Objective To investigate the effect of calcium acetate in treatment of elderly patients with CAPD in peritoneal dialysis patients with hyperphosphatemia and efficacy.MethodsFrom March 2013 to January 2016,46 elderly patients with CAPD were randomly divided into experimental group and control group.The control group were used calcium 1.5mmol/L Liquor Dialysisintraperitoneus CAPD treatment,and control diet.Besides these treatments,the experimental group were given calcium acetate tablets 668mg/3 times every day after a meal, 2 tablets each time.All patients were detected before treatment and 4,6 and 10 weeks after the serum calcium, phosphorus and calcium and phosphorus in blood iPTH index, calculate the product of calcium and phosphorus,record and statistical analysis.ResultsTwo groups after 4 week of treatment, all outcome measures were decreased;the experimental group blood phosphorus decreased significantly after 6 weeks treatment;it after 10 weeks of treatment, serum calcium(t=5.202),phosphorus(t=7.767),blood iPTH(t=-10.324) and the calcium phosphorus product (t=-4.106) compared with that before treatment,there were statistically significant differences(P<0.01);the control group after 10 weeks of treatment, with all outcome measures there were no significant differences.The experimental group after 10 weeks of treatment,serum calcium(t=-4.055),phosphorus (t=-9.037),blood iPTH(t=9.940) and the calcium phosphorus product(t=-4.211)compared with the control group,the differences were statistically significant(P<0.01).ConclusionCalcium acetate treatment can significantly reduce the blood serum of aged CAPD in peritoneal dialysis patients with high phosphorus,effectively prolong the survival time and improve the quality of life during treatment.

Background and purpose: Current colorectal cancer patient-derived xenografts (PDXs) models were established by samples taken during surgery. However, metastatic colorectal cancer (mCRC) patients have less surgical opportunities, and it was difcult to obtain enough tumor fragment. The aim of the present study was to es-tablish mCRC PDXs by image-guided biopsy. Methods: A total of 12 patients with colorectal cancer who underwent surgery were included. All patients had recurrent lesions or metastatic lesions needed to be histologically confirmed, and none of them had contraindication to biopsy. Tumor tissues not required for clinical diagnosis were used to establish mCRC PDXs. Results: Seven PDXs grew sufficiently for transfer into mice. The success rate was 77.8%. Conclusion:The PDXs established by image-guided biopsy had the advantage of convenient operation, good reproducibility, high achievement ratio, short experimental periodicity and reliably retain specific genetic and morphological features of the primary patient tumors.

Objective To establish the reference ranges of the spatial angles among cardiac chambers and great vessels in second and third trimester fetuses measured by spatiotemporal image correlation (STIC).Methods Volume images of 352 normal fetuses from 20 to 38 weeks of gestation were recruited in the study.An off-line analysis of acquired volume datasets was carried out with multiplanar mode.Parameters measured included angles between:(1) the 4-chamber view and the left ventricular long axis view; (2) the left ventricular long axis view and main pulmonary artery; and (3) the ductal arch and aortic arch.The relationships between above-mentioned angles and gestational age were assessed by correlation and regression analysis.Results The angle between the 4-chamber view and the left ventricular long axis view (range:55.7° - 35.7°,mean:45.7° ± 5.12°) was uncorrelated with gestational age (r = 0.03,P = 0.51).In contrast,the angle between the left ventricular long axis view and main pulmonary artery,and the angle between the ductal arch and aortic arch were correlated with gestational age (P ＜ 0.001),and the correlation coefficient was - 0.53 and 0.57 respectively.The best-fit exponential curve regression equations of the angle between the left ventricular long axis view and main pulmonary artery was:Y = 154- 4.24X +0.05X2 ,and the angle between the ductal arch and aortic arch was:Y = - 20.8 + 2.65X - 0.37X2.Conclusions The angles among cardiac chambers and great arteries of fetuses from 20 to 38 weeks of gestation can be quantitatively measured by STIC.The reference ranges provide a reliable quantitative standard to estimate the spatial relationships of the cardiac large arteries of fetuses,which may be clinically useful in prenatal screening congenital heart disease.

Objectives To investigate whether the presence of metabolic syndrome (MS) modifies overall survival and cardiovascular (CV) outcomes among patients undergoing long-term peritoneal dialysis (PD) and to explore suitable diagnostic criterion for PD patients.Methods A total of 258 patients on PD in Peking University Third Hospital between October 2008 and March 2009 were enrolled and followed until June 2017.According to the diagnostic criteria of WHO,IDF and ATP Ⅲ,the patients were divided into MS group and non-MS group.The median following time was 51.9 (26.8,97.9) months.Overall survival and cardiovascular death were analyzed by the Kaplan-Meier method.The analyses were also done among non-diabetic PD patients.The influence of MS and its components on outcomes was analyzed by Cox regression models.Results Among 258 PD patients,106(41.1％) fulfilled the WHO criteria,121(46.9％) the IDF criteria,and 167(64.7％) the ATP criteria.139 cases were dead,among which 50(36.0％) cases were caused by CV diseases.The patients with MS had worse outcomes than those without MS by WHO and IDF criteria (cumulative survival rates of WHO criteria:21.3％ vs 44.8％,P ＜ 0.01;cumulative surviva rats of IDF criteria:23.3％ vs 45.7％,P ＜ 0.01).It was the same even in non-diabetic PD patients.The patients with MS had more CV death than those without MS by WHO and IDF criteria (both P ＜ 0.05).Among non-diabetic PD patients,the results remained the same only by IDF criteria (P ＜ 0.05).By ATP criteria,above analyses showed no difference.By multivariate Cox regression analysis,MS and serum albumin (all P ＜ 0.01) were independently associated with increased risk for overall and cardiovascular survival.Among MS components,waist girth,low-density lipoprotein cholesterol (LDL-C) levels and blood sugar (all P ＜ 0.01) were significant risk factors for adverse survival outcomes.Conclusions In patients undergoing PD,both overall survival and cardiovascular survival were worse in patients with MS than those without MS.Waist girth,blood sugar and serum LDL-C were the main risk factors.For PD patients the IDF criterion for MS was recommended.

Objective To discuss the effect of milking in different times on very low birth weight premature infants .Methods Totals of 78 very low birth weight premature infants were chosen and divided into the no asphyxia group A(Apgar score 7-10), mild asphyxia group B(Apgar score 4-6.9), sever asphyxiation group C(Apgar score 0-3.9) according to the Apgar score.Then every group was randomly divided into the subgroups:13 neonates for group A1, group A2, group B1, group B2, group C1 and group C2.Group A1, group B1 and group C1 added early trace formula into enteral feeding in 24 hours until converted to full-intestinal absorption, while group A2 , group B2 and group C2 were given the same nutrition after 24 hours.Changes of indicators of infants were observed in all groups .Results The weight gain , excrement , time to regain body bass, PPN time, FEN time and hospitalization day was respectively (17.5 ±6.6) g/d,(3.2 ±1.2) times/d, (4.7 ±2.6)d, (9.2 ±4.1)d, (20.4 ±7.1)d ,(25.6 ±4.8)d in group A1, and(11.4 ±5.3)g/d, (1.9 ± 1.7)times/d, (6.2 ±3.1) d,(13.1 ±3.7) d,(25.1 ±7.9) d and(29.7 ±5.3) d in group A2, and the differences were statistically significant ( t =7.045,5.379,6.001,5.891,5.913,7.704, respectively;P <0.05).The weight gain, excrement, time to regain body bass, PPN time, FEN time and hospitalization day was respectively (10.0 ±3.5) g/d,(1.4 ±0.8) times/d,(7.9 ±3.7) d, (15.6 ±5.2) d, (27.7 ±6.8) d, (32.8 ±8.2)d in group B1, and(10.6 ±2.8)g/d,(1.3 ±1.1)times/d,(8.1 ±3.1)d,(14.8 ±6.1)d, (28.1 ±5.4)d,(36.4 ±8.7)d in group B2, and the differences were not statistically significant (t=1.964, 1.157,2.131,1.467,2.003,1.980, respectively;P>0.05).The weight gain, excrement, time to regain body bass, PPN time, FEN time and hospitalization day was respectively (4.4 ±1.8) g/d,(0.0 ±0.3) times /d, (13.4 ±4.8)d, (19.2 ±7.7)d, (36.1 ±9.5)d,(43.5 ±10.2)d in group C1, and (7.4 ±3.4)g/d,(1.1 ± 0.9)times/d,(10.6 ±3.1) d,(17.0 ±6.9) d,(30.2 ±7.5) d and(39.9 ±9.1) d in group C2, and the differences were statistically significant ( t =5.549,6.000,5.836,5.907,8.114,7.908, respectively;P <0.05).There was statistically significant difference of gastrointestinal functional damage between group A 1 and A2(χ2 =8.496,P<0.05).There was no statistically significant difference of gastrointestinal functional damage between group B1 and B2 (χ2 =2.001,P>0.05).There was statistically significant difference of gastrointestinal functional damage between group C1 and C2 (χ2 =13.457,P <0.01).Conclusions Presence of asphyxia hazard is one of the most important standards of starting breastfeeding in 24 hours for very low birth weight premature infants , and Apgar score can be used as one of the references for start milking for premature infants .

Objective To explore the effect of three-in-one nursing including the music therapy , massage and non-nutritional sucking on the prevention of feeding intolerance in very low birth weight infant . Methods One hundred and twenty very low birth weight infants from January 2010 to January 2013 were chosen and randomly divided into the control group and the intervention group , each with 60 cases.All patients received the homogeneous parenteral nutrition and a little formula through enteral feeding , and at the same time the control group received the massage and non-nutritional sucking , and the intervention group received the three-in-one nursing .The feeding effect was compared between two groups .Results The time of recovery of birth weight , the weight gain every day , and the time of parenteral nutrition and reaching enough enteral feeding, the length of time were respectively (2.9 ±2.1)d, (17.8 ±7.9)g and (7.7 ±3.1) d,(17.4 ±6.3)d, (19.6 ±5.9)d in the intervention group, and were better than those of the control group , and the differences were statistically significant (t=7.685, 9.001, 7.061,11.047,17.438,14.225, respectively;P<0.05).The incidence rate of feeding intolerance was 6.67% in the intervention group , and was 20.00% in the control group, and the difference was statistically significant (χ2 =12.005,P<0.01).Conclusions Three-in-one nursing can improve the early enteral feeding in very low birth weight infant , and improve the function of the routine massage and non-nutritional sucking , and reduce the incidence rate of feeding intolerance .

Objective To observe the value of shear wave viscoelastography(SWV)for differentiating lung peripheral inflammatory masses and malignant tumors.Methods Conventional gray-scale ultrasound and SWV were prospectively performed in 70 patients with lung peripheral inflammatory mass or malignant tumor.The patients were divided into malignant group(n=42)and inflammatory group(n=28)according to pathological results.Clinical and ultrasonic data,including the maximum diameter of lesions,the mean Young's modulus(Emean),mean viscosity(Vmean),and mean dispersion slope(Dmean)were compared between groups.Receiver operating characteristic curves of ultrasonic parameters being significantly different between groups were drawn,and area under the curves(AUCs)were calculated to evaluate the efficacy of each parameter for differentiating lung peripheral inflammatory mass or malignant tumor.Results In malignant group,the maximum diameter and Emean of lesions were both higher,while Vmean and Dmean of lesions were both lower than those in inflammatory group(all P＜0.05).Vmean and Dmean of lesions had moderately/good efficacy for differentiating lung peripheral inflammatory mass or malignant tumor(AUC=0.843,0.866),both better than that of conventional ultrasound and Emean(AUC=0.673,0.685)(all P＜0.05).The combination of Emean,Vmean and Dmean had good efficacy for differentiating lung peripheral inflammatory masses and malignant tumors,with AUC of 0.874.Conclusion The viscous parameters of SWV could effectively differentiating lung peripheral inflammatory masses and malignant tumors.

AIM:To evaluate the clinical efficacy of lamellar keratectomy and corneal collagen crosslinking(LKCCC)in treating superficial fungal keratitis.METHODS: Retrospective analysis. Totally 79 patients(79 eyes)with superficial fungal keratitis who underwent LKCCC in our hospital from January 2014 to October 2023 were included. After admission, routine antifungal drug treatment for 7 d showed no obvious improvement or progressive aggravation. The maximum diameter of corneal lesions in all patients was ≤7 mm, the maximum depth was no more than 50% of the corneal thickness at the location, and the remaining healthy corneal thickness was ≥300 μm. The follow-up time was 90 to 112 d.RESULTS:Among the included 79 eyes, the lesions were located in the central region of the cornea in 6 eyes, in the paracentral region in 61 eyes, and in the peripheral region in 12 eyes. Hypopyon was observed in 5 cases. LKCCC was successfully administered in 79 eyes, cured in 76 eyes(96%), and failed in 3 eyes(4%). The healing time of corneal epithelium in 76 cured eyes was 3-15 d, of which 51 eyes(67%)healed within 7 d and 24 eyes(32%)healed within 3 d. The uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)of 76 eyes of cured patients were statistically significant compared with those preoperatively(P<0.0167). Two of the 3 failed eyes were located at the edge of the lesion and recovered after re-keratectomy. One eye was located in the center of the lesion and recovered after being covered by bulbar conjunctival flap. At the last follow-up, no other complications were observed in all patients except superficial cloud and thinning of cornea.CONCLUSION:LKCCC is a rapid and effective treatment for superficial fungal keratitis and can be considered a new treatment option.

AIM: To assess the impact of optimized pulsed technology(OPT)on the morphological and functional changes of meibomian glands in patients with meibomian gland dysfunction(MGD).METHODS: This prospective case-control study enrolled 60 MGD patients(60 right eyes)treated at Weifang Eye Hospital from September 2023 to February 2024. Patients were categorized into mild, moderate, and severe groups based on the extent of meibomian gland loss, with 20 cases(20 eyes)per group. Treatments consisted of bilateral OPT combined with meibomian gland massages, administered biweekly over four sessions. Ocular surface function indicators including the ocular surface disease index(OSDI), corneal fluorescein staining(CFS), non-invasive average tear break-up time(NIBUTav), and non-invasive tear meniscus height(NITMH), as well as meibomian gland function parameters such as meibomian gland expressibility score(MGES)and meibomian gland secretion score(MGYSS)were observed and recorded before treatment and at 3 mo after final treatment. Cellular-level assessments using in vivo confocal microscopy(IVCM)examined meibomian gland acinar unit density(MGAUD), inflammatory cell density(ICD), meibomian gland acinar longest diameter(MGALD)and meibomian gland acinar shortest diameter(MGASD).RESULTS: At baseline, no significant differences were found in NITMH across groups(P>0.05). Statistical significance were observed in NIBUTav, MGES, MGYSS, MGAUD, MGALD, and MGASD(all P<0.05). Compared to the mild group, the moderate and severe groups showed significant differences in OSDI, CFS, and ICD(all P<0.05), though no significant differences existed between moderate and severe groups(all P>0.05). At 3 mo after treatment, all groups showed no significant differences in NITMH(all P>0.05). All parameters improved significantly in the mild group(all P<0.05); all indicators improved in the moderate group(P>0.05), except for MGASD before and after treatment(all P<0.05); significant improvements were noted in OSDI, CFS, and NIBUTav in the severe group(all P<0.05), while MGES and MGYSS did not differ significantly(all P>0.05). IVCM parameters(MGAUD, ICD, MGALD, and MGASD)showed no significant change in the severe group(all P>0.05).CONCLUSION:OPT effectively enhances various ocular surface functions and improves gland expressibility and secretion quality in mild to moderate MGD cases, while also positively impacting certain cellular parameters. In severe cases, where most acinar functions are lost and structural reversibility is limited, OPT can still mitigate MGD symptoms and decelerate disease progression.