Objective:Iris-fixed IOL implantation is a new and effective therapy for phakic eyes. Because the patients are young,they know very few about the operation,which mandated delicate pre-and postoperative nursing. This article discussed how to nurse the patients receiving iris-fixed IOL implantation operation in phakic eyes for super high myopia. Methods:Fifty eight eyes of 30 patients with super-high myopia received iris-fixed IOL (Verisyse IOL) implantation. Pre-and postoperative nursing course were summarized. Results:Focused education through preoperative visits,active cooperation in the operation and meticulous postoperative nursery were beneficial for the operation. Significant vision improvement was found after surgery. Conclusion:The planned,step by step,focused nursing course can improve the effects of operation and reduce the postoperative complication.

Objective To investigate the radiological contamination of body surface for inbound people from Japan to China during Fukushima nuclear accident.Methods According to The guidance for radiological contamination management for body surface issued by Chinese Center for Disease Control and Prevention,for people evacuated from Japan,the body surface monitoring of radiological contamination was performed by the related agencies in main provinces and cities in China. The monitoring data were collected,analyzed and reported to Ministry of Health.Results A total of 432 persons were checked.The monitoring results of 429 cases were close to the background level,while those of three persons were higher than the background level.Conclusions In general,the detected results were as low as the background level.The radiological contamination monitoring of body surface for people from Japan could provide scientific data to relax the horror and panic among them.

Objective To investigate the effects of different chemoradiotherapy ( CRT) schemes on the prognosis of extensive?stage small?cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed in 322 patients with extensive?stage SCLC who were admitted to our hospital from 2011 to 2015.All patients received standard EP/CE ( etoposide+cisplatin/carboplatin) chemotherapy. According to RECIST criteria, the efficacy of chemotherapy was divided into complete response, partial response, stable disease, and progressive disease ( PD). A total of 232 patients without PD after chemotherapy were enrolled as subjects and divided into radiotherapy group (n=187) and non?radiotherapy group (n=45).The patients undergoing radiotherapy were further divided into early radiotherapy group ( before 3 cycles of chemotherapy, n=65) and late radiotherapy group (after 3 cycles of chemotherapy, n=122),or concurrent CRT group ( n=45 ) and sequential CRT group ( n=142 ) . The survival rates were analyzed using the Kaplan?Meier method. Between?group comparison was made by log?rank test. The Cox regression model was used for multivariate prognostic analysis. Results In all the patients, the median overall survival ( OS ) , progression?free survival (PFS),and local recurrence?free survival (LRFS) time was 13?2,8?7,and 14?6 months, respectively. The non?radiotherapy group had significantly shorter median OS, PFS, and LRFS time than the radiotherapy group ( 8?7 vs. 15?0 months, P=0?00;5?6 vs. 9?8 months, P=0?00;5?9 vs. 19?2 months, P=0?00).There were no significant differences in median OS, PFS, or LRFS time between the early radiotherapy group and the late radiotherapy group ( 15?4 vs. 14?6 months, P=0?720;8?0 vs. 10?8 months, P=0?426;19?2 vs. 18?1 months, P=0?981) . The concurrent CRT group had significantly longer median OS time than the sequential CRT group (19?4 vs. 13?8 months, P=0?036),while there were no significant differences in median PFS or LRFS time between the two groups ( 10?8 vs. 9?8 months, P=0?656;19?8 vs. 17?8 months, P= 0?768 ) . Generally, patients undergoing radiotherapy had increased incidence rates of adverse reactions than those without radiotherapy (P=0?038).However, the incidence rates of grade ≥3 adverse reactions were similar between the two groups ( P=0?126) . Conclusions In the treatment of extensive?stage SCLC, thoracic radiotherapy improves the treatment outcomes without increasing the incidence rates of severe adverse reactions. When to receive radiotherapy has nothing to do with the prognosis. Concurrent CRT may further improve the treatment outcomes, which still needs further studies.

Objective:To study the effects and mechanisms of acetyl-11-keto-β-boswellic acid ( AKBA) in myocardial ischemic model induced by isoproterenol hydrochloride ( ISO) in rats. Methods:The SD rats were randomly divided into the sham group, model group, AKBA low dose group and AKBA high dose group. Myocardial injury model was induced by subcutaneous injection of ISO (100 mg·kg-1 ) . The change of ST segment in ECG was observed. Creatine kinase ( CK-MB) , cardiac troponin I ( cTnI) , lactate dehydro-genase( LDH) , malondialdehyde( MDA) and superoxide dismutase( SOD) in the blood were detected by ELISA. The change of histo-logical tissue was determined by HE staining, and cell apoptosis was analyzed by TUNEL assay. Results: Serum CK-MB, cTnI and LDH were decreased significantly in AKBA high dose group when compared with those in the model group. Compared with that in the model group, MDA content was lowered and the SOD activity was increased in AKBA high dose group. Furthermore, AKBA high dose group improved the pathologic changes of myocardium. TUNEL assay revealed significant reduction of cardiomyocytes apoptosis in the hearts of the ischemic rats in AKBA high dose group. Conclusion:AKBA has excellent cardioprotective effect on myocardial ischemic induced by ISO and protection of myocardial cells from injury.

Objective To investigate the effects of different metastatic sites on the prognosis of extensive?stage small cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive?stage SCLC ( stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer) who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non?regional lymph node metastasis;261 had single?organ metastasis and 61 multi?organ metastases. Survival rates were calculated using the Kaplan?Meier method. Between?group comparison of the survival was made by the log?rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time ( MST) was 11. 7 months;1?and 2?year overall survival ( OS) rates were 47. 9% and 19. 5%, respectively. The patients with single?organ metastasis had significantly longer MST and significantly higher 1?and 2?year OS rates than the patients with multi?organ metastases ( 12. 4 vs. 8. 9 months;52. 5% vs. 30. 5%;21. 9% vs. 11. 2%;P=0. 014) . In the patients with single?organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8. 5 months, while those with non?regional lymph node metastasis had the best prognosis with a MST of 14. 5 months ( P= 0. 001 );there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver ( P=0. 139) . In the patients with multi?organ metastases, those with liver metastasis and bone metastasis had the worst prognosis ( P=0. 016,0. 006);there was no significant relationship between brain metastasis and the prognosis of extensive?stage SCLC with multi?organ metastases ( P=0. 995) . There was no significantdifference in the prognosis between those with liver metastasis only and multi?organ metastases ( P=0. 862) . Conclusions Liver metastasis predicts the worst prognosis in patients initially diagnosed with extensive?stage SCLC and single?organ metastasis. Liver metastasis and bone metastasis predict the worst prognosis in patients with multi?organ metastases. Brain metastasis has no significant effect on the prognosis. There is no significant difference in the prognosis of extensive?stage SCLC between patients with single?and multi?organ metastases once liver metastasis occurs.

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Objective To investigate the mRNA expression and methylation status of IL-13 receptor(IL-13R)α1 gene in peripheral T lymphocytes of patients with systemic lupus erythematosus(SLE).Methods Venous blood samples were obtained from 10 SLE patients(5 in active phase,5 in inactive phase)and 6 normal human controls.CD4+ and CD8+ T cells were isolated from these samples via magnetic activated cell sorting(MACS).Real-time quantitative PCR was used to test the mRNA expression of IL-13Rα1 gene,and methylation specific PCR to detect the methylation status.Results The expression level of IL-13Rα1 mRNA was 2.224±0.251,1.712±0.132.and 1.104±0.044 in CD4+ T cells of active SLE patients,inactive SLE patients and controls,respectively;the difference between the three groups was statistically significant(all P＜0.05).The expression level of IL-13Rα1 mRNA in CD8+T cells was significantly higher in active SLE patients than that in the normal controls(1.672±0.142 vs 1.238±0.106,P＜0.05),while no difference was noted between inactive and active SLE patients or normal controls.The methylation index of IL-13Rα1 gene was 0.454±0.023.0.635±0.065.0.844±0.097 in CD4+T cells of active SLE patients,inactive SLE patients and normal controls,respectively,and the difference between the three groups was significant(all P＜0.05),while no significant difference was observed in the methylation index in CD8+T cells among these groups(P＞0.05).The IL-13Rα1 mRNA expression in CD4+T and CD8+T cells was positively correlated with SLE disease activity index(SLEDAI)score(r=0.79,0.76,P=0.007,0.02 respectively).A negative correlation was found between the methylation level Of IL-13Rα1 in CD4+T cells and SLEDAI score(r=-0.89.P＜0.0 1).as well as between the IL-13Rα1 mRNA expression and its methylation level(r=-0.84,P＜0.0 1).Conclusion The development of SLE may be related to the overexpression of IL-13Rα1 gene induced by DNA hypomethylation in T cells.

Objective:To study the differential expression and correlation of salivary secretory immunoglobulin A (sIgA) and peripheral blood hemoglobin (Hb) levels in children with different severity of dental caries.Methods:This study was a case-control study, selecting 106 children with dental caries who received treatment at Jiaxing Maternal and Child Health Hospital from December 2020 to June 2022 as the observation group, and 100 healthy children without dental caries during the same period as the control group. We compared the salivary sIgA and peripheral blood Hb levels between two groups of children. Children with dental caries were divided into mild group (2-3 teeth), moderate group (4-7 teeth), and severe group (≥8 teeth) based on the number of missing teeth. The salivary sIgA and peripheral blood Hb levels of children with different degrees of dental caries were compared. Pearson correlation analysis was used to evaluate the correlation between the number of missing teeth and salivary sIgA and peripheral blood Hb levels. Multivariate logistic regression analysis was used to evaluate the influencing factors of dental caries in children.Results:The salivary sIgA and peripheral blood Hb levels in the observation group were lower than those in the control group, and the differences were statistically significant (all P<0.05). There were 28 cases in the mild group, 50 cases in the moderate group, and 28 cases in the severe group, respectively. There were statistically significant differences in salivary sIgA and peripheral blood Hb levels among children with different severity of dental caries. As the severity of the disease increased, salivary sIgA and peripheral blood Hb levels showed a decreasing trend (all P<0.05). Pearson correlation analysis showed that the number of missing teeth was negatively correlated with salivary sIgA and peripheral blood Hb levels ( r=-0.572, -0.584; P<0.001). Multivariate logistic regression analysis showed that salivary sIgA ( OR=0.660, 95% CI: 0.463-0.941) and peripheral blood Hb ( OR=0.680, 95% CI: 0.505-0.916) were protective factors for the occurrence of dental caries in children (all P<0.05). Conclusions:Salivary sIgA and peripheral blood Hb levels in children with dental caries are low and negatively correlated with the severity of the disease.

Objective: To explore the interrelationships among fathers’ parenting effectiveness, urban children’s sociality and the acceptance of “second-born children” by children (including only children and “first-born children”), and to provide a reference for interventional measured for improving children’s acceptance rate of "second-bron children". Methods: Stratified cluster sampling method was used to select 3 to 9-year-old 778 only children and “first-born children” in two kindergartens and grades 1-3 of two primary schools in a city, and the children and their fathers were investigated with questionnaires survey regarding general information of both fathers and children, the acceptance degree of “second-born children”, the sociality of children and the parenting effectiveness of fathers. Results: Children in different grades had different acceptance levels of “second-born children” and the difference was statistically significant (F=2.89，P<0.05). Correlation analysis showed that the acceptance of “second-born children” was negatively correlated with the interaction between the only children and “first-born children”, and positively correlated with the prosocial behavior of the only children and “first-born children”, both of which are statistically significant (r=-0.10，0.10,P<0.01). Father’s role efficacy was negatively correlated with onlychildren and “first-born-children” peer interaction problems(r=-0.15), and positively correlated with prosocial behavior(r=0.32), both of which were statistically significant (P<0.01). The structural equation model of father’s parenting effectiveness, children’s sociality and acceptance of “second-born children” showed that low father’s parenting effectiveness could positively predict children’s peer communication problems and negatively predict children’s prosocial behavior, and thus children’s peer communication problems could negatively predict the acceptance degree of only children and “first-born children” to “second-born children”, and prosocial behaviors could positively predict the acceptance degree of “second-born children”. Conclusion Promoting father’s parenting efficiency can facilitate the social development of children and the acceptance of siblings.It’s recommended that fathers actively participate in specific parenting matters for the only child and "one child",and consciously improve parenting effectiveness.

Objective To investigate the role of miRNAs in maternal amniotic fluid exosomes in development of isolated ventriculomegaly(VM)in fetuses.Methods Amniotic fluid samples were collected from 9 cases of moderate isolated VM and 8 normal control cases to extract exosomal miRNA,and miRNA sequencing technique was used to identify differentially expressed miRNAs between the two groups.Three miRNAs with significant differential expression between the two groups,whose high expression was associated with VM,were selected for verification with RT-qPCR.Dual luciferase reporter assays were used to verify the regulatory effect of miR-122-5p on its predicted target genes AKT3 and CCDC88C.Gene ontology(GO)and KEGG pathway analyses were performed to explore the possible roles of the top 40 significant differential miRNAs in the pathophysiology of VM.Results We identified a total of 272 differentially expressed miRNAs in VM cases,including 43 up-regulated and 229 down-regulated miRNAs.The target genes of these differential miRNAs were associated with DNA and transcription factor binding,transmembrane transporter and nucleic acid binding transcription factor activity,and cell developmental process.These miRNAs were mostly enriched in the MAPK,cGMP-PKG and Wnt signaling pathways.Verification with RT-qPCR showed that miR-122-5p expression level was significantly lower in VM group than in the control group(P<0.05),which was consistent with miRNA sequencing results;let-7b-5p expression level was significantly lower in VM group,which was contrary to miRNA sequencing result.Dual luciferase reporter assays showed that miR-122-5p was not capable of regulating AKT3 or CCDC88C expressions.Conclusions The highly abundant differentially expressed miRNAs in maternal amniotic fluid exosomes play important roles in the occurrence of fetal VM possibly by regulating the MAPK,PI3K-Akt,Wnt and cGMP-PKG signaling pathways.