Objective:To analyze the clinical features, treatment and prognosis of asymptomatic patients with retinoblastoma.Methods:A retrospective series of case study. Eight asymptomatic patients (11 eyes) with the diagnosis of retinoblastoma by screening enrolled in Department of Ophthalmology of The Eye-ENT Hospital of Fudan University from January 2006 to March 2019 were included. There were 6 males and 3 females ranging from 2 days to 20 months, with a median age of 6 months. Five patients were unilateral retinoblastoma while 3 patients were bilateral. Based on the International Classification of Intraocular Retinoblastoma, 4 eyes were stage A, 3 eyes were stage B and 4 eyes were stage C. One patient had family history. Four patients were evaluated the Rb1 mutation. Routine ophthalmic examinations and ultra-wide field fundus imaging were performed on the 16 parents and 3 siblings of the 8 patients. Systemic intravenous chemotherapy was performed using the Carboplatin, Vincristine, Etoposide protocol, intra-arterial chemotherapy using Carboplatin and Melphalan, and local treatment involved cryotherapy and transpupillary thermotherapy. The mean follow-up time is 47.25 months.Results:None of the 8 children had any ocular symptoms. Six patients received intravenous chemotherapy (5-6 times), 1 patient received intra-arterial chemotherapy (3 times), and 1 patient just received local treatment. Among the 11 eyes, 9 eyes were treated with local cryotherapy and 8 eyes were treated with transpupillary thermotherapy. During the follow-up period, 2 patients had new tumor, and the average time was 6.3 months after the last chemotherapy. At the last follow-up, the tumor disappeared in 11 eyes, remained stable in 11 eyes. The eye protection rate was 100% (8/8) for patients without eyeball excision. The best corrected visual acuity was 0.1 for 3 eyes and 1.0 for 5 eyes. Three eyes were not found. One heterozygous mutation of Rb1 gene [1c.35_69del (p.T12fs)] was identified in 1 patient, and the other 3 patients were not detected. One had bilateral bulbar tuberculosis of the 16 parents, 1 had bilateral RB of the 3 siblings. They were the mother and brother of a child with bilateral RB.Conclusions:Fundus screening is helpful for the detection of early RB. The eye protection rate is high and the long-term vision prognosis is good after systemic or topical chemical drugs (IVC, IAC) and ocular topical treatment (cryopreservation and transpupillary thermotherapy).

In the present study ,we aimed to observe the effect of curcumin on TSST-1-induced inflammatory cytokines in splenocytes of mouse and provide evidence for the further study on the effect of curcumin on inflammatory shock .Lactate de-hydrogenase (LDH) release assay was used to determine cytotoxicity of different doses of TSST-1 and curcumin .Inflammatory cytokines were determined by ELISA and flow cytometry .The doses of TSST-1 and curcumin we used in the present study did not cause significant cytotoxicity .TSST-1 induced higher level of IFN-γand IL-2 production but relatively lower level of TNF-α.The production of IL-1β,IL-6 and IL-12 was undetectable .TSST-1 induced Th1 cytokines (IFN-γand IL-2) were not IL-12-dependent which was different from LPS-induced IFN-γ.Curcumin significantly reduced IFN-γand TNF-αproduction at the concentration of 15 umol/L (P<0 .05) ,but had no effect on IL-2 production (P>0 .05) .It’s suggested that curcumin could significantly inhibit the production of IFN-γand TNF-αby splenocytes induced by TSST-1 ,but could not affect the prolifera-tion of T cells .

Objective The anti-UV-B radiation mechanism of UV-B tolerance strain KFS-9 was studied from the profile of metabolites.Methods The compounds were separated by column chromatography and their structures were elucidated based on GC-MS,LC-TOF-MS,EI-MS and NMR analyses.Results Three unsaturated fatty acids(identified as 9-hexadecenoic acid,9,12-octadecadienoic acid and 11-octadecenoic acid) and 1,2-benzenedicarboxylic acid able to absorb ultraviolet were isolated from the petroleum ether extract of the fermentation liquid of Pantoea agglomerans KFS-9.Fraction(Ⅱ) was isolated from the ethyl acetate extract and was composed of 2,3-butanediol and a series of high unsaturated aroma compounds.Fraction(Ⅱ) had a wide absorption peak,and it could protect E.coli from UV-B damage in some sense.Conclusion Strain KFS-9 produced metabolites that were able to absorb UV to build a natural barrier and so improved the tolerance to UV radiation.The UV-B radiation protection test to the E.coli also showed fraction(Ⅱ) was not the only protector,and there definitely existedother materials and mechanism to protect the strain.

Objective To explore the patients satisfaction with participation in medical and nursing decision making and the influencing factors among cancer patients, and to provide a basis for developing better medical care services. Methods Totally 159 cancer patients were recruited from Beijing Cancer Hospital, and then were investigated with the general information questionnaire, the patients′ expectation for participation in clinical decision making scale, the patients′ competence for participation in clinical decision making scale, and the patients′satisfaction with participation in medical and nursing decision making questionnaires. Results The total score of patients′satisfaction with participation in medical and nursing decision making were (45.92±3.91) and (34.25±3.31) respectively. Compared with female patients, male patients had higher satisfaction with medical decision making (46.45±3.24&44.87±4.84) and nursing decision making (34.68 ± 2.93&33.42 ± 3.84) (t=2.416, P=0.017;t=2.275, P=0.024);and compared with melanoma patients, lung cancer patients had higher satisfaction with medical decision making (46.51 ± 2.69&43.33 ± 7.07, P=0.002);compared withⅢstage patients, Ⅳstage patients had higher satisfaction with nursing decision making(34.97±2.24&32.40±4.56, P<0.01). Meanwhile, the satisfaction with participation in decision making was significantly positively associated with patients′ expectation and competence for participation in clinical decision making. Conclusions Patients′satisfaction for decision making may vary from different gender, tumor types, disease stages, and patients′expectation and competence. Health care providers still further strength patients′ knowledge and initiative of decision making, and then improve patients′satisfaction with participation in decision making.

Objective: To investigate the influence of occupational aluminum exposure on cognitive function and glutamate receptor protein expression in peripheral blood lymphocytes in workers and the possibility of glutamate receptor being used as a biomarker for cognitive impairment in aluminum workers. Methods: From October to December, 2014, cluster sampling was performed to select 121 workers in aluminum electrolysis workshop as exposure group and 231 workers in thermoelectric workshop and logistics department as control group. Mini-Mental State Examination, clock drawing test, digit span test (DST) , verbal fluency test (VFT) , and Fuld Object-Memory (FOM) Evaluation were used to analyze cognitive function. Graphite furnace atomic absorption spectrophotometry was used to measure plasma aluminum level as an exposure indicator. Enzyme-linked immunosorbent assay was used to measure the content of glutamate receptor proteins in peripheral blood lymphocytes, including the subunits of N-methyl-D-aspartate receptor NR1, NR2A, and NR2B and metabotropic glutamate receptor 1 (mGluR1) . The correlation between cognitive function indices and the content of glutamate receptor proteins was analyzed. Results: There was no significant difference in plasma aluminum level between the control group and the exposure group (132.52±80.40 μg/L vs 182.88±72.32 μg/L, P>0.05) . According to the plasma aluminum level, the study subjects were divided into control group and low-, medium-, and high-level plasma aluminum groups, and there were significant differences in plasma aluminum level between these groups (all P<0.01) . The high-level plasma aluminum group had a significantly lower memory ability score than the control group and the low- and medium-level plasma aluminum groups (all P<0.05) . The high-level plasma aluminum group had lower DST and digital span forward (DSF) scores than the control group and the low-and medium-level plasma aluminum groups. The low-, medium-, and high-level plasma aluminum groups had lower digital span backward (DSB) scores than the control group. The medium-and high-level plasma aluminum groups had lower VFT scores than the control group and the low-level plasma aluminum group. The high-level plasma aluminum group had significantly lower expression of NR1 and NR2A proteins than the control group and the low-and medium-level plasma aluminum groups, and the medium- and high-level plasma aluminum groups had significantly higher expression of mGluR1 protein than the control group and the low-level plasma aluminum group (all P<0.05) . The expression of NR1 and NR2A proteins was negatively correlated with plasma aluminum level (r=-0.475 and -0.692, both P<0.05) , andthe expression of mGluR1 protein was positively correlated with plasma aluminum level (r=0.756, P<0.05) . The expression of NR1 protein was positively correlated with DSF, DSB, DST, and VFT scores (r_s=0.213, 0.249, 0.271, and 0.228, all P<0.05) , and the expression of NR2A protein was positively correlated with VFT score (r_s=0.206, P<0.05) . Conclusion Occupational aluminum exposure may affect workers’ memory function, and the expression of NR1 and NR2A in peripheral blood lymphocytes is correlated with cognitive function indices and can be used as biomarkers for cognitive impairment in aluminum workers.

Objective To study the distribution and properly of the transparent globules within Hensen cells (HC) of guinea -pig Corti organ .Methods The cochlear epithelial cells were isolated from 10 guinea pigs .The cells of cochlea were marked by Bodipy493/503 ,sudan III ,oil red O ,and osmium tetroxide .Results The transpar‐ent globules within the HCs of the guinea -pigs were green staining by Bodipy493/503 ,jacinth staining by Sudan III ,ruby red by oil red O .And they were black globules stripe as post -fixed in 1% osmium tetroxide .Conclusion The results indicate that the transparent globules within guinea -pigs HCs'lipid droplets by four methods .

Objective To analyze the clinical effect of ultrasound-guided quadratus lumborum block(QLB)and erector spinae plane block(ESPB)in elderly patients with laparoscopic colorectal cancer surgery.Methods A total of 75 elderly patients who underwent elective laparoscopic radical resection of colorectal cancer in wenzhou central hospital,from August 2021 to March 2022 were selected and divided into quadratus lumborum group(group Q,n=25),erector spinae muscle group(group E,n=25)and group C(n=25).Group Q received QLB combined with general anesthesia,group E received ESPB combined with general anesthesia,the group C was given tracheal intubation with total intravenous general anesthesia.The perioperative anesthesia and analgesic dosage,postoperative recovery quality,resting and cough visual analogue scale(VAS)scores were compared among the groups.Results In contrast to the group C,the number of effective PCIA compressions,the dose of sufentanil,and the analgesic rescue rate were significantly decreased in groups Q and E(P<0.05);In contrast to the the group C,the spontaneous breathing,eye opening and tracheal extubation time of patients in group Q and group E were apparently shortened(P<0.05),and patients in group Q and group E recovered indoor nausea and vomiting,lethargy,restlessness and respiratory depression The number of cases was apparently reduced(P<0.05);at each time point from 2 to 48 hours after operation,compared with the group C,the VAS scores at rest and cough in groups Q and E were apparently decreased(P<0.05).However,there was no significant difference in the above indicators between the group Q and the group E(all P>0.05).Conclusion Ultrasound-guided QLB and ESPB for laparoscopic colorectal cancer surgery can both improve the quality of recovery and achieve satisfactory analgesia in elderly patients.

Objective To explore the epidemiological characteristics and cost structure of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in a tertiary comprehensive hospital in Xi'an from 2014 to 2023.Methods The first page information of AECOPD inpatients in a hospital from January 2014 to December 2023 was col-lected(n=6 748),and the distribution of their demographic characteristics and clinical characteristics as well as the composition of hospitalization expenses were retrospectively analyzed,and the structural change degree was used to analyze the structural change of hospitalization expenses in different years.Results AECOPD patients diagnosed and hospitalized accounted for 4.81 ‰ of all hospitalized patients in this institution from 2014-2023,the proportion of AECOPD inpatients showed a continuous downward trend during 10 years(x2=1 083.351,P＜0.001);The distribution of gender,occupation,medical payment meth-ods,and sources of AECOPD inpatients in different years showed statistical differences(P＜0.05);There is a statistical differ-ence in the seasonal distribution of AECOPD inpatients in different years(x2=157.328,P＜0.001);There is a statistical difference in the average length of hospital stay among AECOPD inpatients in different years(x2=83.463,P＜0.001);There were statistically significant differences in the proportion of hospitalizations,admission conditions,comorbidities or complications,history of drug allergies,and readmission plans among AECOPD patients in different years(P＜0.05);There is a statistical difference in the outcomes of hospitalized AECOPD patients in different years(x2=153.367,P＜0.001);The average hospital-ization cost of AECOPD patients gradually increased from 2014-2016,and gradually decreased from 2016-2023(P＜0.01);The hospitalization expenses of AECOPD patients in different years are mainly based on drug expenses and diagnostic expenses;The overall degree of structural change(DSV)of average hospitalization expenses for AECOPD patients from 2014-2022 was 41.62％,with the highest DSV of hospitalization expenses in 2012-2013(22.69％)and the lowest DSV in 2017-2018(4.23％);The proportion of drug expenses in the average hospitalization cost of AECOPD patients continued to decline,while diagnostic expenses,hygiene material expenses,medical service expenses,and nursing expenses showed an overall increasing trend from 2014-2023.Conclusion The proportion and mortality rate of hospitalized AECOPD patients have shown an overall downward trend in the past 10 years;The proportion of hospitalized AECOPD patients in the age group of 70-79 is the highest,mainly distributed in winter;The overall average hospitalization cost over the past 10 years has shown a downward trend,with drug and diagnostic expenses as the main components.Drug expenses have been decreasing year by year,while diagnostic expen-ses have been increasing year by year.This indicates that medical policy reform plays a significant role in optimizing the hospitali-zation cost structure and controlling unreasonable cost growth.

Objective:To assess respondents' understanding of the items in the Neck Dissection Impairment Index (NDII) through cognitive interviews and to revise the items accordingly.Methods:Totally 30 postoperative neck dissection patients returning for follow-up at Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from November 2023 to February 2024, were selected by purposive sampling for two rounds of cognitive interviews. Based on the interview results, the Chinese version of the NDII was revised.Results:The Chinese version of the NDII included ten items. The first round of interviews identified issues such as "incomplete expression, abstract language, and written form, " leading to revisions of five items. The second round of interviews showed that all respondents understood the revised items, and no new suggestions for modification were made.Conclusions:Cognitive interviews can improve respondents' comprehension of the Chinese version of the NDII, identify cognitive biases caused by cultural differences and improper linguistic expressions during the translation process, and enhance the understanding and acceptance of the scale's content among the target population.

Objective: To analyze the prevalence and related factors of HBV infection among people aged 18 years old and above in Mianyang city. Methods: A total of 260 950 residents, living in Mianyang city more than 6 months, aging 18 years old and above were employed by multi-stage random sampling method from November 2014 to September 2015. Questionnaire survey was conducted on participants using a self-designed questionnaire, including general demographic characteristics, family history of Hepatitis B, history of Hepatitis B vaccination and history of present illness, etc. 5ml blood was collected from all participants, and the blood samples were detected for HBsAg by enzyme-linked immunosorbent assay (ELISA). The multivariate unconditional logistic regression was performed to identify the related factors of positive HBsAg. Results: Among the 260 950 subjects, 113 184 were males (43.37%), 147 766 were females (56.63%), and the average age was (47.68±17.36) years old. The positive rate of HBsAg was 6.10%(15 822 cases). Subjects who were 25-34 years old (OR=1.23), 35-44 years old (OR=1.26), 45-54 years old (OR=1.23), and 55-64 years old (OR=1.34) were more likely to be HBsAg positive,65 years and older (OR=0.88) were less likely to be, compared with subjects aging 18-24 years old; males were more likely to be HBsAg positive compared with females (OR=1.35); people living in Fucheng district were more likely to be HBsAg positive compared with who living in Jiangyou district(OR=1.91); married people were more likely to be HBsAg positive compared with unmarried ones (OR=1.36); medical staff were less likely to be HBsAg positive compared with non-medical staff (OR=0.61); subjects with a surgery history were more likely to HBsAg positive compared with who without (OR=1.13); subjects with trauma history were more likely to HBsAg positive compared with who without (OR=1.13); people with history of Hepatitis B were more likely to HBsAg positive compared with who without (OR=4.21); people with Hepatitis B vaccination history were less likely to be HBsAg positive compared with who without (OR=0.48); all the P values above were less than 0.05. Conclusion The positive rate of HBsAg among adults in Mianyang city was very high, and we should pay more attention to people aging between 25 and 64 years old, male, medical staff, with surgery history, trauma history, and a family history of Hepatitis B and Hepatitis B vaccination history.