Objective To investigate the effect of advanced glycation end products(AGEs)on expression of vascular endothelial growth factor(VEGF)in rabbit retinal M?ller cells in vitro.Methods We successfully cultured rabbit retinal M?ller cells and made AGEs-BSA as well as its control in vitro.Study with M?ller cells were divided into AGEs-BSA group,AGEs-BSA control group and blank control group.AGEs-BSA group and AGEs-BSA control group were respectively treated with 5 different concentration series of AGEs-BSA and AGEs-BSA control and cultured for 3,6 and 9 days,while blank control group was incubated without any intervention.Then VEGF expression in M?ller cells was observed by immunocytochemistry(ICC).Results Compared with control group,VEGF expression in cultured retinal M?ller cells was significantly enhanced in AGEs-BSA group.And the effects were in the time-and concentration-dependent manners.Conclusions AGEs increases VEGF expression in rabbit retinal M?ller cells in vitro,which indicates that AGEs may promote the progression of diabetic retinopathy(DR)through the induction of VEGF expression.

OBJECTIVE: To provide the anatomic data for operation on the middle ear through the observation and measurement of related anatomic structure. METHOD: Forty human temporal bones of 20 voluntary bone donors were dissected, relative anatomical data of operation were observed and measured under operating microscope through posterior tympanum approach entering posterior tympanum. RESULT: The average distances from suprameatal spine to short crus of incus, pyramid segment of facial canal were 19.14 mm, 16.30 mm, respectively. The average distances from pyramid segment of facial canal to the surface of mastoid, crotch of chorda tympani nerve, posterior wall of auditory meatus were 20.84 mm, 11.28 mm, 4.40 mm, respectively. The average length of facial nerve in the horizontal segment, the perpendicular paragraph was about 11.60 mm, 15.30 mm, respectively. The average distance from pyramidal eminence to the anterior lip of round window niche, from oval window to round window niche, from incudostapedial joint to round window niche was 4.46 mm, 3.74 mm, 3.80 mm, respectively. The included angle of facial nerve in the horizontal segment and chorda tympani nerve with facial nerve in the perpendicular paragraph was 110.4 degrees, 24.8 degrees, respectively. Horizontal semicircular canal and facial nerve in the level paragraph was 17.5 degrees, long process of incus and incus buttress was 46.0 degrees. CONCLUSION The position of anatomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region. The anatomical parameters provide a reference value for avoiding the injury during the operation.
Adult ; Chorda Tympani Nerve ; anatomy & histology ; Ear, Middle ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; Female ; Humans ; Male ; Round Window, Ear ; anatomy & histology ; surgery ; Temporal Bone ; anatomy & histology ; innervation

OBJECTIVE: To discuss the diagnosis and effective treatment of cystic lymphangiomas located in head and neck in children. METHOD: Fifteen cystic lymphangiomas,diagnosed with pathological evidence, located in head and neck in children were retrospectively analyzed including clinical characteristics, diagnosis, treatment and follow-up data. RESULT: CT and ultrasonography were used to evaluate the size, shape and extent of lymphangiomas in all patients. All patients were treated with surgery. Complete resection was performed in 14 cases, and subtotal resection in one case. Two post-operative complications were found,one was paralyses of mandibular branch of facial nerve, another was Horners syndrome. Tracheotomy operation was done in one case,and the tracheal cannula was taken away before discharged from hospital. Fourteen patients were followed up. There was no recurrence during the follow-up from 6 months to 8 years, while one case who suffered from Horner's syndrome after operation was not cured. CONCLUSION CT and ultrasonography are effective to diagnose cystic lymphangiomas and evaluate the security of clinical treatment. Total or subtotal resection is effective to treat cystic lymphangiomas.
Child, Preschool ; Female ; Head and Neck Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Infant ; Infant, Newborn ; Lymphangioma, Cystic ; diagnosis ; diagnostic imaging ; surgery ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

Objective:To compare the clinical features of patients with acute Vogt-Koyanagi-Harada syndrome (VKH syndrome) of optic disc swelling (ODS) and serous retinal detachment (RD).Methods:A retrospective clinical study. From January 2013 to November 2019, 212 patients with acute VKH syndrome diagnosed in the Department of Ophthalmology of Shanghai Xuhui District Central Hospital were included in the study. Among them, there were 105 males (210 eyes) and 107 females (214 eyes). The average age was 40.84±13.90 years. All affected eyes were examined by BCVA, FFA, and OCT. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. According to the changes in the fundus, the patients were divided into the ODS group and the RD group, 36 patients with 72 eyes (16.98%) and 176 patients with 352 eyes (83.02%), respectively. The independent sample t test was performed to compare the age of onset, visit time and BCVA of the two groups of patients, the χ2 test was performed to compare the count data. Results:Among the 72 eyes of 36 patients in the ODS group, there were 16 males with 32 eyes (44.44%), 20 females with 40 eyes (55.56%). The average age was 40.56±16.57 years, the average visit time was 22.47±19.98 days, the average logMAR BCVA was 0.68±0.53. Among the 352 eyes of 176 patients in the RD group, there were 89 male patients with 178 eyes (50.56%), and 87 female patients with 174 eyes (49.43%). The average age was 40.90±13.34 years, the average visit time was 17.25±24.40 days, the average logMAR BCVA was 0.80±0.56. The average age ( t=-0.116), gender composition ratio ( χ2=0.448), average visit time ( t=1.204), average logMAR BCVA ( t=-1.661) comparisons between the two groups showed no statistically significant differences ( P>0.05). There was no statistically significant difference in the average logMAR BCVA between the RD group and the ODS group of different eyes ( t=0.227, 0.810; P>0.05). There were 50 (69.44%, 50/72) and 272 (77.27%, 272/352) eyes in the ODS group and RD group with inflammation of the anterior segment. There were anterior segment reactions between the two groups. There was no statistically significant difference in the number of eyes ( χ2=1.003, P>0.05). There were 34 (19.32%, 34/176) and 2 (5.56%, 2/36) patients with headache and hearing loss, respectively. The comparison of the number of patients with headache and hearing loss between the two groups showed statistically significant differences ( χ2=4.015, P<0.05). Conclusion:Compared the patients with ODS acute VKH syndrome, the patients with serous RD acute VKH syndrome are more likely to have extraocular symptoms such as headache and hearing loss.

Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.

Objective: To explore the effect of WeChat platform continuous nursing on reducing the recurrence rate and readmission rate of acute pancreatitis patients. Methods: A total of 162 cases of acute pancreatitis admitted to the Department of Emergency Surgery in the Affiliated Zhongshan Hospital of Dalian University from February 2017 to July 2018 were selected as the research objects. The patients were divided into the observation group (80 cases) and the control group (82 cases) by random number method. In the control group, routine discharge education, release of education manual and regular telephone follow-up were carried out. Observation group based on the conventional discharge, by the continuity of care team to three times a week, for a period of six months WeChat platform continuity nursing intervention, the specific mission includes pancreatitis disease related knowledge, the matters needing attention after discharge, and the content such as recurrence, and weekly WeChat online interactive answering questions. The disease recurrence, readmission rate, rehospitalization days at 1 month, 3 months, 6 months after discharge between the two groups. Results: There was no significant difference in the disease recurrence, readmission rate, rehospitalization days between the two groups at 1 month, 2 months after discharge (P > 0.05). The disease recurrence of the observation group was 11.25% (9/80) and 26.25% (21/80) at 3 months and 6 months after discharge, respectively, which was lower than that of the control group 23.17% (19/82) and 43.90% (36/82), with statistically significant differences (χ²=4.025, 5.533, P < 0.05). The readmission rate of the observation group was 8.75% (7/80) and 21.25% (17/80) at 3 months and 6 months after discharge, respectively, which was lower than that of the control group 23.17% (19/82) and 41.46% (34/82), with statistically significant differences (χ²=6.250, 7.670, P < 0.05 or 0.01). The rehospitalization days of the observation group at 3 months and 6 months after discharge was (12.18±4.20) and (12.48±4.16) points, respectively, which was less than that of the control group (15.08±4.91) and (15.34±4.48) points, with statistically significant differences (t=-4.685, -4.638, P < 0.05). Conclusions WeChat platform continuous nursing intervention for patients with acute pancreatitis, can improve patients' self-management ability and compliance behavior, reduce the recurrence rate of pancreatitis patients, readmission rate and the average number of days of readmission, improve the quality of life of patients, is worthy of clinical application.

Objective To explore the effect midazolam combination with propofol on postoperative recovery in patients undergoing laparoscopic cholecystectomy. Methods A total of 162 patients who were admitted to the hospital for laparoscopic cholecystectomy from April 2019 to January 2021 were selected. According to different anesthesia methods, they were divided into control group (midazolam anesthesia) and observation group (midazolam combined with propofol anesthesia), with 81 cases in each group. The stress index levels before and after operation, MoCA scores before operation (T₀), 24 h after operation (T₁) and 48 h after operation (T₂), sleep quality at T₀, the first day after operation (T₃) and the second day after operation (T₄), the perioperative recovery were compared between the two groups. Results The levels of Cor and NE, the recovery time of eyes opening, extubation, orientation, and the incidence of adverse reactions in the observation group were lower than those in the control group (P<0.05). Observation group MMSE score when T₁, T₂, T₃, T₄ sleep quality score were higher than control group (P<0.05). Conclusion Midazolam combined with propofol was safe and had good postoperative recovery in patients undergoing laparoscopic cholecystectomy.