Objective To evaluate the therapeutic effects of ultrasound biomicroscopy (UBM) assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia.Methods Fifty aphakia patients (50 eyes) with residual lens capsular equal or greater than 180 degrees were chosen.The patients were randomly divided into 2 groups and underwent intraocular lens suspension surgery with one loop suturing:Trial group (25 cases,25 eyes) selected suture site according to the preoperative UBM results,and control group (25 cases,25 eyes) selected the suture site according to the clinical experience.The uncorrected visual acuity (UCVA),astigmatism at preoperative and postoperative 1 week,1 month and 3 months were observed,the eccentric and tilt value of the lens were calculated by UBM measurement at 3 month after operation,and the postoperative complications of the two groups were observed.Results UCVA at each time point after operation were higher than that before operation,and gradually increased with time.There was no significant difference between the two groups at 1 week before and after the operation of UCVA (P ＞ 0.05).At 1 month and 3 months after operation,UCVA in trial group were significantly higher than those of control group (all P ＜ 0.05).The astigmatism value at 1 week after operation in two groups was higher than that before operation and gradually decreased with time.The astigmatism value in trial group at 1 month and 3 months after operation had no significant difference with that of preoperative (P ＞ 0.05),while the astigmatism value in control group increased (all P ＜ 0.05).The astigmatism values had no significant difference between the two groups before and 1 week after operation (all P ＞0.05),which were significantly lower in trial group at 1 month and 3 months after operation (all P ＜ 0.05).Three months after surgery,the proportion of lens accurately implanted in the ciliary sulcus was significantly higher than control group (P ＜ 0.01),the eccentric and tilt values of the lens in trial group were significantly less than control group (P ＜ 0.01).No serious complication was observed in all patients.Conclusion UBM assisted intraocular lens suspension surgery with one loop suturing can significantly improve the postoperative visual quality,safety and lens stability,which can be used as a routine preoperative examination of intraocular lens suspension surgery.In addition,UBM provides an alternative method for the calculation of the eccentricity and tile value of the intraocular lens after the implantation of the intraocular lens.

Objective To compare the diagnostic value of 3.0T and 1.5T magnetic resonance diffusion weighted imaging (DWI) in lymph node metastasis of gastric cancer. Methods Preoperative magnetic resonance examination was performed on 50 patients with gastric cancer by using Siemens 1.5T and 3.0T superconducting magnetic resonance imaging system, and the outcomes were compared with postoperative pathological results. The sensitivity, specificity and accuracy of the diagnosis in lymph node metastasis of gastric cancer were analyzed statistically. The apparent diffusion coefficient (ADC) values of lymph nodes were also evaluated for 1.5T and 3.0T magnetic resonance DWI. Results The sensitivity, specificity and accuracy of the diagnosis on lymph node metastasis of gastric cancer by 1.5T magnetic resonance DWI were 79.4 %, 81.4%and 80.0%, respectively, and the corresponding percentages of 3.0T magnetic resonance DWI were 84.6%, 79.7%and 83.1%. The accuracy rate of 3.0T magnetic resonance DWI was slightly higher than that of 1.5T in the diagnosis of lymph node metastasis of gastric cancer (χ2=5.451, P=0.020), but there were no significant differences in the sensitivity and specificity between the two groups (both P> 0.05). The accuracy rate of 1.5T magnetic resonance DWI in the diagnosis of lymph node metastasis of gastric cancer was less effective than that of the pathological diagnosis (χ2=7.410, P=0.007), but there was no significant difference between 3.0T magnetic resonance DWI and pathological diagnosis (χ2=2.450, P=0.120). The mean ADC values of metastatic and non-metastatic lymph nodes detected by 1.5T magnetic resonance DWI were (1.036 ±0.203) × 10-3 mm2/s and (1.476 ± 0.215) × 10-3 mm2/s (t= 6.813, P< 0.001), meanwhile, the corresponding values detected by 3.0T magnetic resonance DWI were (1.154 ± 0.183) × 10-3 mm2/s and (1.502 ± 0.264) × 10-3 mm2/s (t= 5.991, P< 0.001). The coincidence of the two methods for ADC value was favorable. Conclusions The diagnostic effect of 3.0T magnetic resonance DWI on lymph node metastasis of gastric cancer is better than that of 1.5T. ADC value provides a reliable imaging quantitative indicator for the determination of metastatic lymph nodes in gastric cancer, which plays a significant role in the clinical treatment options and prognosis of patients.

Objective To study the relationship between MRI features and pathological characteristics of the renal clear cell carcinoma,and to conduct a comparative analysis.Methods 23 patients renal clear cell carcinoma who were proved by postoperative pathology were retrospectively analyzed. The preoperative MRI findings and the postoperative pathological characteristics were compared. Results MRI plain scan showed uniform signal was seen in 2 cases, and mixed signal was found in 21 cases with cystic and necrosis. Blood was seen in 11 cases and false envelope was present in 12 cases. Dynamic enhanced scanning revealed that solid part was enhanced obviously, it was lower than the renal cortex but higher than the renal medulla in cortical phase and continued to be enhanced in medullary phase and delay phase.Postoperative pathological characteristics showed that tumor profiles were yellow-white and cystic and necrotic structures were present within tumors, blood was found in 17 cases. Endoscopic tumor cells were present in solid nests or acinar structure, and mesenchyma was rich in thin-walled vessels involved in reticular interval.14 cases were found to have false envelope.Conclusion Renal clear carcinoma MRI imaging manifestion is related to organixational srructure. MR plain scan combined with dynamic enhanced scan has very high value in the diangnodis of renal cell carcoinoma.

Objective To investigate long-term data of dry eye after LASIK in young myopia patients.Methods Young myopia patients were divided into treated group (group A) and control (group B),who were interviewed before surgery and on 1 year,3 years and 5 years after surgery.Their diopters,uncorrected visual acuity (UCVA),tear breakup time test,Schirmer I test and corneal fluorescent staining were taken,then dry eye was diagnosed and OSDI questionnaire were scored.Results The postoperative incidence of dry eye in group A was higher than that before surgery (35.6％) and decreased with time (51.7％,44.9％ and 40.7％,respectively),and there was no significant difference in group B at each time point (P ＞ 0.05).The preoperative incidence of dry eye was equal between two groups (P ＞ 0.05),which were much higher in group A after surgery (all P ＜ 0.05).In group A,the postoperative constituent ratio of mild dry eye was the majority and decreased with time (65.6％,52.8％,41.7％,respectively),while moderate and severe dry eye was increased,especially the latter (6.6％,11.3％ and 16.7％,respectively;P ＜ 0.05).At 5 years after surgery,the UCVA and visual function score in dry eye patients were lower than those of non-dry eye patients (all P ＜ 0.05),while the residual refraction and ocular symptom score were higher than those of dry eye patients (all P ＜ 0.05).Conclusion Dry eye disease may last for a long time and may getting worse after LASIK.Therefore,we should pay more attention to the development of dry eye long after LASIK in young myopic patients.

Objective To explore the cancer incidence in registration areas in Shanxi Province. Methods Data of 8 cancer registration areas in 2011 were taken into account and cancer incidence in different areas with different ages was compared with that in other domestic areas. Results 8 395 new cases in Shanxi all cancer sites were reported in 2011, including 4 810 male and 3 585 female. The incidence of malignant cancer of Shanxi was 207.53/100 000, and the standardized incidence of Chinese population and world population were 125.20/100 000 and 165.72/100 000, respectively. In urban areas, the incidence of Shanxi and the standardized incidence of Chinese population were 202.49/100 000 and 112.81/100 000, respectively. In rural areas, incidence rate of Shanxi was 211.96/100 000 and the standardized incidence of Chinese population was 138.43/100 000. In Shanxi Province, the major malignant cancer sites for males involved stomach, lung, esophagus, liver and colorectum, and cancer sites for females were more on cervix, lung, breast, stomach and esophagus. Conclusions Upper gastrointestinal cancer and uterine cervix cancer are the major cancers in Shanxi registration areas. The incidence of stomach cancer and uterine cervix cancer in Shanxi Province are much higher than national average.

Objective To evaluate the diagnostic accuracy and efficacy on cervical precancerous lesions and cervical cancer by HPV 16/18 E6 protein detection. Methods A total of 439 females with sexual activities were selected from Department of Gynaecology in Shanxi Cancer Hospital from May 2014 to January 2015, including 299 cases of cervical intraepithelial neoplasia (CIN)Ⅱ, CINⅢ or cervical cancer (the case group), and the other 140 cases (the control group). All the patients accepted the thinprep cytology test (TCT), HPV DNA and HPV 16/18 E6 oncoprotein tests and colposcope examination. Results The positive rates of the TCT, HPV DNA, HPV 16/18 E6 oncoprotein in the case group were 97.0 % (290/299), 94.3 % (282/299) and 66.9 % (200/299), respectively, and those in the control group were 44.3 % (62/140), 21.4 % (30/140) and 2.9%(4/140), respectively, and there were significant differences between both groups (all P<0.05). The sensitivity and specificity of the HPV 16/18 E6 oncoprotein test in detecting CINⅡ and above were 66.9 %and 97.1 %, respectively, and both of HPV DNA test were 94.3 % and 78.6 %, respectively; The consistent rate between HPV 16/18 E6 and HPV DNA was 71.9 % (κ= 0.21). In the case group, when TCT was associated with HPV DNA test, the sensitivity, specificity and accuracy were 98.9%, 82.8%and 81.7%, respectively, and when TCT was combined with HPV 16/18 E6 oncoprotein test, those were up to 97.9 %, 97.1 % and 95.0 %. Conclusion HPV 16/18 E6 oncoprotein test can improve the specificity of cervical cancer screening, so it may be used as a primary screening method in the less developed areas where HPV DNA test is difficult to be carried out, or as a shunt method for HPV DNA positive patients, which will allocate the limited health resources rationally.

Objective:To observe the characteristics of choroidal thickness in patients with macular edema secondary to superior temporal branch retinal vein occlusion (BRVO-ME).Methods:A retrospective control study. From November 2020 to September 2021, 30 patients (30 eyes) with BRVO-ME (BRVO-ME group) were diagnosed by ophthalmology examination in Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College and 14 healthy volunteers (28 eyes) were enrolled in the study. The choroidal thickness of macular area was measured by enhanced deep imaging technique of frequency domain optical coherence tomography. According to the subdivision of the diabetic retinopathy treatment group, the choroid within the 6 mm of the macular fovea was divided into three concentric circles with the macular fovea as the center, namely, the central area with the diameter of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. The inner ring area and the outer ring area are divided into upper, lower, nasal and temporal sides, respectively, which are denoted as S3, I3, N3, T3 and S6, I6, N6, T6, totaling 9 areas. To observe the distribution characteristics of choroidal thickness in different regions of two groups of eyes. The choroidal thickness of different macular regions was compared by independent sample t-test. Results:The choroidal thicknesses in the central area, S3, T3, I3, N3, S6, T6, I6, and N6 of the eyes in the control group and BRVO-ME group were 214.11±56.04, 207.89±57.92, 214.07±54.82, 207.14±61.54, 180.18±53.53, 204.25±59.60, 193.93±51.50, 190.54±51.21, 139.82±39.84 μm and 258.00±71.14, 256.43±68.70, 252.07±72.97, 244.37±68.49, 243.10±70.93, 247.20±68.36, 221.00±61.28, 223.77±58.64, 183.20±60.15 μm. In both groups, the choroidal thickness was the thickest in the central area, gradually thinning to the nasal side and temporal side, and the nasal choroidal thickness was thinner than other regions, and N6 area was the thinnest. Compared with the control group, the choroidal thickness of central area, S3, T3, I3, N3, S6, I6 and N6 in BRVO-ME group were significantly thicker ( t=-2.899, -2.229, -2.172,-3.250, -2.543, -2.292, -3.214; P<0.05), there was no significant difference in T6 area ( t=-1.814, P=0.075). Conclusion:The choroidal thickness of macular area in patients with BRVO-ME is thicker than that in normal subjects.

Objective To compare the cost-utility of tislelizumab and sorafenib in the first-line treatment of advanced unresectable hepatocellular carcinoma,and to provide a reference for the selection of treatment regimens from the perspective of pharmacoeconomics.Methods A partitioned survival model was used to simulate the survival status of patients using tislelizumab or sorafenib within 10 years,and the cost and health output were calculated respectively to obtain the incremental cost-utility ratio(ICUR).The 3 times China's per capita gross domestic product(GDP)in 2022 was taken as the threshold for willingness to pay(WTP).Results During the simulation period,the ICER of tislelizumab versus sorafenib was 280 691.4 yuan/quality-adjusted life year(QALY),which was significantly higher than that of the sorafenib group,which had obvious economic performance.Univariate sensitivity analysis showed that the incidence of grade 3 or above adverse reactions in the tislelizumab group,the cost of tislelizumab,and the incidence of grade 3 or higher adverse reactions in the sorafenib group were important factors affecting ICUR.Probabilistic sensitivity analysis showed that tislelizumab had a significant cost-utility advantage when WTP was 3 times GDP,with an economic probability of 81.4％,and the results were robust.Conclusion For the first-line treatment of advanced unresectable hepatocellular carcinoma,tislelizumab has a significant cost-utility advantage over sorafenib.

Objective: The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. Method: From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, n=86）, group B （40-<60 years, n=107） and group C （≥60 years, n=65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Result: Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （P>0.05）, RSI score was significantly different （P<0.05）, RSI score of group A and group B was higher than that of group C （P<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. Conclusion The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, =86）, group B （40-<60 years, =107） and group C （≥60 years, =65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （>0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.