AIM:To study the changes of tear film and ocular surface after the coaxial micro incision 2. 2mm and 2. 8mm in the phacoemulsification.
METHODS:Eighty-six patients ( One hundred and six eyes ) from 2014/06 to 2016/01 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-four patients ( Fifty-three eyes) in group A: coaxial 2. 2mm micro- incision phacoemulsification cataract extraction and intraocular lens(IOL) implantation;Forty-two patients ( Fifty-three eyes ) in group B: the conventional coaxial 2. 8mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time ( BUT) , dry eye symptom ( DES) score, Schirmer's I test ( SⅠt ) and lid-wiper epitheliopathy ( LWE ) score were assessed preoperatively and postoperatively.
RESULTS:At 1wk, 1 and 2mo postoperatively, the BUT in two groups decreased after operations, and the BUT of group B was significantly lower than those of group A, the differences were statistically significant ( t = 3. 098, 4.512, 4.329; all P < 0. 05 ). The DES score in two groups increased, the DES score of group B was significantly higher than those of group A and the differences were statistically significant (t=-9. 449, -10. 029, -7. 141; all P<0. 05). The SⅠt in two groups increased after operations, the SⅠt of group B was significantly higher than those of group A and the differences were statistically significant (t=-6. 293, -4. 009, -3. 283; all P<0. 05). The LWE score in two groups increased after operations, the LWE score of group B was significantly higher than those of group A and the differences were statistically significant (t=-6. 542,-5. 125, -3. 632; all P<0. 05). At 6mo postoperatively, compared with the preoperative data, the BUT, DES score, S Ⅰ t and LWE score in group A showed no statistically significant differences (t=0. 659, 1. 276, 0. 548, 0.169; P>0. 05). The BUT, DES score, SⅠt and LWE score in group B showed statistically significant differences (t=-4. 063, 7. 306, 3. 621, 4. 208;all P<0. 05).CONCLUSION:Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm microincision phacoemulsification, compared with the conventional coaxial 2. 8mm incision phacoemulsification surgery.

Animals ; Behavior, Animal ; Reproduction ; physiology ; Social Behavior ; Tupaiidae ; physiology

Objective: To explore the effect of persistent atrial ifbrillation (AF) on circadian rhythm of blood pressure (BP) in patients with essential hypertension (EH).
Methods: A total of 173 EH patients treated in Gansu Provincial Hospital from 2013-02 to 2014-01were studied. The patients were divided into 2 groups: EH group,n=88 and Persistent AF combining EH group,n=85. The baseline information was studied and the risk factors of persistent AF combining EH were investigated by multivariate logistic regression analysis.
Results: Compared with EH group, the Persistent AF combining EH group showed decreased average daytime DBP, minimum daytime SBP, minimum daytime DBP and the average 24-hour DBP, while increased maximum nighttime SBP and the percentage of reverse dipper in DBP, allP<0.05. There were no significant differences for the average of daytime SBP, maximum daytime SBP, maximum daytime DBP, the average 24-hour SBP, average nighttime SBP, average nighttime DBP, maximum nighttime DBP, minimum nighttime SBP, minimum nighttime DBP and the percentage of reverse dipper in SBP between 2 groups, allP>0.05. Multivariate logistic regression analysis indicated that the maximum nighttime SBP was obviously related to persistent AF combining EH (OR=1.038, 95 CI 1.014-1.062,P=0.001).
Conclusion: Persistent AF may incur daytime BP dropping, such change was not obviously observed for nighttime BP in EH patients.

This study was designed to analyze the effect of the mitochondrial respiratory pathways of Candida albicans (C.albicans) on the biofilm formation.The 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction assay was used to measure the metabolic activities of biofilms formed by the C.albicans which were cultured in the presence of respiratory pathways inhibitors.The biofilms formed by the wide type (WT),GOA1-deleted (GOA31),GOA1-reconstituted (GOA32),AOX1a-deleted (AOX1) and AOX1b-deleted (AOX2) C.albicans strains were examined by the XTT reduction assay and fluorescence microscopy.The expression of adhesion-related genes BCR1,ALS1,ALS3,ECE1 and HWP1 in the biofilms formed by the above five C.albicans strains was detected by real time polymerase chain reaction.It was found that the metabolic activity of biofilms formed by C.albicans was decreased in the presence of alternative oxidase inhibitor whereas it was increased in the presence of classical mitochondrial respiratory pathway complex Ⅲ or complex Ⅳ inhibitor.AOX1 strain produced scarce biofilms interspersed with few hyphal filaments.Moreover,no significant changes in the expression of BCR1 and ALS3 were observed in the AOX1 strain,but the expression of ALS1 and ECE1 was down-regulated,and that of HWP1 was up-regulated.These results indicate that both AOX1 and AOX2 can promote the biofilm formation.However,AOX1a primarily plays a regulatory role in biofilm formation in the absence of inducers where the promoting effect is mainly achieved by promoting mycelial formation.

Objective To analyze the clinical and laboratory characteristics of systemic lupus erythematosus (SLE) in children. Methods Fifty-three inpatients, 5 boys and 48 girls with SLE, who aged from 7 to 14 years with a median age at 12 years, were enrolled into this study. A retrospective study was carried out to assess the clinical and laboratory features of these pediatric patients. Results The ratio of male to female patients was 1:9.6. Skin eruption was the most common initial manifestation (41.51%), followed by fever (20.75%) and arthralgia (20.75%). Systemic involvement was common, and 84.90% of these patients had hematological abnormalities, 60.38% renal involvement, 18.87% nervous involvement. The most common manifestation of hematological, renal and nervous involvement was anemia, proteinuria and seizures, respectively. Among the immunologic parameters tested, anti-nuclear antibody showed the highest positivity rate of 90.57%, followed by anti-dsDNA with a positivity rate of 67.92%. There was no significant difference between the male and female patients in the age of onset, SLEDAI score at admission and discharge, duration of hospitalization or the dose of corticosteroid used initially and at the discharge. Conclusion The manifestations of pediatric SLE are various, and multisystem involvement is common in these patients. Early diagnosis and active treatment might benefit the prognosis of pediatric SLE.

OBJECTIVEThe purpose of this study was to investigate the clinical significance of THY1 protein expression in epithelial ovarian cancer.

METHODSImmunohistochemistry (IHC) and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining were used to detect the protein expression of THY1, Ki67 and cell apoptosis in 76 epithelial ovarian cancers by tissue microarray. The correlation between THY1 expression and patients' clinical features was analyzed.

RESULTSOf the 76 epithelial ovarian cancer samples, 64 were informative for IHC and TUNEL assays and 42 (65.6%) among them showed down-regulated/loss expression of THY1 protein. A significant positive correlation of THY1 protein expression with clinical stage and distant metastasis was observed in this ovarian cancer cohort (P < 0.05). The more advanced the tumor stage, the more frequency of loss expression of THY1 protein. In addition, the mean positive rate of Ki67 staining in tumors with down-regulated/loss expression of THY1 was 33.7% +/- 3.5%, significantly higher than that in the tumors with normal expression of THY1 (17.3% +/- 6.1%, P = 0.0027). However, no significant correlation was observed between THY1 protein expression and tumor cell apoptosis as well as patients' survival in this series (P > 0.05).

CONCLUSIONDown-regulated/loss expression of THY1 protein in epithelial ovarian cancer is significantly correlated with cancer cell proliferation and metastasis in the epithelial ovarian cancer, and it may be used as one of the new molecular biomarkers to predict the disease progression in patients.

Adult ; Aged ; Apoptosis ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Down-Regulation ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Ovarian Neoplasms ; metabolism ; pathology ; Survival Rate ; Thy-1 Antigens ; metabolism

A comprehensive HPLC-DAD-MS method was developed to study the chemical components of semi-bionic extract of Coptis-Evodia herb couple. The extract was isolated on a Hypersil BDS C18 column (4.6 mm x 200 mm, 5 microm) using acetonitrile-ammonium formic buffer as mobile phase by gradient elution. Detection was performed on DAD and MS equipped with an electrospray ionization (ESI) source by full scan and product full scan on positive mode. The chromatogram of Coptis-Evodia showed seventeen main peaks, eight of which were from Evodia while the others were from Coptis. By comparison of the retention time, the on-line UV spectra and MS spectra, four peaks were identified as jatrorrhizine, hydroxevodiamine, palmatine and berberine, and three peaks were deduced as epiberberine, columbamine and coptisine. In addition, berberine and palmatine were quantitatively determined. No new component was created in the semi-bionic extract of the herb couple, yet the solubilities of berberine and palmatine decreased.
Berberine ; analogs & derivatives ; chemistry ; isolation & purification ; Berberine Alkaloids ; chemistry ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Coptis ; chemistry ; Drugs, Chinese Herbal ; Evodia ; chemistry ; Plant Extracts ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective:To investigate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Methods:From January 2018 to January 2020, 74 cases of hip arthroplasty patients aged over 65 years old who were treated in the Third Affiliated Hospital of Sun Yat-sen University were selected as the observation objects. They were randomly divided into experimental group and control group with 37 cases in each group. The experimental group was given early gradual diet on the basis of routine postoperative care, while the control group was given routine postoperative diet on the basis of routine postoperative care. The incidence of postoperative delirium, Pittsburgh Sleep Quality Index (PSQI), patient satisfaction rate, average hospitalization days and average hospitalization expenses were used to evaluate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Results:The incidence of delirium in the experimental group was 2.70% (1/37) and 16.22% (6/37) in the control group, the difference was statistically significant ( χ2 value was 3.945, P<0.05); the hospitalization days of the experimental group were (10.68±5.13) d, (13.62±7.19) d in the control group. The difference of hospitalization days was statistically significant ( t value was 2.877, P<0.01). The incidence of difficulty in falling asleep and the satisfaction rate of the experimental group were 8.11% (3/37) and 94.59% (35/37) respectively, and those in the control group were 29.73% (11/37) and 78.38% (29/37) respectively, and the differences were statistically significant ( χ2 value was 5.638, 4.163, P<0.05). Conclusions:Early gradual diet after operation can reduce the incidence of delirium in elderly patients with hip arthroplasty, shorten the average hospitalization days, reduce the incidence of difficulty in falling asleep, improve patients' satisfaction, and help patients to pass through the perioperative period more safely and comfortably.

Background::Acute pulmonary embolism (APE) is a fatal cardiovascular disease, yet missed diagnosis and misdiagnosis often occur due to non-specific symptoms and signs. A simple, objective technique will help clinicians make a quick and precise diagnosis. In population studies, machine learning (ML) plays a critical role in characterizing cardiovascular risks, predicting outcomes, and identifying biomarkers. This work sought to develop an ML model for helping APE diagnosis and compare it against current clinical probability assessment models.Methods::This is a single-center retrospective study. Patients with suspected APE were continuously enrolled and randomly divided into two groups including training and testing sets. A total of 8 ML models, including random forest (RF), Na?ve Bayes, decision tree, K-nearest neighbors, logistic regression, multi-layer perceptron, support vector machine, and gradient boosting decision tree were developed based on the training set to diagnose APE. Thereafter, the model with the best diagnostic performance was selected and evaluated against the current clinical assessment strategies, including the Wells score, revised Geneva score, and Years algorithm. Eventually, the ML model was internally validated to assess the diagnostic performance using receiver operating characteristic (ROC) analysis.Results::The ML models were constructed using eight clinical features, including D-dimer, cardiac troponin T (cTNT), arterial oxygen saturation, heart rate, chest pain, lower limb pain, hemoptysis, and chronic heart failure. Among eight ML models, the RF model achieved the best performance with the highest area under the curve (AUC) (AUC = 0.774). Compared to the current clinical assessment strategies, the RF model outperformed the Wells score ( P = 0.030) and was not inferior to any other clinical probability assessment strategy. The AUC of the RF model for diagnosing APE onset in internal validation set was 0.726. Conclusions::Based on RF algorithm, a novel prediction model was finally constructed for APE diagnosis. When compared to the current clinical assessment strategies, the RF model achieved better diagnostic efficacy and accuracy. Therefore, the ML algorithm can be a useful tool in assisting with the diagnosis of APE.

Objective To assess the predictive value of computed tomography pulmonary angiography(CTPA)cardiovascular parame-ters for chronic thromboembolic pulmonary hypertension(CTEPH)under the 2022 European Society of Cardiology/European Respiratory Society(ESC/ERS)guidelines,and to compare with the 2021 Chinese guidelines.Methods A total of 201 suspected CTEPH patients were retrospectively selected.All patients underwent right heart catheterization(RHC)and CTPA evaluation.According to the Euro-pean guidelines,they were divided into three groups:mean pulmonary artery pressure(mPAP)≤20 mmHg control group(63 cases)(1 mmHg=0.133 kPa),mPAP＞20 mmHg CTEPH group(138 cases),and mPAP≥25 mmHg CTEPH group(123 cases).Inter-group comparison of CTPA cardiovascular parameters was performed,and receiver operating characteristic(ROC)curve analysis was performed for each parameter.Results Under the 2022 European guidelines,the diagnostic efficacy of the diameter of the main pulmonary artery trunk(MPAd)was the highest[area under the curne(AUC)was 0.933].The binary logistic regression analysis revealed that the MP Ad,right ventricular free wall thickness(RVWT),and interventricular septal angle(IVSA)were inde-pendent risk factors for the diagnosis of CTEPH(P＜0.05).Under both the Chinese and European guidelines,the MPAd,the transverse diameter and area of the right atrium,the transverse diameter and area of the bi-ventricle,the RVWT,and the IVSA showed significant statistical differences in CTEPH and control groups(P＜0.05).Conclusion Under both the Chinese and European guidelines,the MP Ad measured by CTPA has the highest diagnostic efficacy for CTEPH,while the IVSA has the strongest correlation with clinical prognostic indicators.The right atrium structure also has evaluation value.