OBJECTIVETo study the development of anterior fontanel(AF) in children less than 2 years of age.

METHODThe size of AF of the children under 2 years of age was measured. The criteria were: (1) All the children were singletons and term (37 weeks ≤ gestational age ≤ 40 weeks) at birth, birth weight > 2500 g. (3) Those with intracranial diseases (included trauma and asphyxia) and scalp hematoma were ruled out. (3) Healthy children (without intracranial disease, growth retardation, congenital syndrome or bone metabolic diseases such as rickets).

RESULT(1) The mean value of AF in neonates was 1.5 (0.3 - 2.5) cm, and the average of the AF at 1 month after birth was 2.2 cm, which was the largest one. The size of AF was 1.0 (0.3 - 2.0) cm at age 12 months, and 0.5 (0.3 - 0.7) cm at 24 months. (2) The percentage for the closure of the AF was 3% at 6 months, 26.5% at 12 months, and 93.0% at 24 months. (3) There were no gender differences in the size of the AF (P > 0.05). And the size of AF was not correlated with the development levels of weight, length, and head circumference (P > 0.05).

CONCLUSION(1) The size of AF at 1 month was maximum (2.2 cm), and then decreased by years. The AF was almost closed (93%) at 24 months. (2) There were no gender differences in anterior fontanel (P > 0.05). The size of AF was not correlated with the growth of weight, length, and head circumferences (P > 0.05). (3) The fontanel dimensions should be represented by oblique diameters of the fontanel in clinical pediatrics. (4) The AF closure time needs to be further evaluated in normal children.

Age Factors ; Birth Weight ; Body Height ; Body Weight ; Cephalometry ; methods ; Child Development ; Child, Preschool ; Cranial Fontanelles ; anatomy & histology ; growth & development ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Reference Values

【Objective】 To conduct Rh blood group serological testing and third-generation sequencing(TGS) on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing. 【Methods】 From January to August 2023, individuals who participated in blood donation in our blood center were selected as the study objects. RhD variant phenotype identification was performed using routine serological methods. Once the RhD variants were identified, tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit. Furthermore, after the genomic DNA from 22 RhD variant blood samples was extracted, imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS. The RHD gene sequence was analyzed using SnapGene software. 【Results】 Among the 22 RhD variants, 8 were DVI type 3 (36.36%), with the main mutation of RHD-CE (3-6)-D hybrid allele. Six cases (27.27%) showed partial weak D15 type, with the main mutation of c.845G>A. There were 6 cases of Asia type Del (27.27%), with the main mutation of c.1227G>A. One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D (c.491A>T, p. Asp164Val, missense mutation). 【Conclusion】 The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3, and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).

Cataract surgery has moved from the era of anti-blindness surgery to the era of refractive surgery, and vision-related quality of life has become an important prognostic indicator for cataract surgery. Since indicators like visual acuity are difficult to describe the visual quality of patients in a panoramic view, the evaluation of visual function based on subjective experience has received attention in clinical and scientific research. The visual functioning index(VF-14)is the first scale applied to assess the visual function in cataract surgery, and is widely used internationally so far. This review presented the research history of VF-14, scrutinized its clinical applicability, and summarized the research and application of VF-14 in the assessment of visual function, evaluation of surgical efficacy, and postoperative follow-up from three groups of people with cataract, refractive discomforts, and other common ophthalmic diseases, aiming to provide a reference for the clinical application of the VF-14.

AMP activated protein kinase (AMPK) is a pivotal metabolic regulatory enzyme and novel target of controlling inflammation. Our previous studies had demonstrated that 5-amino-4-imidazolecarboxamide riboside (AICAR), an AMPK activator, attenuated lipopolysaccharide (LPS)/D-galactosamine (D-gal)-induced fulminant hepatitis via suppressing inflammatory response. Since inflammation usually activates the coagulation response and aggravates inflammation-induced tissue injury, the present study was to explore the effects of AICAR on inflammation-induced activation of coagulation. Male BALB/c mice received LPS/D-gal intraperitoneal injection were used as fulminant hepatitis model. Western blot was used to detect tissue factor (TF) and hypoxia-inducible factor 1α (HIF-1α) protein expressions in hepatic tissue, as well as nuclear factor kappa B (NF-κB) p65 translocation into the nucleus. Real-time quantitative PCR was used to analyze erythropoietin (EPO) mRNA expression level. Lactic acid (LA) level in hepatic tissue was detected by kit. The results showed that LPS/D-gal induced the enhanced expression of TF, elevation of NF-κB p65 nuclear translocation, up-regulation of HIF-1α and EPO expressions, and increased LA level. These above alterations could be suppressed by AICAR. These results suggest that AICAR may down-regulate LPS/D-gal-induced TF expression (coagulation activity), and relieve hepatic hypoxia and metabolic disorder via suppressing the activity of NF-κB, which may be a novel mechanism of the beneficial effect of AICAR on LPS/D-gal-induced fulminant hepatitis.
AMP-Activated Protein Kinases ; Aminoimidazole Carboxamide ; analogs & derivatives ; Animals ; Down-Regulation ; Erythropoietin ; Hepatitis ; Hypoxia-Inducible Factor 1, alpha Subunit ; Inflammation ; Lipopolysaccharides ; Male ; Mice ; NF-kappa B ; Thromboplastin ; Up-Regulation

In 2022, the Taiwan, China fundus disease expert group issued the Consensus on the Optimal Treat-and-Extend Regimens for Neovascular Age-Related Macular Degeneration. The following explanations are given to help Chinese ophthalmologists better to refer to and use the Consensus. The main contents are as follows: The treat-and-extend(T& E)regimen of anti-vascular endothelial growth factor(VEGF)treatment in patients with neovascular age-related macular degeneration(nARMD)should aim at maintaining long-term vision and reducing the number of injections. We can start the treatment by injecting once a month for consecutive 3mo. After the initial treatment, the treatment interval of patients with stable conditions can be gradually extended(2 or 4wk each time)until 16wk. If the disease is still steady after injecting 2 or 3 times at the most prolonged interval, we can suspend the treatment, and then the patient needs to be rechecked every 3-4mo; If the disease is active again, the treatment interval needs to be shortened and can be extended again after controlling the disease. We can adopt a relatively conservative approach for patients with apparent negative recovery factors. Complications such as subconjunctival hemorrhage, macular fibrosis and macular atrophy deserve our attention during treatment. In the future, we can explore the best injection scheme for nARMD patients with different subtypes and baseline conditions to realize personalized therapy.

The American Association of Cataract Surgeons issued the Consensus on Astigmatism Management in Cataract Surgery in 2019. To help Chinese ophthalmologists better comprehend the consensus, the main contents are explained: Toric intraocular lens(Toric IOL)implantation is the first choice for correcting corneal astigmatism. Three or more than three instruments should be used for preoperative measurement, and the values that are consistent with results should be taken. Then the Barrett Toric calculator can be used to calculate Toric IOL. When calculating toric IOL,the position of the surgical incision, surgically induced astigmatism(SIA), etc. should be considered. Then, the Toric IOL that makes resultant astigmatism close to 0 without flipping the astigmatism axis can be selected. The intraoperative automated image-guided systems can be used to guide the implantation. If residual astigmatism causes discomfort, laser in situ keratomileusis(LASIK)or IOL replacement can be used for correction. Toric IOL implantation is not recommended for patients with pseudoexfoliation(PXF)syndrome or macular lesions. There are many contraindications in dysfunctional lens syndrome(DLS)patients, which should be carried out by senior doctors. In the future, it is necessary to explore further the influence of haptic design and optic material on the rotational stability of IOL. Cataract surgery assisted by intraoperative aberrometers, automated image-guided systems or femtosecond laser still needs further development.

【Objective】 To investigate the current situation concerning volume control of red blood cells in additive solution produced by blood service in Chongqing, and to lay a foundation for promoting the homogenization of preparation process of red blood cells in additive solution. 【Methods】 A questionnaire was designed to investigate the factors related to the preparation of red blood cells in additive solution. The questionnaire was sent by Chongqing Association of Blood Transfusion via E-mail to 18 blood services in the city, and the collected data was sorted, revised and analyzed by research team. 【Results】 A total of 18 blood services(including 1 blood center + 1 sub-center, 6 central blood stations and 11 central blood banks) returned the questionnaires. The results showed that there were differences among blood services across Chongqing, regarding the centrifugal parameters during preparation, the operation mode and monitoring situation of the capacity control during preparation, and the formulation of the capacity standard of red blood cells in additive solution etc. 【Conclusion】 The preparation process of red blood cells in additive solution, produced by Chongqing blood services, should be further standardized, and the capacity control method of this product in Chongqing should be gradually unified to achieve regional homogeneity and to ensure blood safety.

AIM: To evaluate the efficacy of high-intensity focused ultrasound cyclo plasty(UCP)in the treatment of glaucoma and to investigate related influencing factors.METHODS: The study involved a total of 110 patients(134 eyes)who received UCP treatment between January 2019 and January 2022 at three medical centers: Tianjin Eye Aier Eye Hospital, Chongqing Aier Eye Hospital, and Chongqing Nanping Aier Eye Hospital. Patients were classified into three categories: primary angle-closure glaucoma, primary open-angle glaucoma, and secondary glaucoma. Best corrected visual acuity, intraocular pressure, and the usage of anti-glaucoma medications, etc., were recorded at 6 and 12 mo postoperatively.RESULTS: After 6 months of the UCP procedure, statistically significant differences in intraocular pressure were observed across all groups(all P<0.05). At 12 mo postoperatively, intraocular pressure of the primary angle-closure and primary open-angle glaucoma groups showed differences(all P<0.05). Notably, there were no significant changes in visual acuity at either the 6 or 12 mo compared to preoperative values across all patient groups(all P>0.05). Furthermore, the study identified a statistically significant correlation between the changes in intraocular pressure at 6 mo and factors such as age, history of previous glaucoma surgery, baseline white-to-white(corneal diameter), and the extent of UCP treatment(all P<0.05).CONCLUSION: The UCP procedure has been demonstrated to effectively lower intraocular pressure in patients with glaucoma. The efficacy appears to be influenced by variables including patient age, previous glaucoma surgery history, baseline white-to-white(corneal diameter), and the scope of UCP treatment. Importantly, UCP treatment did not adversely affect visual acuity, underscoring its favorable safety profile.

Objective: To explore the early diagnosis, therapeutic methods and efficacy for blunt cardiac injury (BCI). Methods: All BCI patients from September 2003 to August 2018 were studied retrospectively in respect of sex, age, cause of injury, diagnostic methods, therapeutic procedures, and outcome. The patients were divided into two groups: nonoperative group (n=305) and operative group (n=43). The two groups were compared and analyzed. Results: Totally 348 BCI patients accounted for 18.3% of 1 903 patients with blunt thoracic injury (BTI), and the mortality rate was 10.1%. The main cause of injury was traffic accident with an incidence of 48.3%. The diagnostic methods included electrocardiogram (ECG), enzymes and troponin I, echocardiography, and CT scanning, or confirmed by emergency thoracatomy. In the nonoperative group, patients were mainly myocardial contusion, with a mortality rate of 6.9%. In the operative group, patients were mainly cardiac rupture and pericardial hernia, and the mortality was 32.6%. The incidence of negative ECG between the two groups was not significantly different (16.7% vs 11.6%, P>0.05). The incidence of shock and mortality in the operative group were significantly higher than those in the the nonoperative group (P<0.01). The number of death directly resulted from BCI in the operative group was greater than that in the nonoperative group (P<0.05). Conclusions For BTI patients, BCI must be highly suspected, and necessary examinations should be given. To manage myocardial contusion without surgery, it is necessary to protect the heart, alleviate edema of myocardium, and control arrhythmia with drugs. To deal with those patients requiring operation, early recognition and expeditious thoracotomy are essential.

Imipenem-cilastatin is a broad-spectrum carbapenem antibiotic drug that has been widely used in clinical practice ， but there is a lack of guidelines and expert consensus on the development of individualized regimens for special status populations [e.g. continuous renal replacement therapy （CRRT）patients，extracorporeal membrane oxygenation （ECMO）patients， critically ill burn patients ，neonates and children]. In this paper ，by searching population pharmacokinetics research of imipenem- cilastatin in special status populations ，it is recommended that imipenem-cilastatin is given 1 to 3 g/d for CRRT patients ；500 mg to 1 g，q6 h for burn patients ；750 mg to 1 g，q6 h for ECMO patients ；20 mg/kg or 25 mg/kg，q8 h for neonates ；and 25 mg/kg，q6 h for children.