Objective To study the effect of using handhold magnifier on reading speed in patients with low vision and normal-sighted people. Design Prospective,control study. Participants Low vision (13 patients)and normal-sighted readers (37 persons) who use handhold magnifiers or the first time. Method Nine-point text was read by normal vision subjects without magnifier and then with two magnifiers with different magnification (+10 D,+20 D) in different eye-to-magnifier distance (10 cm,35 cm). Nine-point text was also read by low vision people with magnifiers. The big printed text under the same magnification without magnifier was also read by low vision group. Reading speed was recorded. Main Outcome Measures Reading speed (words per minute). Result For normal vision subjects,reading speed without magnifier (194.6?45.2 words/min) is faster than that with a 10D magnifier in an eye-to-magnifier distance of 10cm (159.7?44.7 words/min) (P=0.001),and distance of 35cm (162.5?46.7words/min) (P=0.002),respectively. Reading speed without magnifier is also faster than that with a 20D magnifier in an eye-to-magnifier distance of 10cm (150.3?43.3 words/min) (P

Objective To observe the prevention and treatment of the total flavonoids from Litchi chinensis Sonn( TFL) on hepatic fibrosis induced by dimethylnitrosamine(DMN)in rats, and to explore its mechanism. Methods Ninety SD rats were randomly divided into six groups, normal control group, model control group, colchicine group, high-, medium- and low-dose TFL group(n=15).Expect for normal control group, the other groups were given intraperitoneal injection of 2 mL.kg-1 of 5% dimethylnitrosamine for 4 weeks as the model group. The rats in the normal control group and model control group were given 5 mL.kg-1of 0.9% sodium chloride solution, colchicine group was treated with 0.1 mg.kg-1 colchicine.High-, medium-and low-dose TFL groups were given 200, 100 and 50 mg.kg-1 of TFL.The rats were sacrificed and the livers were harvested and stained with HE and Masson staining to observe pathological changes and liver fibrosis in the same part 6 weeks after all the medicine was given to the rats each day. Immunohistochemistry and Western blotting were used to detect the expression of the transforming growth factor β-Ⅰ/type Ⅱ receptor ( TβRⅠ/Ⅱ) , collagen Ⅰ( Col Ⅰ) and Ⅲ collagen ( Col Ⅲ) . Results Compared with the normal control group, the semiquantitative score of liver fiber and the protein expression of TβRⅠ, TβRⅡ, ColⅠ and Col Ⅲ in the model control group were significantly increased(P<0.01).Compared with the model control group, the protein expression levels of TβR, TβRⅡ, ColⅠand ColⅢwere significantly decreased( P<0.01) in the high-,medium-and low-dose TFL group.The semiquantitative score of liver fiber was significantly decreased( P<0.01) with a dose-effect relationship. Conclusion TFL can inhibit formation of DMN-induced liver fibrosis in rats, which may be related with reduction of expression of TβRⅠ/Ⅱ of hepatic fibrosis promoting factor TGF-β1 , inhibition of the activation and increase of hepatic stellate cells, reduction of the collagen content.

Objective To optimize extraction process of flavonoids from Toosendan Fructus.Methods Three parameters that significantly affect the extraction rate of flavonoids, ratio of material to water, extraction time and ethanol concentration, were taken into consideration for extraction ratio of flavonoids from Toosendan Fructus. Based on the results of single-factor experiment, the extraction parameters of flavonoids from Toosendan Fructus were optimized by Box-Behnken of response surface methodology (RSM).Results The optimum extraction conditions were as follow: material to water ratio was 1:35; extraction time should be 3 h; ethanol concentration was 70%. The extraction ratio was up to 0.587 3% in the optimum extraction conditions.Conclusion The actual value is highly matching the theoretically value of RSM model. The results indicated that this method can rationally optimize extraction process of flavonoids from Toosendan Fructus.

OBJECTIVE: To explore the effect of thrombocytopenia on the prognosis of patients with septic shock and its mechanism in leading to death. METHODS: A retrospective case-control study was conducted. Patients with septic shock admitted to emergency intensive care unit (EICU) and intensive care unit (ICU) in Peking University People's Hospital from April 1, 2015 to January 31, 2023 were enrolled. Patients were divided into the thrombocytopenia group and the non-thrombocytopenia group, according to whether the minimum platelet count was less than 100×10⁹/L within 24 hours after admission to ICU. The outcome index was the mortality during ICU stay. The baseline data, hospitalization information and laboratory test results of the two groups were compared, and the risk factors of in-hospital death were analyzed by Logistic regression, and the mediation effect was performed by Bootstrap method. RESULTS: A total of 301 patients with septic shock were enrolled, of which 172 (57.1%) had thrombocytopenia and 129 (42.9%) did not. There were significant differences between the two groups in age, mortality, disseminated intravascular coagulation (DIC), continuous renal replacement therapy, and level of creatinine, urea nitrogen, total bilirubin, white blood cell count, lymphocyte count, prothrombin time (PT) and activated partial thromboplastin time (APTT). Univariate Logistic regression analysis showed thrombocytopenia [odds ratio (OR) = 4.478], continuous renal replacement therapy (OR = 4.601), DIC (OR = 6.248), serum creatinine (OR = 1.005), urea nitrogen (OR = 1.126), total bilirubin (OR = 1.006) and PT (OR = 1.126) were risk factors of death during hospitalization in patients with septic shock (all P < 0.05). Multivariate Logistic regression analysis showed that thrombocytopenia [OR = 3.338, 95% confidence interval (95%CI) was 1.910-5.834, P = 0.000], continuous renal replacement therapy (OR = 3.175, 95%CI was 1.576-6.395, P = 0.001) and PT (OR = 1.077, 95%CI was 1.011-1.147, P = 0.021) were independent risk factors for in-hospital mortality in patients with septic shock. Mediation analysis showed that 51% of the deaths due to thrombocytopenia in patients with septic shock were due to coagulopathy. CONCLUSIONS Thrombocytopenia is a powerful predictor of death in septic shock patients, and half of all thrombocytopenia-related deaths may be due to abnormal coagulation function.
Humans ; Shock, Septic ; Retrospective Studies ; Case-Control Studies ; Hospital Mortality ; Prognosis ; Thrombocytopenia ; Intensive Care Units ; Bilirubin ; Nitrogen ; Urea ; Sepsis

Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.

Objective Tostudy the influence of pipe structures on the mixing uniformity of airborne effluents from nuclear power plant chimneys. Methods We used the computational fluid dynamics (CFD) method to simulate the velocity distribution and gas mixing in long straight pipes (I type) with square section and circular section, 90° single-bend pipes (L type) with square section and circular section, and 90° double-bend pipes (S type and U type) with square section and circular section. Results For the long straight pipe, due to the lack of flow disturbance caused by structural changes, the mixing effect was not good; when the pipe section was circular, it might take mixing distance 20 times the hydraulic diameter to achieve the uniformity index required by the relevant standard; for the square pipe, the distance might be longer. In the single bend pipe with square section, the velocity uniformity was improved more greatly after the bend, and the tracer gas met the mixing uniformity at a shorter distance (11 times the hydraulic diameter), as compared with the single bend pipe with circular section. For the S-type double-bend pipe, the tracer gas appeared uniformly mixed after a distance 6 times the hydraulic diameter in the square pipe, and 7 times the hydraulic diameter in the circular pipe. For the U-type double-bend pipe, the gas in the square pipe also achieved uniform mixing ata shorter distance downstream, and the airflow showed greater disturbance when passing through the bend. Conclusion The CFD method can make an accurate prediction for the change patterns of gas mixing uniformity in pipes with different structures, and can partially replace physical experiments to study the factors affecting the mixing uniformity of airborne effluents from the chimney of nuclear power plants.

Pancreatogenic diabetes is a type of diabetes mellitus secondary to exocrine pancreatic disease， and it was officially proposed by the American Diabetes Association in 2014， with chronic pancreatitis as the most common etiology， followed by pancreatic cancer. At present， the misdiagnosis rate of this disease is extremely high， and patients with pancreatogenic diabetes have a higher risk of death and readmission than patients with type 2 diabetes. Therefore， it is of great significance to fully understand， correctly identify， and diagnose pancreatogenic diabetes in the early state， so as to reduce the disability rate and mortality rate of this disease. This article reviews the advances in the possible pathogenesis， diagnosis， treatment， and management of pancreatic diabetes secondary to pancreatitis and pancreatic cancer.

Pancreatogenic diabetes is a type of diabetes secondary to pancreatic exocrine disease， and it was officially named by American Diabetes Association in 2014. Chronic pancreatitis and pancreatic cancer are the most common causes of pancreatogenic diabetes. The pathogenesis of this disease remains unclear， and there is still a lack of systematic treatment regimens， which leads to the extremely high misdiagnosis rate of pancreatogenic diabetes in China and globally. In addition， studies have shown that compared with patients with type 2 diabetes， patients with pancreatogenic diabetes tend to have higher risks of death and readmission， which brings great challenges to the health and clinical treatment of patients. Therefore， the comprehensive understanding and early accurate identification and diagnosis of pancreatogenic diabetes are of great significance in reducing the disability and mortality rates of this disease. This article elaborates on the possible pathogenesis of pancreatogenic diabetes.