AIM: To evaluate the efficacy and safety of three doses of Conbercept intravitreal injection with panretinal photocoagulation(PRP)followed by EX-PRESS glaucoma shunt implantation on patients with neovascular glaucoma(NVG).METHODS: Prospective study. A total of 37 patients(37 eyes)with NVG from May 2018 to September 2020 were collected. All accepted intravitreal injection of Conbercept and PRP 3-5d later, and accepted EX-PRESS glaucoma shunt implantation within 1wk after surgery. They were randomly divided into the low-dose group(13 eyes), the conventional dose group(12 eyes)and the high-dose group(12 eyes)according to three doses of preoperative Conbercept intravitreal injection, and they were injected with 10mg/mL Conbercept of 0.03, 0.05 and 0.08 mL(0.3, 0.5 and 0.8 mg Conbercept contained)respectively. The regression of iris and angle neovascularization(NV)after intravitreal injection was observed in the three groups, and postoperative intraocular pressure(IOP), best corrected visual acuity(BCVA)and complications were compared among the three groups.RESULTS: All patients completed follow-up. Cases with NV regression of iris and angle in the high-dose group were significantly more than the low-dose group(χ2=0.132, P=0.003)and the conventional dose group(χ2=0.154, P=0.015)3-5d after intravitreal injection. BCVA and IOP of the three groups at 1, 3 and 6mo after surgery were improved compared with those before treatment. IOP of the low-dose group, the conventional dose group and the high-dose group at 12mo after surgery was 14.12±2.63, 13.37±2.18 and 12.15±1.43mmHg, respectively. IOP of the high-dose group was lower than that of the low-dose group and the conventional dose group(all P<0.05). The BCVA of the high-dose group at 12mo after surgery was better than that of the low-dose group and the conventional dose group(all P<0.05). There was no significantly statistical difference in the incidence of postoperative complications at 12mo after surgery among the three groups(P>0.05).CONCLUSIONS: The intravitreal injection of high-dose(0.8mg)Conbercept combined with PRP and EX-PRESS glaucoma shunt implantation has particularly significant clinical effect on the treatment of NVG.

BACKGROUNDAssessment of the optic disc and retinal nerve fiber layer (RNFL) is essential for the diagnosis and monitoring of glaucoma. Knowledge of normal optic disc topography provides a benchmark for evaluating glaucomatous pathologic changes, especially in its early stages. The purpose of this study was to evaluate the characteristics and correlation factors of the optic disc parameters using the Heidelberg Retina Tomograph II (HRT II) in a large sample of normal eyes of adult Chinese subjects.

METHODSDisc data were obtained from 6 830 subjects aged >30 years from the Handan Eye Study. All participants underwent comprehensive eye examinations and physical examinations. The associations of gender, age, body mass index, blood pressure, waist-to-hip ratio; refractive error, intraocular pressure, axial length, and disc area were assessed using simple and multiple regression analysis. The correlation between HRT II parameters was evaluated.

RESULTSOf the 7 557 eligible subjects, 6 830 took part in the study (90.4% response rate) and 2 633 normal eyes with good-quality HRT II images were selected. The mean disc area was 2.28 mm(2) (standard deviation (SD) 0.43) and mean neural rim area was 1.80 mm(2) (SD 0.29). In multiple regression analysis, optic disc area significantly correlated with age, gender, and axial length (P < 0.001). All optic disc parameters showed a significant correlation with disc area (0.054

CONCLUSIONSThe optic disc area in rural Chinese population is larger than reported in white and Japanese populations, similar to that of Indian population and urban Chinese population. Most optic disc measurements were moderately or weakly affected by disc area. In addition to the RNFL, there may be other factors affecting the rim area. The relationship between optic disc and axial length may suggest a link between larger disc area, thinning of the lamina cribrosa, and increased glaucoma susceptibility in myopic eyes.

Adult ; Female ; Glaucoma ; epidemiology ; Humans ; Male ; Middle Aged ; Myopia ; epidemiology ; Optic Disk ; anatomy & histology

Objective: To analyze the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Tongren City during 2018 to 2022, so as to provide the reference for HFMD effective prevention and control. Methods: Monitoring data on HFMD in Tongren City from 2018 to 2022 was collected from National Infectious Disease Reporting Information Management System. Descriptive epidemiological method was conducted on the data analysis. Results: A total of 14 376 cases of HFMD were reported in Tongren City during 2018 to 2022, the average annual incidence rate of HFMD was 89.43/100 000. Totally 47 severe cases were reported, accounting for 0.33% of the total cases. The incidence rates of HFMD were generally declining trend during 2018 to 2022 (124.68/100 000, 95.37/100 000, 78.50/100 000, 61.63/100 000, 87.80/100 000) ( χ 2 trend =393.05, P <0.01), mainly occurred during April to July (48.13%), among children under 5 years old (95.72%). During 2018 to 2022, a total of 967 laboratory diagnosed cases reported in different years, regions, age groups showed significant differences in pathogen composition ratio ( χ 2=169.62, 456.65 , 167.96, P <0.05). From 2018 to 2022, the dominant pathogen of HFMD was constantly changing. Other enteroviruses were the dominant epidemic strains in 2018 and 2022 (33.04%, 37.62%), CoxA 6 was the dominant epidemic strain in 2019 to 2020 ( 68.75 %, 50.78%), and CoxA16 was the dominant epidemic strain in 2021(43.30%).In 2018, one case was infected with CoxA16 and EV71.The difference of pathogen composition ratio varied in different years ( χ 2=169.62, P <0.01). Conclusions The prevalence of HFMD in Tongren City has showed a declining trend during 2018 to 2022, and the dominant strain of HFMD has changed in recent years. The pathogen monitoring of HFMD should be strengthened to timely grasp the distribution and changes of pathogens, so as to provide a basis for the precise prevention and control of HFMD.

BACKGROUNDPhotodynamic therapy (PDT) has been recommended as a main treatment for idiopathic choroidal neovascularization (I-CNV). But the visual results of PDT were inconsistent and variable, and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries. In recent years, intravitreal ranibizumab therapy, showing favorable visual outcomes, has developed as an advanced treatment for choroidal neovascularization (CNV). Although both methods have been reported to be effective in treating I-CNV, there is no detailed comparative report between the two methods. This study aimed to compare visual outcomes, retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV, and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.

METHODSThirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT. The best corrected visual acuity (BCVA) was recorded before and at each follow-up visit after treatments (logMAR). Enhanced-depth imaging optical coherence tomography (EDI-OCT) was used to evaluate the retinal structural changes, and to measure central retinal thickness (CRT) and central choroidal thickness (CCT).

RESULTSMean BCVA was 0.64 ± 0.27 in PDT group and 0.69 ± 0.22 in ranibizumab group at baseline (P = 0.55). When compared with the baseline, mean BCVA in PDT group was improved significantly at 3-month after PDT (0.41 ± 0.16, P = 0.002), then changed little (0.42±0.25 at 12-month, P = 0.88). Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit. It improved much more obviously in the first month and then remained stable. The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT (P < 0.05). When compared with the baseline, mean CRT in PDT group decreased significantly since 3-month visit, whereas mean CRT in ranibizumab group decreased significantly from 1-month visit. Mean CRT at 1-month and 3-month decreased much more in ranibizumab group than that in PDT group, almost in the same period as BCVA improving. When compared with the baseline, mean CCT did not change significantly at each follow-up visit in each group (P > 0.05). The CCT difference was not statistically significant between the two groups at each same time visit (P > 0.05). Mean BCVA was correlated with CRT, but was not correlated with CCT.

CONCLUSIONSBoth intravitreal ranibizumab therapy and PDT are effective for the treatment of I-CNV. It is obvious that ranibizumab therapy is significantly superior to PDT in improving BCVA and decreasing CRT. CRT decreases much more rapidly in ranibizumab group than in PDT group, simultaneously with visual improvement. CRT reduction has significant correlation with the visual outcomes in the recovery of I-CNV, whereas BCVA prognosis may have no correlation with CCT. CCT is not changed significantly after each of the treatments. Both PDT and ranibizumab therapy may have no significant effect on choroid.

Antibodies, Monoclonal, Humanized ; administration & dosage ; therapeutic use ; Choroidal Neovascularization ; drug therapy ; therapy ; Female ; Humans ; Intravitreal Injections ; Male ; Photochemotherapy ; methods ; Ranibizumab ; Retina ; drug effects ; pathology ; Visual Acuity ; drug effects

Objective: To analyze the therapeutic effect and mechanism of Yishen Simiaotang on gouty nephropathy (GN) complicated with renal failure (RF). Method: Totally 96 cases of GN with RF treated at our hospital from March 2015 to December 2017 were divided into the control group (48 cases) and the observation group (48 cases) according to the random control principle. In addition to the basic therapy, allopurinol was added to the control group, and Yishen Simiaotang was added to observation group. After 2 months of treatment, the clinical efficacy and safety of two groups were compared. The urinary levels of β₂-microglobulin (β₂-MG), α₁-microglobulin (α₁-MG), 24 h urine protein (24 hUpro) and glomerular filtration rate (eGFR) were compared between two groups before and after treatment, and the levels of serum albumin (ALB), urea nitrogen (BUN), serum creatinine (SCr) and uric acid (UA) were detected and compared before and after the treatment. The serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and hypersensitivity C reactive protein (hs-CRP) were compared before and after treatment between two groups. Result: The total effective rate of observation group was 89.58%, which was significantly higher than 72.92%of control group (χ²=4.376,P<0.05). After treatment, BUN, SCr and UA in both groups were significantly decreased, whereas eGFR level was significantly increased than before treatment (P<0.05). After treatment, the levels of β₂-MG, α₁-MG, 24 hUpro in both groups decreased significantly (P<0.05), while the indexes of observation group improved more significantly (P<0.05). After treatment, the levels of TNF-α, hs-CRP and IL-6 in both groups were significantly lower than those before treatment, and the decrease in observation group was more obvious than that in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups. Conclusion: Yishen Simiaotang is effective in the treatment of GN combined with RF, and can reduce renal tubule injury, improve renal function, regulate the state of micro-inflammation, with a high safety.

Objective: To understand the association between non suicidal self injury and self control among rural junior high school students in Guizhou Province, and to provide reference for the development of prevention and control measures. Methods: Using a multistage stratified random cluster sampling method, a questionnaire survey was administered to 4 452 junior high school students in 30 rural schools in Guizhou Province from November to December 2021 to investigate non suicidal self injury and self control using the Non suicidal Self Injury Scale and the Self Control Scale. Results: A total of 986 (22.2%) students had occasional non suicidal self injurious behaviors, 593 (13.3%) students reported frequent non suicidal self injury, and the occurrence of non suicidal self injury among junior high school students varied significantly by gender, grade, only child, residence, left behind experiences, academic performance, academic pressure, parent child relationship, peer relationship, teacher student relationship, and exposure to domestic violence ( χ 2=6.97-168.68, P <0.05); the average score of self control among junior high school students in rural Guizhou Province was 48.0 (39.0, 57.0), and the differences in self control scores, impulse control, healthy habits, resist temptation, focus on work, and moderate entertainment were of statistical significance among students with varied frequency of self injurious behavior ( Z=612.08, 464.64, 193.10, 228.86, 194.04 , 542.20, P <0.05); high self control score was associated with more non suicidal self injurious behavior ( OR=1.06, 95%CI=1.05-1.07, P <0.05). Conclusion The prevalence of non suicidal self injury is high among rural junior high school students in Guizhou province, and self control shows a predictive effect on non suicidal self injurious behavior.Schools, families and relevant government departments should pay full attention to it and formulate targeted prevention and control measures.

Background: Handan Eye Study (HES), a large population-based cohort study in rural area of northern China, was one of the few studies focusing on the major eye diseases of rural Chinese population. The aim of this study was to introduce the design, methodology and to assess the data quality of the follow-up phase of HES. Methods: All participants were recruited in Yongnian county of Handan city between 2012 and 2013. Main outcomes were measured by visual quality scales and ocular examinations. We performed the Chi-square test to make comparison of categorical data among groups, One-way analysis of variance and Kruskal-Wallis test was applied to make comparison of continuous data among groups, a post-hoc test was done to make further pairwise comparison. Inter-class correlation coefficients (ICCs) and Kappa coefficients were used to evaluate the consistency between different operators. Logistic regression was used to explore the influence factors of death, odds ratio (OR) and 95% confidence interval (CI) were used to estimate the effect size of each influence factor. Results: The follow-up rate was 85.3%. Subjects were classified into three groups: the follow-up group (n = 5394), the loss to follow-up group (n = 929), and the dead group (n = 507), comparison of their baseline information was done. Compared with the other two groups, age of the dead group (66.52 ± 10.31 years) was the oldest (Z = 651.293, P < 0.001), male proportion was the highest (59.0%) (χ² = 42.351, P < 0.001), only 65.9% of the dead finished middle school education (Z = 205.354, P < 0.001). The marriage percentage, body mass index (BMI), best-corrected visual acuity (BCVA), and intra-ocular pressure of the dead group was the lowest either. Spherical equivalent error (SER) of the dead group was the highest. Besides, history of smoking, hypertension, diabetes, and heart disease were more common in the dead group. Multivariate analysis showed that age (OR = 1.901, 95% CI: 1.074–1.108), gender (OR = 0.317, 95% CI: 0.224–0.448), and BCVA (OR = 0.282, 95% CI: 0.158–0.503) were associated with death. While between the follow-up group and the loss to follow-up group, there was only difference on age, gender, BMI, systolic blood pressure and SER. The Cronbach coefficients of all scales used in the follow-up were ≥0.63 and the cumulative variances were ≥0.61, indicating good reliability and validity. The ICCs and Kappa coefficients between different operators were ≥0.69. Conclusions HES has a high follow-up rate and a low risk of loss to follow-up bias. Age, gender, and BCVA are influence factors of death. Specifically, male subjects are at a higher risk of death than female, age is a risk factor of death while BCVA is a protective factor for death.

Objective:To observe the therapeutical effect and the safety of Pinggan Yuyin Qingre recipe on the hyperevaporative dry eye disease （Yin deficiency and Yang hyperactivity type） caused by the meibomian gland dysfunction（MGD）. Method:The 120 Consecutive outpatients who met the criteria were included in the trial and divided into three layers （mild， moderate and severe） according to the meibomian gland function classification （grade 1-3）. The patients in each layer were randomly assigned to the experiment group and the control group at a ratio of 1∶1. Both groups were treated with sodium hyaluronate eye drops， 1 drop/eye/time， 3 times a day. In the experiment group， Pinggan Yuyin Qingre recipe was additionally prescribed two times a day. The treatment course was 8 weeks in both groups. All patients were evaluated at the beginning and end of the study mainly for noninvasive tear breakup time （NITBUT），corneal lesions score，meibomian gland exclusion score，meibomian gland structure，eye symptom score，the ocular surface disease index（OSDI） score，and the traditional Chinese medicine（TCM） syndrome scores at both overall and layered levels. Result:A total of 116 cases completed the study，with 1 drop-out case and 3 eliminated cases. Both before and after treatment，NITBUT，the corneal lesions score，the symptom score，and the OSDI score in the experiment group were significantly superior to the control group， but there was no significant difference in meibomian gland exclusion score between two groups，only with a superior tendency in experiment group. There were significant differences in the scores of the related TCM syndrome scores between two groups after treatment. There were no adverse reactions， no abnormal changes in electro cardiogram （ECG） or liver and kidney functions in all patients. Conclusion:Pinggan Yuyin Qingre recipe can effectively improve the hyperevaporative dry eye disease caused by meibomian gland dysfunction， the tear film stability，eye dryness， burning，itching，foreign body sensation and TCM symptoms of patients with dry eye syndrome of Yin deficiency and Yang hyperactivity. The improvement effect is more obvious in moderate and severe patients. It is an effective，safe，and well-tolerated treatment for the hyperevaporative dry eye.