Objective To investigate the correlation of microperimetric parameters,best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME) eyes.Methods It is a prospective,no controlled,open study.Twenty-four consecutive patients (40 eyes) with DME were included.There were 10 males (18 eyes),14 females (22 eyes);aged from 41 to 79 years,with the mean age of (56.84±8.96) years.All the patients were type 2 diabetes,the average duration of diabetes was 8 years.BCVA was evaluated using the international Snellen E vision test chart,and then recorded as logarithm of the minimum angle of resolution (logMAR).CRT was measured by Cirrus HD-OCT4000.MAIA microperimetric parameters were evaluated,including average threshold (AT) of retinal sensitivity,macular integrity index (MI),fixating points within a circle of 1° (P1) and 2° of radius (P2),bivariate contour ellipse area (BCEA) considering 63％ and 95％ of fixating points (A63,A95),and horizontal and vertical axes of that ellipse (H63,H95,V63,V95).Pearson correlation analysis was performed to evaluate the association between these variables.The independent factor influenced the type of fixation was analyzed by multiple linear regression analysis.Results Strong correlations of logMAR BCVA with CRT (r=0.58,P=0.000),V63 (r=0.44,P=0.004),V95 (r=0.41,P=0.008),MI (r=0.36,P=0.024),AT (r=-0.61,P=0.000),P1 (r=-0.41,P=0.009),P2 (r=-0.38,P=0.015) were found.AT was correlations with P1 (r=0.53,P=0.000),P2 (r=0.51,P=0.001),A63 (r=-0.39,P=0.012),A95 (r=-0.40,P=0.012),V63 (r=-0.53,P=0.000),V95 (r=-0.46,P=0.003),MI (r=-0.50,P=0.001).There was no correlation between AT and CRT (r=-0.21,P=0.190).Forty eyes were included in this study,8 eyes (20％) had stable fixation,14 eyes (35％) had relatively unstable fixation,18 eyes (45％)had unstable fixation.Multiple linear regression analysis showed that fixation classification was independently affected by P 1.Conclusions In DME eyes,logMAR BCVA was positively correlated with CRT,negatively correlated with AT,P1 and P2.There is no correlation between AT and CRT.The fixation classification was independently affected by P 1.

Objective To study the therapeutic effect and safety of acupuncture a long with the deep respiration on patient of acute traumat ic laryngitis. Methods Totally 240 cases with wind heat syndrome were divided into a treatment group (treated by puncturing acupoint Ka iyin 1 as the main point in combination with deep respiration of the patient) and a control group (treated by gentamy cin sulfate and dexamethasone spray-inhalation). After the treatment for 5 days , both groups were observed on the changes of the symptom scores for congest i on and swelling of vocal cords, sore throat, and hoarseness for evaluating the t herapeutic effect and safety. Results On the 3rd day of treatment, the cured and markedly effective rate of the treatment group was sig nificantly higher than that of the control group (P0.05). There was no untowards finding in l aboratory test. Conclusion Puncturing acupoint Kaiyin 1 as the main point in combination with deep respiration of the patient is a effe ctive and safe treatment for acute traumatic laryngitis.

STIM1 is recognized as an ER Ca2+ sensor of calcium release-activated calcium (CRAC) channel that is constructed by membrane protein Orai1, However, this regulatory system may also be regulated by other proteins. Reticulocalbin 2 (RCN2) was purified and identified from STIM1-Orai1 complex. Confocal microscopy revealed that RCN2 co-localized with STIM1 in ER before and after Ca2+ store depletion. Single cell [Ca2+]I measurements of RCN2 EF hands mutant showed slight influence on SOC electrophysiological characters. Furthermore, a novel collar form aggregation of RCN2 surrounding STIM1 clusters suggested that RCN2 potentially plays a role of structure maintenance in STIM1 clustering.

The osteogenic in vitro effect of low intensity pulsed ultrasound (LIPUS) on SD rat adipose-derived stem cells (ADSCs) was investigated. Rat ADSCs underwent LIPUS (intensity=100 mW/cm(2)) or sham exposure for 8 min per treatment once everyday in vitro, and then the alkaline phosphatase (ALP) activity and mineralized nodule formation were assessed to evaluate the osteogenic effect of LIPUS on ADSCs. To further explore the underlying mechanism, the osteogenic-related gene mRNA expression was determined by using reverse transcriptase-polymerase chain reaction (RT-PCR) at 1st, 3rd, 5th, 7th day after exposure repectively. Westen blot was used to evaluate the protein expression levels of two osteogenic differentiation associated genes at 7th and 14th day repectively. It was found that ALP activity was increased after LIPUS exposure and LIPUS resulted in mineralized nodule formation of ADSCs in vitro. LIPUS-treated ADSCs displayed higher mRNA expression levels of runt-related transcription factor 2 (Runx2), osteocalcin (OCN), ALP and bone sialoprotein (BSP) genes than controls, and the protein levels of Runx2 and BSP were also increased. The results suggested that LIPUS may induce the osteogenic differentiation of ADSCs in vitro.

Children with prolonged mechanical ventilation often have complex conditions, such as long hospital stay of PICU.They have many complications and high mortality.In addition, these patients have low quality of life, lack of psychological care, family emotional communication, and heavy burden of disease.The long-term management and rehabilitation of these children should be strengthened.This study summarized the researches of prolonged mechanical ventilation in adults at home and abroad, in order to provide experience for prolonged mechanical ventilation management in children.

Objective To explore the anti-tumor effect of 17XL strains of Plasmodium yoelii(P.y)infection on melanoma in mice. Methods B16F10 tumor cells were axillarilly injected into the right flank of 20 C57BL/6 mice to establish tumor-bearing mouse models. The next day,the mice were randomly divided into a P.y infection group and control group,10 mice each group. Each mouse of the P.y infection group was intraperitoneally injected with 1×106 red blood cells including 20% P.y infection red blood cells,and each one of the control group were intraperitoneally injected with 1×106 normal red blood cells of C57BL/6 mice. The time of tumor formation of the mice in the two groups was observed and the tumor volumes were measured. Results The time of tumor formation in the P.y infection group[(11.30 ± 0.21)d]was significantly later than that in the control group [(10.40 ± 0.22)d](P < 0.05). From the tumors could be accurately measured to the study end point,both the tumors of mice in the two groups were growing,and the tumor volumes of mice in the P.y infection group were significantly less than those in the control group at each time point(all P < 0.05). The growth rate of tumors in the P.y infection group[(71.10 ± 6.29)mm3/d]was significantly slower than that in the control group[(302.80 ± 49.94)mm3/d](P < 0.05),and the growth rates of tumors every day in the P.y infection group were significantly slower than those in the control group(all P < 0.05). Conclusion The P.y in-fection can delay the occurrence of tumor and inhibit the growth of melanoma.

Objective:To explore the value of diffusion tension imaging (DTI) in the evaluations of hepatic ischemia-reperfusion injury (WIRI) regulation of liver regeneration after partial hepatectomy.Methods:Thirty healthy adult male New Zealand white rabbits were randomly divided into five groups of control and 10/20/30/40 min warm ischemia time (A0-A4)( n=6 each). Routine magnetic resonance (MR) and diffusion tensor imaging (DTI) were performed at 6 h, 3 d, 7 d, 14 d, 30 d post-keratectomy. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured at Day 30 post-keratectomy. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and proliferating cell nuclear antigen (PCNA) in frozen liver tissues were examined and histopathological examination was performed. The values of apparent diffusion coefficient (ADC), fractional anisotropy (FA) and liver volume were measured and liver regeneration rate (LRR) was calculated. Repeated measurement analysis of variance was employed for comparing the difference of DTI and LRR in different groups at different follow-up times. One-way analysis of variance was utilized for comparing the differences of DTI and LRR between groups at the same follow-up time. Pearson or Spearman correlation analysis was employed for evaluating the correlation between DTI, LRR and biochemical parameters. Results:The interaction between time and warm ischemic factor ( P<0.05) and the effect of both alone ( P<0.001) had statistically significant effects on ADC values. FA value and LRR interaction were not significant between time and warm ischemic factor. However, the dominant effect of time factor was significant ( P<0.05). A significant positive correlation existed between ADC value and LRR in the same warm ischemia group ( P<0.01). FA and LRR were negatively correlated ( P<0.05), except for A3 group. FA had a weak correlation with IL-6 at Day 30 post-operation. Conclusions:DTI can non-invasively and quantitatively evaluate the effect of hepatic WIRI on liver regeneration after partial hepatectomy in rabbits. A certain degree of WIRI (≤30 min) can promote liver regeneration after partial hepatectomy. The longer warm ischemia time, the more obvious promotion effect. However, the promotion effect declines significantly after 30 min.

The osteogenic in vitro effect of low intensity pulsed ultrasound (LIPUS) on SD rat adipose-derived stem cells (ADSCs) was investigated.Rat ADSCs underwent LIPUS (intensity=100 mW/cm2) or sham exposure for 8 min per treatment once everyday in vitro,and then the alkaline phosphatase (ALP) activity and mineralized nodule formation were assessed to evaluate the osteogenic effect of LIPUS on ADSCs.To further explore the underlying mechanism,the osteogenic-related gene mRNA expression was determined by using reverse transcriptase-polymerase chain reaction (RT-PCR) at 1st,3rd,5th,7th day after exposure repectively.Westen blot was used to evaluate the protein expression levels of two osteogenic differentiation associated genes at 7th and 14th day repectively.It was found that ALP activity was increased after LIPUS exposure and LIPUS resulted in mineralized nodule formation of ADSCs in vitro.LIPUS-treated ADSCs displayed higher mRNA expression levels of runt-related transcription factor 2 (Runx2),osteocalcin (OCN),ALP and bone sialoprotein (BSP) genes than controls,and the protein levels of Runx2 and BSP were also increased.The results suggested that LIPUS may induce the osteogenic differentiation of ADSCs in vitro.

Objective:To investigate the clinical epidemiological data of children with prolonged mechanical ventilation (PMV) in pediatric intensive care unit(PICU), and analyze the primary disease of children with PMV as well as the disease characteristics and prognosis of children with PMV under different kinds of primary disease.Methods:The clinical data of hospitalized children with PMV in PICU at Children′s Hospital of Fudan University from January 2019 to December 2020 were retrospectively collected.Results:A total of 46 children with PMV were collected.There were 18 males (39.1%) and 28 females (60.9%). The median age was 37 (8, 86) months and the median body weight was 15 (7, 20) kg.The average pediatric critical illness score at admission was 84.2±7.7, PaO 2/FiO 2 was (245.5±99.8)mmHg.The primary diseases leading to PMV were as follows: there were 14 cases of severe pneumonia, eight cases of severe encephalitis, five cases of bronchopulmonary dysplasia, three cases of upper airway obstruction/craniofacial deformity, three cases of myasthenia, three cases of brain stem tumor, three cases of mitochondrial encephalomyopathy, two cases of spinal muscular atrophy, two cases of Prader-Willi syndrome, one case of dermatomyositis, one case of severe brain injury, and one case of central hypoventilation.The causes of unable to withdraw ventilator were respiratory dysfunction in 24 cases, brain dysfunction in 16 cases, and diaphragm dysfunction in six cases.Compared with neuromuscular diseases, children with PMV caused by respiratory diseases had lower month age, higher preterm birth rate, lower PaO 2/FiO 2 ratio, higher parameters for ventilator treatment, and the differences were statistically significant ( P<0.05). Children with PMV caused by neuromuscular diseases had lower Glasgow coma score and higher coma rate, and the differences were statistically significant ( P<0.05). A total of nine (19.6%) cases underwent tracheotomy.A total of 23 (50.0%) cases were successfully extubated from ventilator, six (13.0%) cases were dependent on invasive ventilator, and six (13.0%) cases were breathing with tracheotomy tube.The median mechanical ventilation time was 33 (28, 40) days, the median PICU hospital stay was 42 (34, 56) days, and the median hospital stay was 51 (41, 65) days.A total of 27 (58.7%) cases were improved and discharged, four (8.7%) cases were transferred to rehabilitation hospital, four (8.7%) cases were transferred to local hospital, and 11 (23.9%) cases died in hospital or at home after giving up. Conclusion:The main causes of PMV in PICU children are respiratory dysfunction, brain dysfunction and diaphragm dysfunction.50.0% of the children with PMV could be discharged from the ventilator, and 23.9% died or died after giving up.

Objective:To explore the effects of external diaphragm electrical stimulation on the diaphragm thickness and function in mechanically ventilated children.Methods:A randomized controlled trial was conducted in children who were admitted to PICU at Children′s Hospital of Fudan University and received mechanical ventilation between June 2021 and April 2022.The control group was given the routine treatment of mechanical ventilation, and the intervention group was given external diaphragm electrical stimulation in the early stage of mechanical ventilation in addition to routine treatment.Diaphragm thickness was continuously measured by bedside ultrasound every day for one week after mechanical ventilation, and the changing trend of diaphragm thickness was observed, and the diaphragmatic thickening fraction (DTf) and the incidence of ventilator-induced diaphragmtic dysfunction(VIDD) were calculated at the same time.Results:A total of 32 valid samples were included, including 15 cases in intervention group (10 males) and 17 cases in control group (11 males). The median age of the patients was 33 (10, 77) months, and the median duration of mechanical ventilation was 12 (8, 21) days.The reasons for mechanical ventilation in children included respiratory insufficiency in ten cases, brain dysfunction in ten cases, heart failure in eight cases, and postoperative surgery in four cases.The diaphragm end-expiratory thickness (DTe) in intervention group and the control group showed a gradually decreasing trend from the 1st day to the 7th day.The left thickness was reduced by 11% on the 7th day compared to 1st day in intervention group, which was reduced by 18% in control group; the average daily DTe was reduced by 2% per day in intervention group and by 3% per day in control group.The trends on the right and left were similar.The DTe thickness in the intervention group was greater than that in control group, among which, the mean DTe thickness in the left side of the intervention group on the 7th day was (0.110 7±0.023 7)cm, which was greater than that in control group (0.093 5±0.016 9)cm, and the difference was statistically significant ( t=-2.372, P<0.05); On the second day, the mean DTe thickness on the right side in the intervention group was (0.1267±0.0277) cm, which was greater than that in control group (0.104 7±0.018 1)cm, and the difference was statistically significant ( t=-2.688, P<0.05). DTf in the intervention group was lower than that in control group at 7th day, but the difference was not statistically significant(left DTf: adjusted mean difference was -0.117, P=0.088; right DTf: adjusted mean difference was -0.065, P=0.277). The incidence of VIDD in the intervention group was lower than that in control group(33.3% vs.41.2%), but the difference was not statistically significant ( χ2=0.005, P=0.946). Conclusion:External diaphragmatic electrical stimulation may be helpful for alleviating diaphragmatic atrophy in mechanically ventilated children.However, whether the improvement of diaphragm atrophy is beneficial to clinical outcome still needs further study.