Background In recent years,with the contiunous progress of the refractive surgery,the operation skill of phakic intraocular lens(PIOL)implantation for correcting extreme high myopia,astigmatism,farsightedness have made greater progression,and its security,effectiveness in clinical attract much more attention. Objective This study was to evaluate the efficacy,safety and stability of Toric Implantable Collamer Lens(TICL)for extreme high myopic astigmatism. Methods This retrospective case series included 33 eyes of 27 patients from May 2008 to February 2009.A TICL was intraocularly implanted via a 3 mm clear corneal incision after paraocular anesthesia.Patients were examined preoperatively and followed-up at 1 day,1 week,1 month,3,6,12 and 18 months postoperatively.The examinations included uncorrected visual acuity,best corrected visual acuity(BCVA),slit lamp examination,refraction,intraocular pressure,endothelial cell morphometry,etc.The written informed consent was obtained from each patient before any medical procedure. Results The uncorrected visual acuity in 96.97% eyes was equal or improved after operation in comparison with BCVA of preoperation.The spherical refraction was within-1.00 D-+0.25 D.The cylinder refraction was within-1.00 D-0 D.The axial deviation of TICL within 10 degree was 93.94%(31/33).No significant differences were found in the intraocular pressure and endothelial cell morphometry between preoperation and postoperation(intraocular pressure:F=3.35,P=5.49;endothelial cell morphometry:t=1.835,P=0.082).The visual acuity and refraction were stable during the follow-up.Astigmatic axial rotation required surgical intervention on one eye.One eye occurred high intraocular pressure because of bigger TICL diameter.The intraocular pressure returned to normal after TICL was exchanged.No cataract occurred during the follow-up duration. Conclusion TICL implantation appears to be an effective,safe and reliable method for extreme high myopic astigmatism.

OBJECTIVETo evaluate the effect of epilepsy on sleep in children.

METHODSWhole night polysomnography was performed in 48 epileptic children and 12 healthy controls. The 48 epileptic children were divided into focal seizure and generalized seizure groups and into waking seizure and sleeping seizure groups according to the time of occurrence of the seizures. Various parameters of sleep structure were analyzed.

RESULTSThe sleep efficiency of epileptic children was significantly lower than that of the healthy controls (85.4 +/- 8.6% vs 90.9 +/- 5.8%; P < 0.05). The total recording time (TRT) of sleep was significantly longer and the sleep efficiency was significantly lower in the focal seizure group compared to the control group (P < 0.05). The percentage of stage 1 non-rapid-eye-movement sleep (S1 sleep) increased and the percentage of rapid-eye-movement (REM) sleep decreased in the generalized seizure group compared to the control group (P < 0.05). The percentage of S1 sleep increased and both the percentage of REM sleep and the sleep efficiency decreased in the sleeping seizure group as compared with the control group (P < 0.05). There were no significant differences in the parameters of sleep structure between the waking seizure and the control group. Among the sleeping seizure group, the children with generalized seizure showed significantly lower REM sleep percentage and sleep efficiency, and those with focal seizure had significantly longer TRT and higher S1 sleep percentage as compared with the controls.

CONCLUSIONSEpilepsy affects sleep structure of patients, and different types of seizure have different influences on sleep structure. Children with generalized seizure have prolonged light sleep and shortened REM sleep. When generalized seizures occur during waking, the increase of light sleep is more pronounced. While generalized seizures occur during sleeping, REM sleep reduction is more prominent. Children with focal seizures have decreased sleep efficiency. When focal seizures occur during waking, the sleep structure of patients is normal. However, when seizures occur during sleeping light sleep increases and sleep efficiency decreases.

Adolescent ; Child ; Child, Preschool ; Epilepsy ; physiopathology ; Female ; Humans ; Infant ; Male ; Polysomnography ; Sleep Stages ; physiology

Objective:To analyze thalassemia genotypes and distribution of children in Wuzhou Guangxi,and evaluate the diagnostic value of HbA2 in children's thalassemia screening,so as to provide scientific evidence for the prevention and control strategies of thalassemia.Methods:Four hundred and fifty-eight children suspected with thalassemia in Wuzhou were enrolled from March 2017 to June 2022.The level of HbA2 was detected using Bio-Rad VARIANT Ⅱ Hb analysis system.The deletion of α-thalassemia was measured with gap-PCR assay,and the point mutation of α-and β-thalassemia was tested with DNA reverse dot blot hybridization assay.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of HbA2 for children's thalassemia.Results:A total of 304 thalassemia carriers were detected in 458 children,accounting for 66.38％.One hundred and seventy-five cases were defined to be α-thalassemia,with the main type of--SEA/αα(54.86％).Thirty-six cases were defined to be intermediate α-thalassemia,with the main type of-α3.7/--SEA(9.72％).In 108 cases with β-thalassemia,βCD41-42/βN was the main type,accounting for 49.07％,followed by βIVS-Ⅱ-654/βN(14.81％).Seven cases were moderate/severe β-thalassemia(predominantly β-28/β-28 and βCD41-42/βCD17)Twenty-one genotypes of α-and β-thalassemia were found in the children.There was significant difference of HbA2 level between the children with different types of thalassemia and healthy controls(all P＜0.001).ROC curve analysis showed that the sensitivities of HbA2 for α-thalassemia,β-thalassemia and αβ-thalassemia were 74.3％,82.4％and 85.7％,with the optimal cut-off values of 2.60％,3.60％and 3.70％,respectively,the specificities were 64.3％,96.1％and 96.8％,and the area under the curve were 0.690,0.887 and 0.916,respectively.Conclusion:The thalassemia genotypes of children in Wuzhou are diverse.It is necessary to further strengthen the prevention and control measure of thalassemia to reduce birth defects and improve birth quality.

BACKGROUND:At present,most of the experiments on the treatment of skin wound by mesenchymal stem cells have been performed in rats,mice and rabbits,while the research on skin wound treatment by canine bone marrow mesenchymal stem calls is less reported.OBJECTIVE:To observe the effect of canine bone marrow mesenchymal stem calls on skin wound healing.METHODS:A 3 cmx3 cm wound was made on the both sides of the scapula and buttocks of the dog,with the right side as experimental group and the left side as control group.After the wound was made,allogeneic canine bone marrow mesenchymal stem calls suspension was injected subcutaneously around the wound in the experimental group on the 1st and 3rd days.The control group was injected subcutaneously around the wound with mesenchymal stem call culture medium on the 1st and 3rd days after the wound was made.Wound healing was observed dynamically in both groups.RESULTS AND CONCLUSION:In the 1st week,there were pale yellow inflammatory substances in the wound of two groups indicating obvious inflammations.Compared with the control group,the inflammatory substances were fewer and the growth rate of the granulation tissue was faster in the experimental group.From the 2nd week until the wound healing,epithelialization on the wound became obvious following the formation of the granulation tissue,which was mainly displayed by the formation of fresh epithelial tissues from the surrounding to the wound center.The epithelialization time of the experimental group was earlier than that of the control group,and the wound area of the experimental group was smaller than that of the control group.In the 3rd week,the wound in the experimental group healed completely,and became smoother than that in the control group.The wound area of the experimental group was slightly smaller than that of the control group on the 8th and 12th days after cell transplantation,and the healing speed of the experimental group was slightly faster than that of the control group,but there was no significant difference between the two groups.Our findings indicate that the transplantation of canine bone marrow mesenchymal stem cells has the possibility or trend to promote skin wound healing.

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022). Conclusion: De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.
Disease-Free Survival ; Female ; Humans ; Lymphoma, Follicular ; Male ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo study the prevalence rates of birth defects in high and low risk areas in China.

METHODSA population-based surveillance system on birth defects was used to obtain the prevalence rates of 24 kinds of major external birth defects from > or = 20 weeks of gestation to 7 days of life in selected areas in Shanxi and Jiangsu provinces.

RESULTSThe birth prevalence of birth defects (232.4 per 10,000 births) and neural tube defects (NTDs) (138.7 per 10,000 births) in four counties of Shanxi province were significantly higher than that in Taiyuan city (75.3 and 28.2 per 10,000 births, respectively). There was no significant difference for all selected birth defects between Wuxi city and Xishan counties in low risk areas. There was a 6.1-fold of higher prevalence for NTDs in Taiyuan city compared with that in Wuxi areas (4.6 per 10,000 births). In four counties of Shanxi province, the prevalence rates of anencephaly, spina bifida, hydrocephaly, cleft palate alone and polydactyly were significantly higher than in Wuxi areas. The NTDs prevalence rate in four counties of Shanxi was 30.2 times higher than in Wuxi areas. When compared with previous surveillance data, the NTDs prevalence rate did not present obvious declining trend in high risk areas. The birth prevalence rate had a 31.8% decrease when births were calculated after 28 gestational weeks and compared with those from 20 gestational weeks.

CONCLUSIONNTDs remained to be the most common birth defect seen in Shanxi province. The birth prevalence rate of NTDs in some areas of Shanxi province was among the highest that ever reported in the world in comparison with data from other countries and regions. The current prevalence rate in high risk areas in Shanxi province did not clearly show a declining trend. Programs on surveillance and prenatal diagnosis were proved to have made big impact on the rates of major external birth defects.

China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Humans ; Male ; Neural Tube Defects ; epidemiology ; Prevalence ; Surveys and Questionnaires

BACKGROUNDAstigmatism is one of the most significant obstacles for achieving satisfactory visual function. This study was to evaluate the influence of astigmatism on contrast sensitivity (CS) and higher-order aberrations.

METHODSCS, accommodation response and wavefront aberration were measured in 113 patients with astigmatism, aged 18 - 36 years. Both single and binocular visual performance were examined under four lighting conditions: photopia, photopia with glare, scotopia and scotopia with glare respectively. Accommodation response was classified as normal, abnormal and low. The contribution of the power and axis of astigmatism to CS, accommodation response and wavefront aberration was analyzed.

RESULTSAs the dioptric power of astigmatism increased, the loss of CS spatial frequency changed from high to intermediate, and then to low frequency. CS scores varied at different illuminance levels, descending in the following sequence: photopia, photopia with glare, scotopia, and scotopia with glare. However, the normal accommodation group showed better CS values under photopia with glare than without glare. The range of influenced direction of sine-wave gratings remained mostly at the meridian line of high dioptric power, which would be expanded when optical accommadation attenuated. The patients with symmetrical astigmatism got higher CS scores with binoculus vision than with dominant eye vision, while the patients with asymmetrical astigmatism did this only at scotopia with glare. Among higher-order aberrations, coma aberration, secondary coma aberration and the total higher order aberration were influenced by astigmatism, all of which rising with the power of astigmatism increased.

CONCLUSIONSReducing astigmatism might improve the performance of visual function. Not only the power of astigmatism should be cut down, but also the binocular axes should be made symmetrically.

Adolescent ; Adult ; Astigmatism ; physiopathology ; Contrast Sensitivity ; Female ; Humans ; Male ; Vision, Ocular

Adolescent ; Eisenmenger Complex ; pathology ; therapy ; Female ; Heart-Lung Transplantation ; Humans ; Treatment Outcome

OBJECTIVETo explore possible interrelationships among resistance to peer pressure, risky decision-making and health risk behaviors among young adolescents.

METHODSBased on the cluster sampling method, the participants who were recruited from 5 junior middle schools in Guangzhou and 3 junior middle schools in Shenyang city on October, 2010, were administered to complete the questionnaire concerned with their experiences with drinking and smoking during the past 30 days preceding the survey, and the hours using computer daily both in weekdays and in weekend. The level of resistance to peer influence and risky decision-making were assessed by Resistance to peer influence scale (RPIS) and Youth decision-making questionnaire (YDMQ). Logistic regression was used to explore possible interrelationships among resistance to peer influence, risky decision-making and health risk behaviors among young adolescents.

RESULTSA total of 1985 questionnaires were valid, including 1001(50.4%) boys and 984 (49.6%) girls. About 27.1% (537/1985) junior middle school students reported having health risk behaviors, boys' (30.7%, 307/1001) was higher than girls' (23.4%, 230/984) with significant gender difference (P < 0.05). The prevalence of smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend were 5.1% (102/1985), 14.3% (284/1985), 3.5% (70/1985) and 13.7% (272/1985), respectively. The rate of drinking, using computer over 3 hours daily in weekdays and in weekend were higher in males (16.4% (164/1001), 4.5% (45/1001), 16.2% (162/1001)) than those in females (12.2% (120/984), 2.5% (25/984), 11.2% (110/984)) (P < 0.05). The scores of RPIS and YDMQ of the two cities adolescents were 2.82 ± 0.39 and 1.68 ± 0.62. The students reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekend gained lower RPIS scores (2.43 ± 0.40, 2.61 ± 0.41, 2.77 ± 0.40) than their counterparts who didn't report these kind of health risk behaviors (2.84 ± 0.38, 2.85 ± 0.38, 2.82 ± 0.39)(P < 0.05). And those reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend gained higher YDMQ scores (2.38 ± 0.66, 2.06 ± 0.66, 1.97 ± 0.72, 1.84 ± 0.64, respectively) than their counterparts who didn't report these kind of health risk behaviors (1.64 ± 0.38, 1.61 ± 0.58, 1.67 ± 0.61, 1.65 ± 0.61, respectively) (P < 0.05). After adjusting gender, area, parental education degree, self-reported family economic condition, multi-variant logistic regression analysis indicated that the low and middle level of resistance to peer influence (low and middle level vs high level, had odds ratios of 2.97 (1.96 - 4.50) and 1.51 (1.05 - 2.16)), and also the middle and high level of risky decision-making (middle and high level vs low level, had odds ratios of 1.62 (1.19 - 2.22) and 3.43 (2.39 - 4.90)) were all the risk factors of adolescent health risk behaviors.

CONCLUSIONAdolescents with poor ability of resistance to peer pressure and high risky decision-making were both the risk factors of adolescent health risk behaviors.

Adolescent ; Child ; Cross-Sectional Studies ; Female ; Health Behavior ; Humans ; Logistic Models ; Male ; Peer Group ; Risk Assessment ; Risk-Taking ; Surveys and Questionnaires

BACKGROUNDAlthough the results of surgical treatment in cardiac valve disease continue to improve, the postoperative mortality rate and the rate of complications in patients with advanced valvular heart disease (AVHD) are still very high. We did this retrospective study to summarize the surgical experience of heart valve replacement for patients with AVHD and discuss effective ways to improve the surgical outcome.

METHODSFrom January 1994 to October 2003, surgical procedures of heart valve replacement were performed on 227 (136 men and 91 women) patients with AVHD in our Department of Cardiothoracic Surgery. The clinical data of all patients were collected and analysed. Patients' age ranged from 10 years to 77 years. In preoperative cardiac function grading, 157 cases were NYHA III and 70 cases NYHA IV. Fifty-one patients had had cardiac operations. The ultrasonic cardiac graphs showed that 145 patients suffered from moderate or severe pulmonary hypertension and 73 had combined giant left ventricle. Mitral valve replacement was performed in 32 cases, aortic valve replacement in 90, tricuspid valve replacement in 1, combined mitral and aortic replacement in 103 and combined mitral and tricuspid replacement in 1. Nineteen patients also received surgical corrections for other minor abnormalities during the operations. A logistic model was established to evaluate the influence of perioperative factors on the mortality rate.

RESULTSThe operative mortality rate was 13.2% (30/227). The main causes of death included multiple organ dysfunction syndrome (MODS), low cardiac output syndrome and ventricular fibrillation. From the results of the binary noncounterpart multivariate logistic regression, the following statistically significant factors were found to influence the operative mortality rate: redo operation, age >/= 55 years, preoperative NYHA cardiac function grading, extracorporeal circulation time >/= 120 minutes and postoperative usage of GIK (glucose, insulin and potassium) solution. All factors were risk ones except postoperative application of GIK. The Hosmer-Lemeshow goodness of fit coefficient of this model was 0.976.

CONCLUSIONSThe risk factors associated with postoperative mortality rate in the patients with AVHD were redo operation, age >/= 55 years, preoperative NYHA cardiac function grading and extracorporeal circulation time >/= 120 minutes. Postoperative usage of GIK acted as a kind of metabolic therapy and will improve the recovery for patients with AVHD. Active perioperative management and care will play a very important role in reducing the operative risk and improving the short term outcome of surgical treatment for the patients with AVHD.

Adolescent ; Adult ; Aged ; Cause of Death ; Child ; Female ; Glucose ; pharmacology ; Heart Valve Diseases ; diagnosis ; physiopathology ; surgery ; Heart Valve Prosthesis Implantation ; Humans ; Insulin ; pharmacology ; Male ; Middle Aged ; Potassium ; pharmacology ; Retrospective Studies ; Risk Factors