Objective: To investigate the distribution of pupil diameter and its association with myopia in school age children, providing ideas into the mechanisms of the role of pupil diameter in the onset and development of myopia. Methods: Adopting a combination of stratified cluster random sampling and convenience sampling method, 3 839 children from six schools in Shandong Province were included in September 2021. Pupil diameters distribution was analyzed by age, sex, and myopic status. Pearson correlation analysis was used to assess the relationship between pupil diameter and cycloplegic spherical equivalent (SE), as well as axial length (AL) and other variables. Propensity score matching (PSM) was applied to match myopic and non myopic children at a 1∶1 ratio based on age and sex. A generalized linear model (GLM) was constructed with pupil diameter as the dependent variable to identify independent factors influencing pupil size and its association with myopia. Results: The mean pupil diameter of school age children was (5.77±0.80)mm. Pupil diameter exhibited a significant increasing trend with age ( F =49.34， P trend ＜ 0.01). Myopic children had a significantly larger mean pupil diameter [(6.10±0.73)mm] compared to non myopic children [(5.62±0.79)mm] with a statistically significant difference( t=18.10, P <0.01). Multivariable GLM analysis, adjusted for age, amplitude of accommodation, and uncorrected visual acuity, revealed a negative correlation between pupil diameter and cycloplegic SE (before PSM: β =-0.089, after PSM: β =-0.063, both P ＜0.01). Conclusions Myopic school age children exhibite larger pupil diameters than their non myopic counterparts. Pupil diameter may serve as a potential indicator for monitoring myopia development in school age children.

This paper summarized the characteristics of constitution， disease， and syndrome of five different phenotypes of bronchial asthma including allergic asthma， cough variant asthma， chest tightness variant asthma， psychological stress asthma， and hormone-dependent asthma， and systematically expounds the application of three-dimensional diagnosis and treatment pattern， that is differentiation of constitution， disease and syndromes in the five phenotypes of bronchial asthma. It is considered that the allergic constitution is the main one of bronchial asthma， which is usually combined with the constitutions of qi-deficiency， yin-deficiency， yang-deficiency， qi-stagnation and others. In the treatment of bronchial asthma， constitution， disease and syndromes should all be taken into account but applied flexibly according to the order of the urgency and priority. The three-dimensional diagnosis and treatment pattern can reflect the essential characteristics and clinical panorama of bronchial asthma more comprehensively and objectively and provide effective intervention measures and management programs for the prevention and treatment by traditional Chinese medicine.

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.

Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD. Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay. Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Objective:To discuss the use and management of medical material in hospital in order to resolve the key problem during medical material was used in department of device management.Methods: Using the modern logistics management idea to overall upgrade the original system. And to reconstruct the hospital integrated operations management platform included all aspects, such as design ideas, technical architecture, software function and so on, from whole management requirement point.Results: This platform could provide the improvement solution of traceability management for medical material in hospital, and increase the efficiency and transparency of management, and improve the whole management level in hospital.Conclusion: The introduced integrated operations management platform has standardized high-value materials management, met the fine management and cost requirements, and greatly improved the management level of medical materials.

AIM:To study the expression level of S100 calcium-binding protein A4 (S100A4) in synovial tissue of the knee joint in rheumatoid arthritis (RA) patients and normal persons, and the effect of S100A4 on the angiogenesis induced by rheumatoid arthritis fibroblast-like synoviocytes (RAFLSs).METHODS:The synovial tissue was taken from the knee joint of the RA patients (RA group) and the normal persons (control group).The protein expression of S100A4 and vascular endothelial growth factor (VEGF) in the synovial tissue of the 2 groups was observed by immunohistochemistry.RAFLSs were isolated from synovial tissue of patients with active RA.ELISA was used to detect the effect of S100A4 on the secretion of VEGF by RAFLSs.The effect of S100A4 on the angiogenesis of HUVECs cultured with conditioned medium from RAFLSs was also detected.RESULTS:The protein of S100A4 and VEGF was highly expressed in the synovial tissues of RA group (P<0.05).rhS100A4 significantly stimulated the secretion of VEGF in RAFLSs in a time-and dose-dependent manner (P<0.05).Cultured with conditioned medium from RAFLSs, rhS100A4 significantly promoted HUVECs to form tube-like structures in vitro.CONCLUSION:S100A4 protein is highly expressed in synovial tissue of the knee joint in RA patients, and S100A4 stimulates synovial angiogenesis by promoting RAFLSs to generate VEGF, indicating that S100A4 may be used as a potential target for the treatment of RA.

Objective To investigate the value of routine MRI in determining placental grading and the relationship between placental apparent diffusion coefficient(ADC)value and the gestational age(GA)in the second and third trimesters of pregnancy. Methods 52 women with singleton pregnancies were referred for MRI examination for underlying maternal or fetal lesions or malformations identified by ultrasound(US).Subjects were divided into three groups according to the GA:group Ⅰ at 18 -26 weeks(n=29);groupⅡat 27-33 weeks(n=14);group Ⅲ at 34-40 weeks(n=9).DWI protocol included 2 sets of b-values:0 s/mm2,200 s/mm2,800 s/mm2 and 50 s/mm2,200 s/mm2,800 s/mm2,and ADC values of the two groups were calculated and correlated with GA by simple linear regression.Results Half-fourier acquisition single-shot turbo spin-echo(HASTE)sequence could clearly define the 3 layers of placenta and determine the grading of placental aging.ADC values with b values of 0 s/mm2,200 s/mm2and 800 s/mm2were correlated negatively with GA (r= -0.900,P<0.001).However,ADC values with b values of 50 s/mm2,200 s/mm2and 800 s/mm2did not show any statistical correlation with GA(r= -0.037,P=0.795).Conclusion MRI can visualize the morphological changes of the placenta during the pregnancy.With a set of b-values at 0 s/mm2,200 s/mm2and 800 s/mm2,placental ADC values are found to have decreasing tendency as the pregnancies progress in the second and third trimesters.

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.
Aged ; Aged, 80 and over ; Cytokines ; immunology ; Female ; Humans ; Hyperglycemia ; drug therapy ; immunology ; Hypoglycemic Agents ; therapeutic use ; Immunity, Innate ; drug effects ; immunology ; Immunologic Factors ; immunology ; Insulin ; therapeutic use ; Male ; Treatment Outcome ; Wounds and Injuries ; drug therapy ; immunology

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.

Objective To evaluate the clinical results of the PCL-retaining total arthroplasty in treatment of knee osteoarthris with valgus.Methods From June 2002 to January 2005,8 cases of osteoarthris with valgus knee were treated with PCL-retaining total knee replacement.The X-ray before operation showed average 21.6 degrees(ranging from 10 to 35 degrees) valgus.The cases were follow-uped from 6 to 36 months,each of them was evaluated with the Special Surgery Knee Scoring System.Results The X-ray after operation showed average 5.7 degrees(ranging from 3 to 9 degrees) valgus.The average HSS scores increased from preoperative 54 to postoperative 91.The range of motion was significantly improved from preoperative 83 degrees to postoperative 118 degrees.All of the cases were no pains after operation,and the function of knees were apparently improved.Conclusions The preliminary clinical results are quite satisfactory for the PCL-retaining total arthroplasty in treatment of osteoarthris with valgus knee.The adequate relaxing and balancing of soft tissue is the key factor to the success of total knee arthroplasty.The follow-up is necessary for further long-term outcome.