The main treatment methods of macular edema (ME) are intravitreal injection of anti-vacular endothelial growth factor drugs, corticosteroids, retinal laser photocoagulation and pars plana vitrectomy (PPV). However, recurrent ME, epiretinal membrane formation and drug resistance have occurred to a part of patients, which is called refractory ME (RME). PPV with internal limiting membrane peeling (ILMP) has the potential of treating and relieving RME. PPV combined with ILMP can treat and relieve RME by removing the posterior vitreous cortex, or removing the epiretinal membrane or internal limiting membrane at the same time during surgery to relieve the traction between the vitreous body and the retina. However, due to the complex pathogenesis of ME, the therapeutic effects of PPV combined with ILMP on ME caused by different etiologies still need clinical studies to explore the best surgical methods for ME caused by different etiologies.

In both clinical and animal experiments,it has been confirmed that the inflammation in brain is involved in the development of brain damage after the ischemia.However,the pro-inflammatory mechanism is extremely complicated.Recently,a growing number of reports indicates that many factors play their roles in the inflammation,such as leukocyte,interleukin-1?(IL-1?),tumor necrosis factor(TNF)and mast cells.They are released/presented in the region of cerebral ischemia and include both ischemic and secondary brain injury.

Objective To investigate the value of serum high sensitive C-reactive protein (hs-CRP) together with total cholesterol(TC)/high-density lipoprotein cholesterol (HDL-C) as a predictor risk factor for future coronary heart disease (CHD). Methods TC,HDL-C and hs-CRP were measured in 260 patients. Results The serum hs-CRP levels in patients with coronary heart disease were significantly increased than those in normal group, P

Objective To investigate the effect of tirofiban on myocardial necrosis biomarker after percutaneous coronary interventions(PCI)in patients with aspirin resistance(AR).Methods 374 consecutive patients with aspirin 100 mg≥1 week,receiving no other antiplatelet therapy,scheduled for PCI were enrolled.all patients were given an loading dose of 300 mg clopidogrel at least 12 hours before PCI and an 75 mg maintenance dose per day.Patients were randomized into tirofiban group(n=38)and control group(n=45)after PCI.The levels of CKMB,TnI at 8,12,and 24 hours after PCI were measured in all patients;if the CK-MB,TnI value was above normal upper limitation,it was considered elevated.Results 83 patients were AR(22.2%)and 54.2%of them are females.The frequencies of CK-MB elevation were 15(39.5%)in tirofiban group and 19(42.2%)in control group,and TnI elevation was 18(47.4%)and 23(51.1%)in the two groups respectively.Conclusion Tirofiban can not decrease the elevation level of CK-MB and TnI in patients with AR after PCI.

China ; epidemiology ; Hepatitis A ; epidemiology ; Hepatitis E ; epidemiology ; Humans

Objective: To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines. Methods: The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed. Results: Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. Conclusions Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

Objective To explore whether remote ischemic preconditioning(RIPC)can prolong the time of ultra-intense exercise(110%VO2max)by increasing the maximum cumulative oxygen deficit(MA-OD),and the specific ways of energy supply of the anaerobic metabolic system.Methods Twenty-four racquet athletes(22.2±2.0 years;174±9 cm;67.1±12.4 kg)completed three supramaximal intensi-ty tests on a treadmill at 110%VO2max intensity to exhaustion separated with Control,Placebo and RIPC interventions.RIPC was induced on the limbs on both sides(5×5 min alternating bilateral occlu-sion 220 and 60 mmHg for Placebo and RIPC interventions,respectively).Moreover,all groups under-went a fourth test with incremental load,and a fifth test with constant load at 40%,50%,60%,70%and 80%VO2max.Results The time to exhaustion and the MAOD of the RIPC group were both greater than those in the Placebo and Control groups(P<0.05).However,no significant differences were found in the average alternative maximal accumulated oxygen deficit(MAODALT),lactic anaerobic metabolism,alactic anaerobic metabolism and parameters of excess post-exercise oxygen consump-tion dynamic curve of the three groups(P>0.05).Meanwhile,in the RIPC group,the average MAOD was significantly higher than MAODALT(P<0.05).Pearson correlation analysis showed a significant rela-tionship between the improvement of MAOD and an increase in exhaustion time after RIPC interven-tion.Conclusion RIPC can improve supramaximal exercise performance of racquet athletes by enhanc-ing their MAOD,and the enhancement of glycolysis energy supply and lactic acid elimination is a po-tential intermediary of the improvement of sports performance.

Objective To assess the effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI.Methods 1055 CHD patients with DM undergoing PCI were divided into complete revascularization (CR) group (n=261),non-CR group 1 (n=385) and non-CR group 2 (n=409).The patients were followed up for 2 years during which the cardiovascular events were recorded.The SYNTAX revascularization index (SRI) was calculated according to the ROC curve and the best prognostic accuracy of revascularization was assayed.Results A significant difference was found in the incidence of MACE,angina pectoris,motality,cardiogenic death,myocardial infarction,unplanned revascularization during the 2-year follow-up period (P＜ 0.05,P＜0.01).Logistic regression analysis showed that SRI was a protective factor for MACE,reduced 64％ of MACE,and thus played a great role in predicting the incidence of MACE in elderly CHD patients with DM after 2 years of PCI (P=0.010).The area under the ROC curve showed the best prognostic accuracy of revascularization was 65％.Conclusion The incidence of cardiovascular events is low in elderly CHD patients with DM after 2 years of CR.The revascularization rate should be higher than 65％ for those who cannot undergo CR in order to reduce their mortality during the long-term follow-up period.

Objective: To establish a method for the determination of the particle size of nifedipine and study the effect of particle size on the in vitro dissolution behaviors of nifedipine sustained release tablets. Methods: Light scattering was used to study the parti-cle size of nifedipine API. Nifedipine APIs with different particle sizes were prepared by a portable high-speed grinder. The in vitro dis-solution curve of nifedipine sustained released tablets (Ⅰ) was determined by HPLC. The similarity was evaluated using the similarity factor ( f2) with the original drug (trade name: Adalat-L, specification: 10mg) as the reference preparation. Results: The granulo-metric conditions were as follows: the pump speed of laser size analyzer was 1 800 r·min-1, the shading rate was 8%-20% , the bal-ance time was 0 s, the media was 0. 3% Tween 80, and the ultrasonic time was 1 min. The in vitro dissolution of nifedipine sustained released tablets (Ⅰ) showed that the smaller particle size of nifedipine API, the better the dissolution was. As the Dv90 ( the particle size accounting for 90% of the total particle quantity) was reduced from 118. 781 μm to 3. 471 μm, the cumulative dissolution in 0. 25 h of nifedipine sustained released tablets (Ⅰ) increased from 11. 2% to 44. 0% , the similarity factor ( f2) compared with the dis-solution cruve of the original drug increased firstly and then decreased, and f2value was 77 when the Dv90 was 29. 823 μm. Conclu-sion: The in vitro dissolution of nifedipine sustained released tablets is improved remarkably by micronization technology. In order to produce nifedipine sustained released tablets (Ⅰ) with the same bioavailability as the original drug preparation, the particle size of nife-dipine API should be controlled within the range of 15 μm≤Dv90≤45 μm.

Objective:To compare the safety and immunogenicity of Sabin strain-based inactivated poliovirus vaccine (sIPV) and the liquid form of typeⅠ+ Ⅲ bivalent oral poliovirus vaccine (bOPV) administered to infants aged ≥2 months in different schedules.Methods:A randomized, blinded, single-center, parallel-group controlled trial was conducted in Hangzhou from 2017 to 2018. Healthy infants aged ≥2 months were enrolled and randomized to receive the vaccines on a schedule of 2, 3, 4 months. Group 1sIPV+ 2bOPV was given one dose of sIPV and two doses of bOPV; group 2sIPV+ 1bOPV was administrated two doses of sIPV and one dose of bOPV; group 3sIPV received three doses of sIPV. Adverse events (AEs) following vaccination were recorded. Blood samples were collected from the subjects (excluding the quitters or subjects against the trial plan) 28-35 d after the full-course immunization. A microneutralization assay was performed to detect the geometric mean titers (GMTs) of neutralizing antibodies against polio virus of Ⅰ, Ⅱ and Ⅲ types. The seroconversion rates of neutralizing antibodies were also calculated.Results:The overall incidence of AEs following vaccination was 3.57% in 1sIPV+ 2bOPV group, 3.61% in 2sIPV+ 1bOPV group and 1.19% in 3sIPV group (χ 2=1.190, P=0.552) and no severe AEs were reported. The antibody seroconversion rates in 1sIPV+ 2bOPV, 2sIPV+ 1bOPV and 3sIPV groups were respectively 100% (84/84), 100% (83/83) and 100% (84/84) against type Ⅰ poliovirus, 81% (68/84), 96% (80/83) and 99% (83/84) against type Ⅱ poliovirus(χ 2=21.469, P<0.001), and 100% (84/84), 100% (83/84) and 100% (84/84) against type Ⅲ poliovirus. In 1sIPV+ 2bOPV, 2sIPV+ 1bOPV and 3sIPV groups, the GMTs of antibody were 1 024.00, 1 015.48 and 982.61 against type Ⅰ poliovirus ( F=2.742, P=0.066), 16.81, 107.94 and 218.85 against type Ⅱ poliovirus ( F=33.570, P<0.001), and 990.75, 990.36 and 613.92 against type Ⅲ poliovirus ( F=37.886, P<0.001). Conclusions:sIPV and bOPV administered in different schedules showed good safety and immunogenicity in infants aged≥2 months. The GMT and the seroconversion rate of neutralizing antibody against type Ⅱ poliovirus after vaccination were higher in 2sIPV+ 1bOPV and 3sIPV group than in 1sIPV+ 2bOPV group. Higher GMT of neutralizing antibody against type Ⅲ poliovirus was induced in 1sIPV+ 2bOPV and 2sIPV+ 1bOPV groups than in 3sIPV group.