Objective To summarize the observation and nursing strategy of side effects for children wearing Ortho-K contact lens in order to improve the effects of treatment and reduce side effects. Methods A total of 1 066 myopic children wearing Ortho-K CL, who could recheck on time in Beijing Children′s Hospital from May 2013 to June 2014 were included. The reason of dyed cornea, dislocation, and discomfortable were analyzed, and corresponding nursing and healthy propaganda were performed. Results Among 1 066 children, 350 children (32. 8% ) wearing Ortho-K CL had epithelial dyed cornea after 6 months, and most of them appeared 1 month after wearing the lens. It would disappear after the treatment by levofloxacin eye drops, sodium hyaluronate eye drops and recombinant bovine basic fibroblast growth factor gel, stopping using the Ortho-K contact lens and providing healthy progaganda after 1 week. A total of 170 children (16% ) wearing Ortho-K CL had dislocation, in which 2 children slipped into conjunctival sac and it was taken out under guidance of nurse by parents. A total of 128 children (12% ) suffered from diplopia after wearing the lens, and 234 children(22% ) wearing Ortho-K CL had discomfortable feeling. No children had irreversible impairment and ocular infection. Conclusions According to the reason of side effects, appropriate nursing strategy and healthy propaganda can improve the success rate of Ortho-K contact lens, prolong their service time, contribute treatment effectiveness, and reduce its side effects.

Objective:To study the safety and efficiency of endovascular treatment in pediatric severe cerebral venous sinus thrombosis(CVST).Methods:This was a case series study.Data of pediatric severe CVST patients who received endovascular treatment in the Department of Neurointerventional, the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2023 were retrospectively analyzed.The technical success rate, periprocedural complications, neurologic and radiologic outcomes were collected to study the safety and efficacy of endovascular treatment in pediatric severe CVST.Results:A total of 15 patients were included in this study, including 6 males(40.0%) and 9 females(60.0%) with a mean age of(14.60±2.26) years.The modified Rankin Scale score(mRS) before endovascular treatment was(3.47±1.06) points, and the time from onset to endovascular treatment was 17(12-26) days.Thirteen patients(86.7%) received mechanical thrombectomy through catheter aspiration and/or stent-retriever thrombectomy followed or not followed by intrasinus thrombolysis(IST), and 2 patients(13.3%) received IST only.The technical success rate was 100%.Three patients(20.0%) had periprocedural complications.Ten patients(66.7%) had mRS≤2 points at discharge.Twelve patients(80.0%) had valuable neurologic and radiologic follow-ups with a duration of 9.5(3.5-19.0) months, and they all had mRS≤2 points.Among the 12 patients, 8(66.7%) had good cerebral venous recanalization.Conclusions:Endovascular treatment is technically feasible in pediatric severe CVST patients, with acceptable safety and efficacy.

Objective:To explore the efficacy of flow diversion combined with coil embolization in treatment of intracranial aneurysms.Methods:The clinical data of 110 patients with intracranial aneurysms treated by flow diversion in our hospital from April 2015 to September 2019 were retrospectively analyzed. In these patients, 48 were treated by flow diversion combined with coil embolization and 62 were treated by flow diversion alone; the efficacy and safety of patients from the two groups were compared.Results:Blood flow diversion was successfully implanted into all 110 patients, with technical success rate of 100%. Immediate complete occlusion rate in the flow diversion combined with coil embolization group (16.7%) was significantly higher than that in the flow diversion group (1.6%, P<0.05). There was no significant difference in the incidence of perioperative complications between flow diversion combined with coil embolization group and flow diversion group (4.17% vs. 4.84%, P>0.05). During the mean follow-up of 6.72±3.80 months, modified Rankin scale (mRS) scores of patients in the flow diversion combined with coil embolization group were all 0; one patient had mRS score of 1, one patients had mRS scores of 2, and 60 patients had mRS score of 0 in patients from the flow diversion group; no significant difference was noted between the two groups ( P>0.05). Patients in the flow diversion combined with coil embolization group had significantly higher rate of complete aneurysm occlusion than those in the flow diversion group (88.3% vs. 66.1%, P<0.05). Conclusions:Flow diversion is an effective and safe strategy in treatment of intracranial aneurysms. Flow diversion combined with coil embolization can effectively promote early healing of aneurysms in selective patients.

Objective To analyze the distribution characteristics of 9 hypertension drug related gene polymorphisms in the population of essential hypertension(EH)in Xi'an area,providing an objective basis for personalized treatment.Methods A total of 306 EH patients who visited the Shaanxi Provincial Armed Police Force Hospital from January 2022 to December 2023 were selected as the research subjects.The PCR melting curve method was used to detect 9 hypertension drug related gene polymorphisms,their genotype and allele distribution frequency were analyzed,and the correlations of gene polymorphism among patients of different genders,ages,and hypertension grading groups were compared.Results Among 306 patients,the distribution frequencies of each gene were consistent with Hardy Weinberg equilibrium(x2=0.153～2.941,all P＞0.05).Mutation rates of various gene were as follows:SLCO1B1 c.388A＞G,ADRB1 c.1165G＞C,MTHFR C677T,ADD1 c.1378G＞T,CYP2D6 c.100C＞T,ACE I/D,CYP3A5 c.806-4288C＞T,SLCO1B1 c.521T＞C,AGTR1 c.1166A＞C and CYP2C9 c.1075A＞C were 77.29％,73.20％,56.54％,48.37％,50.82％,35.13％,29.41％,11.76％,7.68％and 3.43％,respectively,and CYP2C9 c.403C＞T had no mutation.Comparing with patients of different genders,the mutation rate of SLCO1B1 c.388A＞G genotype and allele mutations in male group were higher than those in the female group(x2=5.221,8.237),the mutation rate of CYP2D6 c.100C＞T genotype and allele in the female group were higher than those in the male group(x2=5.093,9.661),the mutation rate of ACE I/D allele in the male group was higher than that in the female group(x2=6.118,8.032),with significant differences(all P＜0.05).The mutation rates of CYP2C9 c.1075A＞C,SLCO1B1 c.388A＞G,CYP2D6 c.100C＞T genotypes and alleles in the middle-aged and young age group were higher than those in the elderly group,and the differences were statistically significant(x2=11.683,10.243;9.003,9.803;10.617,9.931,all P＜0.05).There was no significant difference in the comparison of other genotypes and alleles among different gender and age groups and in the frequency of genotype and allele mutations among different hypertension grading groups(x2=1.321～7.733,1.031～5.198,all P＞0.05).Conclusion The distribution of gene polymorphisms related to antihypertensive drugs in the Xi'an area was related to the gender and age of EH patients.Thus,the genotype testing of antihypertensive drugs may have important guiding significance for personalized medication treatment of EH patients.

ObjectiveTo explore the training mode of ophthalmological specialty nurses,and promote the development of ophthalmological specialty nurses.Methods We developed a personalized,targeted, and standardized training model according to the specific circumstances of the department.Results The professional theory and skills of nurses increased statistically after the training (P<0.05). Meanwhile,the patient satisfaction degree and the quality of nursing were all improved.Conclusions Systematic professional theory and professional skills training could improve the professional ability of ophthalmic nurses. It could also meet the needs of children and their parents for clinical quality nursing services,as well as benefits the cultivation and development of ophthalmic specialist nurses.

Objective:To explore application effects of different meibomian gland massage schemes in postoperative treatment of children with chalazion.Methods:Using the convenient sampling method, a total of 280 children with postoperative chalazion who were treated in Ophthalmology Clinic of Beijing Children's Hospital from January to September 2020 were selected as the research objects. According to the random number table method, the patients were randomly divided into groups A, B, C and D. Group A 70 cases received massage once every 2 weeks. Group B 70 cases received massage once every 4 weeks. Group C 70 cases received massage once every 2 weeks and hot compress nursing before massage. Group D 70 cases received massage once every 4 weeks and hot compress nursing before massage. At 3 and 6 months of intervention, the recurrence rate of postoperative chalazion and meibomian gland function of children in the 4 groups were compared.Results:There were 65, 67, 66, 67 children completed the research in A, B, C and D group. The recurrence rates of postoperative chalazion in groups A, B, C, and D were respectively 10.77% (7/65) ,19.40% (13/67) ,1.52% (1/66) and 1.49% (1/67) after the intervention for 3 months, and the differences were statistically significant ( P<0.05). Further pairwise comparison showed that the recurrence rate in group C was lower than that in group A and B, and that in group D was lower than that in group A and B, and the differences were statistically significant ( P< 0.05). There were no statistically significant differences among the other groups ( P>0.05). After 6 months of intervention, the recurrence rates of postoperative chalazion in groups A, B, C, and D were respectively 9.23% (6/65) ,16.42% (11/67) ,1.52% (1/66) and 1.49% (1/67), and the differences were statistically significant ( P<0.05). Further pairwise comparison showed that the recurrence rate of group C was lower than that of group A and B, and that of group D was lower than that of group A and B, and the differences were statistically significant ( P<0.05). There was no significant difference between group A and B ( P>0.05). There were statistically significant differences in scores of the difficulty of meibum discharge of children in the 4 groups after 3 and 6 months of intervention ( P<0.05). Further pairwise comparisons showed that the score of difficulty of meibum discharge in group C was lower than that in group A and B, and that in group D was lower than that in group A and B, and the differences were statistically significant ( P< 0.05). There were no statistically significant differences among other groups ( P>0.05). After 3 and 6 months of intervention, there were statistically significant differences in the score of eyelid fat traits among the 4 groups ( P<0.05). Further pairwise comparison showed that the score of eyelid fat trait in group C was lower than that in group A and B, and that in group D was lower than that in group A and B, and the differences were statistically significant ( P<0.05). There were no statistically significant differences among other groups ( P>0.05) . Conclusions:Hot compress nursing can enhance the massage effect of the meibomian glands, improve function of the meibomian glands and facilitate the discharge of meibomian gland secretions, which can effectively reduce the recurrence rate of postoperative chalazion in children and is worthy of clinical promotion.

Objective To investigate epidermal growth factor receptor(EGFR)gene T790M mutation in plasmatic ctDNA samples from 171 patients with non-small cell lung cancer and analyze the relationship between EGFR T790M mutation and the clinical factors. Methods The EGFR T790M mutation was detected in 171 cases by super amplification refractory mutation system(Super ARMS)in this paper. Rusults The EGFR gene T790M mutation was identified in 7.60%(13/171)plasmatic ctDNA samples which mostly came from patients withⅢb~Ⅳstages of lung cancer. The EGFR T790M mutation rate was identified in 2.05%(3/146)plasmatic samples of pa-tients who did not received treatment of EGFR-TKIs,which was lower than 40.00%(10/25,P<0.05)plasmatic samples of patients who received treatment of first generational EGFR-TKIs. The EGFR T790M mutation rate was identified in 75.00%(3/4) and 60.00%(6/10) plasmatic samples of patients who have received TKI for 6 to 10 months and more than 10 months,which was higher than 9.10%(1/11,P < 0.05)plasmatic samples of patients who have received TKIs for less than 6 months. Conclusions This article demonstrated that EGFRT790M muta-tion was more common in lately NSCLC patients who have received TKIs treatmentover 6 months,meanwhile the EGFR T790M mutation dynamical detective technology will effectively guide the clinic treatment.

【Objective】 To explore the main development directions and research progress of blood transfusion in the U. S.military based on ClinicalTrials.gov. 【Methods】 The literature of clinical trials related to field transfusion medicine from 2002 to 2021 were retrieved based on www.clinicaltrials.gov with "United States Department of Defense" , "U.S.Army Medical Research and Development Command" and "United States Naval Medical Research Center" as the search terms, and the main characteristics were analyzed in terms of research progress, clinical stage, task allocation, regional distribution, research contents and results. 【Results】 A total of 931 clinical trials were retrieved, of which 16 were closely related to field blood transfusion medicine.Among them, pathogen reduction/inactivation of whole blood, platelet transfusion, plasma transfusion, whole blood transfusion and other types of researches accounted for 25% (4/16), 25% (4/16), 25% (4/16), 18.75 (3/16) and 6.25% (1/16), respectively.The U. S.military focused on the new technological breakthroughs in blood safety and blood storage, the evaluation of the countershock therapy, the application of whole blood early transfusion and the civil-military inosculation in research. 【Conclusion】 This study, based on ClinicalTrials.gov data, redounds to understand the research progress and current situation of the U. S.military field blood transfusion medicine.

Objective: To analyze the alterations and clinical significance of serum calcium binding protein S100A8/A9 and soluble receptor for advanced glycation end products (sRAGE) levels in patients with chronic obstructive pulmonary disease(COPD). Methods: Enzyme-linked immonosorbent assay was established to detect serum levels of S100A8/A9 and sRAGE in 203 patients with COPD[male166, female 37, aged 52-92 years, average years(69.72±9.079)] and in 41 smoking elderly non-COPD patients[male 35,female 6, aged 55-89 years, average years(68.66±8.74)], and 167 non-smoking healthy subjects as the control group[male 132, female 35, aged 57-92 years, average years(69.13±7.21)] from April 2018 to January 2019. The relationship between the S100A8/A9, sRAGE and clinical biomarkers [the percentage of fored expiratory volume in one second(FEV₁) in the predicted value, FEV₁/fored vital capacity(FVC), neutrophile granulocyte(NEU)%, pack-year] were investigated. The diagnostic value of S100A8/A9, sRAGE and their combined detection for COPD was analyzed using the subject operating characteristic curve. Results: The serum S100A8/A9 level [(2.70±1.11)μg/ml] in COPD patients was significantly higher than that in the smoking control group [(1.65±0.63) μg/ml] and the non-smoking control group[(0.99±0.48)μg/ml], t=5.807, P<0.000 1; t=18.45, P<0.000 1. The serum S100A8/A9 levels in patients with COPD[GOLD Ⅰ(2.08±1.08) μg/ml, GOLDⅡ (2.58±1.06) μg/ml, GOLD Ⅲ (2.69±1.12) μg/ml, GOLDⅣ (2.95±1.10)μg/ml] were significantly higher than the non-smoking control group(0.99±0.48)μg/ml, t=6.616, P<0.000 1; t=14.56, P<0.000 1; t=17.10, P<0.000 1; t=18.09, P<0.000 1.The serum sRAGE level [(0.29±0.25)ng/ml] in COPD patients was significantly higher than that in the smoking control group[(0.60±0.24)ng/ml] and the non-smoking control group[(0.85±0.35)ng/ml], t=7.367, P<0.000 1; t=18.14, P<0.000 1. The serum sRAGE levels in patients with COPD[GOLD Ⅰ(0.46±0.40),GOLDⅡ (0.28±0.25),GOLD Ⅲ (0.29±0.25),GOLD Ⅳ (0.25±0.19)ng/ml] were significantly lower compared with non-smoking control group[(0.85±0.35)ng/ml], t=3.459, P=0.000 5; t=10.23, P<0.000 1; t=13.95, P<0.000 1; t=11.70, P<0.000 1. Serum S100A8/A9 levels were positively correlated with smoking amount and NEU% (r=0.458 5, P<0.000 1; r=0.228 3, P=0.001 1), negatively correlated with FEV₁/FVC, the percentage of FEV₁ in the predicted value, and sRAGE(r=-0.190 6, P=0.006 4; r=-0.186 3, P=0.007 8; r=-0.201 7, P=0.003 9). sRAGE levels were negatively correlated with NEU% (r=-0.155 9, P=0.026 4). In the ROC curve, the area under the curve of S100A8/A9, sRAGE and combined detection were 0.922[95%CI(0.897-0.947)], 0.926[95%CI(0.899-0.952)]and 0.966 [95%CI(0.950-0.983)], respectively. Conclusion S100A8/A9 and sRAGE are closely correlated with the degree of airflow constrains and the levels of serum inflammatory mediators, which are expected to be as potential biomarkers of COPD.