Objective To investigate the clinical value of endoscopic transnasal dacryocystorhinostomy ( ET-DCR) by suture techniques.Methods 85 patients of 98 eyes with chronic dacryocystifis were randomly divided into the two groups:control group ( without suture) and observation group ( by suture) .All cases were followed up for more than 12 months.The cure rates and occurrence of granulation tissue were compared between the two groups. Results The cure rate of the observation group ( 96.00%, 48/50 ) was higher than that in the control group (81.25%,39/48) (χ2 =5.35,P<0.05). During process of following up,the occurrence of granulation tissue at the ostium margins accounted for 14.00%(7/50) in the observation group and 31.25%(15/48) in the control group (χ2 =4.19,P<0.05).Conclusion ET-DCR by suture techniques reduces the formation of granulation tissue and improves the cure rate.Especially, ET-DCR by suture techniques for the small lacrimal sac of patients may have special advantages.

Objective To explore the effect of endoscopic transnasal dacryocystorhinostomy(ET-DCR) by suture in the treatment of acute dacryocystitis(AD) as early as possible.Methods The clinical data of 32 patients with unilateral AD who underwent ET-DCR by suture as early as possible were retrospectively analyzed.Results All patients presented clear anatomic structure,intraoperative hemorrhage increased in 3 cases,swelling and pain was rapidly relieving in all patients in the first day of postoperation,the mean resolution time of congestion and swelling in the middle canthus was average 3 days(range 1-6 days),no spread of infection occurred,no facial scar appeared in all patients except one case of abscess rupture.Complete complaint relief in 26 cases,slight epiphora presented in 6 patients who confirmed for lacrimalduct obstruction and cured by intubation,and all ostial patency with no AD recurrences at the mean follow-up of 2 years (range 12 months-5 years).Conclusion ET-DCR by suture as early as possible can be used to cure acute dacryocystitis and it is effective safe and economy.

Objective To investigate the affect of body positions on biochemical indexes. Methods By autogenous contrast and cross matched survey, 107 volunteers divided into 3 season patches of winter, spring and summer, blood samples were drawn from the same part in both standing and lying positions。From19 persons, blood samples were collected respectively after standing and sitting for 15 min, lying for 15 min and 30 min and then sitting for another 15 min。 The blood samples were analyzed for 32 biochemical indexes on analyzer。Results 25 biochemical indexes in sitting position were significantly different from those in lying position (P0。05)。Conclusions Changing body position can result in obvious physiological variation of 28 biochemical indexes, particularly of those related to protein. Such result may lead to abnormality in some marginal values. It suggests body position should not be neglected in analyzing laboratory data.

AIM:To investigate the mechanism by which wogonin(WOG)induces ferroptosis in collagen-in-duced arthritis rat fibroblast-like synoviocytes(rat CIA-FLS cells)through the nuclear factor E2-related factor 2(NRF2)/heme oxygenase-1(HO-1)signaling pathway.METHODS:Rat CIA-FLS cells were divided into:control group,low,medium,and high dose of(25,50 and 100 μmol/L)WOG group,ferroptosis inhibitor(LIP-1)group,LIP-1+high dose WOG group,HO-1 agonist cobalt protoporphyrin(COPP)group,and COPP+high dose WOG group.CCK-8 assay was used for cell viability.Crystal violet staining was used for for cell morphology.The levels of oxidative stress markers gluta-thione(GSH),malondialdehyde(MDA),and superoxide dismutase(SOD)were measured.DCFH-DA fluorescent probe was used to detect the intracellular reactive oxygen species(ROS)content as well as Western blot to detect the protein ex-pression levels of Kelch-like ECH-associated protein 1(KEAP-1),NRF2 and HO-1.RESULTS:Compared with the nor-mal control group,administration of WOG treatment resulted in a significant decrease in CIA-FLS cell viability(P<0.01),a significant increase in the level of oxidative stress(P<0.01),a significant increase in the content of ROS(P<0.01),a significant decrease in the level of expression of NRF2 and HO-1 proteins(P<0.01),and a significant increase in the level of KEAP-1(P<0.01)in the rat.Compared with the WOG group,the LIP-1-treated group showed a significant increase in cell viability(P<0.01),a significant decrease in the level of oxidative stress(P<0.01),and a significant de-crease in the content of ROS(P<0.01).Compared with the WOG group,the addition of COPP resulted in a significant in-crease in the protein expression levels of NRF2 and HO-1(P<0.01)and a significant decrease in KEAP-1 levels(P<0.01).CONCLUSION:WOG can induce ferroptosis in rat CIA-FLS cells by promoting oxidative stress through the NRF2/HO-1 signaling pathway.

ABSTRACT OBJECTIVE To investigate the use of spironolactone tablet in children's hospital, and to explore the feasible scheme that can improve the current dosage distribution of spironolactone tablets, so as to meet the needs of precise and individualized clinical administration of pediatric patients. METHODS All the prescriptions including spironolactone tablet (20 mg per tablet) were obtained from 1st January 2021 to 31th December 2022 in Children's Hospital, Zhejiang University School of Medicine. The children's age, splitting specification, department distribution and problems of common tablet splitting were analyzed, appropriate countermeasures were explored according to literature and team practice. RESULTS A total of 11 239 spironolactone tablet prescriptions were included, among which, the proportion of splitting was 83.91%; in the splitting prescriptions, it showed the characteristics of young age, multi-dose specifications, strong drug specialization and long drug duration. Formulating the practice specification for manipulation of drugs, with the right dosing tool, contribute to improve the accuracy of manipulation of drugs and reduce adverse events caused by incorrect dosing; while, the exploration of extemporaneous liquid preparations and preparations in medical institutions, contributed to improve the accuracy and stability of dosing, and realize individualized drug delivery. CONCLUSION In this study, exploring the appropriate dosage regimen for spironolactone tablet as an example, feasible countermeasures with accurate fractional dose, controllable quality and high compliance of children are explored in combination with team practice and literature retrieval analysis, which is based on the actual clinical needs, so as to provide reference for finding appropriate fractional dose administration schemes for pediatric tablets.