Background Cataract surgery can induce the occurrence of dry eye because of the influence of incision on corneal nerve fibers and the change of corneal regularity derived by surgery.Objective This study was to investigate the change of regularity of anterior corneal surface,tear film and astigmatism caused by the process of manual small-incision cataract surgery (manual SICS) and phacoemulsification (Phaco).Methods A prospective non-randomized controlled study was designed.Fifty eyes of 46 age-related cataract patients were included in this clinical study.Thirty eyes of 30 patients received the manual SICS,and other 20 eyes of 16 patients underwent Phaco.Corneal irregularity measurement (CIM),shape factor (SF) and corneal astigmatism were assessed by the corneal tomography examination,the subjective symptoms were scored and tear film break up time (BUT),Schirmer Ⅰ test (S Ⅰ t) were examined before surgery and 1 day,1 week,1 month after surgery.The examined parameters were compared among different time points and two groups.This study was approved by Ethic Committee of Affiliated Eye Hospital of Wenzhou Medical College,and written informed consent was obtained prior to operation.Results The CIM values were gradually increased with the prolong of time after operation,showing a statistically significant difference dependent on time (Ftime =22.864,P =0.000),and CIM value of 1 day,1 week and 1 month after operation was higher than that of before operation (P＜0.01).However,no significant difference was found in CIM value between two groups in different time points (Fgroup =0.062,P =0.804).There was no significant difference in SF values with time prolong (Ftime =4.600,P =0.428) and different groups (Fgroup =0.009,P =0.925).The BUT was gradually reduced with the time prolongs with the considerably difference (Ftime =39.384,P=0.000).Obviously decreases of BUT values were seen in 1 week and 1 month in comparison with 1 day after operation (both P=0.000).But no significant change was found in BUT between two groups in various time points (Fgroup =0.000,P=0.983).In the manual SICS group,the difference was found in S Ⅰ t values between before operation and 1 week or 1 month after surgery(P＜0.01).Surgery associated astigmatism (SIA) was existed in the operative eyes in various time points after operation.With time lapse,SIA value was declined with a significant difference (Ftime =21.479,P =0.000),the difference also was found in different groups (Fgroup =8.709,P =0.005),and SIA value in the Phaco was significantly lower than that in the manual SICS group (P＜0.01).Conclusions In the present study,in the early stage after manual SICS and Phaco,SIA appears due to the irregular change of the anterior corneal surface increases and stability of tear film worsens.

Objective To explore the use of CA199,CEA,CA50 and ALP combined with magnetic resonance imaging (MRI) in diagnosis of intrahepatic bile duct stones with early bile duct carcinoma.Methods The clinical diagnosis of 36 cases of patients with hepatolithasis-associated intrahepatic cholangiocarcinoma (HICC) and 118 cases with intrahepatic duct stone (IHDS) were analyzed retrospectively.Serum CA199,CEA,CA50,ALP and magnetic resonance (MRI,MRCP) were performed and the results were analyzed.Results Abdominal pain discomfort in Hepatolithasis-associated intrahepatic cholangiocarcinoma showed multiple symptoms.Three typical Charcot syndromes were rare.On the gender distribution,intrahepatic bile duct stones was frequently found in women,on the contrary,Hepatolithasis-associated intrahepatic cholangiocarcinoma was frequently more found in men (P ＜0.05) Abdominal pain and fever in patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma was more than that of patients with Intrahepatic bile duct stone (P＜0.05) When alkaline phosphatase (ALP) was more than 169 U/L,significant difference was seen between two groups (P＜ 0.05) According to the diagnosis of HICC,the accuracy of CA199,CEA,CA50 combined with ALP was 88.6％,the accuracy of magnetic resonance examination alone was 90.2％,and the accuracy of multiple serological markers and magnetic resonance was 95.5％.Conclusion MRI combined with serum CA199,CEA,CA50 and ALP can effectively improve the HICC preoperative diagnosis rate.

OBJECTIVEIn order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group.

METHODSLung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis.

RESULTSThere were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision.

CONCLUSIONSThe density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.

Abnormalities, Multiple ; pathology ; Child, Preschool ; Ductus Arteriosus, Patent ; pathology ; Female ; Heart Septal Defects, Ventricular ; pathology ; Humans ; Infant ; Male ; Pulmonary Artery ; pathology ; Pulmonary Atresia ; pathology

OBJECTIVETo analyse the relationship between the quantitative structural study of lung and right ventricle outflow tract reconstruction in infants with tetralogy of Fallot.

METHODSLung biopsies were taken during the operations in 16 infants suffered from tetralogy of Fallot. Autopsy specimens were obtained from 5 infants died of non-cardiovascular diseases as normal control group. All patients underwent one staged repair. The techniques of right ventricular outflow tract reconstruction included pulmonary valve commissurotomy (n = 3), transanular pericardial patch (n = 4), and transannular homologous monocuspid valve patch (n = 8); homograft was used in one patient because of the abnormal coronary artery. The diameters of main pulmonary artery (MPA), left pulmonary artery (LPA), and right pulmonary artery (RPA) were measured during operation. The tissue was fixed with buffered formalin and routinely impregnated in wax. Sections were stained by hematoxylin-eosin, and Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters of the small pulmonary arteries were obtained, including percentage of media thickness (% MT), percentage of media section area (% MS), numbers of pulmonary small artery per square centimeter (APSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (% PPA), and alveolar/ small arterial ratio per unit area (AAR) by a computer-based image processor for quantitative analysis.

RESULTSIn the TOF group, % MT, % MS, and APSC significantly decreased, while MLI and AAR significantly increased (P < 0.05, compared with the control group). APSC decreased in turn after separately using three different techniques of right ventricular outflow tract reconstruction (i. e. pulmonary valve commissurotomy, transannular pericardium patch, and transannular homologous monocuspid valve patch), which was paralleled with the diameters of MPA, LPA, and RPA. RPA correlated with APSC (r = 0.754, P = 0.001).

CONCLUSIONSThe development of pulmonary small arteries and alveoli are directly affected by the diminished pulmonary flow in infants with tetralogy of Fallot. Right ventricle outflow tract reconstruction may be indicated according to the developmental degree of central pulmonary artery.

Biopsy, Needle ; Child, Preschool ; Heart Ventricles ; surgery ; Humans ; Infant ; Lung ; pathology ; Reconstructive Surgical Procedures ; methods ; Tetralogy of Fallot ; pathology ; surgery

The aim of the present study is to explore the mechanism of estrogen on regulating cardiac function disorder by adjusting the stimulating adenylate cyclase G α protein (Gαs)-cycle adenosine monophosphate (cAMP) signal pathway. Adult female rats were randomly divided into five groups: sham group, ovariectomized group (OVX), OVX and 17β-estradiol given group (OVX+E₂), OVX and isoprenaline injected group (OVX+ISO), OVX and 17β-estradiol, isoprenaline injected group (OVX+E₂+ISO). Rats were ovariectomized, and two weeks later, OVX+E₂group was injected with E₂, OVX+ISO group was injected with ISO, OVX+E₂+ISO group was injected with E₂and ISO. Another four weeks later, the hemodynamic parameters were monitored by carotid artery intubation: left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), maximal differentials of left ventricular developed pressure (+dp/dt(max)), and minimal differentials of left ventricular developed pressure (-dp/dt(max)). Brain natriuretic peptide (BNP) and cAMP concentration in plasma were determined; Gα(s) protein expression in myocardium was determined. The results showed that the hemodynamic parameters, the concentration of BNP and cAMP in plasma had no significant changes after ovariectomy compared with sham group. But after isoprenaline injection in ovariectomized rats, LVSP and +dp/dt(max) declined (P < 0.01), LVEDP and -dp/dt(max) elevated (P < 0.01); plasma BNP concentration increased (P < 0.01); plasma cAMP concentration decreased (P < 0.01), compared with OVX group. Further estrogen supplements improved the heart function treated by isoprenaline: LVSP and +dp/dt(max) elevated (P < 0.01), LVEDP and -dp/dtmax declined (P < 0.05, P < 0.01); the plasma BNP concentration decreased (P < 0.01); the plasma cAMP concentration increased (P < 0.01). Estrogen had no significant influence on Gαs protein expression. The results suggest that estrogen can alleviate myocardial injury and regulate cardiac function disorder by increasing cAMP level, finally improved the excessive suppression of myocardium.
Animals ; Cyclic AMP ; blood ; Estradiol ; pharmacology ; Estrogens ; pharmacology ; Female ; GTP-Binding Protein alpha Subunits, Gs ; metabolism ; Hemodynamics ; Isoproterenol ; adverse effects ; Myocardium ; pathology ; Natriuretic Peptide, Brain ; blood ; Ovariectomy ; Rats ; Signal Transduction

OBJECTIVETo study the clinical features of pediatric acquired immunodeficiency syndrome(AIDS).

METHODSThe epidemiological, clinical and laboratory data of 66 children with AIDS were retrospectively studied.

RESULTSOf the 66 patients, 46 (69.7%) were male and 20 (30.3%) were female, with a mean age of 8.7 years (ranged 2-16 years). The mean age at diagnosis was 7.7 years (ranged 2-15 years). Vertical transmission as the route of infection was documented in 48 cases (72.7%). Fourteen children (21.2%) were infected through blood or blood products. The route of infection could not be identified in 4 cases (6.1%). Body weight loss was noted in 43 cases (65.2%), anemia in 42 cases (63.7%), fever in 40 cases (60.6%), fatigue in 38 cases (57.6%), rash in 31 cases (47.0%), chronic cough in 28 cases (12.1%), chronic diarrhea in 24 cases (36.4%), CNS involvement in 16 cases (24.2%), oral thrush in 13 cases (19.7%), and hepatosplenomegaly in 12 cases (18.2%). Body height of 30 cases (45.4%) and body weight of 26 cases (39.4%) ranked the lower level. The immune system was severely suppressed in 59 cases (89.4%) and moderately suppressed in 7 cases (10.6%).

CONCLUSIONSVertical transmission remained the most common route of pediatric HIV infection. There were various clinical manifestations in children with AIDS. The immune systems of the majority of children with this disorder were severely suppressed.

Acquired Immunodeficiency Syndrome ; complications ; etiology ; immunology ; Adolescent ; Body Height ; Child ; Child, Preschool ; Female ; Humans ; Infectious Disease Transmission, Vertical ; Male ; Weight Loss

OBJECTIVEThe present study was designed to explore the cited status and its correlated factors of articles published in Chinese Journal of Pediatrics.

METHODArticles published in Chinese Journal of Pediatrics from 2001 to 2010 were searched using Wanfang Medical Online database, and the relationship between cited number and column and funding status were analyzed.

RESULTSTotally 3209 articles were published by Chinese Journal of Pediatrics from 2001 to 2010. Two thousand and seventy-three articles (64.60%) were cited. The total cited number was 18 546 (mean rate: 5.78 per paper). Standard/protocol/guideline was the most often cited column (mean rate: 62.92 per paper). Featured articles including editorials (mean rate: 7.12 per paper), special articles (mean rate: 6.50 per paper) and original articles (mean rate: 7.90 per paper) had higher cited rate. Cited rate of original papers in featured articles was higher than other original articles (mean rate: 6.03 per paper). Those with academic perspectives, such as Opinion/Debate/Discussion, were well cited (mean rate: 7.09 per paper). All of original articles in Rapid Pathway were well cited (mean rate: 16.20 per paper). Mean cited number of grant-supported articles was 4.81 per paper, lower than that of all kinds of papers (mean rate: 5.78 per paper) and non-grant-supported articles (mean rate: 6.06 per paper). However, it was slightly higher than that of articles except Standard/protocol/guideline (mean rate: 4.36 per paper).

CONCLUSIONCited status varies among columns. The invited papers should be increased in number to raise commentary papers and original articles with high quality.Grant-supported or non-grant-supported papers should be reviewed based on the same standard after submission.

Bibliometrics ; Pediatrics ; Periodicals as Topic ; statistics & numerical data

Objective: To detect the enterovirus VP4 and VP1 genes in 510 stool samples collected from hand, foot and mouth disease (HFMD) cases and analyze the phylogenetic characteristics of the entire VP1 genes of coxsackievirus A6 (CV-A6) strains in six prefectures/cities of Yunnan Province in 2018. Methods: Viral RNA was abstracted from the stool samples. VP4 gene sequences were amplified by RT-PCR and sequenced using the MD91/OL68-1 primer pair to identify viral genotypes. Whole VP1 gene sequences were amplified and sequenced using appropriate primer pairs. The whole VP1 gene sequences of CV-A6 reference strains were downloaded from GenBank. MEGA5.2 software was used to analyze the similarity in nucleotide and amino acid sequences between different strains and phylogenetic tree was constructed for analysis of genetic characteristics and molecular epidemiology. Results: VP4 and VP1 gene sequences were obtained from 57 out of 510 stool samples with a positive rate of 11.17% (57/510). There were 43 CV-A6 (8.43%, 43/510), six CV-A10 (1.17%, 6/510), two enterovirus A71 (EV-A71, 0.39%, 2/510) and two CV-A9 (0.39%, 2/510) strains. The other four strains were CV-A4 (0.19%, 1/510), CV-A5 (0.19%, 1/510), CV-B1 (0.19%, 1/510) and E11 (0.19%, 1/510). The phylogenetic analysis showed that all 43 CV-A6 strains belonged to sub-genotype D3. Conclusions In the 510 HFMD samples, CV-A6 strains were mostly detected with a detection rate of 8.43% and accounted for 75.44% (43/57) of all isolates, followed by CV-A10 (1.17%, 6/510) and EV-A71 (0.39%, 2/510). There was a large HFMD outbreak mainly caused by CV-A6 in Yunnan Province in 2018. The outbreak was caused by CV-A6 of sub-genotype D3, as was the case with pervious outbreaks in China.

OBJECTIVETo evaluate the association between serum level of leptin and leptin receptor gene (LEPR) polymorphism and patients with breast cancer.

METHODSLEPR G1n223Arg polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in 94 patients with breast cancer and 128 healthy controls. The level of leptin were analyzed by enzyme linked immunosorbent assay.

RESULTSIn univariate regression analyses, we found serum level of leptin and LEPR Gin223Arg genotype polymorphism were significantly higrer than those of the controls (P < 0.05-0.001, respectively). Through multivariable analyses, we found that increased risk estimates for breast cancer were among those with leptin level (OR = 1.53, 95% CI: 1.13-2.07, P = 0.006), LEPR Gin223Arg genotype (OR = 4.87, 95%CI:1.30-18.22, P = 0.019), WHR (OR = 3.68, 95% CI: 1.34-10.11, P = 0.011).

CONCLUSIONResults from this study suggested that LEPR Gln233Agr polymorphism, the elevated WHR and serum level of leptin might be correlated with increased risk of breast cancer.

Breast Neoplasms ; blood ; genetics ; Enzyme-Linked Immunosorbent Assay ; Female ; Genetic Predisposition to Disease ; Humans ; Leptin ; blood ; Lipids ; blood ; Polymorphism, Genetic ; Receptors, Leptin ; genetics ; Risk

Abstract: Objective　To analyze the pathogenic characteristics and epidemiological significance of human plague related strains in Qinghai Province in recent 30 years, so as to provide scientific basis for on-the-spot disposal and prevention and control measures of plague outbreak in Qinghai Province. Methods　A total of 35 strains of Yersinia pestis isolated from 29 typical human plague outbreaks in Qinghai Province from 1980 to 2011 were selected and studied by biochemical fermentation experiments. Virulence factors detection of Fraction 1 antigen (Fra1), virulence antigen (VW), pigmentation (Pgm) and Yersinia pestis Ⅰ (PstⅠ), determinants and genotyping of differential regions (DFRs) were used to study the pathogenic characteristics. At the same time, according to the epidemic situation of human and animal plague in Qinghai Province in recent years, the current situation of plague prevention and control and epidemic characteristics were analyzed. Results　The biotypes of 35 strains of Yersinia pestis were classical, and the biotypes of 29 strains (82.86%) were of Qinghai-Tibet Plateau type, mainly distributed in southern Qinghai and around lake areas, 2 strains (5.71%) belonged to Qilian Mountains type, mainly distributed in Qilian mountains, and 6 genotypes were identified by DFR. Among them, 16 were type 5, 12 were type 8, 2 were type 10, 1 was type 36, 3 were type 30 and 1 was type 1b, the strains of type 5 and 1b were mainly distributed around the lake and the southern foot of Qilian Mountains, while the strains of type 8, 10, 36 and 30 were mainly distributed in the southern part of Qinghai. Conclusions　The pathogen of Yersinia pestis in Qinghai Plateau has complex biochemical types, the epidemic situation among animals is continuous year after year, the situation of prevention and control is serious, the occurrence and prevalence of plague seriously endanger people's health and social development, so it is necessary to do a solid job in the prevention and control of plague to ensure the safety of people's lives.