Objective To evaluate the role of ultrasound biomicroscopy(UBM) as a method for assessing the zonules after eye blunt trauma,in order to help the selection of the surgical technique and improve the outcomes of traumatic cataract surgery.Methods Two hundred and seven eyes with eye blunt trauma were examed using UBM with a 50 MHz transducer.The degree and extent of the zonular defects were recorded.All patients also had the slit-lamp examination before the UBM.Results Examined using UBM,zonular defects were identified in 67 of 207 eyes(32.4%).Zonular abnormalities include broken zonules and stretched zonules.Forty-six eyes(68.7%) had broken zonules,15 eyes(22.4%) had stretched zonules,6 eyes(9.0%) had both broken and stretched zonules.The extent of broken zonules ranged from under one quadrant to 360?.Increased lenticular sphericity and ciliary body flattening were seen in the area of zonular defects on UBM.Examined using slit-lamp,35 of 207 eyes(16.9%) had phacodonesis and iridodonesis.Conclusions UBM is an effective method for identifying zonular defects in patients with anterior segment trauma.Diagnosing zonular defects preoperatively is of helpful in surgical planning and reduce complications.

Objective To assess the prevalence of the metabolic syndrome (MS) in Shanghai adults according to the criteria of the US National Cholesterol Education Programme Adult Treatment PanelⅢ ( NCEP ATP Ⅲ) definition. Methods Randomly selected adults were studied by means of stratified sampling. A cross-sectional study was conducted in Shanghai with a representative sample of 7 414 Chinese adults aged 35-74 years.Results Defined by the ATPⅢ criterion, the preliminary prevalence of MS was 19.81%. The prevalence of MS was 16.21% (95%CI 15.37%-17.05% ) after age was adjusted. The prevalence of MS was higher in female than in male (22.59% vs 16.64% ,P<0.01 ), and higher in urban than rural residents( 17.43% vs 17.16% ,P<0.01 ). The prevalence of MS increased with age in both male and female, especially in females aged above 55 years. There were 19.81% subjects with over 3 risk factors. The most common combination of four components in MS were central obesity, high triglyceridemia, low high-density lipoprotein-cholesterol and hypertension. Conclusions There is a high prevalence of MS in Shanghai adults. MS is increasingly becoming a noteworthy health problem. Early-diagnosis and integrated-methods of prevention and treatment of MS are mandatory.

Objective To explore the inhibition effects of epidermal growth factor receptor (EGFR) antagonist monoclonal antibody cetuximab (C225) on breast cancer stem cells in human breast cancer cell line MCF-7.Methods The effects of C225 on the proliferation of breast cancer cell line MCF-7 were detected by MTT assay. MCF-7 cells were cultured to generate primary mammospheres, and were divided into control group, C225 group, epidermal growth factor (EGF) group and EGF + C225 group according to whether or not the culture media contained exogenous EGF and C225.Thirteen days after culture, the volume and number of mammospheres of these four groups were observed, and mammosphere-forming efficiency ( MFE) was calculated. The percentages of CD44~+ CD24~- cells in mammospheres of these four groups and in routinely cultured MCF-7 cells were determined by flow cytometry. Results The inhibition rate on MCF-7 cells increased with the concentration of C225.Compared with control group, the volume of mammospheres in C225 group significantly decreased, and MFE and percentages of CD44~+ CD24~- cells in mammospheres significantly decreased [(0.61 ±0.04)% vs (1.44±0.09)%, P<0.01; (3.50±0.29)% vs (9.07 ±0.52) % , P<0.01]. Compared with EGF group, the volume of mammospheres in EGF + C225 group significantly decreased, and MFE and percentages of CD44~+ CD24~- cells in mammospheres significantly decreased [ (0.68 ± 0.04) % vs (1.61 ± 0.05) % , P < 0.01; (4.00 ± 0.58) % vs (10.47 ± 0.79) % , P < 0.01]. The percentage of CD44~+ CD24~- cells in routinely cultured MCF-7 cells was (2.03 ±0.15) % , and was significantly different from those in EGF group and control group (P < 0.01). There was no significant difference in volume of mammospheres, MFE and percentage of CD44~+ CD24~- cells in mammospheres between EGF group and control group (P >0.05). Conclusion C225 has significant inhibition effects on CD44~+ CD24~- cells in MCF cells.

Objective To evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.Methods A prospective,uncontrolled and non-randomized study.From April 2017 to April 2018,21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study.There were 9 males (9 eyes,42.86％) and 12 females (12 eyes,57.14％),with the mean age of 35.1 ± 13.2 years.The mean diopter was-11.30 ± 2.35 D and the mean axial length was 28.93 ± 5.68 mm.All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN).Regular follow-up was performed before and after treatment,and BCVA and MAIA micro-field examination were performed at each follow-up.BCVA,macular integrity index (MI),mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed.The fixation status was divided into three types:stable fixation,relatively unstable fixation,and unstable fixation.The paired-sample t-test was used to compare BCVA,MI and MS before and after treatment.The x2 test was used to compare the fixation status before and after treatment.Results During the observation period,the average number of injections was 3.5.The logMAR BCVA of the eyes before treatment and at 1,3,and 6 months after treatment were 0.87±0.32,0.68±0.23,0.52±0.17,and 0.61 ±0.57,respectively;MI were 89.38 ± 21.34,88.87 ± 17.91,70.59 ± 30.02,and 86.76 ± 15.09,respectively;MS were 15.32 ± 7.19,21.35 ± 8.89,23.98 ± 11.12,22.32 ± 9.04 dB,respectively.Compared with before treatment,BCVA (t=15.32,18.65,17.38;P＜0.01) and MS (t=4.08,3.50,4.26;P＜0.01) were significantly increased in the eyes 1,3,and 6 months after treatment.There was no significant difference in the MI of the eyes before treatment and at 1,3,and 6 months after treatment (t=0.60,2.42,2.58;P＞0.05).Before treatment and at 1,3,and 6 months after treatment,the proportion of stable fixation were 28.57％,38.10％,38.10％,33.33％;the proportion of relatively unstable fixation were 47.62％,47.62％,52.38％,57.14％ and the proportion of unstable fixation were 23.81％,14.28％,9.52％,9.52％,respectively.The proportion of stable fixation and relatively unstable fixation at 1,3 and 6 months after treatment were higher than that before treatment,but the difference was not statistically significant (x2=1.82,1.24,1.69;P＞0.05).Conclusion BCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.

The genus Letrouitia is newly recorded for Cambodia, including the four species as L. domingensis, L. leprolytoides, L. sayeri, and L. subvulpina. A brief description and illustrations are provided.
Cambodia* ; Lichens*

Objective:To evaluate the value of shear wave elastography (SWE) and salivary gland ultrasound scoring(SGUS) system in the diagnosis of salivary glands lesions in patients with Sj?gren′s syndrome(SS) and to compare the diagnostic efficiency of the two methods.Methods:From June 2019 to November 2020, Fifty-eight patients with suspected SS were selected from the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University. According to the 2002 American-European Consensus Group classification standard, the enrolled patients were divided into two groups: SS group (47 cases) and non-SS group(11 cases). According to symptom duration, SS group was divided into the ≤5 years group (29 cases) and the >5 years group (18 cases). Meanwhile, 40 healthy volunteers were enrolled in this study as normal control group. The diagnostic value of salivary gland ultrasound scoring system and Young′s modulus in SS were analyzed.Results:The differences in Young′s modulus of parotid gland and submandibular gland between SS group and non-SS group (or control group) were statistically significant (all P<0.05). The ultrasound score of SS group was significantly higher than that of non-SS group and control group (all P<0.05). SGUS and Young′s modulus were not significantly different between different course groups (all P>0.05). The areas under ROC curve of the mean Young′s value in parotid and submandibular gland and the SGUS were 0.801, 0.829 and 0.676, respectively. The comparison of the area under the curve between the Young′s modulus of the parotid and submandibular glands and the ultrasound score was statistically significant (all P<0.05). Conclusions:SWE and Ultrasonography scoring system have certain value in the diagnosis of salivary gland lesions in SS, and can provide important reference information for clinical diagnosis from different perspectives. The diagnostic efficiency of SWE for salivary glands lesions in patients with SS is better than that of SGUS scoring system.

Objective:To analyze the relationship between both quality and duration of sleep and type 2 diabetes in middle-aged and elderly people in Shanghai.Method:Baseline data was from the '2017 epidemiological survey in Shanghai community residents aged 35 and above on type 2 diabetes’. Restricted cubic splines were used to draw dose-response curves to show the relationship between PSQI score, sleep duration and type 2 diabetes. Logistic regression model was used to analyze the effects of quality and duration of sleep as well as the interaction, on type 2 diabetes.Results:Results showed that the average PSQI score was (4.09±0.10) points, the proportion of poor sleep quality was 12.55% (95% CI: 10.77-14.58) and the average sleep duration was (7.19±0.03) hours. The relationship between PSQI score and diabetes appeared linear, with the relationship between sleep duration and diabetes as U-shaped. After adjusting for confounders, both poor sleep quality (>7 for PSQI score) and short sleep duration (sleep duration <6 hours) significantly increased the risk of type 2 diabetes, with OR=1.17 (95% CI: 1.06-1.30) and 1.20 (95% CI: 1.01-1.41), respectively. From the interaction analysis, data showed that after adjusting for confounders, both sleep duration <6 hours ( OR=1.30, 95% CI: 1.12-1.52) and ≥8 hours ( OR=1.79, 95% CI: 1.04-3.07) with poor sleep quality would increase the risks on diabetes. Conclusion:Both poor sleep quality and short sleep duration were associated with the risk of diabetes, while long sleep duration was only associated with the risk of diabetes when accompanied by poor quality of sleep.

Macular edema(ME)secondary to retinal vein obstruction(RVO)and consequent fundus anatomical struc-ture injury is one of the main causes of severe visual impairment.Currently,the treatment of RVO-ME is mainly aimed at controlling ME and improving visual function,and intravitreal injection of anti-vascular endothelial growth factor drugs or corticosteroid drugs is the first-line treatment method.In recent years,many clinal studies have adopted different single or combination drug treatment regimens to compare the visual function recovery of patients after surgery and during the fol-low-up,providing clinicians with the basis for selecting different treatment regimens.This article provides a brief review of the research progress of RVO-ME intravitreal drug injection therapy.

Objective To estimate the prevalence of chronic kidney disease and to identify influencing factors among patients enrolled in diabetes management by the community health centers in Shanghai. Methods A questionnaire survey and physical examination were conducted in patients with type 2 diabetes through a random sampling method. Eligible date of 1 618 subjects were enrolled in the study. Estimated glomerular filtration rate was calculated according to equation of the Modification of Diet in Renal Disease Study for serum creatinine. Logistic regression was performed to examine the association between risk factors and chronic kidney disease. Results The prevalence of chronic kidney disease was 43.4%, of which 16.1%were in Stage 1, 14.8%in Stage 2, 11.6%in Stage 3, and 1.0%in Stage 4/5 in the total of 1 618 patients, but only 3.6% of the patients as defined in this study were aware of their condition. A higher prevalence of chronic kidney disease in females than that in males ( 47. 3% vs 37.8%). The prevalence of chronic kidney disease increased with age (χ2tend＝38.663,P<0.01). Female gender, older age, lower education, lower monthly income per capital, long duration of diabetes, uncontrolled glycosylated hemoglobin, uncontrolled systolic blood pressure, and uncontrolled triglycerides, were influencing factors of chronic kidney disease. Conclusion The patients under diabetes management in community health centers had higher prevalence of chronic kidney disease with lower awareness. Patients with type 2 diabetes should be encouraged to control blood glucose, blood pressure and blood lipids, to reduce the risk for chronic kidney disease. 而下降,2、3期均随年龄增大而升高(2 期 χ2趋势＝34.626,3 期,均 P<0.01) .城乡患病率总体上无差别,仅见3期患病率市区高于郊区(14.4%对9.2%, χ2＝10.465,P<0.01).按糖尿病病程长短进行分层发现,总的患病率随病程延长而升高 ,2、3期也呈现同样趋势( 2 期,3 期,均 P<0.05,图1) .

Objective:To investigate the effect of bedside high-flow continuous blood purification (CBP) combined with Xuebijing in the treatment of severe sepsis (SS) and the influence on the patient′s coagulation-fibrinolysis index, immunity index and expression of peripheral blood Toll-like receptor 4 (TLR4).Methods:Ninety-three patients with SS who were admitted and treated in the Lianyungang First People′s Hospitalfrom January 2017 to October 2019 were selected. They were divided into the combined group (51 cases, treatment with bedside high-flow CBP and Xuebijing injection based on bundle therapy) and the control group (42 cases, treatment with Xuebijing injection based on bundle therapy). The changes in coagulation and fibrinolysis index, immunity index, biochemical index such as TLR4 before treatment and after 1 week of treatment were compared between the two groups. The incidences of complications in both groups were statistically analyzed, and the discharge time from ICU, mechanical ventilation time and 28-day mortality were recorded.Results:After 1 week of treatment, the levels of prothrombin time (PT) and activated partial thromboplastin time (APTT) in the two groups were shortened, D-dimer (D-D) and fibrinogen (FIB) were decreased ( P<0.05); and the levels of PT and APTT in the combined group were shorter than those in the control group, the levels of DD and FIB were lower than those in the control group, there were statistical differences ( P<0.05). After 1 week of treatment, the levels of CD 4+ and CD 4+/CD 8+ ratio in both groups were increased ( P<0.05), and the levels of CD 4+ and CD 4+/CD 8+ ratio in the combined group were higher than those in the control group ( P<0.05). After 1 week of treatment, the levels of TLR4, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), blood lactate (Lac), blood urea nitrogen (BUN) and serum creatinine (Scr) in both groups were decreased ( P<0.05), meanwhile, the above indexes in the combined group were lower than those in the control group ( P<0.05). The incidence of multiple organ failure and the 28-day mortality rate in the combined group were lower than those in the control group: 3.92%(2/51) vs. 19.05%(8/42), 13.73%(7/51) vs. 30.95%(13/42), there were statistical differences ( P<0.05). The discharge time from ICU and mechanical ventilation time in the combined group were shorter than those in the control group: (12.35 ± 2.14) d vs. (14.17 ± 3.36) d, (7.12 ± 2.23) d vs. (8.51 ± 2.39) d, there were statistical differences ( P<0.05). Conclusions:Bedside high-flow CBP combined with Xuebijing injection in the treatment of SS can improve the patient′s condition, regulate the balance of coagulation and fibrinolysis, avoide the activation of coagulation, inhibite inflammatory response, reduce the expression of TLR4 in peripheral blood, improve immune function, protecte kidney function and promotethe patient′s recovery.