Objective To compare the clinical features and auxiliary examination results of sinus-originated intracranial aspergillosis（ICA）and rhino-orbito-cerebral mucormycosis（ROCM）. Methods A retrospective analysis was performed for the clinical data of seven patients with sinus-originated ICA and six patients with ROCM who were diagnosed and treated in our hospital from January 2018 to January 2023. Results The pathogenic factor of CNS fungal infection was observed in all patients with ROCM and 57.1% of the patients with sinus-originated ICA. Compared with the patients with sinus-originated ICA，the patients with ROCM were more likely to develop ocular symptoms and signs such as exophthalmos，periorbital swelling，and intraocular inflammation，as well as non-ocular symptoms and signs including fever，facial swelling，and facial nerve palsy. Compared with the patients with sinus-originated ICA，the patients with ROCM had significantly greater increases in blood glucose，erythrocyte sedimentation rate，C-reactive protein，and procalcitonin. Cranial magnetic resonance imaging showed that sinus-originated ICA often affected the paranasal sinuses，orbital apices，retro-orbital regions，and cavernous sinuses，while the patients with ROCM were more likely to have sinusitis，bone destruction，and mucormycosis invading cerebral vessels. As for treatment，50% of the patients with ROCM and 42.9% of the patients with sinus-originated ICA received antifungal therapy alone，while 50% of the patients with ROCM and 57.1% of the patients with sinus-originated ICA received a combination of medication and surgery. By follow-up to September 2023，50% of the patients with ROCM and 28.6% of the patients with sinus-originated ICA had no response to treatment and died. Conclusion Both sinus-originated ICA and ROCM have rapid progression，and ROCM survivors with diabetes are more likely to experience disabilities. Timely diagnosis and initiation of antifungal therapy，correction of underlying predisposing factors，and active surgical debridement are essential for the treatment of CNS fungal infections.
Aspergillus ; Mucormycosis

【Objective】 To explore the clinical value of thromboelas-tography, coagulation four items and platelet count in guiding platelet transfusion in critically ill patients. 【Methods】 A total of 188 critically ill patients in Intensive Care Unit of our hospital from January 2020 to January 2022 were selected as subjects, and were divided into study group(n=89) and the control(n=99) according to the presence of bleeding symptoms. T-test was used for comparative analysis between the two groups. Spearman was used to analyze the correlation between TEG, coagulation four items and platelet count, and binary Logistic regression analysis was used to predict the influential factors of bleeding in critically ill patients, ROC curve was used to analyze the guiding value of the above-mentioned indexes for platelet transfusion. 【Results】 1) K and PT values in the study group, above the normal range, were significantly higher than those in the control, while the Angle value, MA value, CI value, FIB value and platelet count were significantly lower than those of the control, among which MA value, CI value and platelet count were below the normal range. 2) TEG, coagulation four items and platelet count were correlated. MA and CI values were positively correlated with platelet count, instead, R and K values were negatively correlated. R value was positively correlated with PT and APTT, CI value, on the contrary, was negatively correlated, K value was positively correlated with PT, while Angle value and MA value were negatively correlated. 3) Binary Logistic regression analysis showed that decreased MA value and decreased platelet count were independent risk factors for predicting bleeding in critically ill patients(P<0.05). 4) ROC curve analysis showed that the areas under ROC curve corresponding to Angle value, MA value, CI value, FIB value and platelet count were 0.866, 0.932, 0.9, 0.838 and 0.987(P<0.05). The sensitivity was highest in platelet count and lowest in FIB. The specificity was highest in MA and lowest in Angle. Compared with the single index, the area under the curve of the combined index(K value, MA value, CI value, PT value and platelet count) was 0.995(P<0.05), Yoden index 0.944, sensitivity 100%, specificity 93.3%, all higher than the individual index. 【Conclusion】 Thromboelas-tography combined with coagulation four items and platelet count can be used to accurately predict the critically ill patients with bleeding risk. To guide clinical platelets transfusion, the combined use of indexes, including K value, MA, CI value, PT and platelet count, is superior to separate use of them as the former showed better sensitivity and specificity, demonstrating a good clinical value.

Early life stress in humans can affect the normal development of individual neural networks, ultimately leading to diseases such as anxiety, depression, and autism in such children. The maternal separation model is commonly used to study the effects of early adverse experiences in human infants. Studies have shown that maternal separation in mice can lead to anxiety, depression, and impairments in spatial learning and memory in young mice during adulthood. However, enriched environmental interventions have been found to ameliorate the negative outcomes of early life stress by exerting a range of beneficial effects. This article provides an overview of the positive effects of enriched environmental interventions on mice in the maternal separation model.

Objective : To research the feasibility and preliminary clinical effect of an implant-supported fixed bridge based on interactions with the posterior interocclusal space deficiency. Methods: Four patients with multiple implant-supported fixed-bridge restorations for interocclusal space deficiency in posterior teeth were included in this study. The 8 total implant sites had an average interocclusal space size of 3.3 mm. Two abutments with an undercut area were performed, the fixed bridge was placed by rotating it without a common path of insertion, and the abutment screw was then tightened. In the production process, the interaction retention concept and methods were fully communicated to the technician. The abutments and bridges on the implants were placed, and the clinical effect was observed. Results: The prosthesis was fixed well and presented appropriate functioning. At the 3-month and 18-month follow-up examination, the prosthesis and abutments were not loose, and the abutments did not release or break. No swelling or tenderness was observed in the margin of the implants. Conclusion The interaction retention is a good method of resolving the problem of interocclusal space deficiencies in the posterior teeth.

Objective: Abstract: Objective: To investigate the expression and significance of miR-138 and programmed cell death protein 1 (PD-1) in the patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods: A total of 30 patients with HBV-related HCC, 20 with HBV-related cirrhosis (LC) and 30 with chronic hepatitis B (CHB) were recruited from Jiaozuo People′s Hospital. The blood samples from all patients and the peritoneal effusion samples from HCC and LC patients were collected. The levels of miR-138 and soluble PD-1 (sPD-1) in blood and peritoneal effusion samples were detected by real-time PCR and ELISA, respectively. The expressions of PD-1 in T lymphocytes were measured with flow cytometry and western blot. The targeting effect of miR-138 on the 3′-non-coding region (3′-UTR) of PD-1 gene was verified by the dual-luciferase reporter gene system. Results: The relative expression levels of miR-138 in the peritoneal effusion and plasma of HBV-related HCC patients were significantly lower than those in LC and CHB patients (P＜0.05). The serum sPD-1 levels and the expression levels of PD-1 in CD3 + T lymphocytes of HBV-related HCC patients were significantly higher than those in LC and CHB patients (P＜0.05). The relative expression levels of miR-138 were negatively correlated with serum sPD-1 levels and the expression levels of PD-1 in CD3 + T lymphocytes (P＜0.05). The dual-luciferase reporter gene system and western blot results demonstrated that there was a targeting relationship between miR-138 and the 3′-UTR of PD-1 gene. After miR-138 was transfected, the expression level of PD-1 was significantly down-regulated. Conclusion miR-138 participates in the development and progression of HBV-related HCC probably by targeting PD-1.

AIM: To evaluate the efficacy and characteristic of lock stitch suture with bandage contact lens for pterygium.

METHODS: A prospective randomized controlled double-blind study was conducted. Totally 140 cases(140 eyes)with pterygium were involved in the study from January 2014 to December 2015. All cases were randomly divided into two groups: 68 cases(68 eyes)in Group A received lock stitch suture, while 72 cases(72 eyes)in Group B received lock stitch suture with bandage contact lens. The postoperative reaction, effect, complications and so on were retrospectively analyzed between two groups.

RESULTS: One week later, the pain index scores at 1, 3 and 7d after surgery were 1.62±0.71, 0.83±0.52, 0.31±0.36 in Group A, and the pain index scores were 0.98±0.47,0.27±0.14, 0.12±0.21 in Group B, there were significant difference between the two groups(t=6.23, 8.56, 7.03, P<0.05), and the difference were statistically significant within Group A and B(F=8.60, 13.60, P<0.01); 4 of 68 eyes(5.9%)were recurrence after 1a in Group A and 4 of 72 eyes(5.6%)were recurrence in Group B, demonstrating no significant differences(P>0.05); 10 of 68 eyes(14.7%)with complications in Group A and 3 of 72 eyes(4.2%)with complications in Group B, demonstrating significant differences(χ2=4.61, P<0.05).

CONCLUSION: A good result can be obtained by using the lock stitch suture with bandage contact lens in the treatment of pterygium. The lock stitch suture with bandage contact lens could significantly release pain response, it can significantly reduce the probability of the concurrent appearance.

Bacterial meningitis (BM) is one of the most serious central nervous system diseases of childhood worldwide.However, for the patients who had received antibiotic pretreatment, the clinical symptoms, as well as cerebrospinal fluid (CSF) composition, are not typical, the diagnosis tests, such as CSF Gram staining and bacterial culture, often present high false negative rates.All above factors add difficulties in distinguishing BM from viral meningitis.Till now, more and more biomarkers and diagnostic technologies had been proposed, now, the focuses on the recent advances in biomarkers like C-reactive protein, procalcitonin, CSF lactic acid and technologies like immunochromatography tests, real-time polymerase chain reaction, next-generation sequencing in the aspect of differentiating BM from viral meningitis in children were reviewed, in order to provide clinical suggestions for early diagnosis of BM.

Objective: To investigate the clinical effict of 0.01% atropine for myopia progression in school children,and to provide a reference for probing into an effective methods of preventing myopia among children. Methods: Thirty children, with a median age of 10 years (range 7-17), were given topical treatment with preservative free 0.01% atropine eye drops in both eyes before going to bed every night, and the efficacy and safety were analyzed 12 months later. Efficacy was assessed every 6 months. In 10 children, treatment of the second eye was delayed by one day to allow for a controlled safety assessment of side effects such as dilated pupils, hypoplasia and decreased myopia. Results: In terms of myopia treatment, after 12 months of treatment with 0.01% atropine, it was 0.43 D/year(t=8.66，P<0.01). In terms of safety,in the 10 children s treatment of the second eye was delayed by one day, the measurable side effect was the induction of 1 mm pupil dilatation,and there was no other significant abnormalities were observed. Conclusion Topical low-dose (0.01%) atropine is safe and effective in school-age children,and it has certain clinical promotion value.

AIM: To observe the visual recovery and complications in patients with proliferative diabetic retinopathy(PDR)after vitrectomy combined with phacoemulsification.

METHODS: According to different surgical methods, 95 cases(95 eyes)with PDR were divided into the observation group(50 cases)and the control group(45 cases). The observation group was treated with vitrectomy and phacoemulsification, while the control group was treated with vitrectomy and lensectomy. The visual recovery, changes of intraocular pressure before and after surgery and the complications were compared between the two groups.

RESULTS: The visual acuity of the two groups was significantly improved after surgery(P<0.05), and the improvement in observation group was significantly greater than that in the control group(P<0.05). The intraocular pressure of the two groups was increased significantly at 1, 3 and 6mo after surgery(P<0.05), without significant difference between the two groups(P>0.05). The incidence of iris neovascularization and capsule opacification in the observation group(2%, 6%)were significantly lower than those in the control group(18%, 27%; P<0.05).

CONCLUSION: Vitrectomy combined with phacoemulsification can obviously improve the visual acuity of patients with PDR, and the incidence of complications is low. Although it will lead to an increase in intraocular pressure, it can be improved after symptomatic treatment.

Objective: To investigate the difference and correlations of the EphrinA1, vascular endothelial growth factor (VEGF) expression and microRNA (miRNA)-210 in the kidney tissue of rats in the unilateral ureteral obstruction (UUO) model. And to understand the regulation mechanism of the three factors in the occurrence of renal tissue injury in rats. Methods: Using unilateral ureteral ligation to establish a model of hydronephrosis in mice (except for the NC group), and they wrere randomly divided into an acute hydronephrosis group (UUO group) and a false surgical control group (NC group). The UUO group was divided into four groups (UUO 2 d group, UUO 5 d group, UUO 9 d group, and UUO 14 d group), and eight mice in each group. The pathological changes of renal tissue were observed by hematoxylin-eosin (HE) staining. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression of EphrinA1, VEGF and miRNA-210; Western blot was used to detect the protein expression of EphrinA1 and VEGF. Resulsts: Hydronephrosis was not shown in the NC group, and hydronephrosis and inflammatory cell infiltration were observed in the UUO group. Compared with NC group, the mRNA expression of EphrinA1 , VEGF and miRNA-210 were up-regulated in UUO 2 d group (P<0.05). With the extension of the time of hydronephrosis, the expressions of all three factors were down-regulated in 9 d and 14 d groups compared with 2 d and 5 d groups, and reached the lowest point at 14 d (P<0.05); Western blot result indicated that the expression of EphrinA1 and VEGF in renal tissue of UUO 2 d and 5 d group was increased compared with NC group (P<0.05). Conclusions The UUO mouse model verified that miRNR-210 participated in hydronephrosis. The consistency of EphrinA1, VEGF, and miRNA-210 indicated that the three factors played an important role in the occurrence and development of UUO.