Objective To analyze the risk factors of ANCA-associated systemic vasculitis with pulmonary infection to improve the alertness of clinicians to imprave the survival of patients.Methods Seventyfive AASV patients in Shanghai Renji Hospital from January 2010 to June 2013 were selected,and logistic regression models was applied to analyze the correlation.Results Of 75 AASV patients,39 (52％) cases were males,36(48％) cases were females,the average ages were (56±19),56(75％) cases were MPA,17(23％) cases were WG and 2(3％) cases were CSS.42(56％) cases were diagnosed to have pulmonary infection.Among the patients with pulmonary infection,23 (55％) were males,19 (45％) were females,24 (57％) were older than 60 years old,17(12％) had WG,37(88％) had MPA,and 8(19％) died.Meanwhile,11(26％) had bacterial infection,2(5％) had tuberculosis,2(5％) had fungi infection,and 27(64％) had mixed infections respectively.8(19％) cases died.Multivariate logistic regression analysis showed that those who were older than 60 years (OR=15.13,95％CI 2.16-106.04,P＜0.01),who were diagnosed as MPA (OR=9.00,95％CI 1.37-59.14,P＜0.05),who had hypoproteinemia (OR=17.61,95％CI 3.14-98.74,P＜0.01) and interstitial lung disease (OR=11.83,95％CI 2.19-63.85,P＜0.01) were more likely to complicate with pulmonary infection.Conclusion Those who are elders,diagnosed as MPA,with hypoproteinemia and interstitial lung disease have higher risk to have pulmonary infection among AASV patients,which underscores that clinicians should pay more attention to this complication of AAV patients.

Occult myopia refers to a special type of myopia, which is caused by the axial length beyond the normal range of children's normal age, and the corneal curvature is lower than the normal range of children with the normal age range of the vision. Because the vision of occult myopia children is within the normal range, it is easy to be ignored in myopia screening. Without timely myopia prevention and control, occult myopia is very easy to develop into dominant myopia, not only the visual development is seriously affected, but visual function will also produce irreversible changes. It is found that the axial length, corneal curvature, retina and chorioid of occult myopia are different from those of ordinary myopia. The change of these indicators can be used to assist the diagnosis and observe their development process. The purpose of this paper is to summarize the research progress at home and abroad on ocular axis length, corneal curvature, macular retinal thickness, macular choroidal thickness and other related factors in children with occult myopia, in order to provide references for related clinical research.

Objective To investigate the causes of fever in systemic lupus erythematosas (SLE)patients and identify the characteristics of the fever caused by SLE fever infection after steroid therapy.Methods From January 2002 to May 2007, 487 SLE hospitalized patients with fever were admitted and their data were retrospectively studied. The clinical manifestations and medications were followed up. A case control design was carried out to identify the differences between fever caused by lupus and infection. Results Among all the 487 patients, 265 had infection, 206 had fever that was caused by SLE per se, fever caused by both lupus and concurrent infection was confirmed in 8 patients, malignancy and miscellaneous were the causes of fever in 4 respectively. The most common sites of infection were respiratory tract (61.3%), skin and mucosa (10.9%) and central nervous system (9.1%). The main microorganisms isolated were bacteria (77.4%), fungi (13.5%) and virus (7.8%). Prednisene ≤ 100 mg/d could suppress fever caused by lupus in 81.0% patients, usually within 1 to 5 days. In the case control study, lower C3, C4 and CH50, anemia, lymphocytosis, higher immunoglobulin levels, elevated anti-dsDNA antibodies, elevated anti-nuclear antibodies and higher SLEDA1 score were associated with SLE fever. Long SLE duration, old age, elevated CRP levels,leukocytosis, neutrophilia, high accumulated doses of prednisone and ever use of immunosuppressive medications were factors associated with infection. Conclusion The fever of in-patient SLE patients is mainly caused by infections and disease flare. Moderate dose of steroid therapy is effective to control the fever caused by lupus flare. The fever caused by SLE has different clinical features and laboratory results when compared to that caused by infection although both responses to steroid therapy.

In order to study the new function of riboflavin, the experiments of ri-boflavin on the prevention of teratogenesis were conducted. The experimental rats were divided into four groups A,B,C,D. A served as a control group, B,C,D, were given 50?g, 250ng and 1000?g of riboflavin respectively for one week intragastrically prior to the study. After pregnancy, all rats including controls were given teratogenic pesticide Dikushuang 0.75mg/kgbw for contaminaton intragastrically, riboflavin being given continually as before, to observe the effects on body weight growth and hemoglobin level of pregnant rats. The following parameters were measured: the reproduction of pregnant rats, the development of fetus and the teratogenic activity of fetus after animals were killed. The experimental results showed that the average body weight gain in the each dose groups of riboflavin were higher than the control group, but the difference was not significant. The hemoglobin levels at various experimental times were less significant among the groups.The rates of the resorption and the living fetus in 250?g and 1000?g groups were significantly lower than the control (P

Objective:To observe the effect of different doses of Fufang Huangbaiye Tuji asin the treatment onof the inflammatory response in healing process for of skin with deep Ⅱ degree burn. Methods in healing process. Methods:The 120 cses patients with deep Ⅱ degree burn of fire-toxin injuring fluid syndrome diagnosed in the affiliated hospital of Chengde Medical University between June 2019 and March 2020 were randomly divided into control group，low -dose treatment group and high -dose treatment group，with 40 cases in each group and once. They got a dressing change perevery day. Control group was locally administered with lodophor solution 35 mL per 1% on the body surface area. Low-dose treatment group was locally administered with compound cortex phellodendri fluid 17.5 mL per 1% on the body surface area，while high-dose treatment group was locally administered with compound cortex phellodendri fluid 35 mL per 1% on the body surface area. Observe theThe inflammatory reaction of wound surface in each group onwas observed at admission and after treatment. The pathological changes of each groupsgroup were observed， and determination of nuclear factor kappa-B（NF-κB） p65 expression inon the wound surface was determined by immunohistochemistry on the 4th day after the treatment. The levels of interleukin（IL）-2，IL-8 and tumor necrosis factor（TNF）-α in wound tissue were measured with ELISA and Bacterial culture and count were performed in each group on the 4^th，10^th and 21^st daydays after treatment. The levels of IL-2，IL-8 and TNF-α in wound tissue were measured with ELISA. Results:There was no significant difference in the degree of wound inflammation in each group at admission，and the degree of relief after treatment was positively correlated with the treatment time. At the simultaneous phase point，the inflammatory reaction was severest in control group，which was followed by low-dose treatment group and high-dose treatment group. Bacterial growth were observed on the 4^th day in control group，which was found in low-dose and high-dose treatment groups on the 10^th day，the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa were the highest. Compared with control group，the mean integrated optical density of NF-κB p65 in wound tissue decreased markedly in low-dose and high-dose treatment groups on the 4th day after treatment（P<0.05），the bacterial count decreased significantly in low-dose and high-dose treatment groups on the 10^th and 21^st days after treatment（P<0.05），and the levels of IL-2，IL-8 and TNF-α in wound tissue decreased markedly in low-dose and high-dose treatment groups on the 4^th，10^th and 21^st days after treatment（P<0.05），with statistically significant differences between low-dose and high-dose treatment groups（P<0.05）. Histopathological examination showed that inflammatory granulocytes and edema were improved in low-dose and high-dose treatment groups compared with control group，with a more significant performance in high-dose treatment group. Conclusion:The external application of compound cortex phellodendri fluid can reduce thebacterial growth of bacteria in on the wound surface，which may reduce the inflammatory reaction by inhibiting the production and release of inflammatory mediators，with a certain dose-effcteffect relationship，and is worth clinical promotion.

Objective:To study the intervention effect and underlying mechanism of Fufang Huangbaiye Tuji （FFHBY） on skin with deep Ⅱ degree burn wound. Method:Patients with deep Ⅱ degree burn of fire-toxin injuring fluid syndrome diagnosed in the Affiliated Hospital of Chengde Medical University from June 2019 to June 2020 were randomly divided into a control group （iodophor solution， 35 mL per 1% body surface area）， a low-dose treatment group （FFHBY， 17.5 mL per 1% body surface area）， and a high-dose treatment group （FFHBY， 35 mL per 1% body surface area）， 40 cases in each group. The patients in each group were treated correspondingly with dressing chance once per day. The pathological changes of the wound were observed on the 14th day after treatment. Wound symptoms and signs in each group before treatment and on the 7th， 14th， and 21st days after treatment were quantified， and the clinical efficacy on the 21st day after treatment was evaluated. Wound healing rates in each group were calculated on the 7th， 14th， and 21st days after treatment. The levels of vascular endothelial growth factor （VEGF）， fibroblast growth factor （FGF）-2， FGF-7， epidermal growth factor （EGF）， interleukin （IL）-10， tumor necrosis factor （TNF）-α， and Caspase-3 in wound tissues were measured with enzyme-linked immunosorbent assay （ELISA）. Nuclear factor kappa-B （NF-κB） p65 expression in wound surface was detected by immunohistochemistry. The apoptosis rate in wound tissues was determined by the TdT-mediated dUTP-biotin nick end labeding assay （TUNEL） method. Result:There was no significant difference in scores of symptoms and signs among groups before treatment. Compared with the control group， the treatment groups showed no significant difference in wound healing rates on the 7th day after treatment and increased healing rates on the 14th and 21st day after treatment（P<0.05）. The clinical efficacy in the treatment groups was superior to that in the control group on the 21st day after treatment. Additionally， the treatment groups also showed decreased scores of local symptoms and signs， increased levels of VEGF， FGF-2， FGF-7， EGF， and IL-10， and dwindled apoptosis rate and levels of Caspase-3， TNF-α， and NF-κB p65 expression in wound tissues on the 7th，14th and 21st day after treatment （P<0.05）. The high-dose treatment group was superior to the low-dose treatment group in the above indicators （P<0.05）. Histopathological examination showed that inflammatory cell infiltration was relieved in the treatment groups as compared with that in the control group， and the high-dose treatment group exhibited superior efficacy. Conclusion:FFHBY had an obvious therapeutic effect on deep Ⅱ degree burn. It could promote wound healing by up-regulating the level of growth factors， improving inflammatory response， and inhibiting cell apoptosis in a dose-dependent manner.

The acupoint effect of Sanyinjiao (SP 6) and Xuanzhong (GB 39) as well as the internal relation of Sanyinjiao (SP 6)-Xuanzhong (GB 39) were analyzed in this paper to explore the relationship between opposite acupoints and acupoint effect. It was found both Sanyinjiao (SP 6) and Xuanzhong (GB 39) had acupoint effects, and the two acupoints had close relationship in acupoint effects (specificity along meridian and specificity of acupoints), acupoint-meridian relationship (anatomical locations, meridians and organs, indications). It is indicated the opposite acupoint of Sanyinjiao (SP 6)-Xuanzhong (GB 39) had related aspects in acupoint effects, which is related with acupoint effect through specificity and relationship of acupoint-meridian.

Chorioretinal disease has become a significant problem affecting human vision. Abnormal expression of vascular endothelial growth factor(VEGF)leads to increased fundus permeability and neovascularization. Vitreous injection of anti-VEGF agents can rapidly inhibit the level of VEGF in the eye and effectively control the development of the disease. At present, anti-VEGF agents are widely administered in ophthalmology. However, studies have shown that intravitreal anti-VEGF agents can reduce plasma VEGF concentration after entering the circulatory system, and the pointless off-target effects of drugs may lead to systemic adverse reactions. For elderly patients, patients with serious comorbidities, lactating women, premature infants and other special populations, attention should be paid to systemic VEGF inhibition after multiple injections. In this paper, in order to provide reference for clinical anti-VEGF therapy, the pharmacokinetics therapy, systemic adverse reactions, contralateral eye effects, and effects of anti-VEGF on breast milk and preterm infants were discussed, and the systemic effects of vitreous injection of anti-VEGF agents were reviewed.

OBJECTIVE: To observe the effect of moxibustion at oppositely-located points "Mingmen" (GV 4) and "Shenque" (CV 8) on the motor function of the hind limbs and bladder function in rats with neurogenic bladder after suprasacral spinal cord injury (SCI), so as to explore the effect of this therapy on bladder tissue apoptosis mediated by endoplasmic reticulum stress pathway. METHODS: Twenty-eight female Wistar rats were randomly divided into a sham-operation group (8 rats) and a model establishment group (20 rats). Using the modified Allen's method, the spinal cord of T₁₀ segment was injured to establish a neurogenic bladder model in the model establishment group. Sixteen rats were modeled successfully and then divided into a model group (8 rats) and a moxibustion group (8 rats). In the moxibustion group, 2 h after consciousness regaining from modeling anesthesia, moxibustion was exerted at "Shenque" (CV 8) and "Mingmen" (GV 4), 2 cones at each acupoint in one intervention. The intervention was administered once every two days and 5-time intervention was required totally. After intervention, Basso, Beattie and Bresnahan locomotor rating scale (BBB) score for the motor function of the hind limbs, and the urodynamics indexes (maximum bladder capacity, urine leakage pressure and bladder compliance) were compared among groups. HE staining method was adopted to observe the morphological changes of bladder tissue. With Western blot method and real-time PCR assay, the protein and mRNA expressions of the endoplasmic reticulum stress-related genes (glucose- regulated protein 78 [GRP78], activating transcription factor 4 [ATF4] and cysteinyl aspartate specific proteinase-12 [Caspase-12]) were determined. RESULTS: The transitional epithelial cells were arranged irregularly, the bladder wall was getting thinner, and the cellular vacuolar degeneration and neutrophil infiltration were found in the model group. Whereas, compared with the model group, in the moxibustion group, the arrangement of transitional epithelial cells was clear and continuous in layers, the cellular vacuolar degeneration was mild and the infiltration presented in a small amount of neutrophil granulocytes. Compared with the sham-operation group, in the model group, the BBB score was reduced (P<0.01), the maximum bladder capacity and bladder compliance were increased (P<0.01), and the protein expression levels of GRP78, ATF4 and Caspase-12, as well as mRNA expressions were all increased (P<0.01). In comparison with the model group, in the moxibustion group, BBB score was increased (P<0.01), the maximum bladder capacity and bladder compliance were decreased (P<0.01), and the protein and mRNA expression levels of GRP78, ATF4 and Caspase-12 were all decreased (P<0.01). CONCLUSION Moxibustion at the "oppositely-located points" improves the urination function, alleviate urine retention in neurogenic bladder rats after spinal cord injury. The underlying mechanism may be related to the down-regulation of the expressions of GRP78, ATF4 and Caspase-12 in the endoplasmic reticulum stress pathway of the bladder tissues, and thus to alleviate the apoptosis of bladder tissue.
Animals ; Caspase 12/genetics* ; Electroacupuncture ; Endoplasmic Reticulum Stress ; Female ; Moxibustion ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Spinal Cord ; Spinal Cord Injuries/therapy* ; Urinary Bladder, Neurogenic/therapy*

AIM:To observe the different effects of three intervention approaches on related biometric parameters in children diagnosed with latent myopia, and to investigate different control effects on children with latent myopia.METHODS:Prospective cohort concurrent controls trials. A total of 60 cases(120 eyes)of children who were initially diagnosed as latent myopia and untreated previously at ophthalmology clinic of the Affiliated Hospital of Chengde Medical University from December 2021 to May 2022 were recruited. They were randomly divided into three groups, with 20 cases(40 eyes)in group A treated with 0.01% Atropine eye drops, 20 cases(40 eyes)in group B treated with vision training with a flip chart, and 20 cases(40 eyes)in group C treated with esculin and digitalis glycosides eye drops. They were followed-up for 12 mo, and the spherical equivalent(SE), axial length(AL), corneal curvature(CC), accommodative facility(AF), and macular retinal thickness of the three groups of children were compared at 6 and 12 mo post-intervention.RESULTS:Significant statistical differences were found in AL, SE and AF of the three groups of children at 6 and 12 mo(all P<0.05), and there were significant differences between 6 and 12 mo after the intervention(all P<0.05). SE and AF in the group B and C were higher than those in the group A(all P<0.05). However, there were no significant differences in CC before and after the intervention(all P>0.05). The retinal thickness of the temporal, nasal, inferior and macular fovea of the outer ring at 6 and 12 mo after intervention in the three groups was significantly different from that at the initial diagnosis(all P<0.05), and there was significant difference between 6 mo and 12 mo after intervention(all P<0.05). There was no significant difference in the retinal thickness of the other macular areas among the three groups before and after intervention(all P>0.05).CONCLUSION:When it comes to preventing and controlling myopia, 0.01% Atropine is more effective than flip chart training and esculin and digitalis glycosides eye drops. Therefore, the administration of 0.01% atropine and the implementation of flip chart training can effectively slow down the advancement of latent myopia.