Effect of endoscopic therapy and drug therapy on prognosis and rebleeding in patients with esophagogastric variceal bleeding.

Esophagogastric variceal bleeding (EVB) is one of the common digestive system emergencies with poor prognosis and high rate of rebleeding after treatment. To explore the effects of endoscopic therapy and drug therapy on the prognosis and rebleeding of patients with EVB, and then select better treatment methods to effectively improve the prognosis. From January 2013 to December 2022, 965 patients with EVB who were hospitalized in gastroenterology Department of the 940 Hospital of Joint Logistic Support Forces of PLA were retrospectively analyzed. Patients were divided into endoscopic treatment group (ET, n = 586) and drug treatment group (DT, n = 379). Propensity score matching (PSM) analysis was performed in both groups, and the general information, efficacy and length of hospital stay were recorded. The patients were followed up for 3 months after bleeding control to determine whether rebleeding occurred. There were 286 cases in each group after PSM. Compared with DT group, ET had higher treatment success rate (P < 0.001), lower rebleeding rate (P < 0.001), lower mortality rate within 3 months, and no significant difference in total hospital stay (P > 0.05). Compared with drug therapy, endoscopic treatment of EVB has short-term efficacy advantages, and can effectively reduce the incidence of rebleeding and mortality within 3 months.

Risk factors of infection among close contacts of COVID-19: A systematic review and meta-analysis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was first detected in December 2019, and declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. The current management of COVID-19 is based generally on supportive therapy and treatment to prevent respiratory failure. METHODS: PubMed, Web of Science, Embase, CNKI, and other databases were searched by computer, and relevant literature published from December 2019 to November 2022 on the influencing factors of infection in close contacts with novel coronavirus pneumonia was collected. Meta-analysis was carried out after literature screening, quality assessment, and data extraction. RESULTS: A total of 425 articles were retrieved and 11 were included. Meta-analysis showed that there were 6 risk factors, and the combined OR value and 95% CI of each influencing factor were 5.23 (3.20, 8.57) for family members, 1.63 (0.56, 4.77) for regular contact, 2.14 (0.62, 7.32) for the elderly, 0.58 (0.001569.89) for cohabitation, 1.97 (1.02, 3.82) for women and 0.75 (0.01, 54.07) for others. The Deeks' funnel diagram indicates that there is no potential publication bias among the included studies. CONCLUSION: Family members and gender differences are the risk factors of infection among close contacts, and it cannot be proved that there are differences in infection among frequent contact, advanced age, and living together.

Analyses on the misdiagnoses of 25 patients with unilateral optic nerve sheath meningioma.

AIM: To investigate clinical features of optic nerve sheath meningioma (ONSM) that was misdiagnosed, and to find methods to reduce the misdiagnoses. METHODS: Retrospective series study. Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan. 2008 to Jan. 2015 and the clinical records reviewed. RESULTS: Patients were misdiagnosed with acute papillitis most frequently (n=17), immediately followed by optic atrophy (n=8), ischemic optic neuropathy (n=5), acute retrobulbar optic neuritis (n=5), optic disc vasculitis (n=3). For each patient, the minimum frequency of misdiagnoses was once and the maximum was 4 times. As for the lasting time of being misdiagnosed, the shortest was 1.5mo and the longest was 45mo. Twenty-one cases (84%) were once treated with glucocorticoids, and its side effects was found in seventeen patients. Twenty patients (80%) complained with varying degree of vision loss. When a definite diagnosis was made, sixteen cases (64%) showed slight exophthalmos and eighteen cases (72%) had the tubular ONSM. CONCLUSION: ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic, and for most of these ONSMs are tubular.

[A randomized controlled trial: acclimatization training on the prevention of motion sickness in hot-humid environment].

OBJECTIVE: Incidence and severity of motion sickness (MS) in hot-humid environment are extremely high. We tried to know the effect of two-stage training for reducing incidence and severity of ms. METHODS: Sixty male subjects were divided into experimental group and control group randomly. Subjects in experimental group received: (2) adaptation training including sitting, walking and running in hot lab. After adaptation confirmation based on subjective feeling, rectal temperature, heart rate, blood Pressure, sweat rates and sweat salt concentration, we tested both groups by Coriolis acceleration revolving chair test and recorded Graybiel's score and grading of severity to evaluate whether adaptation training was useful; (2) Anti-dizzy training 3m later of deacclimatization contained revolving chair training for 10 times. Then we did the same test as mentioned above to evaluate effect of anti-dizzy training. RESULST: Graybiel' s score and grading of severity had no difference between two groups through acclimatization training (P > 0.05). While they had difference through anti-dizzy training (P < 0.01). CONCLUSION: Adaptation training seems useless for reducing incidence and severity of MS in hot-humid environment, but anti-dizzy training is useful.

Mechanism of the DL-alpha-aminoadipic acid inhibitory effect on form-deprived myopia in guinea pig.

AIM: To investigate the effect of intravitreal injection of DL-alpha-aminoadipic acid (DL-α-AAA) on ocular refractive state and retinal dopamine, transforming growth factor-ß2 (TGFß2), vasoactive intestinal polypeptide (VIP) in guinea pig form-deprived myopia. METHODS: Four-week-old pigmented guinea pigs were randomly assigned to 4 groups: normal control, deprivation, deprivation plus DL-α-AAA, deprivation plus saline. Form deprivation was induced with the self-made translucent eye shields, and lasted for 14 days. 8µg DL-α-AAA was injected into the vitreous chamber of deprived eyes. The corneal radius of curvature, refraction and axial length were measured. Retinal dopamine content was evaluated by the high-performance liquid chromatography with electrochemical detection, and TGFß2 and VIP protein were detected by Western blotting. RESULTS: Fourteen days of eye occlusion caused the axial length to elongate and become myopic in the form-deprived eyes, with the decrease of retinal dopamine and the increase of TGFß2 and vasoactive intestinal polypeptide (VIP) protein. Intravitreal injection of DL-α-AAA could inhibit the myopic shift from (-3.65±1.06)D to (-1.48±0.63)D, P<0.01 due to goggles occluding and cause the decrease of retinal TGFß2 protein in the deprived eyes. However, intravitreal injection of DL-α-AAA had no significant effect on retinal dopamine and VIP protein in deprived eyes. Retinal TGFß2 protein correlated highly with the ocular refraction (y=-3.34+0.31/x, F=74.75, P<0.001) and axial length (y=8.39-0.02/x, F=48.32, P<0.001) in different treatment groups. CONCLUSION: Intravitreal injection of DL-α-AAA is effectively able to suppress the development of form deprivation myopia, which may be associated with retinal TGFß2 protein in guinea pigs.

Retinoic acid metabolic change in retina and choroid of the guinea pig with lens-induced myopia.

AIM: To investigate the role of retinoic acid (RA) and retinaldehyde dehydrogenase-2 (RALDH(2)) of retina and choroid in the guinea pig lens-induced myopic eyes. METHODS: Totally 45 guinea pigs, at age of three weeks, were randomly assigned into three groups: the normal control, the lens-induced group and the recovering group. Out of focus was induced by the -6.00D concave lens on the left eye, and lasted for 15 days. All animals underwent biometric measurement (corneal radius of curvature, refraction and axial length). Subsequently, RA content in the retina and RPE/choriod complex was detected by reversed-phase high-performance liquid chromatography. RALDH(2) protein in the retina and RPE/choriod complex was evaluated by the immunohistochemical staining and Western blotting. RESULTS: After wearing -6.00D lens for 15 days, axial length of the lens-induced eye extends and myopia was formed, with RA contents increasing in both the neural retina and RPE/choroid complex. Comparing with the lens-induced group, myopic degree significantly relieved, and its RA contents in both the neural retina and RPE/choroid complex decreased in the recovering group. In the normal control, RALDH(2) protein was expressed positively in the retinal nerve fiber layer (RNFL), inner plexiform layer (IPL) and lateral border of outer nuclear layer (ONL). Retinal RALDH(2) protein increased in the lens-induced group, and was also positive in the outer plexiform layer (OPL). In the recovering group, retinal RALDH(2) protein attenuated the expression in the OPL turns to negative. RALDH(2) protein was not expressed in the choroid of any group. CONCLUSION: RA of retina and chorid participates in the regulation of the lens-induced myopia in guinea pigs, which may be related with retinal RALDH(2) protein.

Modulation of TGFß(2) and dopamine by PKC in retinal Müller cells of guinea pig myopic eye.

AIM: To investigate the effect of protein kinase C (PKC) on transforming growth factor-ß(2) (TGFß(2)) and dopamine in retinal Müller cells of guinea pig myopic eye. METHODS: Myopia was induced by translucent goggles in guinea pig, whose retinal Müller cells were cultured using the enzyme-digesting method. Retinal Müller cells were divided into 5 groups: normal control, myopia, myopia plus GF109203X, myopia plus PMA, myopia plus DMSO. PKC activities were detected by the non-radioactive methods. TGFß(2) and tyrosine hydroxylase (TH) proteins were analyzed by Western Blotting in retinal Müller cells. Dopamine was determined by the high-performance liquid chromatography-electrochemical detection in suspensions. RESULTS: After 14 days deprived, the occluded eyes became myopic with ocular axle elongating. Müller cells of guinea pigs were obtained using enzyme digestion. Compared with normal control group, the increase in PKC activity and the up-regulation in TGFß(2) expression were found in retinal Müller cells of myopic eyes, with the decrease of TH and dopamine content (P<0.05). After PKC activated by PMA, TGFß(2) and TH content were up-regulated with the increase of dopamine content (P<0.05). While the PKC activities was inhibited by GF109203X, proteins of TGFß(2) and TH were down-regulated in the myopic eyes, with the decrease of dopamine content (P<0.05). CONCLUSION: TGFß(2) and dopamine are modulated by PKC in Müller cells of the myopic eyes in guinea pig.

[Apoptosis and c-myc protein expression in the retinal of form-deprivation myopia].

OBJECTIVE: To study the apoptosis of retina and the expression of c-myc protein in form-deprivation myopia. METHODS: Two-day-old chickens were sutured with right eyelid for 4, 8 and 12 weeks. After measurement of refracation, the eyeballs were observed by light microscope and taken photos. Retinal apoptotic cells were measured by TUNEL staining and flow cytometry. C-myc protein were examined by immunohistochemistry and flow cytometry. RESULTS: Lacquer crack lesions were found in sutured eyes at 12 weeks. Apoptotic cells were observed in retinal outer and inner nuclear layer of the sutured eyes at 12 weeks and obvious peak of apoptosis was observed in sutured eyes at 12 weeks. The expression of c-myc protein was significantly more than control eyes at 8 and 12 weeks. CONCLUSION: The apoptosis of retinal was present in form-deprivation myopia with the degeneration of retina. C-myc protein plays an important role in retinal apoptosis of myopia.

[The treatment of retinal apoptosis by Caspase 3 inhibitor Ac-DEVD-CHO in experimental myopia].

OBJECTIVE: To investigate the mechanism of retinal apoptosis in chick experimental myopia and the therapy of Caspase 3 inhibitor Ac-DEVD-CHO. METHODS: Chick myopia was induced by lid-suture. After Ac-DEVD-CHO had been injected into vitreous, myopia was confirmed by optometry. Subsequently, chick eyeballs removed were measured its extro-dimensions, and the change of fundus were observed. Retinal apoptotic cells were determined by electron microscopy, TUNEL technique and flow cytometry. Retinal Caspase 3 proteins and its activities were measured by immunohistochemistry, flow cytometry and a colorimetric method using Ac-DEVD-pNA as a substrate. RESULTS: Ocular diopters and extro-diameters in all sutured eyes remarkly increased in comparison with its control eyes at 12 weeks after lid-suture. Lacquer crack lesions were found in 41 of 90 sutured eyes (45.56%). Apoptotic cells were observed in retinal outer and inner nuclear layer of the sutured eyes, and its apoptotic rate was significantly more than in control eyes (P < 0.05). Moreover, the expression of retinal Caspase 3 proteins and its activities were increased. After Ac-DEVD-CHO was injected into vitreous, the decrease of retinal apoptotic rate, Caspase 3 proteins and its activities was found. The treated effect of Ac-DEVD-CHO was in a dose dependent manner. CONCLUSIONS: Caspase 3 plays an important role in retinal apoptosis of chick myopia. Ac-DEVD-CHO can effectively ameliorate retinal apoptosis by blocked the effect of Caspase 3.