BACKGROUND: Cervical lymph nodes are draining region of cornea. It is believed that aqueous fluid goes through a minor pathway named uveoscleral drainage, which will allow passage of antigen-presenting cells (APC) directly to the draining lymph nodes and induce allograft rejection after keratoplasty.OBJECTIVE: To explore the inhibitory effects of cervical lymphadenectomy in alkali induced high-risk corneal transplantation.DESIGN: A randomized controlled animal experiment.SETTING: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University.MATERIALS: The experiment was performed in the State Key Laboratory of Ophthalmology (No. 2006DA105054), Zhongshan Ophthalmic Center, Sun Yat-sen University from May 2005 to February 2007. 144 male animals (1-2 months old) including 104 SD rats and 40 Wistar rats were provided by the animal experimental center of Sun Yat-sen University. Sandwich enzyme-linked immunosorbent assay (ELISA) kits for interleukin-2 (IL-2) and interferon-γ (IFN-γ) were brought from BioSource International company (USA). The animal treatment in the experiment was accorded with the statement in Association for Research in Vision and Ophthalmology (ARVO) for animals.METHODS: With the SD rats as recipients, and Wistar rats as donors, all rats were subjected to corneal allografting. The recipient rats were randomly divided into 4 groups (n=20): group A (control group) which underwent corneal transplantation; group B which was subjected to bilateral cervical lymphadenectomy; group C, corneal transplantation 21 days after the alkali burn injury; group D, cervical lymphadenectomy following group C. The immune rejection of grafts was evaluated by detecting the expression of IFN-γ and IL-2 using ELISA. The time when allograft rejection occurred was recorded and mean survival time (MST) was compared among the groups. The development of corneal inflammation and new vessels was examined by slit lamp microscope and histopathological examination.MAIN OUTCOME MEASURES: ①The development of corneal inflammation after corneal alkaline burns. ②MST of rats in each group following transplant. ③The expression of IL-2 and IFN-γ in grafts of each group. RESULTS: ①Normal rat cornea was transparent without inflammation or neovascularization. There were many inflammatory cells invading to stroma on day 3 after burn. Then, the inflammation of cornea resolved gradually 3 weeks after the burn, but corneal neovascularization reached the peak at that time. Corneal blood vessels regressed completely at the end of 8 weeks after the burn. ②The MST of group A, B, C, and D was (10.40±1.14), (46.30±9.46), (7.00±1.58), and (15.00±3.39) days, respectively. Compared with the group A, the MST of group B was significantly longer (P < 0.05), and the MST of grafts in group D was also significantly longer than group C (P < 0.05). ③The expression of IFN-γ and IL-2 proteins was absent in group B. Compared with group C, the expression of IL-2 and IFN-γ proteins in group D significantly decreased on days 3, 7, 10, and 14 after keratoplasty (P < 0.05). CONCLUSION: Cervical lymphadenectomy therapy can effectively inhibit corneal allograft rejection in normal and high-risk corneal beds after alkali burn injury.

Objective To explore the mechanism of self-awareness in the heavy smokers(HS)by using regional homogeneity(ReHo)combined with resting-state functional MRI(fMRI).Methods Thirty HS and 31 healthy non-smokers(NS)matched for age and sex underwent a 3.0 T resting-state fMRI.The data were post-processed by SPM 5 and then the ReHo values were calculated by REST software.The ReHo values between the two groups were compared by two-sample t-test.The brain map with significant difference of ReHo value was obtained.Results Compared with that in NS group,the regions with decreased ReHo value included the bilateral precuneus,superior frontal gyrus,medial prefrontal cortex,right angular gyrus,inferior frontal gyrus,inferior occipital gyrus,cerebellum,and left middle frontal gyrus in HS group.The regions of increased ReHo value included the bilateral insula,parahippocampal gyrus,white matter of parietal lobe,pons,left inferior parietal lobule,lingual gyrus,thalamus,inferior orbital gyrus,white matter of temporal-frontal lobe,and cerebellum.The difference was more obvious in the left hemisphere.Conclusions In HS,abnormal ReHo on a resting state which reflects network of smoking addiction.This method may be helpful in understanding the mechanism of self-awareness in HS.

Cerebral cavernous malformations (CCMs) are the common cerebrovascular malformation. Its incidence was 0.16%-0.5%. CCM can exist in both sporadic and familial forms, with the latter being inherited in an autosomal dominant manner. Its pathogenesis is associated with mutations in the CCM1, CCM2, and CCM3 genes. The somatic mutations of these genes are the basis for the occurrence of brain lesions. In order to explore the pathogenesis of CCM and identify therapeutic targets, various CCM animal models have been developed, providing assistance for the study of the pathological and physiological mechanisms of CCM. However, each CCM model has its own advantages, disadvantages, and applicability. Mice are the most commonly used animals to model CCM. Therefore, this article summarizes the characteristics and research progress of current murine CCM models.

Objective To discuss the possible etiology,pathogenesis,clinical features,diagnosis and treatment of epidermoid cysts of the jaw and to provide a reference for clinical diagnosis and treatment.Methods A case of an epi-dermoid cyst in the right mandible with retained deciduous teeth and succedaneous impacted teeth was reviewed and an-alyzed in combination with the relevant literature.Results A patient presented with a mass in the right mandible that had persisted for 1 month after being found at imaging examination.Tooth 83 was retained,and tooth 43 was unerupted.Swelling was characterized by no obvious tenderness,fluctuation,or table tennis sensation and was observed in the lin-gual alveoli of teeth 83,44,and 45.Imaging revealed a low-density shadow in the apex of teeth 83,44,45,and 46,approximately 1.9 cm × 2.6 cm × 1.6 cm in size,which wrapped around the dental crown of tooth 43.Preliminary diag-noses were as follows:right mandibular mass thought to be a dentigerous cyst;impacted tooth 43;and retained primary tooth 83.The mass in the right mandible was removed,and teeth 43 and 83 were extracted under intravenous and inha-lation anesthesia.During the operation,the mass was observed to have a thin cyst wall and contained bean-like residue.Histopathological examination indicated an epidermoid cyst in the right mandible.At the 1-week follow-up examination,the patient reported no discomfort,and the surgical area showed good recovery.According to the literature,epidermoid cysts are benign cysts originating from ectopic ectodermal tissue that can occur throughout the body but rarely in the oral cavity and are even extremely rarer in the jaw.Epidermoid cysts of the jaw,which have no specific clinical manifes-tations,can be confused with odontogenic cysts such as dentigerous cysts and odontogenic tumors.Dental pulp tests and other techniques can serve as a reference for clinicians.The diagnosis is confirmed via histopathology.Surgical removal is a common treatment,with a good prognosis and a low recurrence rate.Conclusion The principle of treatment for an epidermoid cyst of the jaw is similar to that for a jaw cyst.The prognosis is good when the cyst is removed completely.

Objective: To explore the spatial distribution of low birth weight (LBW) and the potential environmental risk factors and provide the evidence for the prevention and intervention of LBW. Methods: Data were from a surveillance system for newly born population and adverse pregnancy outcome between 2007 and 2012 in Pingding county, Shanxi province. The data from 313 villages were analyzed. Spatial hierarchical Bayesian model was used to adjust the risk of LBW at village level, Moran’s I and Getis-Ord Gi* were used to analyze the difference in distribution of LBW risk area. Spatial negative binomial model was used to evaluate the association between the risk of LBW and chemical fertilizer application. Results: A total of 18 749 new births were recorded between 2007 and 2012, including 911 LBW cases, the total incidence of LBW was 4.86%. The result of the spatial hierarchical Bayesian model showed that high-risk area of LBW was in the southeast of Pingding and low-risk area was in the middle west of Pingding. The result of Moran’s I showed that there was a clustering pattern of LBW risk, and Getis-Ord Gi* found a high risk (hot spot) area in the south area. Moreover, the findings of association analysis showed that the risk of LBW increased with the increased chemical fertilizer application at village level. Conclusions There were area specific differences in the risk of LBW, and dose-response relationship between chemical fertilizer application and the risk of LBW. Our findings suggest that maternal exposure to chemical fertilizer during pregnancy might be a potential risk factor for LBW in rural area.

Objective: To investigate the prevalence and related risk factors of prostate diseases in traffic policemen. Methods: A total of 848 traffic policemen who took part in the physical examination among August and September in 2016 were selected as research subjects, and a questionnaire survey was conducted to collect their information including smoking, alcohol drinking, biological and physiological indicators, as well as prostate disease etc. The relationship between the prevalence of prostate diseases and related risk factors was analyzed by Non-conditional Logistic Regression. Results: The total prostate disease prevalence rate was 40.2% in the study subjects, and there is statistical significance (P<0.05) of differences between prostate disease group and non disease group in age, work age, smoking, drinking and field work. Single factor analysis showed that age, work age, smoking, and field work are independent risk factors of prostate disease (P<0.05) . Multivariate Logistic regression analysis showed that increasing age (OR 1.03) , smoking (OR 1.92) and field work time (OR 1.47) significantly increased the risk of prostate disease in male police after age, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids and other indicators were adjusted. Conclusion age, smoking and field work time are risk factors of prostate diseases in the traffic police. There is great significance in publicizing the harmful effects of smoking and reducing the duration of field work.

Objective:To investigate the per capita expenses of physical examination and its related factors in health examination (management) institutions in 2019.Methods:Using the census method, the basic information, including the name, address, nature, level and operation nature of the institutions, and per capita expenses of physical examination in provincial health examination (management) institutions in 2019 were collected by questionnaire survey. Rank sum test and Spearman correlation analysis were used to analyze the data.Results:In 2019, the top three provinces in terms of per capita expenses of physical examination were Shanghai, Inner Mongolia Autonomous Region and Beijing, with 612.00 yuan, 547.90 yuan and 528.83 yuan, respectively; Guizhou Province, Xinjiang Uygur Autonomous Region and Guangdong Province ranked the last three, with 255.25 yuan, 244.00 yuan and 235.10 yuan, respectively. There were significant differences in per capita expenses of physical examination among different health examination (management) institutions in different regions and of different institutional nature, institutional level and business nature (all P<0.05). The per capita expenses of physical examination was positively correlated with the local per capita health care expenditure, the proportion of local population aged 15-64 years and the proportion of local people with education of college and above ( r=0.465, 0.374 and 0.401, all P<0.05). Conclusions:There are differences in the per capita expenses of physical examination in health examination (management) institutions among different regions, institutional nature, institutional level and business nature in 2019, and it is related to the per capita health care expenditure, age and educational level of the local people.

Objective To investigate the effect of malignant cerebellar hemorrhage on 3-month prognosis of small spontaneous cerebellar hemorrhage.Methods Clinical data of 380 consecutive patients with spontaneous cerebellar hemorrhage admitted in Emergency Department of the Affil-iated Hospital of Guizhou Medical University,Neurosurgery Department of Jinyang Hospital Af-filiated to Guizhou Medical University,and Neurosurgery Department of the Second Affiliated Hospital of Guizhou Medical University from April 2014 to March 2023 were collected and retro-spectively analyzed,and finally,70 patients who met the requirements of small amount of sponta-neous cerebellar hemorrhage were enrolled in this study.They were assigned into benign cerebel-lar hemorrhage group(43 cases)and malignant cerebellar hemorrhage group(27 cases).Accord-ing to their clinical outcomes in 3 months after onset,they were divided into a good prognosis group(51 cases)and a poor prognosis group(19 cases).General clinical data,imaging data,com-plications,inflammatory indicators and prognosis were collected.After collinear diagnosis was used to exclude factors with collinear influence,the independent correlation between good progno-sis and poor prognosis was analyzed by binary logistic regression model.Finally,ROC curve was plotted to analyze the significant data.Results The maximum diameter of hematoma was signifi-cantly larger in the malignant cerebellar hemorrhage group than the benign group(P=0.021).The patients of the poor prognosis group had larger proportion of malignant cerebellar hemor-rhage,and higher neutrophil percentage,WBC count and NLR than those of the good prognosis group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that malignant cere-bellar hemorrhage was an independent predictor of poor prognosis in 3 months(OR=6.218,95％CI:1.140-17.623,P=0.013).The sensitivity,specificity,positive predictive value,negative pre-dictive value and Youden index of malignant cerebellar hemorrhage in predicting the 3-month prognosis of patients were 63.2％,70.6％,44.4％,83.7％and 0.338,respectively,and the AUC value was 0.669.Conclusion Malignant cerebellar hemorrhage is an independent predictor of 3-month prognosis in patients with small spontaneous cerebellar hemorrhage.The patients with malignant cerebellar hemorrhage have poor prognosis than those with benign cerebellar hemorrhage.

Objective:To investigate the adverse childhood experience (ACE) effects on the risk of chronic diseases among middle-aged and elderly.Methods:A retrospective cohort study was conducted using the China Health and Retirement Longitudinal Study data. We used life history study data in 2014 as baseline data and data of chronic diseases of middle-aged and elderly in 2015 as outcomes. A zero-inflated negative-binominal model was used to estimate the incidence rate ratio ( IRR) for the association between ACE and chronic diseases. Results:Compared with the less than 4 points of ACE exposure in childhood, individuals with ACE exposure 4-, 6- and ≥9 were associated an increased risk of chronic disease, adjusted IRR (95% CI), 1.10(1.04-1.16), 1.18 (1.13-1.25), 1.34 (1.27-1.42), respectively, with a significant dose-response relationship that chronic diseases risks increase parallel with the increase of ACE exposure. Conclusions:ACE might serve as one of the critical risk factors of chronic diseases in middle-aged elderly. It's of public health significance for early screening and intervention of ACE, reducing the incidence of chronic diseases, and improving middle-aged and older adults' quality of life and health.

Objective:To depict the long-term trends of prevalence and disease burden of preterm birth from 1990 to 2019.Methods:Data was from the 2019 Global Burden of Disease study. The prevalence rate (%) and disability adjusted life years (DALYs) rate of preterm birth were adopted and were further stratified by sex. China's prevalence rate and DALYs rate were compared with those of high-income, middle and high-income, middle and low-income, and low-income countries, defined by the World Bank. Joinpoint log-linear regression model was used to analyze the trend.Results:In 2019, the prevalence of preterm birth in China was 6.34% [95% uncertainty interval ( UI): 6.23%-6.44%], lower than the global average level (11.24%,95% UI: 11.16%-11.32%) or the average level of low-income (13.15%, 95% UI: 12.97%-13.33%), lower-middle income (12.53%, 95% UI: 12.39%-12.68%), upper-middle income (8.22%, 95% UI: 8.15%-8.29%) and high-income (8.75%, 95% UI: 8.67%-8.84%) countries. The DALYs rate (person-year /100 000) of preterm birth in China was 217.12 (95% UI: 191.30-246.69), lower than the average level of the world (886.81, 95% UI: 762.12-1 034.49), low-income (1 905.24, 95% UI: 1 542.35-2 377.54), lower-middle-income (1 349.98, 95% UI: 1 154.04-1 583.81) and upper-middle-income (366.56, 95% UI: 321.51-416.88) countries, but higher than the average level of high-income countries (206.21,95% UI: 179.96-234.90). From 1990 to 2019, the prevalence and DALYs rate of preterm birth in China showed a downward trend, with an average annual decline of 0.56% (95% CI:0.54%-0.58%) and 5.87% (95% CI:5.54%-6.19%), respectively. In general, the prevalence rate of preterm birth in men declined faster than that in women (men:0.64%, 95% CI: 0.62%-0.66%; women: 0.46%, 95% CI: 0.44%-0.48%), so as the DALYs rate (men:5.90%, 95% CI: 5.56%-6.24%; women:5.81%,95% CI: 5.50%-6.13%). Conclusions:From 1990 to 2019, the prevalence and DALYs rate of preterm birth in China showed an overall downward trend, and the decline rate was higher in men than in women. The etiological research on the risk factors of preterm birth, especially spontaneous preterm birth, should be further pursued, and a more comprehensive and precise monitoring, prevention, and health care system for preterm birth needs to be formulated.