Objective To explore the morphological mechanism of contrast-induced encephalopathy（CIE）by observing the effect of ioversol on blood-brain barrier（BBB）in rats. MethodsA total of 42 Sprague-Dawley rats were randomly divided into normal control group（n=6），ioversol group（n=24）and normal saline group（n=12）. The latter two groups were divided into four subgroups based on time points after treatment（0.5 h，3 h，6 h，and 24 h）. Carotid injection of ioversol was to prepare a rat model of brain damage. BBB permeability was examined by an Evans Blue（EB）assay. BBB ultrastructural changes were observed via transmission electron microscopy（TEM）. ResultsCompared with the normal group，there was no significant change in EB content in brain at 0.5 h after the administration of ioversol，while other groups were significantly higher（both P<0.05）. EB content increased at first and then decreased with time，and the highest level was found in 6 h group. The morphology of vascular endothelial cells changed and the structure of tight junctions（TJs）was incomplete in 3 h and 6 h groups，but the ultrastructure of BBB in 0.5 h and 24 h groups had no obvious change compared with the normal group. ConclusionBBB permeability and ultrastructure of rats at different time points after carotid injection of ioversol showed consistent reversible changes，and this dynamic change of BBB was related to the structural changes of TJs.

Objective　To evaluate the role of ultrasound in evaluating hemodynamic parameters for post-operative patients with ocular ischemia syndrome.Methods　 to direction of ophthalmic artery blood flow，68 cases of OIS patients were divided into forward blood flow group（n=41） and reverse blood flow group（n=27）. The carotid stenosis rate and PSV using ultrasound and BCVA were detected.Results　Before operation，carotid artery stenosis rate of forward blood flow group was significantly lower than reverse blood flow group（P<0.05） Before and after operation，posterior ciliary artery PSV and BCVA of forward blood flow group was obviously higher than reverse blood flow group（P<0.05）. The ophthalmic artery，posterior ciliary artery and central retinal artery PSV after operation in the two groups were significantly higher than those before operation（P<0.05）. BCVA after operation in forward blood flow group was significantly higher than before operation（P<0.05）.Conclusion　Ultrasound can accurately evaluate carotid artery stenosis，PSV，and provide reference value for evaluating hemodynamic changes.

AIM:To explore the clinical outcomes of RS lacrimal tube for lacrimal canaliculi rupture without nasal endoscope.

METHODS:A retrospective analysis from September 2017 to March 2018 were taken. According to admission time sequence. Totally 52 patients with lacrimal canaliculi rupture was divided into two groups. One group was treated with RS lacrimal tube, the other was treated with annular silicone tube. The treatment results were comparatively analyzed.

RESULTS:There were 15 eyes of nasal mucosa hemorrhage in annular silicone tube group. There was no eye with this in RS tube group, the difference between the two groups was significant(P<0.001). In RS tube group, 26 eyes were cured, 3 eyes improved, 3 eyes failed. The effective rate was 91%. In annular silicone tube group, 15 eyes were cured, 3 eyes improved, 2 eyes failed. The effective rate was 90%, the clinical efficacy was not significantly different between groups(P=0.877). There were 2 eyes in RS tube group occurred fall off in 2wk to 2mo after operations; 1 eye of lacrimal puncture were removed from the lacrimal puncture without 2wk, and was anastomosed again. The other eye was removed from the lacrimal puncture within 1-2mo after the operation, the lacrimal canal flushing was improved during follow-up. There were 3 eyes in annular silicone group occurred fall off without 2wk, and were not anastomosed again. The lacrimal duct flushing was improved during follow-up. No statistical significance was found in the two groups(P=0.361).

CONCLUSION:Lacrimal canaliculi rupture should be timely given surgical treatment. RS lacrimal tube can not only achieve good operation effect and reduce the probability of complications, but also has the advantages of simple surgical methods, good histocompatibility and no influence on the appearance of patients.

The vasoactive substance resistance (VSR) in the end-stage liver disease (ESLD) refers as the reduction of patients' responsiveness to endogenous and exogenous vasoactive substances, cardiac and vascular excitability, peripheral circulatory dysfunction, but induction of related adverse events. VSR is closely related to pathogenesis and treatment-related ESLD complications. However, to date, there are so many unsolved issues, like 1). The cause and underlying mechanism of VSR in ESLD patients; 2). VSR and ESLD multiple organ damages; 3). The preventive and mitigated measurement of VSR; and 4). VSR vasoactive drug use in ESLD patients. This review discussed and summarized the up to date progress in this field of research and clinical VSR in patients with ESLD, i.e., VRS in ESLD patients, disputes of vasoconstrictor drug therapy in ESLD patients, and future research direction of the field.

AIM: To investigate the correlation of the expression of stromal cell-derived factor-1(SDF-1)and angiopoietin like protein 4(ANGPTL4)in serum with the severity of disease in patients with diabetic macular edema(DME).METHODS: From April 2020 to August 2023, 193 patients with diabetic retinopathy who were admitted to our hospital were prospectively separated into DME group(128 cases)(56 cases in mild group, 44 cases in moderate group, 28 cases in severe group)and non DME group(65 cases)according to whether the patients had macular edema and the severity of disease. Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of ANGPTL4 and SDF-1 in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of DME; receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of ANGPTL4 and SDF-1 levels in serum of DME patients for the severity of DME.RESULTS: The levels of ANGPTL4 and SDF-1 in serum of the DME group were obviously higher than those of the non DME group(P<0.01); the expression levels of ANGPTL4 and SDF-1 in serum of the mild, moderate, and severe groups increased obviously in sequence(P<0.05); multivariate Logistic regression analysis showed that the levels of ANGPTL4 and SDF-1 in serum were risk factors affecting the severity of DME(P<0.01); The area under the curve(AUC)of serum SDF-1 in the diagnosis of DME severity was 0.772(95%CI: 0.690-0.842), and the AUC of ANGPTL4 in the diagnosis of DME severity was 0.801(95%CI: 0.722-0.867). The AUC of ANGPTL4 combined with SDF-1 in the diagnosis of DME was 0.884(95%CI: 0.816-0.934), the sensitivity was 87.50%, and the specificity was 85.71%, which were significantly higher than ANGPTL4 or SDF-1 alone(Z=2.658, 2.469, all P<0.05).CONCLUSION: The levels of ANGPTL4 and SDF-1 in serum of DME patients are significantly increased, and their levels increase with the severity of the disease. They can be used as auxiliary indicators for diagnosing the severity of DME disease, and the combined diagnosis has a better effect.

AIM: To investigate the correlation of the expression of stromal cell-derived factor-1(SDF-1)and angiopoietin like protein 4(ANGPTL4)in serum with the severity of disease in patients with diabetic macular edema(DME).METHODS: From April 2020 to August 2023, 193 patients with diabetic retinopathy who were admitted to our hospital were prospectively separated into DME group(128 cases)(56 cases in mild group, 44 cases in moderate group, 28 cases in severe group)and non DME group(65 cases)according to whether the patients had macular edema and the severity of disease. Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of ANGPTL4 and SDF-1 in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of DME; receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of ANGPTL4 and SDF-1 levels in serum of DME patients for the severity of DME.RESULTS: The levels of ANGPTL4 and SDF-1 in serum of the DME group were obviously higher than those of the non DME group(P<0.01); the expression levels of ANGPTL4 and SDF-1 in serum of the mild, moderate, and severe groups increased obviously in sequence(P<0.05); multivariate Logistic regression analysis showed that the levels of ANGPTL4 and SDF-1 in serum were risk factors affecting the severity of DME(P<0.01); The area under the curve(AUC)of serum SDF-1 in the diagnosis of DME severity was 0.772(95%CI: 0.690-0.842), and the AUC of ANGPTL4 in the diagnosis of DME severity was 0.801(95%CI: 0.722-0.867). The AUC of ANGPTL4 combined with SDF-1 in the diagnosis of DME was 0.884(95%CI: 0.816-0.934), the sensitivity was 87.50%, and the specificity was 85.71%, which were significantly higher than ANGPTL4 or SDF-1 alone(Z=2.658, 2.469, all P<0.05).CONCLUSION: The levels of ANGPTL4 and SDF-1 in serum of DME patients are significantly increased, and their levels increase with the severity of the disease. They can be used as auxiliary indicators for diagnosing the severity of DME disease, and the combined diagnosis has a better effect.

OBJECTIVES: To investigate the expression of interleukin-37 (IL-37), vascular endothelial growth factor A (VEGFA), and transforming growth factor-β1 (TGF-β1) in children with primary immune thrombocytopenia (ITP) and their correlation with T cells. METHODS: A retrospective analysis was conducted on 45 children with ITP (ITP group) who were admitted to Handan Central Hospital from January 2020 to April 2022, and 30 healthy children who underwent physical examination during the same period were included as the healthy control group. The mRNA expression levels of IL-37, VEGFA, and TGF-β1 and the levels of regulatory T cells (Treg) and helper T cells 17 (Th17) were measured before and after treatment, and the correlation between the mRNA expression levels of IL-37, VEGFA, and TGF-β1 and the levels of Treg, Th17, and Treg/Th17 ratio were analyzed. RESULTS: Compared with the healthy control group, the ITP group had a significantly higher mRNA expression level of IL-37 and a significantly higher level of Th17 before and after treatment, as well as significantly lower mRNA expression levels of VEGFA and TGF-β1 and significantly lower levels of Treg and Treg/Th17 ratio (P<0.05). After treatment, the ITP group had significant reductions in the mRNA expression level of IL-37 and the level of Th17 and significant increases in the mRNA expression levels of VEGFA and TGF-β1 and the levels of Treg and Treg/Th17 ratio (P<0.05). Correlation analysis showed that in the ITP group, the mRNA expression levels of IL-37 and TGF-β1 were negatively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and were positively correlated with the level of Th17 (P<0.05) before and after treatment; the mRNA expression level of VEGFA was positively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and was negatively correlated with the Th17 level (P<0.05) before and after treatment. CONCLUSIONS Abnormal expression levels of IL-37, VEGFA, and TGF-β1 may be observed in children with ITP, which is significantly associated with the imbalance of Treg/Th17 ratio. It is speculated that the cytokines such as IL-37, VEGFA, and TGF-β1 may be involved in the development and progression of ITP or may become important potential targets for the treatment of children with ITP. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(11): 1131-1136.
Child ; Humans ; Interleukins ; Purpura, Thrombocytopenic, Idiopathic ; Retrospective Studies ; RNA, Messenger/metabolism* ; T-Lymphocytes, Regulatory ; Th17 Cells/metabolism* ; Transforming Growth Factor beta1/genetics* ; Vascular Endothelial Growth Factor A/genetics*

AIM: To explore a more convenient and accurate method for evaluating the anterior chamber angle width based on the Van Herick method.METHODS:A total of 58 patients(69 eyes)with age-related cataract who visited our hospital between January and December 2021 were included. They were divided into the chamber angle width ≥1/2 corneal thickness(CT)group(44 eyes of 37 cases)and <1/2CT group(25 eyes of 21 cases)according to the Van Herick method. The central anterior chamber depths and the peripheral anterior chamber angle degrees were measured by ultrasound biomicroscopy.RESULTS: There were statistically significant differences in central anterior chamber depth between the two groups(2.64±0.27 mm vs. 2.23±0.29 mm, P<0.01), and the differences of chamber angle degrees of quadrants of superior, temporal, inferior and nasal compared between two groups were all statistically significant(P<0.01). The difference of chamber angle degrees of quadrants of superior and inferior in chamber angle width ≥1/2CT group was not statistically significant(P>0.05), while the differences of chamber angle degrees of other quadrants were all statistically significant(P<0.05). The differences of chamber angle degrees of quadrants of superior and nasal, temporal and the chamber angle degrees of quadrants of inferior and temporal were all statistically significant in chamber angle width <1/2CT group(P<0.05).CONCLUSION: In the overall evaluation of the anterior chamber angle, it would be more simple, fast and accurate when evaluating the temporal chamber angle width and inferior quadrant of chamber angle width by using the Van Herick method under silt lamp.

BACKGROUND: Hip arthroplasty is most effective method to treat hip diseases such as femoral head necrosis, osteoarthritis, hip dysplasia and femoral neck fracture in the elderly. Therefore, it is necessary to study the biomechanical behaviors of hip arthroplasty. OBJECTIVE: To simulate the contact stress and Von Mise stress values and distributions of trabecular acetabular cup and solid acetabular cup by finite element analysis method, and to predict its effects on prosthesis and hip joint. METHODS: Two hip joint component models with different structures, trabecular acetabular cup and solid acetabular cup were designed in 3-Matic Research 11.0 software. The well-designed models were imported to Hypermesh 14.0 software to divide meshes and assign material properties. Finite element analysis software Abaqus 6.13 was used to simulate the stress values and distributions of both models. RESULTS AND CONCLUSION: The results of this study showed that the stress of the trabecular acetabular cup was scattered and distributed widely. The solid acetabular cup is prone to stress concentration, and the stress distribution is concentrated near the point of stress. Compared with the solid acetabular cup and the trabecular acetabular cup, the latter has larger contact area of stress distribution and more uniform stress distribution, which can reduce the wear between hip prostheses and the risk of aseptic loosening of hip prostheses.

With the new-style thoracentesis needles with spring-loaded valve designed by ourselves, thoracentesis were carried out in 60 patients with ages ranging from 2 to 74 years. The successful rate for the operation was 100% (198/198), without any major complications such as pneumothorax, hemothorax, pleural shock or infection. The results show that this kind of puncture needle is multi-purpose and easy to operate, with high safety and reliability.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Equipment Design ; Female ; Humans ; Male ; Middle Aged ; Needles ; Paracentesis ; instrumentation ; methods ; Pleural Effusion ; diagnosis ; therapy ; Young Adult