Objective:To objectively evaluate the postoperative efficacy and rotational stability of two common types of toric intraocular lenses (IOLs), and perform vector analysis of postoperative residual astigmatism.Methods:A cohort study was performed.A total of 80 cases (80 eyes) of age-related cataract combined with corneal regular astigmatism patients who underwent phacoemulsification combined with toric IOL implantation in Ningbo Aier Guangming Eye Hospital from January 2019 to October 2021 were selected.The astigmatic corrected IOL was implanted according to the patients' wishes.Among them, 39 cases (39 eyes) implanted with Tecnis ? ZCT IOL were classified as Tecnis group, and 41 cases (41 eyes) implanted with AcrySof ? IQ Toric IOL were classified as AcrySof group.The uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), and residual astigmatism of subjective refraction were observed 1 week, 1 month, and 3 months after operation.After mydriasis, OPD-Scan Ⅲ was used to measure the toric IOL axial position, and the IOL axial deviation (LAD) was calculated.Vector analysis of preoperative corneal astigmatism, expected residual astigmatism and postoperative residual astigmatism was performed using the astigmatism double-angle map.The study protocol was approved by the Ethics Committee of Ningbo Aier Guangming Eye Hospital (No.2019-001). Results:There was no significant difference in the overall comparisons of UCDVA and BCDVA between the two groups ( Hgroup=2.503, P=0.113; Hgroup=0.399, P=0.527), while there were statistically significant differences between before and different time points after operation ( Htime=147.535, P<0.001; Htime=146.808, P<0.001). Postoperative UCDVA and BCDVA were significantly improved compared to preoperative, and the difference was statistically significant (all at P<0.001). There were statistically significant differences in the overall comparison of astigmatism between the two groups before and at different time points after operation ( Hgroup=5.489, P=0.019; Htime=171.070, P<0.001). The residual astigmatism was significantly higher in AcrySof group than in Tecnis group 1 month after operation ( P=0.016), and the residual astigmatism after operation in both groups decreased compared to before operation, showing statistically significant differences (both at P<0.001). There was no statistically significant difference in IOL LAD between the two groups at different time points after operation ( Hgroup=3.013, P=0.083; Htime=1.689, P=0.430). Vector analysis of astigmatism showed that residual astigmatism was significantly reduced in both groups at 3 months after operation compared to before operation, and the 95% confidence ellipses were significantly reduced.There were differences in the mean and centroid values of residual astigmatism prediction errors between the two groups 3 months after operation, but there was no significant difference in the 95% confidence ellipse.The percentage of eyes with residual astigmatism prediction error ≤1.0 D in Tecnis group and AcrySof group was 82%(32/39) and 90%(37/41), respectively, showing no statistically significant difference ( χ2=1.131, P=0.288). Conclusions:Both Tecnis ? ZCT IOL and AcrySof ? IQ Toric IOL can effectively improve postoperative visual acuity of patients with cataract and corneal astigmatism, reduce postoperative residual astigmatism and have good rotational stability.The online calculators of the two types of toric IOLs have good performance in the prediction of postoperative residual astigmatism.

Objective: To compare the difference of the clinical and laboratory characteristics between γδ T-cell large granular lymphocyte leukemia (γδT-LGLL) and αβ T-cell large granular lymphocyte leukemia (αβT-LGLL) . Methods: The clinical and laboratory characteristics of 17 patients with γδT-LGLL and 91 patients with αβT-LGLL in the department of therapeutic center of anemia of enrolled in our hospital from January 2009 to January 2019 were retrospectively analyzed. Results: The median age of the 17 patients with γδT-LGLL was 54 years (range, 25-73 years) , the most common presenting symptom was anemia. In comparison with αβT-LGLL patients, splenomegaly was common (41% and 44%, respectively) , whereas hepatomegaly (12% and 5%, respectively) and lymphadenopathy (6% and 8%, respectively) were rare. The positive rates of antinuclear antibody (59% and 45%, respectively) were high, whereas the positive rates of rheumatoid factor (6% and 10%, respectively) were rare for both groups. There were no differences on peripheral blood counts between the two groups. However, γδT-LGLL patients were found to be predominantly expressed a CD4⁻/CD8⁻ phenotype. Steroid therapy with prednisone was used alone as first-line therapy for 1 patient. Cyclosporin A (CsA) was used alone as first-line therapy for 3 patients. CsA in combination with steroids were administered in 13 patients. After 4 months treatment, 2 patients acquired complete response, 4 patients acquired partial response, the overall response was 35%. Conclusion γδT-LGLL is a rare mature T-lymphocyte proliferative disease. Clinical and laboratory characteristics were quite similar for γδT-LGLL in compare with αβT-LGLL. γδT-LGLL predominantly expressed a CD4⁻/CD8⁻ phenotype. The data presented here indicate the CsA is an effective option for the first-line treatment of γδT-LGLL.

In this study,the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated.From March to August,2009,17618 women,from Wufeng area of Hubei province,China,were recruited to screen breast diseases by using breast infrared diagnostic apparatus.Other diagnostic methods,such as B-mode ultrasound,X-ray mammography,needle biopsy and pathological examination were,if necessary,used to further confirm the diagnosis.The screening showed that 5990 of 17618 cases (34.00％) had breast diseases,5843 (33.16％) had mammary gland hyperplasia,48 (0.27％) had breast fibroadenoma,ll (0.06％) had breast carcinoma,and 88 (0.50％) had other breast diseases.The peak morbidity of breast cancer was found in the women aged 50-0 ages.The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8,0.157％) in comparison with that in the subjects younger than 50 years old (n=3,0.024％) (u=2.327,P＜0.05).It was shown that the occurrence of breast diseases was concentrated in women aged 20-40 years,while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40.Compared with the patients elder than or equal to 40 years old (n=3289,27.46％),the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases,47.18％; P＜0.001).However,there was no significant difference in the morbidity of breast diseases between the age group of 20-29 years and that of 30-39 years (P=0.453),and both of them were high.There was no significant association between the morbidity of breast diseases and cervical cancer.Since the morbidity of breast diseases was higher among young women,more attention should be paid to the screening of breast diseases among young women for early diagnosis.

Objective:To investigate the expression of iron-regulating erythroid factors in different types of erythropoiesis disorders.Methods:From January 2016 to November 2019, the plasma concentrations of iron-regulating erythroid factors were measured by ELISA methods in 47 patients with different types of erythropoiesis disorders. The adaptation orientation of iron-regulating erythroid factor expression with bone marrow erythropoiesis activities (represented by bone marrow-nucleated erythrocytes ratio) was analyzed.Results:The median plasma growth differentiation factor (GDF) 15 levels in patients with polycythemia vera (PV) , pure red cell aplasia (PRCA) , autoimmune hemolytic anemia (AIHA) , and myelodysplastic syndrome (MDS) were 266.01 ng/L (112.40, 452.37) , 110.63 ng/L (81.41, 220.42) , 52.11 ng/L (32.61, 171.66) , and 276.53 (132.16, 525.70) ng/L, respectively, which were significantly higher than those in normal patients with 37.45 (19.65, 57.72) ng/L (all P < 0.01) . The plasma TWSG1 expression levels were not significantly different in patients with PV, PRCA, AIHA, and MDS from those of normal patients (P>0.05) . The median plasma GDF11 level in PV was 74.75 (10.95, 121.32) ng/L, which was significantly higher than 36.90 (3.38, 98.34) ng/L in normal control subjects ( P<0.01) . However, no statistical differences were observed in the other three subjects ( P>0.05) . The median plasma erythroferrone (ERFE) levels in AIHA and PV were 121.76 ng/L (68.12, 343.11) and 129.63 (47.02, 170.03) ng/L, respectively, with the highest level in AIHA in all the studied types of erythropoiesis disorders. The bone marrow-nucleated erythrocytes ratio was significantly and positively correlated with ERFE ( r=0.458, P=0.001) but not with GDF15 ( r=-0.163, P=0.274) , GDF11 ( r=0.120, P=0.421) , and TWSG1 ( r=-0.166, P=0.269) . Conclusion:The expression profile of iron-regulating erythroid factors is not exactly the same in different types of erythropoiesis disorders. ERFE demonstrated the highest correlation with erythropoiesis activities.

Objective:To study the effect of iron deficiency level for oral iron absorption in iron deficient patients.Methods:37 non-pregnant female patients who were diagnosed with iron deficiency and 13 healthy females who completed their physical examination at the outpatient department of the Anemia Center of the Institute of Hematology & Blood Diseases Hospital from July 2018 to June 2020 were included. Hepcidin and C2-C0 of oral iron absorption test were analyzed in different iron deficiency and serum ferritin level.Results:The median of Hepcidin in IDA, ID/IDE and healthy control group were 4.9 (2.17-32.86) , 26.98 (11.02-49.71) and 69.89 (42.23-138.96) μg/L ( P<0.001) , respectively. Hepcidin level of IDA group was lower than that of ID/IDE group (adjusted P=0.005) and healthy control (adjusted P<0.001) . Hepcidin level of ID/IDE group had no significant difference compared with healthy control (adjusted P=0.22) . The mean of C2-C0 in IDA, ID/IDE and healthy control group were (35.30±21.68) , (37.90±14.06) and (23.57±10.14) μmol/L ( P=0.130) , respectively. Multilinear regression analysis showed C0, SF, sTFR and HGB were independent factors for Hepcidin in iron deficient patients, with an equation of Hepcidin=-31.842-0.642*C0+2.239*SF+1.778*sTFR+0.365*HGB-0.274*RET-HB. We didn't find independent factor of C2-C0. Conclusion:The degree of iron deficiency had an effect on oral iron absorption. Patients of ID/IDE group absorbed iron more slowly than patients of IDA group. Iron deficient patients with normal gastrointestinal function absorbed more iron by oral administration when they were in a more serious iron deficient stage. Hepcidin was a better parameter to distinguish iron absorption level among different iron deficient patients than C2-C0 of oral iron absorption test.

[Objective] To explore the clinical characteristics, diagnosis and treatment of benign liver tissue ectopia in adrenal tumor, so as to improve the understanding of this disease. [Methods] We reported the data of a rare patient with ectopic liver tissue to adrenal gland admitted in the Department of Urology, Liaocheng Second Hospital Affiliated to Shandong First Medical University and discussed it in conjunction with literature. [Results] The patient was a 32-year-old male who sought medical attention for more than half a year due to elevated blood pressure and detection of a tumor in the right adrenal gland.Ultrasound and CT examinations showed a tumor in the right adrenal gland, suggesting myeloid lipoma.Laparoscopic right adrenalectomy was performed, and the postoperative pathology showed benign liver tissue ectopia in adrenal tumor, hepatocyte proliferation, steatosis, and slight lymphocyte infiltration.Immunohistochemistry suggested Hep-1 (+ ). During the follow-up of 12 months, the patient recovered well with no complications.Imaging examinations showed no signs of recurrence. [Conclusion] Benign liver tissue ectopia in adrenal tumor is very rare and is difficult to diagnose preoperatively.Diagnosis is mainly based on pathology, and surgical resection is usually chosen.