Background The dysfunction of the blink reflex the eyelid-closure ability appears in the patients with facial paralysis,and its management is the implantation of mechanical-assisted eye-closure device in the upper eyelid.A novel device is palpebral spring implant.However,there is no similar study in China.Objective This study was to evaluate the clinical efficacy of palpebral spring placement for lagophthalmos caused by facial nerve palsy.Methods This clinical research complied with Helsinki declaration and the protocol was approved by Ethic Committee of Henan Eye Institute & Henan Eye Hospital.Written informed consent was obtained from each patient prior to the surgery.A retrospective serial case-observational study was performed.The medical records of 11 patients who underwent palpebral spring placement for hypophasis due to facial nerve palsy were reviewed at Henan Eye Hospital from August 2010 to November 2012.Palpebral spring placement was performed by the same surgeon to ensure a more even outcomes.Palpebral spring was made by nickel wire,with the diameter of 0.3 mm and implanted on tarsal plate in 11 eyes of 11 patients with symptomatic facial nerve palsy.The lower tip of Levine spring was encased into a small terylene bag and sutured to the anterior tarsal surface during the surgery.Preoperative and postoperative symptoms,upper eyelid margin to mid pupil distance (ULMD),degree of lagophthalmos and eyelid moving scope were examined and compared between before and after operation.The operating complication was followed-up for 8-38 months.Results The discomforted symptoms disappeared in all the operated eyes.The ULMD was (3.51±0.73) mm in preoperation and (3.20±0.86) mm in posteration,without significant difference between them (t=1.36,P=0.10).The degree of lagophthalmos was (5.94±1.57) mm and (1.06±0.98) mm in preoperation and postoperation respectively,showing a significant difference between them (t =9.42,P =0.00).The eyelid moving scope was (5.89±0.70) mm in postoperation,which was significantly increased in comparison with (0.11 ±0.33) mm of preoperation (t =22.97,P =0.00).The palpebral spring implant was regulated in 1 patient during the follow-up duration due to the trauma.No complication in other 10 patients appeared during the follow-up duration,such as implant exposure,metal fatigue or infection.Conclusions Palpebral spring placement is safe and effective for lagophthalmos in patients with facial nerve palsy.

OBJECTIVETo explore the prevalence of pulmonary surfactant associated pathway genes functional variants in Chinese population.

METHODUsing a cohort of 258 mixed ethnic population of Han and Zhuang, we pooled DNA samples from 146 term male infants and 112 term female infants and then used an Ill umina next generation sequencing platform to perform the complete exonic resequencing in 6 target genes:surfactant protein-B (SFTPB), surfactant protein-C (SFTPC), ATP-binding cassette transporter A3 (ABCA3), lysophospholipid acyltransferase 1 (LPCAT1), choline phosphotransferase 1 (CHPT1), phosphate cytidylyltransferase 1, choline, beta (PCYT1B). Collapsing methods was used to determine the functional allele frequency.

RESULT(1) Altogether, 128 variants were found, including 44 synonymous variants, 66 nonsynonymous variants and 18 insertions-deletions. Of these, 28 variants were predicted to alter protein function. Two of these variants were seen twice, the rest variants were only seen once, for a total of 30 functional alleles; (2) ABCA3 had the most functional variants in both male and female groups with the minor allele frequencies of 0.014 (1.4%) and 0.04 (4%), respectively. The total functional allele frequencies of 6 genes were 0.041 (4.1%) and 0.08 (8%) in the two groups, respectively (P = 0.06).

CONCLUSION(1) Functional variants in pulmonary surfactant associated pathway genes are present in the mixed Han-Zhuang population. (2) ABCA3 contained the most functional variants suggesting that ABCA3 could contribute significantly to neonatal respiratory distress syndrome and other lung disease.

1-Acylglycerophosphocholine O-Acyltransferase ; genetics ; metabolism ; ATP-Binding Cassette Transporters ; genetics ; Asian Continental Ancestry Group ; ethnology ; genetics ; China ; ethnology ; Female ; Gene Frequency ; Genetic Association Studies ; Genetic Predisposition to Disease ; Genetic Variation ; Genotype ; Humans ; Infant, Newborn ; Male ; Pulmonary Surfactant-Associated Protein C ; genetics ; Pulmonary Surfactant-Associated Proteins ; genetics ; Respiratory Distress Syndrome, Newborn ; ethnology ; genetics

Purpose: Medical schools have faced various challenges in preparing their clinical students for the frontlines of a pandemic. This study investigated medical students’ satisfaction with their institutions during the coronavirus disease 2019 (COVID-19) pandemic with the intention of guiding educators in future public health crises. Methods: In this cross-sectional study surveying students in clinical rotations, the primary outcome was overall satisfaction regarding medical schools’ responses to the pandemic, and the four secondary outcomes were school communication, exposure to COVID-19, availability of personal protective equipment, and access to COVID-19 testing. Results: The survey was distributed to ten medical schools, of which 430 students responded for a response rate of 13.0%. While most students were satisfied (61.9%, n=266) with their schools’ response, more than one in five (21.9%, n=94) were dissatisfied. Among the four secondary outcomes, communication with students was most predictive of overall satisfaction. Conclusion In future crises, schools can best improve student satisfaction by prioritizing timely communication.