Blood Coagulation Factors ; administration & dosage ; Child ; Factor IX ; administration & dosage ; Factor VIII ; administration & dosage ; Hemophilia A ; prevention & control ; therapy ; Humans

Background Cataract phacoemulsification combined with intraocular lens (IOL) implantation is a primary treatment for cataract.However,tear film stability and ocular surface structure are affected after surgery,especially some cataract patients with diabetes.Researches determined that tear film dysfunction is an important causative factor of dry eye.Objective This study was to investigate the change of tear film after phacoemulsification in cataract patient with diabetes.Methods A non-randomized cases-controlled study was designed.Thirty-six cataract patients with diabetes (54 eyes)and matched 32 patients (40 eyes)with age-related cataract were included in this study in Tianjin First Center Hospital from October,2010 to May,2011.Phacoemulsification and IOL implantation was performed on the all patients with the same topical eyedrops in both groups.Dry eye-related symptom was surveyed and scored by questionnaire,and tear film break-up time (BUT),Schirmer Ⅰ test(S Ⅰ t)and corneal fluorescein(FL) were examined 3 days before operation and 1 day,1 week,1month,3 months after operation.Written informed consent was obtained from each patient before entering this trial.Results The percentage with preoperative symptoms of dry eye was 36.2％ and postoperative dry eye symptoms accounted for 75.8％.Significant differences were seen in dry eye symptom score,FL score,BUT value and S Ⅰ t value between the diabetic cataract group and only cataract group as well as among 4 time points(dry eye symptom score:Fgroup =139.347,P =0.000 ; Ftime =342.741,P =0.000 ; FL score: Fgroup =14.073,P =0.000 ; Ftime =332.697,P =0.000 ; BUT value: Fgroup =28.198,P =0.000 ; Ftime =868.364,P =0.000 ; S Ⅰ t value: Fgroup =2.848,P =0.095 ; Ftime =564.017,P=0.000).FL scores of 2 groups were significantly higher in postoperation than those in preoperation (P＜0.05),and those of diabetic cataract group were significantly higher than only cataract group(P＜0.05),but no significant difference was found between postoperation 3 months and preoperation (P＞0.05).BUT was shorter in postoperation than that in preoperation in the diabetic cataract group(P＜0.05).S Ⅰ t values in postoperative 1 day and 1 week were significantly lower than in preoperation in both groups(P＜0.05).However,S Ⅰ t values returned to normal from 1 month through 3 months in both groups(P＞0.05).Conclusions Tear film dysfunction occurs after operationin cataract patient with type 2 diabetes.It is thought that cataract patient with diabetes is susceptible population of dry eye.Dry eye appears more early and severer in diabetes patients after phacoemulsification combined with IOL implantation.

BACKGROUNDConsidering the existence of a large number of liver cell degeneration and necrosis in fibrotic liver, liver function was damaged severely and could not effectively regenerate after partial hepatectomy (PHx). The aim of this study was to investigate whether decorin (DCN) could promote the liver regeneration after PHx in fibrotic mice.

METHODSForty mice (5-week-old, Balb/c) were injected with CCl4 intraperitoneally and liver fibrosis model was established after 5 weeks. The survival mice were randomly divided into two groups: control group and DCN group. Then, we performed 70% PHx on all these mice and injected DCN or phosphate-buffered saline plus normal saline (NS) to each group, respectively, after surgery. Liver body weight ratio (LBR), quantitative real-time polymerase chain reaction, and immunohistochemistry were used to analyze liver regeneration and fibrosis degree in both groups, and to find out whether exogenous protein DCN could promote the regeneration of fibrosis liver after PHx.

RESULTSExpressions of a-smooth muscle actin (SMA) mRNA and LBR had significant increases in the DCN group at postoperative Day 3 (POD 3, P < 0.05). The protein expressions of CD31, a-SMA, and tumor necrosis factor (TNF)-a were higher in the DCN group than those in the control group by immunohistochemistry at POD 3 (P < 0.05).

CONCLUSIONExogenous protein DCN could promote liver regeneration after PHx in fibrotic mice.

Animals ; Decorin ; therapeutic use ; Hepatectomy ; Immunohistochemistry ; Liver Cirrhosis ; drug therapy ; metabolism ; surgery ; Liver Regeneration ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism

OBJECTIVE: To evaluate the effect of standardized health education on the sputum specimen collection rate for nucleic acid detection of coronavirus disease 2019 (COVID-19). METHODS: Two hundred and twenty-seven patients in fever clinics and isolation wards of Sir Run Run Shaw Hospital of Zhejiang University and 307 migrant workers returning to 5 enterprises in Shanghai from February 3 to March 14, 2020 were enrolled in the study. Through clarifying the procedures of collecting sputum specimens, making graphic/video health education materials, standardizing the contents and methods of health education, we conducted education to the subjects. The subject expectorated spontaneously or with medical assistance. For patients, the number of sampling attempts and sputum acquisition times were documented before and after the implementation of the standardized expectoration method; for the returning migrant employees in the enterprises, only the number of collected samples after the implementation of the standardized expectoration method were recorded. RESULTS: A total of 378 sputum samples were collected from 227 patients. The sputum sampling rates before and after the implementation of health education were 40.9%and 58.4%, respectively ( CONCLUSIONS The education for standardized sputum sample collection method can effectively increase the sputum collection rate.
Betacoronavirus/genetics* ; COVID-19 ; China ; Coronavirus Infections/diagnosis* ; Efficiency ; Humans ; Nucleic Acid Amplification Techniques/methods* ; Pandemics ; Pneumonia, Viral/diagnosis* ; SARS-CoV-2 ; Specimen Handling/methods* ; Sputum ; Time Factors

Objective: To investigate the effect of an information module for delirium assessment in ICU. Methods: The information module for delirium assessment was designed according to the route chart of the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU) information assessment. Totally 70 nurses Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in the application of the information module. The compliance and accuracy of the delirium assessment and acceptance of nurses' assessment of information module were compared. Results: The information module for delirium assessment was implanted into the clinical critical information system. The rate of compliance and accuracy of delirium assessed was 55.9%(2 728/4 877), 64.2%(231/360) before the application of information module, and 92.0%(4 360/4 740), 92.5%(333/360) after the application of information module. The difference between two groups were statistically significant (χ²=1 611.531, 85.139, P<0.01). The score of nurses′ acceptance of the input method before and after the application of information module were 69.00±4.00, 100.56±3.50, and the difference were statistically significant (t=-49.70, P<0.01). Conclusions The information module for delirium assessment can simplify the assessment process, improve nurses′ compliance and accuracy to assess delirium, optimize critical care management and worth spreading.

Humans ; Semicircular Canals ; abnormalities

BackgroundGlaucoma associates with apoptosis of retinal ganglion cells ( RGCs).Research showed that ciliary neurotrophic factor (CNTF) can repair optic nerve trauma,but it has not reported whether CNTF has a protective effect on glaucomatous optic neuropathy.ObjectiveThis experimental study was to explore the protective effect of CNTF on RGCs in rat eyes with acute ocular hypertension.MethodsOcular acute hypertension models were induced in bilateral eyes of 24 clean Wistar rats by forced perfusion of a balanced salt solution into the anterior chamber.Two days before molding,0.5 μg recombinant human CNTF (5 μl) was injected intravitreously in the left eyes,and 5 mmol/L sodium phosphate solution (5 μl) was injected in the same way as the control group.Three other Wistar rats were used as the normal control group.The animals were sacrificed by excessive anesthesia and the retinal sections were prepared 1,3,7,14 days after molding.The morphology of the retina was examined and RGCs counting was performed by hematoxylin & eosin staining and observed under a light microscope.The expression of glutamic acid in RGCs was assessed by immunochemistry.ResultsRegular retinal structure with clearly defined cell layers were observed in normal control rats.Changes in vacuoles in RGCs were seen in the model control group.The number of degenerative RGCs decreased in the CNTF group.Compared with the model control group,number of normal RGCs increased from 1 day to 14 days after molding with a significant difference between the two groups (all P=0.000).Immunochemistry assay showed that the numbers of positive cells for glutamic acid were 5.50±1.04 and 6.00±1.41 for the average of 3 fields at 3 days or 7 days in the CNTF group,and those in the model control group were 9.00±2.91 and 10.83 ± 1.94,respectively,showing significant differences between them ( all P =0.000 ).However,no comparable differences were found in the numbers of positive cells for glutamic acid at 1 day and 14 days between the two groups( P=0.578,0.180).ConclusionsCNTF down-regulates the expression of glutamic acid in RGCs and offers neuroprotection for RGCs in an acute glaucoma rat model.

AIM: To evaluate the relationship between damages of visual field and retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG)with highly myopia. POAG with highly myopia group (21 eyes of 17 cases), POAG with non-highly myopia group (17 eyes of 16 cases), highly myopia without POAG group (25 eyes of 20 cases) and normal control group (19 eyes of 17 cases).automated perimeter and thickness of RNFL was measured by optical coherent tomography(OCT). Main outcome mean deviation (MD), pattern standard deviation (PSD) and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others (P＜0.05).The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant(P＜0.05).Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia(P＞0.05). The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia. Field; optical coherent tomography

Objective To assess response of rectal carcinoma to preoperative chemoradiation therapy(CRT)using DWI and tumor ADC values,and to investigate the value of ADC in predicting and monitoring therapeutic effect of CRT.Methods Twenty-six patients with primary rectal carcinoma undergoing preoperative CRT were recruited to the study.DWI was performed on a 1.5 T MR scanner in all patients at the time point of pre-therapy,the end of the 1st,2nd week of therapy and pre-operation,respectively.ADC values of the tumors were calculated on the workstation.Randomized block design was applied to analyze change in ADCs following treatment Results All patients were divided into T-downstaging group(n=12)and T-non-downstaging group(n=14).In T-downstaging group,the mean tumor ADC values were(1.10±0.13)×10~(-3),(1.32±0.19)×10~(-3),(1.35±0.13)×10~(-3),(1.32±1.00)×10~(-3) mm~2/s at the time point of pretreatment,week 1,week 2,pre-operation,respectively(F=16.420,P＜0.01).The mean tumor ADC value in T-non-downstaging had a slight increase from(1.16±0.16)×10~(-3) mm~2/s to(1.23±0.13)×10~(-3) mm~2/s at the time of week 1(P＞0.05).The ADC value in T-non-downstaging group continuously increased to(1.30±0.16)×10~(-3) mm~2/s at the end of the 2nd week of CRT(F=5.023,P＜0.01)and appeared statistical difference.The evolution of tumor ADC values in the two groups was significantly different.Early increases in tumor ADC were observed in T-downstaging group.Regarding the increase percentage of ADC value at 1st week as a diagnostic marker of tumor downstaging,when it was set as 11.6%,the sensitivity,specificity,positive predictive value and negative predictive value is 75.0%,78.6%,75.0% and 78.6% respectively,the area under curve(Az)was 0.774(95% confidence interval:0.583 to 0.964).Conclusions An early significant increase of mean tumor ADC value in rectal carcinoma has a potential to predict therapeutic effect of CRT.One week after beginning CRT is an early time point to monitor therapy efficacy.

Objective To investigate the effect of valsartan on expression of HIF-1α,TIMP-1,MMP-9 in the process of renal interstitial fibrosis(RIF) in diabetic nephropathy(DN) rats.Methods Fifty-four SD rats were randomly divided to 3 groups:control group (group C),DN group (group D),valsartan treatment group (group T).Rats of group D and T were given streptozocin (STZ) by intraperitoneal injection to establish animal model of diabetes.After diabetic models were successfully made,rats of group T were treated by valsartan (40 mg·kg-1·d-1).Serum glucose,serum creatinine and urinary protein were measured at the 4th,8th and 12th weeks.Masson staining was used to calculate the area of RIF.The methods of immunohistochemistry and real-time PCR were used to detect the expressions of HIF-1α,TIMP-1,MMP-9 in renal interstitium.Results Compared with group C,the areas of RIF were larger,24-hour urinary protein,Scr were higher,the mRNA and protein expression of HIF-1α and TIMP-1 increased,while the mRNA and protein expression of MMP-9 decreased in D and T group (P＜0.05).At the 8th,12th weeks,compared with group D,the areas of RIF were smaller,24-hour urinary protein,Scr were relatively lower expressions of HIF-1α and TIMP-1 decreased,while the eapressions of MMP-9 increased in group T (P＜0.05).Conclusion Valsartan may delay the progress of RIF in DN rats by down-regulating the expressions of HIF-1α,TIMP-1,up-regulating the expression of MMP-9,then improve renal function.