ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules （明视方颗粒） for low myopia in children with heart yang insufficiency. MethodsA multicentre， prospective， double-blind randomised controlled study was conducted， in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group， and the treatment group was given education， dispensing glasses， and Chinese herbal medicine Mingshi Granules， while the control group was given education， dispensing glasses， and granules placebo. Both Mingshi Granules and placebo granules were taken orally， 1 bag each time， twice daily， 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment， a total of 4 courses of treatment （24 weeks）. Equivalent spherical lenses， best naked-eye distance visual acuity， ocular axis， corneal curvature K1， adjustment amplitude， traditional Chinese medicine （TCM） symptom scores， calculate the amount of progression of equivalent spherical lenses， were observed at the 12th and the 24th week of treatment， at the 36th week and 48th week of follow-up， resectively， the control rate of myopia progression was evaluated at the 24th week， and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher （57.60%， 72/125） than that in the control group （44.63%， 54/121） （P＜0.05）. The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group （P＜0.05）. Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment （P＜0.05）， and were higher in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment （P＜0.05）. The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up （P＜0.05）. Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment （P＜0.05）. The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment （P＜0.05）. The scores of white/dark complexion， white coating thin pulse， fatigue and total TCM symptom scores of children in both groups at the 12th， 24th， 36th and 48th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment （P＜0.05）. In the treatment group， the score of fatigue was higher than that of the control group at the 36-week follow-up， and the score of blurred vision was lower than that of the control group at the 48-week follow-up （P＜0.05）. No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia， improving the best naked eye distance visual acuity， slowing down the growth of the eye axis， improving some of the TCM symptoms， with good safety.

Objective:To analyze the genus, drug resistance/virulence and phylogenetic characteristics of Brucella strains isolated from brucellosis surveillance sentinels in Henan Province from 2013 to 2022, and provide baseline data for the surveillance, early warning and outbreak tracing of brucellosis. Methods:Blood samples were collected from patients with Brucella infection for strain isolation, culture and species identification, drug susceptibility test, whole genome sequencing, splicing and assembly, functional/virulence/resistance gene prediction analysis and phylogenetic tree drawing based on single nucleotide polymorphism (SNP). Results:In 36 brucellosis patients, the majority were men (86.11%, 31/36), young adults aged 18-50 (88.89%, 32/36) and farmers/herdsmen (72.22%, 26/36). A total of 36 strains of Brucella melitensis were isolated, and average 1 305 functional proteins of 21 categories were predicted by strain genome; all the strains carried four main virulence factors (pmm, VirB group, BtpA/BtpB, BvrS/BvrR). The drug sensitivity rate was 100.00% to six types of antibiotics including levofloxacin, rifampicin, doxycycline, streptomycin, tetracycline and gentamicin, they showed different resistances to three antibiotics including compound trimethoprim-sulfamethoxazole, ciprofloxacin and ampicillin. The strains carried four types of resistance genes and two clusters of resistance genes, with four combinations of genotypes, the resistance mechanisms included antibiotic degradation/modification enzymes, resistant nodular cell differentiation (RND) efflux pumps, 16S/23S ribosomal rRNA binding site mutations, etc. The number of SNP differed in the genomes of 36 Brucellamelitensis strains ranged from 0 to 454 and phylogenetic tree was divided into three major branches, with relative branch distances between 0.000 0 and 0.498 6 for each strain. Conclusions:Human Brucellamelitensis strains isolated from surveillance sentinels in Henan from 2013 to 2022 carried multiple virulence and antibiotic resistance genes and had different drug resistance phenotypes. Single nucleotide polymorphism analysis and phylogenetic tree analysis showed significant differences in phylogenetic relationships among different strains.

Objective:To explore the clinical features, etiologies and outcomes of unknown origin fever after simultaneous pancreas-kidney transplantation(SPK).Methods:From March 2015 to January 2020, clinical data were retrospectively reviewed for 120 SPK recipients.According to the definite evidence of fever, such as microbial culture, imaging findings or rejection, they were divided into three groups of free-fever(FF, n=41)and defined-fever(DF, n=47)and fever of unknown origin(FUO, n=32). The differences in general clinical features, surgical complications, laboratory tests and prognoses were compared.Logistic regression was employed for analyzing the risk factors of FUO and Kapla-Meier for survival analysis.And P<0.05 was deemed as statistically significant. Results:Multivariate analysis revealed that preoperative diabetic gastroenteropathy was an independent risk factor for unexplained fever.Significant differences existed between FUO and DF groups in leucocyte count[6.50(5.13, 7.36)vs.10.36(6.11, 12.97)×10 9/L], C-reactive protein(CRP)[11.75(6.25, 16.85)vs.35.00(16.30, 75.00)μg/ml], procalcitonin[0.13(0.06, 0.18)vs.0.19(0.11, 1.05)ng/ml]( P<0.001, P<0.001, P=0.025). As compared with DF group, 19 recipients in FUO group only received 1-2 antibiotics and there was a shorter course of treatment[13(40.6%)vs.32(68.1%), P=0.016]. For 6(18.7%)recipients after a diagnosis of FUO, clinical outcome was achieved with only NSAIDs.Length of stay was(48.72±19.51)days in FUO group versus(57.36±27.46)days in DF group and the difference was statistically significant( P<0.001). Hospitalization expenses of two groups were 253 463.25 and 334 605.96 yuan respectively and the difference was also statistically significant( P=0.002). Conclusions:Diabetic gastroenteropathy is an independent risk factor for early FUO after SPK transplantation.Inflammatory markers of leukocytes, CRP and procalcitonin in FUO patients are significantly lower than DF group.And these clinical features can help diagnose FUO in an early stage.

Condylar displacement can lead to temporomandibular joint (TMJ) symptoms and relapse after orthognathic surgery. To minimize condylar displacement, numerous condylar positioning techniques have been applied in clinical practice. To verify the effectiveness of condylar positioning techniques in preventing postoperative TMJ symptoms and relapse, we reviewed the literature related to all types of intraoperative condylar positioning techniques in the past 20 years. According to a literature review, positioning techniques aim to seat the condyles at a preoperative position during surgery and are divided into noncomputer-aided and computer-aided condyle positioning methods. At present, computer-aided design/computer-aided manufacturing condylar positioning devices (CAD/CAM CPDs) are the most superior positioning methods and are composed of teeth-supported and bone-supported guidance. The sequence of the remaining technology positioning effect from high to low is as follows: CAD/CAM titanium plate positioning > manual positioning > computer-aided navigation system > image positioning system. Different techniques reach considerable accuracy within 1-2 mm and 1°-2° in locating the preoperative condylar position and preventing TMJ symptoms or disorders and surgical relapse to provide a clinical reference for different levels of surgeons and cases. However, this study lacks randomized controlled trials with large samples and long-term follow-up. Future studies should upgrade the current methods, improve the clinical utility, and develop new positioning techniques.

Objective:To explore the efficacy and safety of simultaneous pancreas-kidney (SPK) transplantation in patients aged over 60 years.Methods:A retrospective analysis was performed for 150 SPK patients from January 1, 2013 to June 30, 2019. Based upon age, they were divided into three groups of ≥60 years ( n=21), 50-60 years ( n=44) and <50 years ( n=85). Clinical data of three groups were compared, including postoperative rejection, perioperative graft thrombosis, reoperative frequency, average hospitalization time and readmission ratio. And cardiocerebrovascular complications before/after-SPK, CMV viremia within 1 year post-SPK, fasting blood glucose, fasting C-peptide, fasting insulin level, HbA1c at 1 year post-SPK, glomerular filtration rate (eGFR) at 1 year post-SPK and survival rate of patient/graft were compared. Results:There were 21 cases in ≥60 years group, accounting for 14% of the total number of cases and the maximal age was 67 years. The proportion of preoperative cardiovascular events was 14.3%(3/21) in ≥60 years group, 34.1%(15/44) in 50-60 years group and 7.1%(6/85) in <50 years group. Statistical difference existed among three groups ( P=0.001). A pairwise comparison indicated that preoperative cardiovascular event in 50-60 years group was higher than that in <50-years group ( P=0.0006). The postoperative cardiovascular events in three groups were 4.8%, 4.5% and 2.4% respectively and there was no statistical difference ( P=0.537). The incidence of graft thrombosis in three groups was 2 cases (9.5%) in ≥60 years group, 1 case (2.3%) in 50-60 years group and 7 cases (8.2%) in <50 years group ( P=0.384). The proportion of reoperation in three groups was 14.3%, 18.3% and 18.8% respectively and there was no statistical difference ( P=0.889). The causes of death were cerebral hemorrhage ( n=2), myocardial infarction ( n=2) and tumor ( n=1); ≥ 60 years group ( n=1), 50-60 years group ( n=1) and <50 years group ( n=3). No significant difference existed among three groups ( P=0.842). There was no significant difference in average postoperative hospitalization time, readmission rate, postoperative rejection, postoperative 1-year CMV viremia, postoperative cerebrovascular events, postoperative 1-year fasting blood glucose, fasting C-peptide, fasting insulin level, HbA1c, postoperative 1-year eGFR or patient/graft survival rate among three groups. Conclusions:Through strict preoperative evaluations, SPK for patients aged over 60 years increases no operative risk and achieves the same outcome.

Objective To explore the feasibility and safety of radiofrequency ablation for difficult access liver cancer under percutaneous local anesthesia combined with contrast-enhanced ultrasonography.Methods 45 patients(62 lesions) in the experimental group were treated by percutaneous,local anesthesia combined with contrast-enhanced ultrasound and in some cases with artificial ascites assisted by radiofrequency ablation vs control group of 40 patients (54 lesions) receiving radiofrequency ablation guided by CT or ultrasound through laparoscopy or open surgery.The complications,and postoperative residual and recurrence rates were compared between the two groups.Results Of the all patients,4 cases suffered from severe complications.The pain scores and the blood loss were less significant in the experimental group.There was no significant difference in tumor residual rate between the two groups when evaluated on one month after the procedures,and in the recurrence rate after three and six months.Conclusion Radiofrequency ablation for difficult liver cancer by percutaneous local anesthesia combined with contrastenhanced ultrasonography is less traumatic and less of complications compared to traditional method with a similar tumor residual rate and recurrence rate.

Objective To explore the surgical indications for pancreas-kidney surgery and summarize the experiences of ,selecting surgical approaches ,formulating immunosuppressive regimens and preventing complications .Methods A total of 145 donor simultaneous pancreas-kidney transplants in uremic patients with T1DM/T2DM between 2002 and 2018 were retrospectively analyzed .Based upon surgical approaches and immunosuppressive agents ,they were divided into three eras of 2002-2010 ,2011-2014 and 2015-2018 respectively .Patient profiles ,survival outcomes of patient and graft , surgical techniques ,immunosuppressive agents and incidence of common complications were compared among different groups .Results The overall 1/3/5-year patient and graft survival rates of three groups were above 75％ and the survival rates of group Ⅰ were inferior to those of groups Ⅱ and Ⅲ(P<0 .001) .The overall 1/3/5-year pancreas graft survival rates were the highest in group Ⅲ and the lowest in group Ⅱ (P=0 .004) .In the 2015-2018 group ,ipsilateral pancreas-kidney transplantation and SE-ED surgery were more preferred .Regarding the incidence of complications ,graft thrombosis frequently occurred from 2011 to 2014 and intestinal obstruction was more common from 2002 to 2010 .For univariable analysis of graft loss ,anticoagulation programme with argatroban monohydrate were 0 .28 times likely to lose pancreas graft (OR= 0 .28 ,95％ CI:0 .09-0 .86) and T1DM patients were 4 times likely to have kidney graft loss (OR=4 .08 ,95％ CI:1 .37-12 .15) .Conclusions SPK is an effective treatment for uremic diabetics . Effective perioperative management and preventing complications are crucial for prolonging patient and graft survivals .

Objective To explore the predictive value of partial pressure of end-tidal carbon dioxide (PETCO2) on the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and serum S100B protein on cerebral function. Methods 142 adult patients with in-hospital cardiac arrest (IHCA) AACD-CPR in Zhengzhou People's Hospital, Affiliated Southern Medical University from September 2014 to December 2017 were enrolled. Patients were divided into successful group and failure group according to restoration of spontaneous circulation (ROSC) or not; and then according to Glasgow-Pittsburgh cerebral performance categories (CPC) one month after ROSC, the successful group was divided into good prognosis group (CPC 1-2) and poor prognosis group (CPC 3-5) further. The variations of hemodynamic, arterial blood gas index, PETCO2and serum S100B protein level (25 healthy subjects as normal S100B protein level reference value) during the recovery were analyzed. The predictive value of PETCO2on the effect of AACD-CPR and serum S100B protein on cerebral function of successful resuscitation patients were analyzed by receiver operating characteristic curve (ROC). Results ① According to the traditional qualitative indexes, such as pulsation of the large artery, redness of lips and extremities, spontaneous fluctuation of chest, narrowing of pupil, existence of shallow reflex, etc, 54 in 142 patients with IHCA were successfully resuscitated; 57 cases were successfully resuscitated through the guidance of PETCO2, there was no significant difference between the two groups (χ2= 0.133, 1 = 0.715). With the AACD-CPR, 142 CA patients' arterial partial pressure of oxygen (PaO2), arterial blood carbon dioxide partial pressure (PaCO2) were all improved with different degrees; heart rate (HR), mean arterial pressure (MAP), PaO2and PaCO2were further improved at 20 minutes after ROSC. At beginning of AACD-CPR, PETCO2of both groups were about 10 mmHg (1 mmHg = 0.133 kPa). PETCO2was gradually rising to above 20 mmHg in successful group during AACD-CPR process; the failed group increased slightly within 2-5 minutes, then gradually decreased to below 20 mmHg, there was a significant difference in PETCO2between the two groups at each time. The area under the ROC (AUC) of PETCO2at CPR 20 minutes in predicting the outcome of the resuscitation was 0.969, 95% confidence interval (95%CI) was 0.943-0.995 (1 = 0.000), when the cut-off value of PETCO2was 24.25 mmHg, the sensitivity was 90.7%, and the specificity was 96.6%. ② The level of serum S100B protein at 0.5 hour after ROSC in the good prognosis group and the poor prognosis group were significant higher than that of the normal control group; there was no significant difference between poor prognosis group and good prognosis group. S100B protein concentration of the poor prognosis group reached the peak within 3-6 hours, then gradually decreased, and was higher than that of the normal control group at ROSC 72 hours; the good prognosis was gradually decreased and recovered to normal control group within ROSC 72 hours. The AUC of S100B at 3 hours after ROSC on cerebral function prognosis prediction was 0.925, 95%CI was 0.867-0.984 (1 = 0.000), when the cut-off value of S100B protein was 1.215 μg/L, the sensitivity was 85.2%, and the specificity was 85.5%. Conclusion The variation of PETCO2can be used as an objective index to predict the success of AACD-CPR, and serum S100B protein can be used as an objective clinical index to predict cerebral function after AACD-CPR, both of which have some reference and guiding significance for clinical treatment.

Objective:To explore the protective effect of the water-soluble total flavonoids from Isodon lophanthoides var.gerardia-nus (Benth.) H.Hara on LO2 cells damage.Methods:The cytotoxicity was evaluated by MTT cell viability determination to confirm the concentration range .Hepatocyte damage model was established by H 2 O2 treatment.After the oxidative stress hepatocyte was coin-cubated with WSTF at different concentrations for various times , the protective effect of WSTF on H 2 O2-induced hepatocyte damage was evaluated by MTT cell viability determination and the content determination of ALT , AST and MDA in cell supernatant .The inhibition of WSTF against H 2 O2-induced LO2 cells apoptosis was evaluated by the quantitative determination of Rhodamine 123 fluorescence and intracellular ROS.Results:The LO2 cells injured by 0.3 mmol· L-1 H2 O2 treatment for 4 h were used as the hepatocyte damage model.The concentration range of WSTF was 0.0312-0.125 mg· ml-1.WSTF could inhibit H2O2-induced injury in LO2 cells and obviously reduce ALT, AST and MDA.Moreover, WSTF could reverse mitochondrial membrane potential depolarization and decrease the amount of intracellular ROS .Conclusion:WSTF exhibits notable protective and curative effects on hepatocyte damage in vitro.

Objective To summarize the clinical characteristics of recipients of renal transplantation who used tacrolimus extended-release capsules,to optimize the postoperative immunosuppressive regimen,and provide reference for the therapeutic administration of imnmunosuppressive agents after renal transplantation.Methods 156 patients who had renal transplant in our center were divided into three groups according to the time of the change of the extended-release tacrolimus capsules,and the blood glucose and blood lipids of each group were analyzed.Results The longer the postoperative duration was,the higher proportion of new-onset diabetes cases (P =0.025).There was no significant difference among the three groups of immune induction regimens.The immnunosuppressive regimen was changed from MMF (68.8％ in G3 group) to MPA (72％ in G1 group).With the prolongation of postoperative time,the dosage of tacrolimus decreased gradually.The mean tacrolimus concentration in the 3 groups was significantly different (P＜0.001) as time went by.There was no significant change in the average daily dosage before and after the change.The trough value before and after the change in the first two groups was significantly different (P＜0.001).Conclusion The extended-release tacrolimus capsules could be used in different stages after renal transplantation.After the conversion of the extended-release tacrolimus capsules,the dosage of adjuvant is reduced,and blood concentration and creatinine level are more stablem which is a more optimized immunosuppressive regimen.