ObjectiveTo investigate the effect of tropicamide eyedrop in the treatment adolescent pseudomyopia.Methods Tropicamide eyedrop were instilled at 68 adolescents( 136 eyes) with pseudomyopia.Effects of mydriasis were observed and visual acuity scopes were analyzed based on chi-square test.ResultsThe time interval( 1 minute or five minutes time interval) between the instillation of the two drops had no significant influence on effects of mydriasis(P ＞0.05 ).And the time interval between the instillation of the two drops had no significant influence on dioptoscopy(P ＞ 0.05 ).There was significant difference in the visual acuity scopes before treatment and post-treatment( x2=16.3308,P=0.000969964).There was significant difference in the visual acuity scopes in one-week treatment and four-week treatment ( x2 =50.2750,P =6.98115 × 10-11 ).Conclusion Instilling two drops of 0.25％tropicamide eyedrop 1 minute or 5 minutes could achieve satisfied mydriasis effect.Short-term application of tropicamide eyedrop could relieve the spasm of adolescent pseudomyopia.

Objective To evaluate the effect of different tube voltages on the radiation dose and image quality of a full field digital mammography system.Methods Both experiments were performed under manual exposure mode.In one experiment,the tube voltages were kept constant at 25,28 and 31 kVp,and the CIRS 015 phantom was exposed at three target/filter combinations molybdenum/molybdenum (Mo/Mo),molybdenum/rhodium (Mo/Rh),and rhodium/rhodium (Rh/Rh) and at tube current-exposure time products of 32-140mAs.The entrance skin exposure (ESE) and average glandular dose (AGD) were recorded,the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) and figure of merit (FOM) were measured to evaluate the influences of different tube voltages on dose and image quality at same target/filter combination.The univariate of randomized completed block-design was used for statistics.In second experiment,the phantom were exposed using Mo/Rh combination when the tube current-exposure time product was kept constant at 56 mAs,and the tube voltage varied between 23 and 33 kVp in 1-kVp increments.The ESE and AGD were recorded,the SNR,CNR and FOM were measured for plotting the curves against tube voltages.Results At Mo/Mo combination,the AGD,ESE,SNR,CNR and FOM of 25,28 and31 kVp were(1.25 ±0.56) mGy,(6.46±2.86) mGy,71.52±8.37,1.91 ±0.26,3.21 ± 0.68; (1.94 ±0.85) mGy,(9.18±4.07) mGy,144.46 ± 11.31,2.41 ±0.28,3.37 ±0.96 and (3.01 ±1.38) mGy,(12.60±5.59) mGy,128.89 ±15.29,2.47 ±0.31,2.31 ±0.76 respectively; at Mo/Rh combination were (1.23 ±0.55) mGy,(5.26 ±2.33) mGy,67.31 ±4.11,1.82 ±0.19,3.01 ± 0.82; (1.86 ±0.84) mGy,(7.57 ±3.34) mGy,139.54 ± 12.16,2.30 ±0.25,3.23 ±0.92 and (2.81 ±1.24) mGy,(10.48 ±4.62) mGy,127.77 ±15.14,2.59 ±0.31,2.67 ±0.68; and at Rh/Rh were(1.09 ±0.48) mGy,(4.89 ±2.16) mGy,67.46 ±2.23,1.48 ±0.72,3.08 ± 1.69; (1.75 ± 0.78) mGy,(6.88 ±3.03) mGy,137.74 ± 14.65,2.37 ±0.26,3.62 ± 1.07 and (2.59 ± 1.13) mGy,(9.32 ± 4.12) mGy,117.91 ± 19.05,2.51 ± 0.31,2.74 ± 0.84.Both experiments indicated that,for a given target/filter combination,the AGD,ESE and CNR increased,but the ESE/AGD decreased with the tube voltage increasing; The first experiment indicated both SNR and FOM of 28 kVp were higher than that of 25 kVp and 31 kVp; the second experiment showed both SNR and FOM decreased with tube voltages increasing.The differences of AGD、ESE、ESE/AGD、SNR、CNR and FOM among the three tube voltages were significant (F =4.391-528.848,P ＜ 0.05) ; but the difference of CNR between 28 and 31 kVp at Mo/Mo and Rh/Rh had no statistical significance (P ＞ 0.05) ; and the differences of FOM between 25 and 28 kVp at the three target/filter combinations were not statistically significant (P ＞ 0.05).Conclusion For a breast with 4.2 cm thickness and 50％ adipose 50％ glandular composition,different tube voltages have significant effects on the radiation dose and image quality.

Objective To analyze the effects of feeding with non-nutritional sucking and simultaneous transoral tube feeding on the quality of life of very low birth weight infants. Methods A total of 84 cases of very low birth weight infants from January 2017 to December 2017 in NICU of children′s hospital of Soochow University were randomly divided into the observation group and the control group, 42 cases in each group. Children in the observation group were fed with non-nutritional sucking and simultaneous transoral tube feeding and those in the control group were fed by transoral tube alone. The clinical manifestations of front, middle and after feeding and before refeeding of the two groups were observed. Results The breathing and heart rate along with percutaneous oxygen concentration during and after eating of the two groups had no statistically significant differences (all P>0.05). the sucking appetite, the frequency of the oral movement, the expression of the facial musclar tension, the state of quiet sleep, complications of feeding intolerance such as stomach retention with vomiting, abdominal distension, fecal occult blood and necrotizing enterocolitis during and after feeding and before refeeding of the observation group were 83.33% (35/42), 85.71% (36/42), 92.86% (39/42), 95.24% (40/42), 4.76% (2/42), the control group was 54.76% (23/42), 61.90% (26/42), 64.29% (27/42), 69.05% (29/42), 21.43% (9/42), the difference was statistically significant (χ2=5.126-10.182, P<0.05). The feeding volumes and mean relative growth rate during hospitalization, the time of extracting gastric tube, the average hospital stay of the observation group were (3.10 ± 1.23) ml, (20.00 ± 2.50) g, (19.06 ± 2.23) d, (41.50±4.23) d, and it had more advantages than the control group (1.50±1.15) ml, (13±1.33) g, (36.45± 4.31) d, (52.03 ± 4.21) d, the difference was statistically significant (t=6.16- 23.22, P<0.01). Conclusions Feeding with non-nutritional sucking and simultaneous transoral tube feeding for very low birth weight infants is safe and effective, it can reduce complications and promote feeding tolerance and achieve the desired growth target and shorten the hospital stay, and finally improve the quality of life.

With the development of perinatal medicine,the proportion and number of hospitalized preterm infants are increasing year by year.However,preterm infants are often dependent on intravenous nutrition to maintain their growth and development due to their immature digestive function and high nutritional requirements (especially in extremelypremature infants and extremelylow birth weight infants).The application of parenterai nutrition can not only reduce the inhalation pneumonia and neonatal necrotizing enterocolitis and other related complications caused by intestinal feeding,but also meet the nutritional needs of preterm infants who cannot tolerate intestinal feeding in a short term,and play an important role in improving the survival rate of preterm infants and improving the prognosis of diseases.The present situation and development of clinical application of intravenous nutrition in preterm infants were reviewed.

Objective:To investigate the application of anterolateral thigh chimeric perforator flap in repairing complex soft tissue defects in lower extremities.Methods:From January, 2015 to June, 2019, 76 cases of complex soft tissue defects in lower extremities were repaired with free anterolateral thigh chimeric perforator flap pedicled with the descending branch of lateral circumflex femoral artery, including 29 cases in shank and 47 cases in ankle, and all had various tissue necrosis, infection, deep tissue defect and orthopaedic implant exposure. The size of the wound ranged from 15 cm×8 cm to 35 cm×20 cm, in which 45 cases associated with dead cavity formation, 62 cases with combined fractures at the same site, and 38 cases with combined fractures or other system injuries in other sites. After debridement, VSD treatment, good wound granulation and infection control, the chimeric perforator flap pedicled with the descending branch of the circumflex lateral femoral artery was designed and harvested. The perforator flap was used to repair most of the wounds with deep tissue exposures, the muscle flap was used to fill the dead cavity and (or) cover the wound around the flap, and free skin was grafted of the muscle flap at the first or second stage. Scheduled follow-up was conducted after the operation.Results:All 76 flaps survived, including vascular crisis occurred in 2 cases within 72 hours after surgery and ceased after immediate surgical exploration. One case had a further surgical operation due to excessive bleeding. Partial necrosis occurred at the distal end of the flap or the skin graft area of the muscle flap in 4 cases, of which 2 cases were treated with grafted skin again and the other 2 cases completely eliminated the wound after active dressing change. Other 16 cases of post-traumatic osteomyelitis with bone defect were repaired respectively with bone grafting, bone transportation or Masquelet technique in 3 to 6 months after wound healing. Among the 76 cases, 68 cases had primary wound healing while 8 cases delayed. Seventy-one cases were followed-up from 9 to 24 months, with an average of 16 months, while 5 cases lost. The appearance and function of the affected limbs recovered satisfactorily without recurrence of infection.Conclusion:With the anterolateral thigh chimeric perforator flap transplantation, the perforators flap can be conveniently used to repair the wound, and the muscle flap can be used to fill dead cavity and(or) deep wounds with free skin graft. Only the descending branch of lateral circumflex femoral artery is required to be anastomosed. It achieves a 3-dimensional effective reconstruction of the complex wound in extremities. It is a safe and effective technique to repair and reconstruct the complex wound in lower extremities and ideal in clinical applications.

Objective:To analyze the correlation between clinical phenotypes and genotypes in 6 children with primary distal renal tubular acidosis (dRTA).Methods:The clinical data of 6 children confirmed as dRTA in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from November 2017 to August 2019 were collected, and related auxiliary examination was performed to assess their growth and development.The venous whole blood was reserved for Trio whole exome sequencing, and full spectrum genetic disease accurate diagnosis cloud platform was applied to systematic data screening and analysis.The suspected mutations were checked by Sanger sequencing, and then the role of protein was predicted by software.Results:Clinical manifestations, signs and auxiliary examination results of the 6 children accorded with the diagnostic criteria of dRTA, and the prominent characteristics was growth retardation.One case had knee valgus, one had osteoporosis, and the auxiliary examination results showed that both of them had alkaline urine, metabolic acidosis, and hypokalemia.Three children had nephrocalcinosis, and 2 children had nephrolithiasis.The parents of the 6 patients were all normal without phenotypes.Mutations in the SLC4A1 gene were identified in 4 patients, including 1 child with a reported homozygous autosomal recessive missense mutation(c.2102G>A, p.G701D), who had dRTA and hemolytic anemia, and 3 children with the reported de novo heterozygous autosomal dominant missense mutation(c.1766G>A, p.R589H, c.1765C>T, p.R589C), whose age at diagnosis was related to abnormal renal imaging.Compound heterozygous autosomal recessive mutations in the ATPV1B1 gene were identified in 1 patient, and they were novel heterozygous missense mutations (1153C>A, p.P385T and c. 806C>T, p.P269L). A novel homozygous autosomal recessive missense mutation was identified in 1 patient in the ATPV0A4 gene(c.1899C>A, p.Y633X, 208). Conclusions:Mutations in SLC4A1, ATP6V1B1, ATP6V0A4 genes are identified as the main causes of the primary dRTA, and the phenotypes was related to the mutation features and genotypes.Genetic test should be conducted on patients suspected as dRTA for early molecular diagnosis, thereby improving clinical phenotypic screening and individualized treatment.

OBJECTIVE: To explore the role of DNMT3B in regulating the proliferation and invasion of hepatocellular carcinoma (HCC) cells. METHODS: We collected the tumor tissues and adjacent tissues from a total of 175 patients with HCC diagnosed in the Second Affiliated Hospital of Chongqing Medical University between May, 2008 and May, 2013 to prepare the tissue microarrays. The association of the expression of DNMT3B with the prognosis and the tumor-free survival and tumor-specific survival rates of the patients was analyzed. Univariate and multivariate Cox regression analyses were used to analyze the effect of DNMT3B expression on the prognosis of HCC. We used RNA interference technique to knock down the expression of DNMT3B in Huh-7 hepatoma cells and observed the changes in cell proliferation using CCK-8 assay and EDU staining and in cell migration and invasion ability using Transwell assay. RESULTS: The positive rates of DNMT3B was significantly higher in HCC tissues than in paired adjacent tissues (67.4% 41.1%, =0.015). A high DNMT3B expression in HCC was significantly associated with the tumor size (=0.001), vascular invasion (=0.004), and intrahepatic metastasis (=0.018). The patients with high DNMT3B expressions had significantly lower tumor-free and tumor-specific survival rates than those with low DNMT3B expressions ( < 0.005). In Huh-7 cells, silencing DNMT3B significantly inhibited the cell proliferation and inhibited cell migration and invasion. Western blotting showed that silencing DNMT3B obviously increased LATS1 expression, decreased the expression of YAP1, and activated Hippo signaling pathway. Methylation-specific PCR showed that the methylation level of LATS1 was decreased in the cells with DNMT3B silencing. CONCLUSIONS The expression level of DNMT3B is significantly higher HCC tissues than in the adjacent tissues, and the high expression of DNMT3B is closely related to the low survival rate of the patients. Silencing DNMT3B inhibits the proliferation, migration and invasion of HCC cells. DNMT3B promotes the progression of HCC primarily by enhancing the expression of YAP1 through methylation of LATS1 and inhibition of its expression, which inhibits the anti-cancer effect of Hippo signaling pathway.
Carcinoma, Hepatocellular ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Liver Neoplasms ; Protein-Serine-Threonine Kinases ; Signal Transduction

Objective: To investigate the feasibility of contrast-enhanced computer tomography (CT) texture analysis in predicting early recurrence after transarterial chemoembolization (TACE) in patients with liver cancer. Methods: A retrospective analysis was performed for 47 patients with liver cancer confirmed by liver biopsy and digital subtraction angiography who underwent upper abdominal contrast-enhanced CT scan before TACE, and according to the presence or absence of focal recurrence within half a year, these patients were divided into early recurrence (ER) group and non-early recurrence (NER) group. The texture analysis was used to delineate tumor boundary layer by layer on the axial contrast-enhanced CT image before liver cancer surgery, and related parameters of tumor heterogeneity, including entropy, mean, non-uniformity, skewness, and kurtosis, were obtained. The independent samples t-test was used for comparison of texture parameters between the two groups. The receiver operating characteristic (ROC) curve was used for the analysis of entropy, mean, and non-uniformity, and the area under the ROC curve (ROC), optical cut-off value, sensitivity, and specificity were calculated to evaluate the efficiency of texture analysis in predicting early focal recurrence after TACE. Results: There were 20 patients in the ER group and 27 in the NER group. The ER group had a maximum major axis length of 88.2±36.3 mm and a maximum minor axis length of 41.4±21.4 mm, and the NER group had a maximum major axis length of 66.9±30.2 mm and a maximum minor axis length of 29.3±19.8 mm; the ER group had significantly higher maximum major and minor axis lengths than the NER group (t = 4.89 and 4.62, P < 0.001). The ER group had significantly higher entropy and non-uniformity values than the NER group, and there were no significant differences in skewness and kurtosis between the two groups. Entropy, non-uniformity, and mean had high efficiency in predicting early recurrence after TACE, and the optimal cut-off value of entropy was 4.135. Conclusion Volumetric texture analysis of contrast-enhanced CT images before liver cancer surgery has a high value in predicting early recurrence after TACE.