AIM: To explore the clinical effect of femtosecond laser combined with cataract phacoemulsification(PHACO)in the treatment of senile patients with cataract.

METHODS: The clinical data of 78(78 eyes)patients with cataract were retrospectively analyzed. Patients with femtosecond laser combined with PHACO were included in observation group(40 cases in 40 eyes), and patients with PHACO alone were included in control group(38 cases in 38 eyes). The changes of intraocular pressure(IOP), best corrected visual acuity(BCVA)\〖logarithmic visual acuity chart(LogMAR)\〗, central corneal thickness(CCT), corneal endothelial cells(CEC)count and tear oxidative stress indexes \〖prostaglandin E₂(PGE₂), glutathione peroxidase(GSH-Px)\〗 were compared before operation, at 1d,1wk and 1mo after operation, and phacoemulsification time and the occurrence of complications within 1mo after operation were analyzed in the two groups.

RESULTS: At 1d, 1wk and 1mo after operation, the values of IOP and BCVA in two groups were decreased significantly compared with those before operation, and the values showed significantly decreasing trend with the prolongation of postoperative observation time, and the values in the observation group were significantly lower than those in the control group after treatment(P<0.05). The levels of CCT and PGE₂ in two groups were significantly increased compared with those before operation, and the levels showed significantly decreasing trend with the prolonged observation time, and the levels in the observation group were significantly lower than those in the control group(P<0.05). The levels of CEC count and GSH-Px in two groups were significantly decreased compared with those before operation, and the levels showed an obvious upward trend with the prolonged observation time, and the levels in the observation group were significantly higher than those in the control group(P<0.05). The phacoemulsification time and the total incidence rate of complications within 1mo after operation in observation group were significantly lower than those in control group(P<0.05).

CONCLUSION: Femtosecond laser combined with PHACO can effectively improve the levels of IOP, CCT and CEC count in elderly patients with cataract, and reduce the occurrence risk of postoperative complications, and it is beneficial to prognosis and recovery.

AIM: To investigate the cause and the description of pathogenic characteristics of chronic infective keratitis in different age groups.

METHODS: Totally 89 patients(89 eyes)with chronic infective keratitis were diagnosed in our hospital from January 2015 to December 2017 were selected as the research objects and the cause of the disease and pathogenic characteristics of different age groups, including 13-32 years group(35 eyes in 35 patiens), 33-52 years group(28 eyes in 28 patiens)and 53-73 years group(26 eyes in 26 patiens), were retrospectively studied.

RESULTS: There were no significant differences in the etiological distribution of patients in the three groups(P=0.290). There was no significant difference in the distribution of microbial composition among the three groups(χ²=0.258, P=1.000). The incidence of chronic infectious keratitis caused by fungal infection in the three groups was higher than that of other pathogenic microbes. In this study, 26 cases were positive in bacterial culture, including Staphylococcus epidermidis(50%), Pseudomonas aeruginosa(15%), Streptococcus salivarius(12%), Streptococcus pneumoniae(8%), Escherichia coli(8%)and Neisseria gonorrhoeae(8%). Pseudomonas aeruginosa and Staphylococcus epidermidis were the common bacterial strains in the positive culture results. In the cultivation of fungal strains 24 were positive cultures including Fusarium(46%), Aspergillus(17%), Alternaria(21%), Mycelium(no spore,4%), Penicillium(4%)and Curvularia(8%). Two strains of Fusarium spp. and Alternaria spp. were high of all patients.

CONCLUSION: There were no significant differences in the etiology of infectious keratitis among different age groups. Fungal infection is the main pathogen in the distribution of pathogens, the bacteria were mainly Streptococcus epidermidis in etiological features but in fungi, Fusarium dominates. So early prevention and prevention of infective keratitis should be strengthened and early treatment should be given.

AIM: To investigate the effect of silicon oil and heavy silicone oil as two kinds of intraocular stuffing to the retinal electrophysiology of the rabbits in the medium and long term.

METHODS: Totally 28 standard rabbits were selected with right eyes operated for vitrectomy, and then, they were randomized into three groups: Group A 12 rabbis, Group B 12 rabbits, Group C 4 rabbits. Group A: vitreous body was cut-down and filled with silicon oil; Group B: vitreous body was cut-down and filled with heavy silicon oil; Group C: vitreous body was cut-down and filled with BSS. Taken into account were the experimental animals' different periods thickness of the retinal, intraocular pressure and ERG b-wave amplitude for statistical analysis.

RESULTS: Comparison between any two means of Group A, B or C surgery eyes' preoperative and postoperative at different time points: measured IOP showed no significant difference(P> 0.05); the retinal thickness mean value measured by OCT had statistically significant(P<0.05)at the postoperative 24wk; there was a conspicuous statistically significant(P<0.01)of ERG'sb-wave amplitude at the postoperative 24wk.

CONCLUSION: As the stuffing of vitreous cavity, the silicone oil or heavy silicone oil has no obvious difference to the influence of intraocular pressure for medium to longer term. But heavy silicone oil has more serious negative impact of retinal visual information transmission function, more significantly reduce of retinal thickness than ordinary silicone oil in the longer term.

Objective: To evaluate the clinical value of non-contrast-enhanced MR angiography (NCE-MRA) combined with captopril renal scintigraphy (CRS) in the diagnosis of renovascular hypertension (RVH). Methods: A total of 52 patients (33 males, 19 females; age: (54.5±16.3) years) with highly suspected RVH between January 2018 and October 2018 from Henan Provincial People′s Hospital were retrospectively analyzed. The examination data of NCE-MRA, basic renal dynamic imaging, CRS and digital subtraction angiography (DSA) were collected and reviewed. The renal artery stenosis (RAS) rate≥70% was the criterion for RVH diagnosed by DSA, which was considered as the gold standard. The diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of NCE-MRA, CRS and NCE-MRA+ CRS were determined. The consistency between NCE-MRA and DSA was analyzed by Kappa test. The differences of diagnostic efficiencies between CRS and NCE-MRA + CRS were compared by χ² test or Fisher exact test. Results: There was a high consistency between NCE-MRA and DSA in the diagnosis of RVH (Kappa=0.81, 95% CI: 0.62-0.96; P<0.01). The diagnostic sensitivity, specificity, accuracy, PPV and NPV of NCE-MRA were 88.89%(24/27), 92.00%(23/25), 90.38%(47/52), 92.31%(24/26), and 88.46%(23/26) respectively, those of CRS were 81.48%(22/27), 72.00%(18/25), 76.92%(40/52), 75.86%(22/29) and 78.26%(18/23) respectively, and those of NCE-MRA+ CRS were 74.07%(20/27), 100%(25/25), 86.54%(45/52), 100%(20/20) and 78.12%(25/32) respectively. Compared with CRS, the specificity (P=0.01) and PPV (P=0.03) of NCE-MRA+ CRS in the diagnosis of RVH were increased. Conclusion NCE-MRA and CRS are effective in the diagnosis of RVH, and the combination of two methods can significantly improve the diagnostic specificity and PPV than CRS alone.

OBJECTIVETo investigate the expression of p73 and c-fos protein and its significance in the development of children hemangioma.

METHODSThe quantitative expressions of p73 and c-fos protein in hemangioma and normal skin were detected by immunohistochemistry.

RESULTSThe expressions of p73 and c-fos protein were strong in proliferative hemangioma while they were very weak in involutional hemangioma and normal skin. There were significant differences between the proliferative and involutional hemangioma or the normal skin in the expressions of p73 and c-fos (P < 0.01). No statistical significances of p73 or c-fos P73 expressions were observed between involutional hemangioma and normal skin (P > 0.05).

CONCLUSIONSP73 and c-fos may play an important role in the development and involution of skin hemangioma.

Child ; Child, Preschool ; DNA-Binding Proteins ; metabolism ; Female ; Hemangioma ; metabolism ; pathology ; Humans ; Infant ; Male ; Neoplasm Staging ; Nuclear Proteins ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Tumor Protein p73 ; Tumor Suppressor Proteins ; metabolism

Objective: To review and compare radiological parameters between degenerative lumbar kyphoscoliosis (DLKS) and degenerative lumbar kyphosis (DLK), and analyze the relationships between coronal and sagittal deformities and compensatory mechanisms of sagittal balance. Methods: A total of 82 patients with lumbar degenerative deformities were enrolled for our radiographic study at Department of Spinal Surgery, Peking University People′s Hospital from January 2016 to May 2017. These patients were divided into two groups: DLKS group (39 patients) with lumbar coronal and sagittal deformities, and DLK group (43 patients) just with lumbar sagittal deformity. Complete spinopelvic radiographic parameters were compared. Results: The Cobb angle and lumbar lordosis of DLKS group were (23.0±11.8)° and (18.2±12.1)°, while the lumbar lordosis of DLK group was (20.4±10.2)°. In DLKS group, Cobb angle had correlations with lumbar lordosis(r=-0.338, P=0.035), and central sacral vertical line distance had significant correlations with thoracolumbar junctional angle (r=0.488, P=0.002) . Moreover, no significant differences of all sagittal spinopelvic parameters were found between two groups (P>0.05). In DLKS group, significant correlations between lumbar lordosis and sacral slope (r=0.617, P=0.000), and correlations between lumbar lordosis and thoracic kyphosis(r=-0.363, P=0.023) were observed. In DLK group, lumbar lordosis showed significant correlations with thoracic kyphosis(r=-0.341, P=0.025) and sacral slope (r=0.772, P=0.000). According to Nash-Moe grading scale of apical vertebral rotation, 10 patients were with Ⅰ-Ⅱ grade while 29 patients with Ⅲ-Ⅴ grade in DLKS group. Conclusions Both as typical lumbar degenerative deformities, there are some correlations between scoliosis and kyphosis. However, coronal scoliosis may not influent sagittal morphological parameters for DLKS patients. Thoracic curve changes and pelvic backtilt are both important for maintaining the sagittal balance in patients with degenerative lumbar kyphoscoliosis.

Objective: To examine the prospective association between peripubertal diet quality and pubertal timing. Methods: Multivariate regression analyses were performed using data obtained from 1 588 SCCNG (Southwest China Childhood Nutrition and Growth) study participants, which included dietary data, anthropometric parameters, and information about potential confounders during peri puberty, two and four years before the onset of menarche or voice break. Dietary intake in peri puberty was assessed using a validated food frequency questionnaire. Diet quality was determined using the Chinese Children Dietary Index (CCDI), which measures adherence to current dietary recommendations. Age at menarche or voice break (M/VB) were used as pubertal markers. Results: The CCDI score ranged from 58.0 to 132.5 for girls and from 48.3 to 129.9 for boys. The pubertal markers consistently indicated that girls and boys with a higher peripubertal diet quality entered puberty later than their counterparts with lower CCDI scores (higher vs. lower CCDI tertiles: age at M was 13.1 years (11.2-13.3) and 12.5 years (12.0-13.9)(P<0.01); VB was 13.8 years (12.1-14.8) and 13.4 years (12.5-15.1)（P=0.03), after adjusting for paternal education level, energy intake, and pre pubertal body fat. Conclusion Children with a higher diet quality during peri puberty entered puberty at a later age. Dietary guidance and intervention are needed for better dietary quality among children during pubertal transition.

Objective: To understand the etiological characteristics of bacterial diarrhea in different areas, including large cities, mid-sized/small cities and rural area, in China. Methods: A cross-sectional surveillance was conducted in 17 provinces of China from 2010 to 2014. The acute diarrhea outpatients were selected from clinics or hospitals in large cities, mid-sized/small cities, including rural-urban fringe zones, and rural areas. The demographical and clinical characteristics of the patients were collected by using questionnaire, and stool samples were taken from them for laboratory detection of 17 kinds of bacteria. The differences in pathogen positive rates (PPR) and pathogen spectrum across the cases from three-type areas were compared. The different infection risk in different cases were analyzed with unconditional logistic regression model. Results: In our study, we enrolled 9 253 cases from large cities, 5 138 cases from rural areas and 13 683 cases from midsized/small cites. The pathogen with largest differences in infection rate across the three-type areas was Shigella (S.) flexneri (rural area: 5.81%, mid-sized/small city: 2.78%, large city: 0.46%), followed by Aeromonas (A.) hydrophila (rural area: 2.14%, mid-sized/small city: 0.96%, large city: 0.48%). Compared with cases in large cities, the cases in mid-sized/small cities and rural areas had higher infection risks for S. flexneri (mid-sized/small city: OR=6.481, 95%CI: 4.666-9.002, rural area: OR=11.304, 95%CI: 8.018-15.938) and A. hydrophila (mid-sized/small city: OR=1.992, 95%CI:1.401-2.832, rural area: OR=4.083, 95%CI: 2.833-5.884). The constituent ratio of diarrheagenic Escherichia coli and Salmonella increased with the urbanization development, while the ratios of Shigella and A. hydrophila had an opposite trend. S. sonnei (60.00%) was the predominant serogroup of Shigella in urban infections, while S. flexneri (77.37%) was the predominant serogroup in rural infections. Conclusion: The differences in pathogen spectrum of bacterial diarrhea were obvious across large cities, mid-sized/small cities and rural areas in China, especially the differences in the infection rates of S. flexneri and A. hydrophila.
Adolescent ; Adult ; Bacterial Infections/microbiology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Diarrhea/microbiology* ; Dysentery/epidemiology* ; Escherichia coli/pathogenicity* ; Feces/virology* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Rural Population ; Salmonella/pathogenicity* ; Shigella/pathogenicity* ; Suburban Population ; Urban Population

Objective: To analyze the current situation of adolescent depressive symptoms in singleparent families in Jianyang City, and to construct and verify the early warning model, so as to provide a scientific basis for the government to formulate a plan of promoting the development of adolescent mental health. Methods: A stratified cluster random sampling method was used to select 12 125 middle and high school students from 25 middle schools in Jianyang City from March 2022 to October 2023 for an anonymous selffilling questionnaire survey, and a total of 1 142 adolescents from valid singleparent families were obtained as the survey objects. They were randomly divided into the training set (914 participants) and the verification set (228 participants) according to the ratio of 8∶2. The Chinese version of Beck depression Inventory (BDI) was used to evaluate depressive symptoms among adolescents from singleparent families in Jianyang City. The factors related of depressive symptoms in adolescents from singleparent families were analyzed, and a prediction model was established to verify the model and evaluate its effectiveness. Results: There were 158 adolescents (17.29%) in the training set and 43 adolescents (18.86%) in the verification set with depressive symptoms. Multivariate Logistic regression analysis showed that learning stress (OR=4.31, 95%CI=1.67-11.13), Connor-Davidson Resilience Scale (CDRISC) score (OR=0.29, 95%CI=0.12-0.71) and Family Adaptability and Cohesion Scale (FACESⅡ) scores (OR=0.19, 95%CI=0.06-0.63) were all related factors the occurrence of depressive symptoms in adolescents from singleparent families (P<0.05). The results showed that the C-index was 0.80 (95%CI=0.75-0.80), and the correction curve for predicting the occurrence of depressive symptoms in singleparent families was close to the ideal curve (χ2=0.26, P>0.05). Receiver operating characteristic (ROC) curve results of the training set showed that the sensitivity and specificity of the nomogram model in predicting depressive symptoms in adolescents from singleparent families were 80.38% and 80.03% respectively, ROC area under the curve (AUC) was 0.84 (95%CI=0.76-0.92). The ROC curve results of the verification set showed that the sensitivity, specificity and AUC of histogram model to predict depressive symptoms in adolescents from singleparent families were 79.07%, 82.16% and 0.83 (95%CI=0.76-0.91). Conclusions Learning stress, mental resilience and family function are all factors that affect the occurrence of depressive symptoms in adolescents from single parent families in Jianyang City. Based on this, the early warning model can predict depressive symptoms in Jianyang City.

Objective: To understand the factors affecting the compliance of blood glucose monitoring in patients with type 2 diabetes in rural areas, and to provide evidence for improving the compliance of patients with blood glucose monitoring. Methods: A method of phenomenological study in qualitative research was conducted to conduct deep semi-structured interviews on 43 patients with poor blood glucose compliance in type 2 diabetes in rural areas, and to analyze the collected data. Results: Extracted five themes: bad experience affected compliance; lack of knowledge about blood glucose monitoring; economic and time was not sufficient; "long-term illness into a good doctor" overconfidence; social support uncertainty. Conclusions The status of blood glucose monitoring in rural type 2 diabetes patients is not optimistic. In order to improve the compliance of patients with blood glucose monitoring, nursing workers should pay attention to the mastery of blood glucose monitoring knowledge in rural type 2 diabetes patients, improve blood glucose monitoring methods and techniques, and give full play to the role of family doctors. Efforts to improve patient blood glucose monitoring compliance.