Objective:To evaluate the effect of anti-vascular endothelial growth factor (VEGF) in patients with wet age-related macular degeneration (wAMD) and investigate the recurrence factors.Methods:In this case-control study, 40 eyes of 38 patients with wAMD treated by anti-VEGF therapy in Xijing Hospital from October 2015 to April 2017 were included.Ranibizumab or conbercept was consecutively intravitreally injected monthly under 3+ pro re nata (PRN) regimen.All included patients were followed-up at least 12 months.The best corrected visual acuity (BCVA) was expressed in logarithm of the minimum angle of resolution (LogMAR) units.Optical coherence tomography (OCT) was used to observe the morphologic characteristics of macula and measure the central retina thickness (CRT). Patients were divided into recurrence and recurrence-free group based on whether recurrence occurred during follow-up.Potential associated factors with recurrence after treatment were analyzed by multivariate logistic regression analysis.Meanwhile, the morphological and functional response were identified at 1 month after loading phase as well as at last follow-up visit.This study protocol was approved by the Ethics Committee of Shanghai General Hospital (No.2016KY243) and written informed consent was obtained from each patient prior to receiving injection.Results:All the operative eyes showed retinal effusion absorption at least once, and 21 (52.5%) eyes had relapse during follow-up.The patients with lower BCVA (LogMAR) value at the first absorption time had higher risk of recurrence ( OR=16.7, 95% CI=1.22-100, P<0.05). The eyes in the recurrence group received more times of treatment than eyes in the recurrence-free group (5.8±2.3 vs 3.5±1.4, t=3.64, P<0.05). However, there was no significance between the two groups in BCVA change before and after treatment ( t=-1.52, P>0.05). In the recurrence group, the BCVA (LogMAR) and CRT at last visit were 0.73±0.34 and (187.2±81.7)μm respectively, while were significantly improved in comparison with 0.81±0.37 and (234.2±74.5)μm at the relapse time ( t=2.14, 2.62; both at P<0.05). There were 87.5% (35/40) eyes showed good morphological responses at 1 month after the loading phase while 12.5% (5/40) eyes presented poor morphological responses, the retinal effusion was absorbed after additional (3.2±2.2) times of injections.The BCVA of eyes with a good morphological response at 1 month following loading phase was better than that at the first retinal effusion absorption time ( t=-2.23, P<0.05). Average CRT at last visit was significantly decreased in comparison with the baseline CRT ( Z=-4.62, P<0.01). Conclusions:For wet AMD patients, the anti-VEGF treatment is safe and effective in the short term, while there is still a high rate of recurrence.More attention should be paid to eyes with better vision at the first time of retinal effusion absorption which may have more chance to experience recurrence.Patients need long-term follow-up after treatment to prevent recurrence.In addition, the complete loading treatment is needed for patients who have a good morphological response after the first retinal effusion absorbed.

Objective To investigate the level and its influencing factors of quality of life for burn patients undergoing amputation,and take treatment measures for clinical nursing. Methods The single factor analysis method was taken on the burn patients undergoing amputation in different social demographic characteristics from January 2013 to July 2016. Results The score of quality of life was (56.08 ± 17.97) points,and the four dimensions scored as physical function (63.64 ± 27.51) points, mental health(54.76±20.28)points,social relations(58.71±19.19)points and general health(46.00±18.61)points, which were at a low level.Multiple regression analysis showed that the influencing factors of quality of life were patient education, marital status, cost source, economic conditions, prosthetic replacement, and amputation site,which had a statistically significant difference between the effects on the quality of life(F/t=4.367,3.836,4.436,4.412,2.916,4.591,P<0.01)and into stepwise multiple regression equations.The patient′s age and career had statistically significant(F=3.495,3.640,P<0.05),but not into stepwise multiple regression euqtions. Conclusions Burn patients undergoing amputation are physical and spiritual double whammy,through to the influencing factors,clinical medical staff to be able to make this part of the population cause enough attention,enhancing the quality of life,strive for an early return to family and society.

OBJECTIVETo explore significance of serum soluble CD163(sCD163) and soluble CD25(sCD25) in diagnosis and guiding treatment of children with hemophagocytic lymphohistiocytosis (HLH).

METHODData of 42 cases of children with HLH, 32 cases of non-HLH children with infection presented to First Affiliated Hospital of Zhengzhou University pediatric clinic and ward were collected from December 2013 to December 2014. Twenty-four healthy children were enrolled into a normal control group in the same period.Peripheral venous blood specimens (3 ml) were taken from the children with HLH after fasting before treatment, two weeks after treatment and eight weeks after treatment.Peripheral venous blood specimens (3 ml) were also taken from children of non-HLH infected group and normal control group after fasting at the initial visit. Serum sCD163 and sCD25 levels in the peripheral blood in three groups were determined by ELISA. According to cause of disease, children with HLH were divided into infection-related HLH, tumor-related HLH, primary HLH and others; relationship between serum sCD163 and sCD25 level and cause of disease was analyzed.

RESULTSerum sCD163 of HLH group ((6 094 ± 2 769) µg/L) and serum sCD163 of non-HLH infection group ((2 174 ± 950) µg/L) were significantly higher than that of normal control group ((777 ± 256) µg/L), F=71.396, P<0.05), and the differences among groups were statistically significant (P<0.05); serum sCD25 of HLH group ((41 963 ± 31 821) ng/L) and serum sCD25 of non-HLH infection group ((6 700 ± 4 105) ng/L) were significantly higher than that of normal control group ((2 440 ± 1 870) ng/L, F=37.513, P<0.05).There was no statistically significant difference between the non-HLH infection group with the normal control group (P>0.05), and the difference between the remaining groups was statistically significant (P<0.05). And serum sCD163 and sCD25 level of HLH group had a positive linear correlation, and Pearson correlation coefficient r=0.742 (t=7.000, P<0.05). The difference of serum sCD163 and sCD25 level among the different cause of disease in HLH group was significant (P<0.05).Pairwise comparison showed that serum sCD163 and sCD25 level of tumor-associated HLH group significantly increased as compared with infection-associated HLH group (P<0.05), but the difference was not statistically significant between the other groups (all P>0.05). Serum sCD163 and sCD25 level of HLH group before treatment, 2 weeks and 8 weeks after treatment showed a statistically significant tendency of decrease (P<0.05). Seen from the ROC curve, when sCD163 cut-off point was 2 359.08 µg/L, the diagnostic sensitivity was 83.3%, and specificity was 83.9%.When sCD25 cut-off point was 14 901.024 ng/L, the diagnosis sensitivity was 76.2%, and specificity was 98.2%.

CONCLUSIONSerum sCD163 and sCD25 levels may be used for diagnosis of HLH.Dynamically monitoring of serum sCD163 and sCD25 level can help to determine deterioration of HLH and guide treatment.

Antigens, CD ; blood ; Antigens, Differentiation, Myelomonocytic ; blood ; Case-Control Studies ; Child ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-2 Receptor alpha Subunit ; blood ; Lymphohistiocytosis, Hemophagocytic ; blood ; diagnosis ; therapy ; ROC Curve ; Receptors, Cell Surface ; blood ; Sensitivity and Specificity

Objective:To analyze the optical coherence tomography (OCT) imaging characteristics in patients with Coats disease and their value in predicting macular fibrosis.Methods:A nested case-control study was performed.A total of 43 patients (43 eyes) diagnosed with Coats disease through color fundus photography, ocular B-scan ultrasonography, fundus fluorescein angiography, and spectral-domain OCT examination were enrolled from January 2008 to October 2021 at the Xijing Hospital.Among them, there were 40 males and 3 females, aged from 2 to 60 years old, with a median age of 13 years.Macular fibrosis was used as an indicator of poor prognosis, and patients were divided into two groups based on whether macular fibrosis occurred at the end of follow-up.The differences in OCT characteristics between two groups were compared and logistic regression analysis was used to identify the risk factors for macular fibrosis.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Xijing Hospital of Fourth Military Medical University (No.KY20202009-C-1).Results:The OCT clinical features of 43 cases of Coats disease included intraretinal hard exudates in 43 eyes (100%), subretinal fluid in 21 eyes (48.8%), macular cysts in 17 eyes (27.9%), subretinal exudates in 9 eyes (20.9%), anterior retinal hyperreflective dots in 7 eyes (16.3%), epiretinal membrane in 21 eyes (48.8%), and intraretinal fluid in 22 eyes (51.2%).In color fundus photos of 41 eyes, 38 eyes (93.0%) had hard exudates distributed in the posterior pole and 27 eyes (65.9%) had the mid-peripheral region.OCT examination showed that hard exudates were distributed in the inner nuclear layer in 35 eyes (81.4%) and the outer nuclear layer in 33 eyes (76.7%).Among 21 eyes with exudative retinal detachment detected by OCT, 9 eyes (42.9%) were detected by fundus photography and 18 eyes (85.7%) were detected by B-scan ultrasonography.The proportions of eyes with subretinal fluid and subretinal exudates were higher in the macular fibrosis group than in the non-macular fibrosis group, and the differences were statistically significant ( χ2=20.755, P<0.001; χ2=6.133, P=0.013).Logistic regression analysis showed that the presence of subretinal fluid was a risk factor for macular fibrosis (odds ratio=48.345, 95% confidence interval: 4.272-547.066, P=0.002). Conclusions:OCT examination can detect subretinal fluid, subretinal exudates, macular cysts, macular exudates, and hyperreflective spots in the retina of patients with Coats disease.Subretinal fluid is a risk factor for macular fibrosis.

Objective:To explore the current status of quality of life in domestic patients with extremely severe burns during the rehabilitation period and its influencing factors, so as to provide guidance for early clinical psychological intervention and continuous nursing.Methods:From June 2016 to June 2020, convenience sampling was adopted to select 168 patients with extremely severe burns admitted to the Burn Department of 22 ClassⅢ Grade A hospitals in China as the research subject for questionnaire survey. The questionnaire included the Burn Specific Health Scale-Chinese Version and the General Information Questionnaire. Multiple linear regression analysis was used to determine the factors affecting the quality of life of patients with extremely severe burns during the rehabilitation period.Results:The initial quality of life score for patients with extremely severe burns during the rehabilitation period was (157.27±30.61) , and the final quality of life score was (49.14±9.56) . The final scores of the quality of life in each field were ranked from high to low in the order of social relations, general health, physical function, and mental health. Multiple linear regression analysis showed that the factors affecting the quality of life of patients with extremely severe burns during the rehabilitation period included gender, age, education level, marital status and source of expenses ( P<0.05) . Conclusions:The quality of life of patients with extremely severe burns in my country during the rehabilitation period is at a relatively low level. Nurses should strengthen the psychological intervention of patients during hospitalization and carry out continuous nursing according to the relevant factors that affect the quality of life of patients.

The Chinese Standard Aphasia Examination was made according to Chinese language and cultural habits by referring to Japanese Standard Language Test of Aphasia.151 normal people and patients whose brain damaged without aphasia were tested.Mean and standard deviations were calculated.The significant differences were not found by analysis of variance to age,sex,handedness,profession and education except oral instruction and describing pictures in different educational groups.Therefore,the examination is suitable for Chinese aphasics who live in different parts of China and spoken mandarin.

Objective: To study the quality of life and its influencing factors of patients with deep partial-thickness and above burns on head and face at discharge, and to guide clinical nurses to provide targeted nursing for patients. Methods: A cross-sectional survey was conducted on 42 patients with deep partial-thickness and above burns on head and face who met the inclusion criteria. The patients were hospitalized from January 2014 to November 2017 in the Department of Burns and Plastic Surgery of our hospital and were selected by adopting the convenient sampling method. On the day before discharge, the Chinese version of the Abbreviated Burn Specific Health Scale was used to assess the scores in various fields of patients′ quality of life and total scores. The self-designed general situation questionnaire was used to investigate the gender, age, education level, occupation, marital status, cause of injury, and source of expenses of patients, and the scores in various fields of quality of life of patients in various general conditions and total scores were recorded. Data were processed with t test or one-way analysis of variance. The indicators with statistically significance in the total score difference in the above analysis were chosen, and multivariate linear regression analysis was performed to screen the factors influencing the quality of life of patients. Results: Totally 42 groups of questionnaires were sent out and 42 groups of valid questionnaires were retrieved. The effective recovery rate was 100%. The total score of quality of life of patients at discharge was (49±10) points. The scores of general health status (57±23) points, social relations (56±18) points, physical function (49±17) points, and mental health (41±20) points were ranked from high to low. There were statistically significant differences in the scores of physical function, mental health, and general health status among patients of different age groups (F=8.115, 14.182, 19.285, P<0.01). There were statistically significant differences in the scores of mental health, social relations, and general health status among patients with different educational levels (F=3.312, 51.176, 21.852, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status among patients with different occupations (F=3.667, 2.947, P<0.05). The scores of mental health and social relations of married patients were significantly higher than those of unmarried patients (t=27.096, 4.885, P<0.05 or P<0.01). There were statistically significant differences in the scores of physical function, mental health, social relations, general health status of patients with different causes of injury (F=3.000, 5.438, 4.005, 9.125, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status of patients with different sources of expenses (F=10.456, 3.368, P<0.05 or P<0.01). The total scores of quality of life of patients with different gender and causes of injury were similar (t=0.407, F=1.145, P>0.05); there were statistically significant differences in the total scores of quality of life of patients of different age groups, with different education levels, occupations, sources of expenses, and marital status (F=2.947, 17.064, 9.324, 4.101, t=7.225, P<0.05 or P<0.01). Multivariate linear regression analysis showed that age, education level, occupation, marital status, and source of expenses were the factors influencing the quality of life of patients at discharge (t=-2.437, 8.037, -2.994, 5.016, 3.519, P<0.05 or P<0.01). Conclusions The quality of life of patients with deep partial-thickness and above burns on head and face is at a low level at discharge. The influencing factors include age, education level, occupation, marital status, and source of expenses. Nurses should screen the relevant items when the patient is hospitalized. Emphasis should be laid on young, with undergraduate and above education, unmarried, self-funded patients, and those engaged in occupations with high facial requirements, to minimize the negative mood of patients, encourage them to face life, choose the right career, and improve their quality of life.

Objective To investigate the clinical effect of acupotomology combined with Bushenzhuanggu prescription in the treatment of residual lumbar pain after percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fractures.Methods A total of 77 patients with PKP postoperative residual lumbar pain admitted to the Department of Orthopedics,Ningbo Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2018 to December 2021 were randomly divided into control group and observation group.Patients in control group were treated with calcitriol soft capsules and calcium carbonate D3 tablets,and patients in observation group were treated with acupotomy combined with Bushenzhuanggu prescription.The pain degree,lumbar function and self-care ability of the two groups were compared.Results After treatment,the pain level,lumbar function,and self-care abilityof the two groups of patients improved compared to before treatment.Compared with control group,the visual analogue score(VAS)score and Oswestry disability index(ODI)index of observation group decreased more significantly,and the difference was statistically significant(P<0.05);The Barthel index of observation group increased more significantly in the early stage(3 days and 1 month after treatment),with a statistically significant difference(P<0.05).However,there was no statistically significant difference in Barthel index between the two groups at 3 months after treatment(P>0.05).Conclusion Acupotomy combined with Bushenzhuanggu prescription has satisfactory clinical efficacy in the treatment of residual lumbar pain after PKP operation of osteoporotic vertebral compression fracture.It can significantly reduce pain,improve lumbar function,shorten the improvement time of patients'self-care ability,improve patients'quality of life,and effectively promote patients'rapid recovery.

Skin ulcers are the most prevalent consequence of diabetes mellitus, and people with diabetic ulcers have a substantially greater death risk than those who do not have ulcers. Herbal medications have gained wide concern in recent years due to their multi-component, multi-target, and multi-pathway synergistic therapeutic effects. Clinical trials have demonstrated the safety and efficacy of herbal treatments in diabetic refractory ulcers. To systematically evaluate the healing effect of herbs on diabetic wounds, a literature search was conducted, the mechanism of action of 15 herbal extracts in promoting diabetic wound healing were reviewed, and the classification based on traditional Chinese medicine theory was discussed, which could provide a reference for the precise treatment and exploitation of herbal medicines for diabetic ulcers.