that parvalbumin fibers are widely distributed in the brain with specific morphological characteristics in different regions, among which the cortex and thalamus exhibited the most intense parvalbumin signals. In regions such as the striatum and optic tract, even long-range thick parvalbumin projections were detected. Furthermore, in mouse models of temporal lobe epilepsy and Parkinson's disease, parvalbumin fibers suffered both massive and subtle morphological alterations. Our study provides an overview of parvalbumin fibers in the brain and emphasizes the potential pathological implications of parvalbumin fiber alterations.

Adverse events in platelet-rich plasma collection and countermeasures / 中国输血杂志

【Objective】 To explore the quality of platelet-rich plasma(PRP) and adverse events during PRP collection and the countermeasures, so as to provide reference for the development of PRP therapy. 【Methods】 A total of 412 patients who underwent PRP treatment from November 2020 to October 2022 were statistically analyzed in terms of the general data, PRP quality and adverse events during collection, and the countermeasures were formulated. 【Results】 PRP was collected from 409 patients with a volume of (48.391±6.262) mL, with platelet concentration at (1 125.548±366.036)×109/L. There were 33 adverse events occurred in 412 patients, with an incidence of 8.01% (33/412), among which 10 was regarding to collection and 23 were adverse reaction to blood donation. The reasons include mental factors, hyperlipidemia, hypovolemia, abnormal red blood cell morphology and venous puncture injury. 【Conclusion】 Countermeasures against the relative risk factors of adverse events during PRP collection, such as exclusion of hyperlipidemia, relieving mental stress, providing adequate communication and water to patients with low body weight, lowering the collection and transfusion flow rate to patients with poor vascular status and providing calcium gluconate to patients with low calcium response should be taken.

The method of determining oral implantation sites based on an anatomical model of mandibular premolar area of a Beagle dog / 中国基层医药

Objective:To investigate the method of determining oral implantation sites based on an anatomical model of mandibular premolar area of a Beagle dog.Methods:This study was performed in the Second Affiliated Hospital of Zhejiang Chinese Medical University between January 2019 and October 2020. Mandibular anatomical structure and measurement data were compared between before and after removal of premolar teeth to determine safe implantation areas and oral implantation sites.Results:Among all mandibular premolars, the roots of the 1 st to 4 th premolars (P1-P4) gradually increased. The diameter of the mesial roots of the double root teeth P2, P3, and P4 was (2.72 ± 0.45) mm, (3.22 ± 0.32) mm, (4.16 ± 0.34) mm, respectively, which was significantly shorter than those in the distal roots [P2: (2.98 ± 0.29) mm, P3: (3.48 ± 0.27) mm, P4: (4.58 ± 0.22) mm]. The length of distal roots P2, P3 and P4 was (8.79 ± 0.41) mm, (9.21 ± 0.31) mm, (10.12 ± 0.36) mm), respectively, which was significantly shorter than that of mesial root [P2: (8.91 ± 0.69) mm, P3: (9.48 ± 0.27) mm, P4: (11.58 ± 0.24) mm]. Among all mandibles, the distance (H) from the mental foramen to the first molar and the width (W) of the alveolar crest increased successively [H1: (7.24 ± 0.49) mm, H2: (8.28 ± 0.71) mm, H3: (9.52 ± 0.37) mm, W1: (5.71 ± 0.81) mm, W2: (5.82 ± 0.28) mm, W3: (6.72 ± 0.54) mm]. Conclusion:The mental foramen and the distal part outside the canine apical area are safe implantation areas. In the safe implantation area, the length and diameter of the implant prosthesis do not exceed the root length in the implantation area and the maximum diameter in the buccal lingual direction.

Research on the key driving factors of the transformation of scientific and technological achievements in public hospitals / 中华医院管理杂志

Objective:To learn the key driving factors in the management of scientific and technological achievements transformation in public hospitals, so as to provide basis for improving the effectiveness of achievements transformation.Methods:From March to July 2021, 1 226 medical staff from 7 municipal hospitals in Hangzhou were investigated by stratified random sampling. The questionnaire included the main demographic information, the perceived importance and actual performance of the management mechanism(6 dimensions, 18 items)which was scored by Likert 5. Descriptive analysis was carried out and paired samples were compared by t-test, and the difference was significant when P<0.05. Importance matrix analysis was carried out on all items to identify the key driving factors for the transformation of achievements in public hospitals. Results:1 157 valid questionnaires were finally included. The difference between the scores of perceived importance and actual performance of the various management mechanisms was significance( P<0.001). The gap was presented as follows: evaluation mechanism(1.29), investment mechanism(0.88), organization and leadership mechanism(0.87), guarantee mechanism of services(0.44), benefit and distribution mechanism(0.15), incentive mechanism(-0.11). Matrix analysis results showed that, " special funds support" , " grasp market demand and accurately connect" , " formulate corresponding supporting systems" , " professional transformation team with multidisciplinary background" , " classified and multi-level achievement transformation evaluation index system" , " full life cycle management" , " incorporate into central work and key tasks" and " scientific and technological achievement transformation reporting system and application monitoring system" were the key driving factors for the transformation of scientific and technological achievements in public hospitals. Conclusions:The perceived importance of medical staff to the transformation of scientific and technological achievements in public hospitals is acceptable, while the actual performance is relatively weak. The management effectiveness should be improved and give priority to consolidate the management foundation, build index evaluation system, provide the life cycle management service and improve scientific interaction as well as consultation service mechanism.

Predictive value of serum N-terminal pro-B-type natriuretic peptide concentration for postoperative acute kidney injury in neonates undergoing cardiac surgery: based on pROCK criteria / 中华麻醉学杂志

Objective:To evaluate the predictive value of the serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration for postoperative acute kidney injury (AKI) in neonates undergoing cardiac surgery.Methods:Perioperative data of 110 consecutive neonates (≤28 days) who underwent cardiac surgery in our hospital from October 2017 to May 2021, were collected retrospectively.According to pROCK criteria, the patients were divided into AKI group and non-AKI group.Demographics, predominant diagnosis, laboratory examination, perioperative management and postoperative outcomes were compared between two groups.The concentration of serum NT-proBNP was routinely measured within 12 h after operation.Multivariate logistic regression analysis was performed for the association between serum NT-proBNP and postoperative AKI.Receiver operating characteristic curve was drawn, and the predictive value of serum NT-proBNP for postoperative AKI was determined according to the area under the curve.Results:A total of 106 neonates were enrolled, and the incidence of postoperative AKI was 54.7%.There were significant difference in the baseline hemoglobin concentration, hematocrit and serum creatinine and serum NT-proBNP concentration between AKI group and non-AKI group ( P<0.05). Multivariate logistic regression analysis indicated that NT-proBNP level was an independent risk factor for AKI after cardiac surgery in neonates ( odds ratio 2.49, 95% confidence interval 1.183-5.23, P=0.016). The area under the curve of NT-proBNP predicting AKI after cardiac surgery was 0.66 (95% confidence interval 0.56-0.76, P=0.007). Conclusions:Elevated serum NT-proBNP concentration is an independent risk factor for AKI after cardiac surgery in neonates and has a certain predictive value for AKI, and close monitoring of perioperative NT-proBNP level is helpful for early identification of high-risk neonates.

Status quo of frailty and its influential factors among the community-dwelling elderly / 中华健康管理学杂志

Objective:To investigate and analyze the status quo and influential factors of the elderly in the community.Methods:From July to September 2021, 543 elderly people were investigated in 9 community healthcare service centers in Hangzhou by using the Comprehensive Frailty Assessment Instrument (including four dimensions: physical, psychological, social, and environmental frailty) and the Social Support Rating Scale (including three dimensions: subjective support, objective support, and support availability). Independent sample t-test, analysis of variance, correlation analysis, and multiple linear regression were conducted to examine key determinants of frailty. Results:The total score of frailty among older adults in the community was (43.1±12.0). The results showed that the total score of social support was negatively associated with frailty of community-dwelling older adults ( r=-0.449, P<0.01); age ≥80 years old ( β=0.229, P<0.001) was positively associated with frailty; not living alone, children′s household support, children′s spiritual support, the accessibility of elderly care facilities within a 15-minute walk, and social support score were negatively associated with frailty ( β=-0.118, -0.081, -0.260, -0.155, -0.250,all P<0.05). Conclusion:The elderly in the community have a moderate degree of frailty, which affected by age, living condition, children′s support, the accessibility of elderly care facilities, and social support.

Removal of serological interference in the treatment of multiple myeloma with CD38 monoclonal antibody using polybrene method / 中国输血杂志

【Objective】 To investigate the clinical feasibility of polybrene method to remove serological interference in patients receiving anti-CD38 monoclonal antibody for the treatment of multiple myeloma, and its detection performance of alloantibodies. 【Methods】 For patients receiving anti-CD38 monoclonal antibody for the treatment of multiple myeloma, unexpected antibody screening and cross-matching blood test were performed by polybrene method. 【Results】 The polybrene method can remove the interference of anti-CD38 monoclonal antibodies on blood group serology; both methods can effectively remove anti-CD38 monoclonal antibody to detect anti-E, anti-D, anti-Fya and anti-S antibodies.The titers of anti-D, anti-E, anti-Fya and anti-S alloantibodies, yielded by enhanced polybrene method, were higher than those of the polybrene method.Seven patients received K-antigen-negative blood transfusion without any adverse reactions to blood transfusion. 【Conclusion】 For the treatment of multiple myeloma using CD38 monoclonal antibody, the polybrene method can quickly and effectively remove the interference of daratumumab with blood group serology.

Effects of enriched environment on anxiety- and depressive-like behavior and synaptic plasticity in neuropathic pain rats / 中华行为医学与脑科学杂志

Objective:To explore the effect of enriched environment on pain sensitivity, anxiety- and depressive-like behavior in selective nerve injury(SNI) rats model and its potential mechanism.Methods:A total of 36 male clean grade SD rats aged 6-8 weeks were randomly divided into three groups( n=12 in each group): sham operation+ standard environment group (sham group), SNI+ standard environment group (standard environment group), SNI+ enriched environment group (enriched environment group). The rat model of neuropathic pain was established by SNI.The rats in the enriched enviroment group were placed in an enriched enviroment 7 days before operation until 21 days after operation.The paw withdraw threshold(PWT) and paw withdraw latency (PWL) were performed to assess hyperalgesia.The open field test, elevated plus maze test, novelty suppressed feeding test and forced swimming test were used to assess anxiety and depression like behavior.The expressions of cAMP response element binding protein (CREB), p-CREB, brain-derived neurotrophic factor (BDNF), postsynaptic density-95 (PSD-95) and neuroligin 2 (NLGN2) were detected by Western blot.The expression of CREB and BDNF in contralateral ACC were measured by immunofluorescence.GraphPad prism 8.0 and SPSS 23.0 were used for data analysis.One way ANOVA was used for inter group comparison, repeated measurement ANOVA was used to analyze PWT and PWL results, and Tukey test was used for pairwise comparison. Results:(1) In PWT and PWL experiments, the interaction effect between group and time, group main effect and time main effect of PWT were significant ( F=13.4, 39.6, 369.6, all P<0.05), and the interaction effect between group and time, group main effect and time main effect of PWL were significant ( F=3.8, 10.3, 58.8, all P<0.05). Compared with sham group, PWT((8.0±3.5) g, (2.4±1.4) g, (2.3±1.1) g, (2.2±1.6) g, (1.6±0.5) g) and PWL((8.6±1.3) s, (7.3±1.5) s, (7.9±1.0) s, (6.6±1.1) s, (7.7±1.4) s) in standard environment group decreased at each time point (all P<0.05). (2) Compared with sham group, the number of entrying into the central area (1.3±1.7), the time of entrying into the central area((1.6±1.3) s), the proportion of entering open arms ((8.0±7.8) %) and the proportion of time in the open arms ((1.3±1.2) %) all significantly decreased in standard environment group ( t=4.585, 5.423, 4.682, 5.202, all P<0.05). The eating latency ((365.2±94.4) s) and immobility time ((127.6±24.3) s) dramatically increased ( t=6.008, 14.290, both P<0.05). The number and time of entrying into central area of enriched environment group were both higher than those of standard environment group(both P<0.05), while the eating latency and immobility time of enriched environment group were both lower than those of standard environment group(both P<0.05). (3) Compared with sham group(CREB: (1.6±0.2), (0.8±0.5); BDNF: (0.8±0.5), (1.0±0.4)), the expression of CREB ((1.8±0.1), (1.5±0.2)), BDNF ((0.9±0.6), (1.4±0.3)) in spinal cord and ACC of standard environment group increased (spinal: t=3.283, 4.989; ACC: t=5.502, 4.257, all P<0.05). The expression of PSD-95 ((1.6±0.2), (1.0±0.2) and NLGN2 ((1.5±0.5), (1.1±0.2)) also increased in ACC of standard enviroment group ( t=4.257, 2.214, both P<0.05). Compared with standard environment group, the expression of CREB (1.3±0.3), BDNF (0.7±0.4), PSD-95(1.0±0.3) and NLGN2(1.1±0.4) in spinal cord of enriched environment group decreased ( t=5.007, 2.166, 2.358, 2.322, all P<0.05). The expression of PSD-95(1.2±0.3) and NLGN2(1.1±0.2) also decreased in ACC of enriched environment group ( t=2.674, 2.944, both P<0.05). However, the expression of p-CREB (1.7±0.6) and BDNF (2.4±0.2) increased in ACC ( t=4.180, 7.610, P<0.05). Conclusion:Enriched environment can improve neuropathic pain and anxiety- and depressive-like behavior in SNI rats, which may be related to the change of synaptic plasticity in spinal cord and ACC.

Macular microvascular findings in familial exudative vitreoretinopathy on optical coherence tomography angiography / 中华眼底病杂志

Objective:To evaluate macular microvessel changes in familial exudative vitreoretinopathy (FEVR) by optical coherence tomography angiography.Methods:Cross-sectional clinical case-control study. From November 2019 to November 2020, 21 FEVR patients (41 eyes) from Weifang Eye Hospital were selected; 17 healthy volunteers (28 eyes) with the same age and gender as FEVR group were selected as normal control group. According to the best corrected visual acuity (BCVA) 1.0 and <1.0, FEVR group was divided into normal visual acuity group (27 eyes) and visual acuity decreased group (14 eyes). All enrollees received BCVA and OCTA. BCVA was performed with an international standard visual acuity chart, which was converted to logarithm of the minimum angle of resolution (logMAR) vision. The OCTA instrument was used to scan the macular area of all the examined eyes in the range of 3 mm×3 mm, 6 mm×6 mm, and the blood vessel density (VD) and blood perfusion density (PD) within the range of 3 mm×3 mm, 6 mm×6 mm were measured and the area, circumference, and morphological index of the foveal avascular zone (FAZ) within the range of 6 mm×6 mm. Quantitative data were compared between groups by independent sample t test. Statistical data were compared by χ 2 test. The area under curve (AUC) of each index was determined according to receiver operating characteristic curve (ROC curve), and the predictive value of each index was evaluated. Results:In the macular area of 6 mm×6 mm, VD, PD, FAZ area and FAZ perimeter of FEVR group were all lower than those of normal control group, and the differences were statistically significant ( t=-3.350, -2.387, -3.519, -3.029; P<0.05). In macular area of 3 mm×3 mm and 6 mm×6 mm, compared with normal vision group and vision loss group, both VD and PD decreased. The differences were statistically significant ( t=2.088, 2.114, 2.160, 2.545; P<0.05). In the macular area of 6 mm×6 mm , the FAZ morphological index of the two groups was significantly different ( t=2.409, P<0.05). ROC curve analysis showed that all the indicators had low diagnostic value for FEVR (AUC<0.5). Conclusion:There are microvascular abnormalities in macular area in FEVR patients, and the decrease of blood vessels and the change of FAZ shape may be related to the loss of visual acuity.

Individual dose of intravitreal conbercept for efficacy in retinopathy of prematurity / 中华眼底病杂志

Objective:To observe the efficacy and safety of individual dose of intravitreal conbercept (IVC) in the treatment of retinopathy of prematurity (ROP) before type 1 threshold.Methods:A retrospective case study. From January to July, 2019, 23 cases (46 eyes) of children with type 1 pre-threshold ROP were included in the study. Among them, 14 cases (28 eyes) were male and 9 cases (18 eyes) were female. The mean gestational age at birth was 28.06±1.73 weeks. The average birth weight was 1.14±0.19 kg. The mean corrected gestational age was 34.38±1.41 weeks at the time of first intravitreal injection of IVC. The axial length (AL) of children was measured by A-mode ultrasound before IVC for the first time. According to the calculation of AL, the corresponding injection dose range was 14.23-16.19, 16.20-17.57, 17.58-18.63 mm and the injection dose of IVC was 0.015, 0.020, 0.025 ml (including IVC was 0.15, 0.20, 0.25 mg, respectively). The first IVC dose was 0.015 ml. On the first day before IVC and on the first and seventh days after IVC, 2 ml of arterial blood was taken from children, serum vascular endothelial growth factor (VEGF) concentration was detected. The follow-up time after treatment was ≥1 year. After one year of follow-up, the effective rate and recurrence rate of IVC for the first time were tested by χ2 tests. The short-term changes of injection times, injection intervals, retinal vascularization time and serum VEGF concentration in children were tested by t test. Results:Retinal neovascularization subsided and vascular buckling decreased in all eyes. Iris neovascularization subsided, 1-3 weeks after IVC for the first time. Within one year after the first IVC, 16 eyes underwent IVC twice with or without new blood vessels at the junction of the vascular area. The average corrected gestational age was 40.56±3.81 weeks. The injection dose of IVC was 0.015 ml and 0.020 ml for 2 eyes and 14 eyes, respectively.The mean interval from IVC for the first time was 40.89±8.99 days. Of the 16 eyes who underwent IVC twice, 8 eyes showed neovascularization again in the retinal area with or without blood vessels. The average corrected gestational age was 43.00±1.41 weeks. The injection dose of IVC was 0.020 ml and 0.025 ml for 3 eyes and 5 eyes, respectively. The mean interval of the second IVC was 28.60±6.07 days. The mean interval from the first IVC was 69.20±12.40 days. At the end of follow-up, all eyes were treated effectively (100%, 46/46). The mean time of retinal vascularization was 46.31±3.42 weeks. The average number of injections was 1.52±0.76. On the first day before IVC and on the first and seventh days after IVC, the average serum VEGF concentrations were 111.21±148.71, 25.60±27.71 and 42.99±38.01 pg/ml, respectively. Serum VEGF concentration was significantly lower than that before IVC on the 1st and 7th day after IVC ( Z=-4.054, -2.779; P<0.05). Serum VEGF concentration was higher 7 days after IVC than 1 day after IVC, and the difference was statistically significant ( Z=-2.505, P<0.05). All eyes were not treated by laser photocoagulation or vitrectomy. No eye complications such as lens opacification, endophthalmitis and retinal detachment related to drugs or treatment methods were found in all patients. Conclusion:Intravitreal injection of individualized dose of IVC is effective in the treatment of type 1 pre-threshold ROP. Seven days after treatment, serum VEGF concentration of patients’serum decreases.

Analysis on research evolution, status and hotspot of hospital Party construction work based on CNKI database / 中华医院管理杂志

Objective:To identify current research hotspot and future trends of hospital Party construction work from 2009 to 2019, provide references for promoting integration of Party construction with medical work to guide the development of the hospital.Methods:Literature published during 2009-2019 were retrieved in CNKI database using the method of subject research. The Citespace V software was used to generate the research institutions and cooperative network, the keyword co-occurrence network and emergent word graph, information visualization was used to analyze the research institutions, research hotspots, research trends and frontiers.Results:A total of 1 161 papers were obtained. The cooperation between research institutions and hospitals needed to be strengthened. In the past 10 years, the researches focused on the management of Party members and the standardization construction of Party branches, the empirical research combining the policy hotspots, and the promotion of development of hospitals by Party construction.Conclusions:The cooperative research mode between hospitals and universities should be carried out. The internal integrity of the theoretical system needs reinforcement, and the achievement transformation of Party construction research also should be enhanced.

Clinical significance of the detection of bone mineral density and serum vitamin D levels in elderly patients with Parkinson's disease / 中华老年医学杂志

Objective:To investigate clinical significance of the detection of bone mineral density(BMD)and serum levels of vitamin D in elderly patients with Parkinson's disease(PD).Methods:Sixty elderly patients with PD(the PD group)admitted in our hospital from June 2016 to December 2018 were enrolled in this retrospective study.And 60 healthy persons confirmed by annual health check-up matched for age and sex during the same period were included as the control group.PD patients were divided into the osteoporosis group(n=23)and the non-osteoporosis group(n=37). The clinical data, bone mineral density and serum vitamin D level were compared between the two groups.Multivariate Logistic regression method was used to analyze related factors for osteoporosis in PD patients.Results:The incidences of osteoporosis and vitamin D deficiency were higher in PD group than in control group[23 cases(38.3%) vs.13 cases(21.7%)、35 cases(58.3%) vs.21 cases(35.0%), all P<0.05]. Bone mineral density and serum 25-(OH)D level were lower in PD group than in control group[(0.77±0.08)g/m 2vs.(0.83±0.09)g/m 2, (25.65±8.65)nmol/L vs.(39.80±10.74)nmol/L, t=4.381 and 8.439, P<0.05]. The age, course of disease and H-Y grade were higher and serum level of 25-(OH)D was lower in the osteoporosis group than in the control group( P<0.05). Spearman correlation analysis showed that BMD and 25-(OH)D were negatively correlated with age, course of disease and H-Y stage, respectively, and BMD was positively correlated with 25-(OH)D( r=0.396, P<0.05). Multivariate Logistic regression analysis showed that vitamin D deficiency was an independent risk factor for osteoporosis in elderly PD patients( OR=2.332, 95% CI: 1.772-8.224, P<0.01). Conclusions:The incidence of osteoporosis is high in elderly PD patients, and vitamin D deficiency is often present.Vitamin D deficiency may be an independent risk factor for osteoporosis.

Effects of exercise prescription on quality of life in patients with pituitary adenomas after surgery / 中国实用护理杂志

Objective:To investigate the effects of exercise prescription on quality of life in patients with pituitary adenomas after surgery.Methods:A total of 82 patients with pituitary adenomas who met the inclusion criteria from December 2017 to September 2018 were enrolled. The control group received routine nursing care. The intervention group was given exercise prescription on the first day after surgery and 3 months after discharge from hospital. Both groups of patients completed the Health Status Survey(SF-36) before and after the intervention.Results:Before the intervention, there was no significant difference in baseline date of patients between two groups( P>0.05). After intervention, the general health dimension score (53.03±11.30) of the control group was significantly higher than the score within the group before treatment ( Z value was -4.398, P<0.05). The physiological function (86.67±7.46), physical function (66.67±29.28), role-emotional (71.30±22.75), vitality (68.33±8.78), general health dimension (61.39±10.66) of the intervention group were significant higher than the score within the group before treatment ( Z values were -4.809--2.041, P<0.05) . After the intervention, the significant difference were found in role-physical, general health, vitality, social function(77.18±15.71) and physiological health dimensions (73.75±10.00) between the intervention and control group ( Z values were -3.122- -2.467, t value was 3.044, P<0.05). After the intervention, non-function patients′ physiological function (72.06±23.19), general health (60.59±10.75), vitality (69.71±10.23) and social function (81.04±10.22) were significantly higher than the control group ( Z values were -2.832- -2.059, P<0.05). Conclusion:Exercise prescription can improve the quality of life in patients with pituitary adenomas after surgery.

Genetic diagnosis for a case of hypophosphatasia and the prenatal diagnosis of his sibling / 中华内分泌外科杂志

Hypophosphatasia is a rare hereditary metabolic bone disease caused by ALPL gene mutation.This papaer report the genetic diagnosis of a child with childhood hypophosphatasia,and the prenatal diagnosis of his sibling.We hope it can provide reference for clinical diagnosis and prenatal diagnosis of this disease.

Clinical efficacy and strategy of complications of blepharoplasty for double eyelids / 中华医学美学美容杂志

Objective To investigate the causes,the prevention and the treatment of the complications of blepharoplasty for double eyelids.Methods The clinical data,the surgery methods and the causes were analyzed in 100 cases of blepharoplasty from July 2011 to December 2017.Results All of these patients underwent these perfect procedures with satisfied anesthesia.Incisions were all healed in one stage with no infection.Double eyelid width was (7.0± 1.2) mm with natural and smooth lines after 3 months operation,86 patients (86％) had double eyelid with natural and smooth lines,slight scars and good bilateral symmetry.14 patients (14％) required surgical revision for complications,as asymmetry of supratarsal folds (7 ％),over narrow of supratarsal folds (4 ％),over width of supratarsal folds (2 ％),disappearance of supratarsal folds (2 ％),multiple eyelid (3 ％) and ptosis (1％),and the effects were satisfactory.Conclusions In order to achieve the natural and smooth double eyelids,it is important for plastic surgeons to have the comprehensive grasp of overall outline and operational details in blepharoplasty for double eyelids.Preoperative design should be accurate,intraoperative procedures should be careful,and postoperative care should be standardized.