Application of spherical lens with 0.05 D intervals in optometry for small incision lenticule extraction in myopic eyes / 中华实验眼科杂志

Objective:To investigate the clinical value of spherical lens with 0.05 D intervals in optometry for small incision lenticule extraction (SMILE) in myopic eyes.Methods:A randomized controlled clinical study was conducted.Sixty patients (120 eyes) with low to moderate myopia and myopic astigmatism who underwent SMILE in the 989th Hospital of the PLA from June 2021 to February 2022 were enrolled.The patients were randomly divided into 0.05 D interval group (optometry with spherical lens at 0.05 D interval) and 0.25 D interval group (optometry with spherical lens at 0.25 D interval), with 30 cases (60 eyes) in each group.There was no significant difference in matched age, sphericity, cylindricity, and best corrected visual acuity (BCVA) (all at P>0.05). The preoperative monocular red-green balance, 1- and 3-month postoperative monocular red-green balance, uncorrected visual acuity and spherical equivalent of both groups were compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the 989th Hospital of the PLA (No.WZLL-2021-034). Written informed consent was obtained from each subject before any medical examination. Results:The preoperative red-green balance rate in 0.05 D interval group was 95.00%(57/60), which was higher than 35.00%(21/60) in 0.25 D interval group, showing a statistically significant difference ( Wald χ2=17.642, P<0.001). The 1- and 3-month postoperative red-green balance rates in 0.05 D interval group were 63.33%(38/60) and 56.67%(34/60), which were higher than 23.33%(14/60) and 21.67%(13/60) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=9.137, P=0.003; Wald χ2=7.483, P=0.006). The 1- and 3-month postoperative visual acuity in 0.05 D interval group were -0.1(-0.1, -0.1) and -0.1(-0.1, -0.1), which were higher than 0.0(-0.1, 0.0) and -0.1(-0.1, 0.0) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=11.624, P=0.001; Wald χ2=12.841, P<0.001). The 1- and 3-month postoperative spherical equivalent were -0.07(-0.25, 0.13)D and -0.13(-0.25, 0.13)D in 0.05 D interval group, which were higher than -0.13(-0.38, 0.25)D and -0.13(-0.38, 0.25)D in 0.25 D interval group respectively, showing no statistically significant difference between the two groups ( Wald χ2=0.029, P=0.866; Wald χ2=0.189, P=0.664). Conclusions:Compared with spherical lens at 0.25 D interval, 0.05 D interval can improve the accuracy of preoperative and postoperative red-green balance rate and postoperative visual acuity in patients with low to moderate myopia who undergo SMILE.

Identification of COL3A1 variants associated with sporadic thoracic aortic dissection: a case-control study / 医学前沿

Thoracic aortic dissection (TAD) without familial clustering or syndromic features is known as sporadic TAD (STAD). So far, the genetic basis of STAD remains unknown. Whole exome sequencing was performed in 223 STAD patients and 414 healthy controls from the Chinese Han population (N = 637). After population structure and genetic relationship and ancestry analyses, we used the optimal sequence kernel association test to identify the candidate genes or variants of STAD. We found that COL3A1 was significantly relevant to STAD (P = 7.35 × 10

Nested case-control study on paediatric early warning score and ventilator-associated complications in children with acute respiratory distress syndrome / 中南大学学报(医学版)

To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS).
 Methods: A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University, who underwent mechanical ventilation, were selected. The baseline data, blood gas analysis index, laboratory test index, ventilator parameters, pediatric critical illness score (PCIS) and PEWS in the children were recorded. With reference to ventilatory treatment results, the children with ventilator-associated complications were included in the trial group (n=20), while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study. Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment.
 Results: There were statistically significant differences in multiple organ dysfunction syndrome (MODS), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2), serum creatinine (SCr), albumin (ALB), blood urea nitrogen (BUN), mechanical ventilation time, mean article pressure (MAP), tidal volume (VT), positive end-expiratory pressure (PEEP), PCIS, PEWS between the control group and the experimental group (all P<0.05). Multivariate logistic regression analysis showed that MODS, PaO2/FiO2, PaCO2, VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05).
 Conclusion: The MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS exert effects on complications after mechanical ventilation in children with ARDS. PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.

The effect of nutrition intervention on the body composition and blood glucose in newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity / 中华预防医学杂志

Objective@#To study the effect of nutrition intervention on the body composition and blood glucose in newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity.@*Methods@#A total of 84 newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity were selected from the department of endocrinology in China-Japan Friendship Hospital from April 2015 to December 2016. Basic information and body composition of these patients were collected and measured. Also the food frequency questionnaire (FFQ) was used to investigate the dietary status in the past month, and calculate the intake of energy, three major nutrients and dietary fiber. All patients received nutrition intervention by nutritionist for three months as requested by Diabetes guidelines. After 3-month intervention, blood glucose, body composition and dietary status were examined again. Relevant indicators of patients were compared before and after the intervention. All patients were divided into three groups according to the degree of body mass index (BMI)′s change: <5%, 5%-10% and >10%. The differences of body weight, muscle, body fat rate, visceral fat index and blood glucose level among three groups were quantified.@*Results@#There were 53 male patients with age (41.5±8.9) years and HbA1c (7.5±0.4)%, and 31 female patients with age (40.1±8.5) years with HbA1c (7.6±0.5)%. The intake of energy, carbohydrate and fat of patients were significantly decreased (P<0.05) and dietary fiber was significantly increased (P<0.05) after nutrition intervention. The body weight, muscle mass, fat mass and visceral fat index were also significantly decreased (P<0.05). The average decrease of fat was about 2.8 kg accounting for 73.7% (2.8 kg/3.8 kg) of the total weight loss. The body fat rate decreased from (31.2±3.1)% to (28.8±3.2)% (P<0.05). The fasting blood glucose and postprandial blood glucose were both decreased significantly after intervention (P<0.05). Among three BMI decreased groups, there was no significant difference in body weight and muscle mass (P>0.05), but a significant difference in body fat rate and visceral fat index (P<0.05). The body fat rate, visceral fat index, fasting blood glucose and postprandial blood glucose had more decreases with the greater amount of weight loss (P<0.05).@*Conclusion@#The three-month nutrition intervention could change the dietary habit and components of patients with type 2 diabetes mellitus by reducing the blood glucose, body fat rate and visceral fat index significantly. The degree of reduced BMI is positively related to the decrease of fasting blood glucose and postprandial blood glucose.

Changes of serum ferritin and hepidin in elderly patients with chronic heart failure and their clinical signif-icance / 实用医学杂志

Objective To investigate the correlation of serum(SF)and hepcidin(Hepc)level with cardi-ac function and chronic heart failure(CHF).Methods A total of 80 elderly patients with CHF who had received treatment in our hospital from October 2015 to February 2017 were assigned to CHF group and 80 patients without heart failure were assigned to a control group. Serum SF and hepidin levels in both the groups were measured and compared.Results Serum hepidin and hs-C-reactive protein levels were all significantly higher in CHF group than in the control group[(69.58 ± 27.16)ng/ml vs.(128.46 ± 33.28)ng/mL;(97.16 ± 16.81)ng/mL vs.(54.12 ± 15.76)ng/mL;(3.3 ± 1.64)mg/L vs.(2.78 ± 1.36)mg/L].Multiple logistic regression analysis showed that SF was an independent protective factor for CHF(P < 0.05);Hepc and hs-CRP were independent risk factors for CHF (P<0.05).Conclusions Serum hepcidin and hs-C-reactive protein may be risk factors for chronic heart failure. Measurement of serum hepidin and hs-CRP levels is helpful for early prevention and treatment of heart failure.

The effect of liver function on the awake BIS value / 临床麻醉学杂志

Objective The main objective of this study is to explore the effect of liver function on the awake BIS value.Methods According to the Child-Pugh classification,65 patients were divid-ed into three groups.Group A (n=27):patients with normal liver function;group B (n=21):pa-tients with Child-Pugh A;group C (n=1 7):patients with Child-Pugh B-C.The awake BIS value at rest was measured.Results Total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin (IBIL),alanine aminotransferase (ALT),aspartate aminotransferase (AST),albumin (ALB)of group B and C were significantly poorer than group A (P <0.05 or P <0.01).The coagulation func-tion of group C was poorer than group A and B (P <0.01).Compared with group A (96.2 ± 1.7) and group B (95.6±0.8),the awake BIS value of group C (94.1±3.0)was significantly reduced (P<0.01).The awake BIS value was negatively correlated with the TBIL value (r = - 0.26,P =0.039).Conclusion The awake BIS value in end-stage liver disease patients was significantly lower than that in patients with normal liver function and mild liver dysfunction.The awake BIS value may be related with the amount of total bilirubin in the blood.

Accuracy of continuous noninvasive hemoglobin monitoring in patients undergoing cesarean section / 中华麻醉学杂志

Objective To evaluate the accuracy of continuous noninvasive hemoglobin ( Hb ) monitoring in the patients undergoing cesarean section. Methods A total of 200 patients, at 36-42 weeks of gestation, aged 19-40 yr, with body mass index of 20.5-35.1 kg∕m2 , of ASA physical statusⅠorⅡ, undergoing elective cesarean section from June 2014 to October 2014 in our hospital, were enrolled. A sensor was positioned at patient′s finger and connected to the Masimo Radical?7 Pulse CO?Oximeter, a continuous noninvasive Hb measurement device. Noninvasive Hb obtained with Pulse CO?oximeter ( SpHb) was recorded. Before skin incision ( T0 ) , after delivery of the placenta ( T1 ) , after suturing the uterus ( T2 ) and at the end of operation ( T3 ) , blood samples from the radical artery were collected for determination of total Hb ( tHb) , and SpHb was also recorded. The agreement between two methods was assessed using Bland?Altman analysis. Results At T0-T3, tHb was 111±9, 103±8, 94±8 and (89±7) g∕L, respectively, and SpHb was 124 ± 9, 120 ± 12, 108 ± 9 and ( 103 ± 8 ) g∕L, respectively. Bland?Altman analysis showed that at T0-T3 , the mean difference between SpHb and tHb was 13.5, 17.1, 14.1 and 13.9 g∕L, respectively, and 95% confidence interval was 13.1-13.9, 16.5-17.7, 13.6-14.6 and 13.4-14.4 g∕L, respectively. The limit of agreement was 8.4-18.6, 9.1-25.1, 7.8-20.4 and 7.4-20.4 g∕L at T0-T3 , respectively, and the interchangeable limits of the two methods ranged between 3.5-23.5, 7.1-27.1, 4.1-24.1 and 3.9-23.9 g∕L at T0-T3 , respectively. The repeatability coefficient of tHb and SpHb was 16.5 and 15.8 g∕L, respectively. The relative error of SpHb was (4.6±1.0)%, (5.3±1.4)%, (4.9±1.2)% and (4.8±1.2)% at T0-T3, respectively. Conclusion Continuous noninvasive Hb monitoring provides good accuracy in the patients undergoing cesarean section.

Investigation of the relationship between antihypertensive medication and orthostatic blood pressure changes in the elderly hypertensive inpatients / 中国医师杂志

Objective To observe the incidence of orthostatic hypotension and hypertension in the elderly hypertensive inpatients and investigate the effect of antihypertensive medication on the orthostatic blood pressure changes in the elderly hypertensive inpatients.Methods A total of 185 aged hypertensive inpatients was divided into elderly group(n =126,60～79 years old) and very elderly group(n =59,≥80 years old) according to the age.The orthostatic blood pressure was measured in supine position and after standing.Subjects were divided into 3 subgroups:orthostatic hypotension (OH),orthostatic hypertension (OHT),and orthostatic normotension (ONT) groups according to the standing blood pressure levels.Clinical characteristics of each subgroup were evaluated and analyzed according to the antihypertensive medication.Results Among 185 patients,the OH incidence was 31 (16.76％) cases,the OHT incidence was 23 (12.43 ％) cases,and the ONT incidence was 131 (70.81％) cases.There were 16 (12.70％) patients with OH and 10(7.90％) patients with OHT in elderly group,but 15 (25.42％) patients with OH and 13 (22.03％) patients with ONT in very elderly group.The prevalence of OH and OHT in each elderly group was both higher than elderly group (P ＜ 0.05).Antihypertensive medications such as Calcium channel blockers,angiotensin Ⅱ receptor-blockers,Beta-blockers,diuretics,and angiotensin converting enzyme inhibitors were not significantly different among three subgroups.Conclusions OH and OHT were common in the elderly hypertensive inpatients,especially in the very elderly people.The five-class antihypertensive medication that doctors commonly used at present might be not related to the orthostatic hypotension and hypertension.

[A hardware-in-the-loop simulation model of the cardiovascular system for ventricular assist device evaluation].

This paper presents a novel technique for evaluating the performance of ventricular assist devices in vitro, innovatively combining dynamic physical testing of assist devices with a mature, numerical human cardiovascular model. Based on this technique, one self-made direct mechanical ventricular assistance (DMVA) prototype is tested. With the true representation of device performance in vivo, the real-time interactions between DMVA and the cardiovascular system are captured and studied. Hemodynamic simulations under DMVA are performed. Experimental results demonstrate that it provides a useful tool for the study of device assist impact on the cardiovascular system as well as the improvement of device structure and effectiveness of control mechanism.

Design and control of a simulating cardiovascular system / 生物医学工程学杂志

In order to study the cardiovascular hemodynamic characteristics and evaluate the artificial heart, especially the compression cardiac assist devices, we put forward a simulating device which is made of pump, valve, tubes and controller, and can be used to imitate cardiovascular system. Moreover, in this essay, we put forth an algorithm to draw pressure-volume loop with the parameters measured, including liquid pressure, volume and air pressure. The changes in the frequency and duty of control signal and in the angle of proportional valve can symbolize cardiovascular system in different heart rates, with different systole period, and at different level, respectively. The result of simulating device experiment proved to be coincident with physiology.

Vitreoretinal surgery for complicated rhegmatogenous retinal detachment / 第三军医大学学报

Objective To evaluate the efficacy of vitreoretinal surgery for the treatment of complicated rhegmatogenous retinal detachment and to study the correlated factors affecting the surgical outcomes. Methods Complete follow up data from 103 patients (eyes) with complicated rhegmatogenous retinal detachment treated with vitreoretinal surgery were analyzed retrospectively. Conditions of the eyes included macular hole in 21 eyes [with proliferative vitreoretinopathy (PVR) stage C2 or more serious in 12 eyes], giant hole in 11 eyes, and PVR stage C2 to D3 in 71 eyes. Filling with C3F8 was performed in 82 eyes, and silicone oil in 21 eyes. A follow up for 3-18 months was conducted. Results The reattachment of retina was achieved in 99 eyes (96.1%) and functional success in 68 eyes (66.0%). In eyes with functional success, visual acuity of 0.02-0.08 was achieved in 18 eyes, 0 1-0 4 in 39 eyes, 0.5-0.9 in 10 eyes, and 1.0 in 1 eye. Conclusion Vitreoretinal surgery is an effective way for the management of complicated rhegmatogenous retinal detachment. Early surgery may result in satisfactory surgical outcomes.