Objective To investigate the relationship between hemodynamic changes in cervical and retrobulbar vessels and asymmetric diabetic retinopathy.Methods Color Doppler imaging(CDI) was used to quantitate diameter(D),peak systolic velocity(PSV),end diastolic velocity(EDV) and resistance index of the common carotid artery(CCA),the internal carotid artery(ICA),the ophthalmic artery(OA) and the central retinal artery(CRA),to quantitate diameter,velocity of central retinal vein(CRV),and to check carotid atherosclerosis in 12 patients with asymmetric diabetic retinopathy.Results The detection-rate of CCA and ICA atherosclerosis plaques was significantly increased in backgroud DR(41.7%)compared with that in proliferation DR(66.7%).There was a significant decrease in both PSV and EDV in OA in background diabetic retinopathy(BDR)(20.02±5.32 cm/s,5.26±2.15 cm/s) compared with PDR(27.23±12.20 cm/s,6.23±2.67 cm/s,P<0.05).There was a significant decrease in both PSV and EDV in CRA in BDR(6.44±1.78 cm/s,2.03±1.49 cm/s) compared with PDR(8.41±2.05 cm/s,2.66±0.67 cm/s,P<0.01).Conclusion The imbalance of perfusion in two eyes in diabetic patients might be one of the causes resulting in the asymmetric diabetic retinopathy

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery.Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months,weighing 9-15 kg,scheduled for laparoscopic surgery,were randomly divided into two groups (n =15 each):pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group Ⅴ).After anesthesia was induced with propofol 2-4 mg/kg,vecuronium 0.1 mg/kg and fentanyl 2 μg/kg,the children received endotracheal intubation and mechanical ventilation.The maximum inspiratory pressure was adjusted to make the tidal volume (VT) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V.The end-tidal pressure of carbon dioxide (PET CO2) was controlled at 35-45 mm Hg.The mean arterial blood pressure (MAP),heart rate (HR),arterial carbpn dioxide tension (PaCO2),PETCO2,minute ventilation and peak airway pressure were recorded immediately after intubation (T0),immediately before skin incision (T1),after 30 minutes of pneumoperitoneum (T2) and 15 minutes after the end of pneumoperitoneum (T3).Arterial blood samples were taken at the same time points mentioned above for blood gas analysis.Dynamic lung compliance and the ratio of the physiological dead space to the tidal volume were calculated.Results Compared with group Ⅴ,PaCO2 and PET CO2 were significantly decreased and dynamic lung compliance was significantly increased at T1-2,and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P (P ＜ 0.01).There was no significant difference in MAP,HR and the ratio of the physiological dead space to the tidal volume between the two groups (P ＞ 0.05).Conclusion Compared with volume-controlled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy,is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children undergoing laparoscopic surgery.

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery. Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months, weighing 9-15 kg, scheduled for laparoscopic surgery, were randomly divided into 2 groups (n = 15 each): pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V) . Anesthesia was induced with propofol 2-4 mg/kg, vecuronium 0.1 mg/kg and fentanyl 2 μg/kg. The children were tracheal intubated and mechanically ventilated. The maximum inspiratory pressure was adjusted to make the tidal volume (VT ) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V. PETCO2 was maintained at 35-45 mm Hg. MAP, HR, PETCO2 , minute ventilation and peak airway pressure were recorded immediately after intubation (T0 ) , immediately before skin incision (T1 ) , 30 min of pneumoperitoneum (T2 ) and 15 min after the end of pneumoperitoneum (T3 ) . Arterial blood samples were taken at the same time points mentioned above for blood gas analysis. Dynamic lung compliance and physiological dead space to tidal volume ratio were calculated.Results Compared with group V, PaCO2 and PETCO2 were significantly decreased and dynamic lung compliance was significantly increased at T1,2 , and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P ( P < 0.01) . There was no significant difference in MAP, HR and physiological dead space to tidal volume ratio between the two groups ( P > 0.05) . Conclusion Compared with volume-controlled ventilation, pressure-controlled ventilation can better improve the ventilatory efficacy, is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children undergoing laparoscopic surgery.

Purpose To prepare 68Ga-NOTA-SPIO as PET/MRI dual mode imaging probe with high sensitivity and resolution,and further evaluate its in vitro and partly in vivo biological properties.Materials and Methods The precursor SPIO-PEG2000-NOTA was prepared and characterized.The precursor was radiolabeled by using one step method to prepare 68Ga-NOTA-SPIO as dual mode imaging probe.The labeling rate of the probe was determined by rapid thin-layer chromatography.Besides,the in vitro stability and lipid water partition coefficient of the probe were evaluated,and its biodistribution in normal mice was also observed.Results The precursor SPIO-PEG2000-NOTA with uniform dispersion and uniform particle size was prepared,and the dual mode probe 68Ga-NOTA-SPIO was synthesized.The labeling rate reached 99％,and the lipid water partition coefficient (Log P) was (-2.60±0.13).The radiochemical purity of the probe was higher than 95％,as it was incubated in the phosphate buffer and fetal bovine serum within 2 hours.The probe was mainly distributed in the liver and spleen of mice,and its clearance velocity in blood was fast.Conclusion The double mode probe 68Ga-NOTA-SPIO synthesized by one step method has high labeling rate with no need of purification,which has good physic-chemical properties and biocompatibility.The probe can be used in the further research of PET/MRI dual modality imaging.

Objective:To study the efficacy and drug-related adverse reactions of long-term appli-cation of biological anti-rheumatic drugs (bDMARDs) to patients with ankylosing spondylitis (AS), and provide reference for clinical diagnosis and treatment.Methods:We retrospectively analyzed the clinical data of AS patients who were followed-up for more than 5 years in the Department of Rheumatology and Immunology of Peking University Shenzhen Hospital. The patients treated with bDMARDs alone or combined with traditional antirheumatic drugs were included as the treatment group, while those who did not receive biological or non-biological antirheumatic therapy were included as the control group. The data collected included clinical sym-ptoms, inflammatory biomarkers, imaging results, drug applications and drug-related adverse reactions, etc. The counting data were tested by χ2 test, the measurement data in normal distribution was tested by t test, and the measurement data that not normally distributed was tested by Mann-Whitney U test. Paired test was used for statistical processing before and after treatment. Results:We collected the data of 114 eligible patients, including 64 in the treatment group and 50 in the control group. There were no significant differences in baseline data between the 2 groups, including mean follow-up time, course of disease, age, sex ratio, HLA-B27 positive rate, morning stiffness duration, night pain, peripheral arthritis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and imaging. After 5 years, patients in the treatment group had shorter morning stiffness [(3±7) min vs (26±37) min, t=4.827, P<0.01], lower nighttime pain rates [(3/64, 4.8%) vs (29/50,58.0%), χ2=38.329, P<0.01], lower ESR level [(14±14) mm/1 h vs (20±18) mm/1 h, t=2.102, P=0.038], lower CRP level [(7±8) mg/L vs (14±19) mg/L, t=2.431, P=0.017], and lower progression rate of sacroiliac arthritis [(18/64, 28.1%) vs (35/50, 70.0%), χ2=19.786, P<0.01], than the control group. The main drug-related adverse reactions in the treatment groupincluded reversible leucopenia, elevated transaminase level, redness and swelling at the injection site. Conclusion:Biologics treatment for more than 3 consecutive years can effectively control the clinical symptoms of most AS patients, reduce inflammatory indicators and delay the imaging progression of the sacroiliac joint. Without treatment, the imaging progress of the sacroiliac joint in AS patients could be 70% after 5 years.

OBJECTIVE: To investigate the influence of denervation on myofiber morphology of the adductor and the abductor in patients with recurrent laryngeal nerve (RLN) paralysis and to provide experimental evidence for the clinical feasibility of RLN repair. METHOD: Adductor muscles were acquired from the lateral cricoarytenoid muscle (LCAM) and abductor muscles from the posterior cricoarytenoid muscle(PCAM). Normal human PCAM and LCAM are treated as control group (n = 7). Thirty-eight cases of PCAM with damaged RLN were divided into five groups according to the duration of their RLN damage: 0.5-1 year (7 cases), > 1-2 years (10 cases), > 2-3 years (8 cases), > 3-6 years (8 cases) and > 6 years (5 cases); twenty-nine cases of LCAM were also divided into five groups: 0.5-1 year (7 cases), > 1-2 years (6 cases); > 2-3 years (6 cases), > 3-6 years (6 cases) and > 6 years group(4 cases). They were all stained with HE and Masson three-color staining, the fiber cross-sectional area of muscle tissue and collagen connective tissue were quantitative analyzed. The changes of myofiber morphology of adductor and abductor muscles after the loss of the RLN were analyzed with image analysis system. RESULT: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation. (1) Difference between the denervated groups of LCAM of 0.5-1 year, > 1-2 years and > 2-3 years groups were not significant (P > 0.05). Fiber cross-sectional area of > 3-6 years group decreased most obviously with significantly difference compared with > 2-3 years group (P < 0.05); (2) There were obvious difference between the control group, 0.5-1 year group, > 1-2 years group, > 2-3 years group and > 3-6 years of PCAM(P < 0.05); (3) There was no significant difference between the group of > 3-6 years and > 6 years of two kinds of laryngeal intrinsic muscle (P > 0.05); (4) Fiber cross-sectional area of each group of the LCAM after 1 year denervation were significantly greater than that of the PCAM under same conditions (P < 0.05). CONCLUSION The influence of denervation on myofiber morphology following denervation is different between the abductor and adductor owing to the different fiber type composition and functional properties. The rate of muscle atrophy of the adductor is slower than that of the abductor. To restore the structure and function of denervated laryngeal muscles better, the recurrent laryngeal nerve injury repair surgery for PCA muscle function recovery should be carried out within 1 year after denervation while the surgery for LCA muscle function recovery should be carried out within 3 years after denervation.
Case-Control Studies ; Denervation ; Humans ; Laryngeal Muscles ; innervation ; pathology ; Myofibrils ; pathology ; Neurosurgical Procedures ; Recurrent Laryngeal Nerve ; pathology ; Staining and Labeling ; Vocal Cord Paralysis ; pathology ; surgery

OBJECTIVETo investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.

METHODSThree patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.

RESULTSRapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.

CONCLUSIONSHDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; therapy ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Mastectomy, Radical ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; Salvage Therapy

OBJECTIVE: To investigate the expression of myosin heavy chain (MHC) in normal laryngeal muscle and the difference between the adductor and abductor. METHOD: Seven patients with total laryngectomy were enrolled in this study. The adductor muscles were acquired from the lateral cricoarytenoid (LCA) muscle and the abductor muscles were acquired from the posterior cricoarytenoid (PCA) muscle. The expression of myosin heavy chain were detected with fluorescent quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining respectively. RESULT: (1) MHC-II b was expressed in laryngeal muscles at mRNA levels, and not expressed at the protein level; (2) At both mRNA level and protein level, the expression of MHC-I was higher in the PCA muscles than in the LCA muscles while MHC-II level was higher in the LCA muscles than in the PCA muscles. CONCLUSION (1) MHC-II b protein was not expressed in human laryngeal muscles; (2) Phenotypic differences were significant in laryngeal adductor and abductor muscles based on their different functions. PCA contained larger percentage of MHC-I fibers, while LCA contained more MHC-II fibers.
Aged ; Female ; Humans ; Laryngeal Muscles ; chemistry ; metabolism ; Male ; Middle Aged ; Myosin Heavy Chains ; genetics ; metabolism ; Phenotype ; Protein Isoforms

Objective: To evaluate the status of dietary diversity and determinants among school age left behind children. Methods: A total of 501 children aged 9-10 years in Sheyang Mini Cohort Study were enrolled from Sheyang City in Jiangsu Province during 2019. A questionnaires survey was administrated to collect left behind and socioeconomic information. Twenty four hour dietary recall survey was conducted, dietary diversity score (DDS 10 and DDS) and food variety score (FVS) were computed according to Food and Agriculture Organization (FAO). Weight and height of children were measured and sex and age standardized body mass index was used to define obesity. Multivariable regression models were preformed to explore the determinants of dietary diversity in school age left behind children. Results: The proportion of left behind children was 40.9%. The mean value and standard deviation of three kinds of dietary diversity score (DDS 10 , DDS, FVS) in left behind children were (5.69±1.31)(6.55±1.44) and (13.48± 4.23 ), respectively. All of these were lower than that in non left behind children (DDS 10 :5.99±1.29; DDS:6.79±1.40; FVS:14.15±4.22). Significant difference in DDS 10 between left behind and non left behind children was observed ( P =0.01). The results of multivariable regression demonstrated that gender, passive smoking, family education level and family economic status were related to dietary diversity scores ( P <0.05). Conclusion Dietary diversity in school age left behind children was not optimistic and gender, passive smoking, parental education level, family economic status and left behind situation play a critical role in dietary diversity among these children.

Objective: To analyze the impact of persistent obesity on their lung function, so as to offer insights for implementing intervention measures to increase lung function in obese school age children. Methods: A total of 335 children from the Sheyang Mini Birth Cohort established in 2009 in Yancheng City, Jiangsu Province, who participated in the follow up at the ages of 7 years (2016) and 10 years (2019), were selected as the study participants. Physical measurements including height, weight, and lung function were recorded. According to the World Health Organization standard, that is, gender and age specific to correct the body mass index to calculate the body mass index Z score, was used to evaluate the obesity status of children at the age of 7 and 10. Children were divided into four groups, including sustained non obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Meanwhile, the lung function prediction equations recommended by the Global Lung Function Initiative were used to standardize the lung function indexes of children. Pulmonary function differences among these groups were examined, and the relationship between childhood obesity and pulmonary function was longitudinally analyzed using generalized estimating equations. Results: The prevalence of obesity were 9.0% and 16.1% at the age of 7 and 10 years, respectively. The proportion of both newly classified and persistent obesity group were 8.1%, respectively. The forced expiratory volume in one second (FEV 1) and forced vital capacity (FVC) were (1 269.90±202.70) and (1 415.70±230.00) mL, respectively, at the age of 7 years. FEV 1 and FVC at the age of 10 years were (1 440.80±403.20) and (1 555.60±517.60) mL, respectively. Cross sectional analysis at age 7 showed that forced expiratory flow at 75% vital capacity (FEF 75 ) ( β=-0.52, 95%CI =-0.96--0.07) and maximal mid expiratary flow (MMEF) ( β=-0.45, 95%CI =-0.89--0.00) were significantly lower in obese children compared to their non obese peers ( P < 0.05). Longitudinal analysis indicated that obese children had lower levels of lung pulmonary function, with a statistically significant difference in FEV 1 ( β=-0.44, 95%CI=-0.85--0.02, P <0.05). There was no significant difference among the various obesity groups ( P >0.05), while gender stratified results revealed significant reductions in FEV 1/FVC in newly classified obese girls at age 10 years ( β=-1.76, 95%CI =-3.13--0.38) and in MMEF in persistently obese girls at age 10 years ( β=-1.44, 95%CI = -2.79- -0.09) ( P <0.05). Conclusion Obesity may contribute to reduced lung function levels in school aged children, with newly classified and persistent obesity having more pronounced effects on lung function in girls.