Twenty-six eyes which appeared rejection after allograft penetrating keratoplasty between April 2003 and April 2004 in Shandong Shi'erming Eye Hospital were collected, including 16 males and 10 females, 9 cases were repeated relapsing viral keratitis, 8 cases were traumatic posterior corneal leucoma, 5 cases were corneal decompensation caused by various intraocular surgery, 2 cases were congenital leucoma, and 2 cases had other symptom. The rejection occurred at 2 month to 2.5 years after operation. Among them 19 cases were transferred to our hospital and asked adding traditional Chinese therapy because western medicine was ineffective in other hospital. All cases were received local treatment with hormone and non-steroidal anti-inflammatory eyedrop, some cases applied systemic administration with glucocorticoid, mainly based on eye black immunosuppression decoction, potion daily, twice per day, the average time of medication was 11-42 days. Clinical symptoms were served as observation indexes, results showed that the total effective rate of the 26 cases were 100%. The bulbar conjunctiva hyperemia and edema was reduced, corneal opacity became light, and rejection was complete response in 9 cases, 5 of 19 cases which were transferred to our hospital were exempted from operation, and the average vision was improved three lines. It was found that purging liver and eliminating dampness compound Chinese medicine can rapidly reduce anterior chamber's inflammatory response and backoff corneal neovascularization in clinical practice.

OBJECTIVE:To study the percutaneous permeability of methoxypsoralen liposomal gel METHODS:The preparations were applied on the rat skin in vitro and in vivo with common gel and Mingbailing tincture as control,and the drug concentrations in the receiver,skin,blood and other organs were determined by RP-HPLC RESULTS:In vitro experiment,liposomal gel showed the lowest percutaneous permeation rate and the highest retention in skin In vivo studies illuminated that the skin depositions of drug encapsulated in liposome was(4 37?0 91) and (3 36?0 58) times those of the common gel and tincture respectively CONCLUSION:Methoxypsoralen liposomal gel showed an evident targeting effect on skin

Hypertension is classified to fire-heat constitution,yang deficiency constitution,phlegm-wet constitution and yin deficiency causing predominant yang constitution on base of consititutional theory. The therapeutic method of TCM is to modify the unbalance of constitution of hypertension patient.

Objective To explore the therapeutic effect of combining continuous venovenous hemofiltration (CVVH) with hemoperfusion (HP) on patients with septic shock.Methods A prospective study was conducted. Thirty-two patients with septic shock admitted to Changshu No.1 People's Hospital were enrolled, and they were divided into two groups according to random digits table. The observation group (17 cases) was given HP before CVVH, in the control group (15 cases), only CVVH treatment was carried out, and lasting for 5 days in both groups. The changes of pulse oxygen saturation (SpO2), central venous pressure (CVP), systemic vascular resistance index (SVRI), cardiac index (CI), extra-vascular lung water index (EVLWI) were observed before treatment and 5 days after treatment.Results Compared with those before treatment, the levels of SpO2, CVP, SVRI, CI were obviously elevated, and EVLWI was markedly decreased after treatment in two groups. Compared with those of control group, the degrees of improvement of above indicators in observation group were more prominent [SpO2: 0.966±0.035 vs. 0.939±0.036, CVP (mmHg, 1 mmHg = 0.133 kPa): 8.5±3.2 vs. 8.1±4.2, SVRI (kPa·s·L-1·m-2): 1 497.35±157.08 vs. 1 343.60±144.48, CI (mL·s-1·m-2): 120.36±15.34 vs. 106.69±12.33, EVLWI (mL/kg): 6.84±0.73 vs. 7.65±0.70, allP < 0.05].Conclusion Combing HP with CVVH for treatment of patients with septic shock can improve their prognosis more obviously than using CVVH alone.

Objective: To examine and analyze the nm23, p16 gene expression in gastric cancer tissure,and follow up patients 5 years to discuss the relationship between nm23 and p16 gene synergy expression and gastric cancer biological characteristic and prognosis.Methods: nm23 and p16 protein in gastric cancer tissue and control were detected by immunohistochemistry,and the patients had been followed up for 5 years. Results: In 84 samples of gastric cancer, nm23 positive rate was 46.43%, p16 was 44.05%, the positive rate of gastric cancer tissue and metastasitic lymph node was lower than that of normal control, normal tissue near cancer or benign polyp,and these two genes were related to the depth of tumor invasion and clinical stage.The mortality and recurrence-metastasis rate was higher in these low expression group, and had a shorter median survive period. Conclusion: Abnormal expression of nm23 and p16 gene plays a important role in gastric cancer recurrence and devolepment and may be one of markers for evaluating tumor biological behavior and prognosis.

Objective: To evaluate the prevalence and consistency of screening myopia, non-cycloplegic myopia and cycloplegic myopia in children and adolescents, and to provide references for exploring the factors affecting the consistency of different definition methods. Methods: A total of 3 868 children and adolescents aged 6 to 17 years from seven schools were included in a school based cross sectional study in Shandong Province in September 2020. The prevalence of screening myopia, non cycloplegic refraction, and cycloplegic refraction at different ages and all children and adolescents were analyzed. With cycloplegic spherical equivalent ≤-0.50 D as the gold standard for myopia, and Kappa test and area under the ROC curve were used to evaluate the consistency. Results: The prevalence of cycloplegic myopia and screening myopia were 36.7% and 38.3% among children and adolescents. The prevalence of non cycloplegic myopia was 62.4%, which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools. Among 3 868 subjects, there were 3 628 (93.8%) subjects with screening myopia and 2 862 (74.0%) subjects with non cycloplegic myopia who were consistent with the gold standard for myopia. The Kappa values of screening myopia and non cycloplegic myopia were 0.87 and 0.51, and the area under the ROC curve was 0.94 (95% CI =0.93-0.95) and 0.79 (95% CI =0.78-0.81). Compared with other groups, children and adolescents aged 8 to 17 years, in junior or high school, urban residence, better presenting distance visual acuity, and astigmatism ≤1.50 D had a higher consistency in the application of screening myopia ( P <0.05). Conclusion The consistency between screening myopia and cycloplegic myopia is high, and the consistency between non cycloplegic objective myopia is low.

Objective To evaluate the diagnostic value of MRI-measured fetal percent predicted lung volume (PPLV) for the prognosis of left congenital diaphragmatic hernia (CDH) in fetus. Methods Clinical data of 32 children who were admitted to Women and Children's Medical Center of Guangzhou from September 2012 to December 2017 for prenatally diagnosed left CDH were retrospectively analyzed. These children were divided into two groups, the survival group (n=24) and the death group (n=8), according to the postoperative outcomes at 30 days after CDH repair. Moreover, they were also divided into non-pulmonary hypertension (non-PH) group (n=20) and PH group (n=12), based on whether they suffered from PH or not. Clinical data such as gestational age, birth weight, Apgar score and PPLV values in different groups were compared with t- or Fisher's exact test. The receiver operating characteristic (ROC) curve of the MRI-measured fetal PPLV values of the 32 children was plotted. Results (1) Comparing with the death group, fetal PPLV was significantly higher [(39.5±2.5)% vs (20.4±2.1)%, t=4.27], the gestations on initial diagnosis of CDH was later [(31.6±4.2) vs (25.4±4.6) gestational weeks, t=3.40], Apgar score of the neonates at 5 min was higher (8.7±1.5 vs 5.7±3.8, t=3.26), and fewer cases of PH were reported in the survival group [16.7% (4/24) and 8/8], all P<0.01. The area under the ROC curve of PPLV values for mortality prediction was 0.930 (95%CI: 0.843-1.016, P<0.01). When the PPLV value was 28.55%, its sensitivity and specificity for death prediction in children with left CDH were 100% and 79%, respectively. (2) Comparing with the PH group, fetal PPLV was significantly higher [(41.7±2.6)% vs (23.0±2.0)%, t=4.98], the gestations on initial diagnosis of CDH was later [(32.3±3.4) vs (26.3±5.2) gestational weeks, t=3.81], neonatal Apgar score at 5 min was higher (8.6±1.4 vs 6.8±2.5, t=2.62) and death rate was lower [0(0/20) vs 8/12] in the non-PH group (all P<0.01). The area under the ROC curve of the PPLV values for predicting PH was 0.902 1 (95%CI : 0.800-1.004, P＜0.01). When the PPLV value was 33.67%, its sensitivity and specificity for PH prediction was 100% and 75%, respectively. Conclusions Prenatal MRI measurement of PPLV can be used to predict death or as a warning sign of PH in children with left CDH, which may provide evidence for prenatal evaluation and rational clinical decision-making.

BACKGROUNDThis research aims at identifying relative interventions on trachoma and testing the effectiveness of control measures adopted by assessing its prevalence and related risk factors in Shandong province of China.

METHODSTrachoma rapid assessment (TRA) was conducted in 6 sub-districts selected from Shandong province based on primary high risk assessment. Active trachoma in children aged 1-9 years and environmental risk factors of trachoma (unclean faces, absence of running water, and absence of flush toilets) were assessed (TRA 1). Control measures were taken in endemic areas. A second TRA (TRA 2) was conducted after 12 months in the same 6 districts and findings of the two TRAs were compared.

RESULTSIn TRA 1, we found trachoma in 3 sub-districts and the detection rate was 4% (95% CI: 0.39%-11.12%), 6% (95% CI: 1.18%-14.17%), and 6% (95% CI: 1.18%-14.17%) respectively. We could not find trachoma cases in TRA 2. Research data supports that children living with environmental risk factors face an increased risk to active trachoma. However, we could not find statistical evidence for this association, which may be caused by the limited data on prevalence.

CONCLUSIONSThis research indicates that the TRA methodology is easy to assess trachoma and its related risk factors. Based on the results of this study, we have already achieved the goal of "elimination of trachoma" in Shandong province, as the detection rate of trachomatous inflamation follicular/trachomatous inflammation intense in 1-9-year-old children was less than 5%.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Prevalence ; Risk Factors ; Trachoma ; epidemiology

Chloral hydrate is a commonly used central sedative drug before pediatric clinical examination, but its clinical safety and medication adherence are needed to focus on normally because of its poor stability and palatability. Under the premise of investigating the stability of different formulations, their palatability were also screened by using both human sensory and electronic tongue evaluation techniques. Human sensory evaluation has been conducted with the informed consent of all participants in accordance with the ethical requirements of the Good Clinical Practice for Drug Trials. The results showed that the addition of sorbitol and sucralose could effectively ensure the stability of the oral solution. Sorbitol is the main taste-masking component, and the ratio of 40% sorbitol and 0.5% sucralose can effectively mask the bitterness, astringency and spicy taste of 10% chloral hydrate oral solution. The results detected by human sensory and electronic tongue have good correlation and complementarity, and the combination of these two methods is more conducive to getting objective and reasonable conclusions.

In medical research,predictive models have been widely used to predict disease progression and identify high-risk populations in advance, especially in the prevention and diagnosis of chronic diseases. In ophthalmology, the predictive and diagnostic models for fundus diseases such as age-related macular degeneration and diabetic retinopathy have demonstrated expert-level accuracy. However, the application of predictive models is still in the exploratory stage as for myopia prevention and control. The establishment of a predictive model is helpful to identify the high-risk myopic children in advance, so that preventive measures such as adequate outdoor activities and reducing near work can be taken in time, which is of great significance to prevent or slow down the occurrence and development of myopia. Because the mechanism of myopia has not been fully elucidated, there are still challenges and limitations in the selection of application objects, predictors and predictive outcomes. This paper reviews the research progress of different types of myopia predictive models in order to provide reference for further development and improvement.