Background Orthokeratology has been proved to temporarily alter the equivalent sphere,but its effects on visual quality deserve attention.Objective The present study was to investigate the visual quality after overnight orthokeratology in pre-adolescent myopes.Methods Written informed consent was obtained form each subject prior to entering into this series.A descriptive study design was used.One hundred and fifty eyes of 76 teenagers aged (14.90± 1.24)years with low and moderate myopia (-2.79 ± 0.82)D were included in the study.Fitted with Ortho-K contact lens,the lens was wore every night for over 8 hours.Subjective refraction,uncorrected visual acuity (UCVA),contrast sensitivity function,corneal-topography,and aberrometry were examined before,1 week and 3 months after the initiation of orthokeratology.Visual quality was generally evaluated by comparing before wearing,1 week and 3 months after wearing using the National Eye Institute refractive error quality of life instrument (NEI-RQL-42TM).All the procedures were performed by the same clinician.Results Spherical equivalent refractions were (-0.33± 1.02) D and (-0.26 ± 0.60) D 1 week and 3 months after orthokeratology,showing significant decline in comparison with (-2.79±0.82) D of before orthokeratology (P =0.001,0.001).However,no considerable difference was seen between 1 week and 3 months after orthokeratology (P=0.161).Contrast sensitivity function was significantly different in all spatial frequencies before wearing,1 week and 3 months after wearing,and those of 1 week and 3 months after wearing were significantly lower than those of before wearing (1 week:3 cpd P =0.001,6 cpd P=0.001,12 cpd P＜0.05,18 epd P＜0.05 ;3 months:3 cpd P=0.001,6 cpd P=0.001,12 cpd P＜0.05,18 cpd P＜0.05).There was no significant change in contrast sensitivity function between 1 week and 3 months of orthokeratology (P＞0.05).Flat K,steep K and corneal eccentricity (e) were significantly reduced (P =0.000),and surface asymmetry index (SAI) and surface regularity index (SRI) were significantly improved after orthokeratology in comparison with before orthokeratology (both P =0.001).Root mean square (RMS) of total higher-order,third-order and fourth-order aberrations were significantly increased (P＜0.05),but RMS of whole aberration and second-order aberrations significantly decreased after orthokeratology (P＜ 0.05).There were no significant changes in the fifth-order,sixth-order and seventh-order aberration among pre-wear,1 week and 3 months after orthokeratology.Scales of dark to bright,nocturnal driving,glare,visual fluctuate and halo were lower than those before orthokeratology (P＜0.05).The scales of visual fluctuate between 1 month and 3 months after orthokeratology had significant differences (P＜0.01),while the rest of the scales had no significant differences (P＞0.05).Conclusions Orthokeratology can reduce myopic diopter 1 week after orthokeratology.The overnight wearing of fitted orthokeratology can decrease contrast sensitivity and increase corneal surface irregularity and RMS of third-order and fourth-order.Compared with spectacles,orthokeratology reduces subjective visual quality,especially nocturnal quality.

OBJECTIVETo describe the pathologic features and diagnostic algorithm of pulmonary alveolar proteinosis (PAP).

METHODSThirty-nine biopsy and postmortem cases of PAP were studied by light microscopy and histochemical staining using periodic acid-Schiff (with digestion) (PAS-D), mucicarmine (with digestion) (mucicarmine-D) and alcian blue.

RESULTSHistologically, the affected lung tissue displayed the following characteristic features: (1) alveoli and some of the small bronchioles were filled with eosinophilic and fine granular proteinaceous material with needle-like clefts; (2) proteinaceous material was seen admixed with various numbers of degenerated and sometimes exfoliated pneumocytes; (3) pneumocytes were hyperplastic; (4) alveolar capillaries and alveolar septa had become hyperemic, but pulmonary interstitial inflammation was not obvious; (5) no significant inflammation was identified in the bronchial wall; (6) compensating emphysema was noted in the surrounding lung parenchyma. Fragments of eosinophilic, finely granular proteinaceous material with needle-like clefts were also found in the bronchoalveolar lavage fluid under light microscopy. The proteinaceous material was stained red by PAS-D. The staining for mucicarmine-D was negative, while alcian blue staining was either weakly positive (faint blue staining) or negative. Pathologic examination of lung biopsies and bronchoalveolar lavage fluid thus remaines the gold standard for diagnosis of PAP.

CONCLUSIONSIdentification of homogeneous, eosinophilic, finely granular and PAS-D-positive proteinaceous material with needle-like clefts in alveolar spaces or bronchoalveolar lavage fluid is of diagnostic importance in PAP. Bronchoalveolar lavage, being a relatively safe and non-invasive procedure, can be a useful adjunct in arriving at the final conclusion.

Adult ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; cytology ; Female ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Periodic Acid-Schiff Reaction ; Pulmonary Alveolar Proteinosis ; pathology ; therapy ; Pulmonary Alveoli ; pathology

Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

The Z-drugs (zolpidem, zopiclone, and zaleplon), as the innovative hypnotics, have an improvement over the traditional benzodiazepines in the management of insomnia. Z-drugs have significant hypnotic effects by reducing sleep latency and improving sleep quality, though duration of sleep may not be significantly increased. As benzodiazepines, Z-drugs exert their effects through increasing the transmission of γ-aminobutyric acid. Z-drugs overdose are less likely to be fatal, more likely would result in poisoning. Z-drugs can be detected in blood, urine, saliva, and other postmortem specimens through liquid chromatography-mass spectrometry techniques. Zolpidem and zaleplon exhibit significant postmortem redistribution. Z-drugs have improved pharmacokinetic profiles, but incidence of neuropsychiatric sequelae, poisoning, and death may prove to be similar to the other hypnotics. This review focuses on the pharmacology and toxicology of Z-drugs with respect to their adverse effect profile and toxicity and toxicology data in the field of forensic medicine.
Acetamides/poisoning* ; Azabicyclo Compounds/poisoning* ; Drug Overdose ; Forensic Medicine/trends* ; Forensic Toxicology/trends* ; Humans ; Hypnotics and Sedatives/poisoning* ; Piperazines/poisoning* ; Pyridines/poisoning* ; Pyrimidines/poisoning* ; Sleep Initiation and Maintenance Disorders/drug therapy* ; Zolpidem

Acute myeloid leukemia (AML) is a genetic heterogeneous disease in which primordial and juvenile myeloid cells proliferate or accumulate abnormally in bone marrow, peripheral blood and other tissues, resulting in damage to normal hematopoietic function. Studies have shown that about 30% of AML patients have FMS-like tyrosine kinase 3 (FLT3), FLT3 abnormal regulation is closely related to the occurrence and development of AML. At present, FLT3 has become an important target for developing small molecular targeted drugs. Currently, a variety of FLT3 inhibitors and FLT3 degraders have been developed targeting FLT3, and some compounds have exhibited good anti-AML activity. This article summarizes and sorts out the current mainstream drugs for AML therapeutic targeting FLT3, in order to provide a reference for the development and design of AML drugs.

A strain NK13 was screened for a certain extent asymmetric hydrolyze the rac-ketoprofen chloroethyl ester and identified as Bacillus megaterium. For the preparation of gene libraries, a positive clones was obtained from the tributyrin flat. The sequence of this esterase gene had been analysised, and contained the whole ORF of an esterase gene with the length of 933bp. The esterase gene of NK13 was compared with the esterase genes of GenBank and the result showed that the esterase gene of NK13 was a novel gene(GenBank accession nember DQ196347).The new esterase gene was inserted into the plasmid pET21b+, then the recombinant plasmid transformed E.coli BL21. After being induced by IPTG, it was expressed in the host strain. SDS-PAGE analysis showed that the relative molecular mass of the esterase was about 34kDa. The result of TLC and HPLC showed that the recombinant strain had higher conversion ration than templet strain. 47.4%of the rac-ketoprofen Chloroethl ester was hydrolyzed to ketoprofen by the recombinant strain in 45min. The (S)- ketoprofen enantiomeric excess, in the later,was 55.46%, which indicated that the esterase could hydrolyze (S)-ketoprofen chloroethyl ester firstly.

OBJECTIVETo observe the clinical efficacy of acupuncture at Hegu (LI 4) on central facial nerve paralysis after ischemic stroke, and explore dose-effect relationship among different stimulation intensities of acupuncture at Hegu (LI 4) as well as its optimal treatment plan.

METHODSAccording to different acupuncture stimulation intensities which were based on treatment time and needle insertion direction, fifty patients were randomly divided into a Hegu 1 group, a Hegu 2 group, a Hegu 3 group, a Hegu 4 group and a control group, ten cases in each one. Different stimulation intensities of acupuncture at Hegu (LI 4) combined with facial paralysis acupoints, including Yingxiang (LI 20), Dicang (ST 4), Jiache (ST 6) and Quanliao (SI 18), were applied in Hegu 1 to 4 groups; meanwhile acupuncture at stroke acupoints, including Neiguan (PC 6), Shuigou (GV 26) and Sanyinjiao (SP 6), and medication treatment were adopted. Except acupuncture at Hegu (LI 4), the treatment of the control group was identical as Hegu groups. The treatment duration lasted for 14 days. The House-Brackmann facial never grading systems (H-B), Toronto facial grading system (TFGS), degrees of facial never paralysis (DFNP), facial disability index (FDI) and clinical efficacy were compared among groups.

RESULTS(1) Compared before the treatment, H-B, TFGS, DFNP and physical function score in FDI were all improved significantly in the Hegu 1 to 4 groups (all P < 0.05), but social function score in FDI was not obviously improved (all P > 0.05); all the scores in the control group were not evidently changed (all P > 0.05). (2) Compared with the control group, differences of H-B before and after treatment in the Hegu 1 to 4 groups, differences of TFGS in the Hegu 2 group and differences of DFNP in the Hegu 1 and Hegu 2 group were significantly improved (all P < 0.05). The differences of any scale among Hegu 1 to 4 groups were not significant (all P > 0.05), in which the most evident change was found in Hegu 2 group. (3) The total effective rate was 90.0% (9/10), 100.0% (10/10), 90.0% (9/10) and 80.0% (8/10) in Hegu 1 to 4 groups, which were significantly higher than 60.0% (6/10) in the control group (all P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI 4) has affirmative clinical efficacy on central facial nerve paralysis after ischemic stroke, in which oblique insertion along the opposite direction of meridian for 5 s of twirling manipulation has the best clinical effect.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Paralysis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

A 44-residue hybrid peptide (CB (1-24)-Arg-Ser-Tyr-Tan (4-21)) incorporating 1-24 residues of cecropin B (CB) and 4-21 residues of thanatin (Tan) was designed and constructed. The CB-Tan gene was cloned into expression plasmid pGEX-3X and expressed in E. coli BL21. The fusion protein was purified by affinity chromatography. After digested with enterokinase the gene product released with antibacterial activity and gave one band in Tricine-SDS-PAGE.
Amino Acid Sequence ; Anti-Bacterial Agents ; metabolism ; Antimicrobial Cationic Peptides ; Base Sequence ; Cloning, Molecular ; Escherichia coli ; genetics ; Insect Proteins ; biosynthesis ; Molecular Sequence Data ; Peptides, Cyclic ; biosynthesis ; Recombinant Fusion Proteins ; biosynthesis ; isolation & purification ; pharmacology

Objective To investigate the protective effect of Astragalus on islet β cell apoptosis in vivo.Methods Fifty-six healthy male mice were divided into control group,diabetic mellitus (DM) group,and Astragalus pretreatment group.After pretreatment with different doses of Astragalus,each group of mice received intraperitoneal injection of Streptozotocin(STZ) in order to induce DM,and then the incidence of DM was observed.Serum nitric oxide (NO)was measured by the nitratase method,the activity of induced nitric oxide synthase(iNOS) was measured by chemical colorimetric method,and insulin level was detected by enzyme linked immunosorbent assay method.Insulitis score was evaluated according to pancreatic histology.Islet β cell apoptosis was measured by using a terminal dexynucleotidyl transferase(TdT)-mediated dUTP nick end labeling assay.Results 1.DM attack began 1 week after STZ injection in DM group.Pretreatment with 30 g/(kg · d) of Astragalus,DM appeared 2 weeks after STZ injection.Compared with DM group,the onset of DM was delayed,and the incidence of DM was significantly reduced(P ＜ 0.01).After pretreatment with 15 g/(kg · d) of Astragalus,the DM began 1 week after STZ injection,compared with DM group,the incidence of DM was reduced,but there was no statistical difference(P ＞ 0.05).2.Compared with DM group,after pretreatment with 30 g/(kg · d) of Astragalus,the activity of iNOS was significantly inhibited(all P ＜ 0.01),and then NO level significantly declined(all P ＜ 0.01),and the insulitis score and apoptosis of β cells were also significantly decreased (all P ＜ 0.01) ;after pretreatment with 15 g/(kg · d) of Astragalus,there was no statistical difference in all the indexes (all P ＞ 0.05).Conclusions Astragalus can protect islet β cells of mice in vivo,which is associated with its inhibition on the iNOS activity,reduction on NO generation,and can decrease β cells insulitis and apoptosis.Therefore,improving the body free radicals scavenger ability may prevent and delay the occurrence of DM.

Objective To evaluate the clinical features of Rathke cleft cysts(RCCs) in children diagnosed by pituitary magnetic resonance(MR) and their features on MR.Methods Twenty-two children with RCCs aged 2-18 years old who visited the Affiliated Hospital of Qingdao University Medical College between Jan.2002 and Feb.2012 were enrolled.RCCs was conformed by pituitary MR.The clinical symptoms and imaging features were reviewed retrospectively.Results The clinical presentation of symptomatic children were as follows:endocrinopathy in 13 cases (59.1％),headache in 5 cases(22.7％) and visual disturbance in 1 case(4.5％) and variety of symptoms in 3 cases (13.6％),which including 1 case of short stature and dysgenitalism,1 case of type 1 diabetes with electrolyte disorder and the other of headache associated with visual impairment.Endocrinopathy included short stature 5 cases(22.7％),precocious puberty 4 cases(18.2％)and diabetes insipidus 4 cases(18.2％).Generally,RCCs appeared various on Tl-weighted MR,whereas on T2-weighted sequences the signal intensity was mostly high.High signals in the T1-weighted image on brain MR were related to pituitary hormone deficiency.Hypointensity of the cysts in T1-weighted was appeared when enhanced images.Conclusions The most common clinical manifestation of children with RCCs is endocrinopathy.Pituitary MR shows a certain characteristics and it is favorable in agreement with pathological diagnosis.MR may be of predictive value for the preoperative diagnosis.