Objective:To observe the characteristics of early changes in choroidal thickness and choroidal microvascular morphology in the macula of patients with systemic lupus erythematosus (SLE) using swept-source optical coherence tomography angiography (OCTA).Methods:A cross-sectional study was conducted.Thirty-seven patients (37 eyes) who were diagnosed with SLE without obvious ocular symptoms in Hebei General Hospital from January 2022 to July 2022 were enrolled in this study as a SLE group.At the same time, 35 normal adults (35 eyes) matched with age and sex were included as a control group.Swept-source OCT was used to perform a 9 mm×9 mm radial scan of the macular region of subjects to obtain the average choroidal thickness of the macular central concave area, the paracentral concave area (1-3 mm), and the pericentral concave area (3-6 mm). OCTA was used to perform a 3 mm×3 mm scan of the macular region and images of retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) blood flow density, choroidal capillary plexus (CC) blood flow density, and microvascular blood flow in the macular region were obtained and binarized using ImageJ software (Phansalkar method) to calculate the choroidal capillary flow void area (FDa) and percentage of flow deficits (FD%). The study protocol followed the Declaration of Helsinki and was approved by the Ethics Committee of Hebei General Hospital (No.202310). Informed consent was obtained from all subjects.Results:The choroidal thickness of the subfoveal region in SLE group was (268.73±81.67)μm, which was significantly higher than (230.14±68.14) μm of control group ( t=2.170, P=0.033). The blood flow density of SCP, DCP and CC in the macular central zone area of SLE group were (16.58±3.90)%, (14.25±3.15)% and (51.80±4.27)%, respectively, which were significantly lower than (20.55±4.41)%, (16.57±3.74)% and (54.33±3.41)% of control group ( t=-4.043, -2.851, -2.763; all at P<0.05). The FDa and FD% in SLE group were 3.43(3.25, 3.56)mm 2 and 38.11%(36.13%, 39.52%), which were greater than 3.25(3.21, 3.32)mm 2 and 36.11%(35.64%, 36.84%) of control group, and the differences were statistically significant ( Z=-3.470, -3.476; both at P<0.05). Conclusions:OCTA can detect an increase in choroidal thickness and a decrease in blood flow density of CC in eyes with SLE without obvious ocular symptoms.

Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.

3-Deoxy-D-manno-octulosonate 8-phosphate synthase (KDO8PS) is the key enzyme to synthesize eight-carbon sugar in plant and gram-negative bacterial cell wall. To analyze the polymerization and characterization in plant KDO8PS, the candidate gene was cloned from fresh Phyllostachys edulis seedling by RT-PCR. The open reading frame of PeKDO8PS is 876 bp deduced into 291 amino acid residues. The target protein was overexpressed in Escherichia coli induced by IPTG and then lager amount of fusion protein was purified through two-step methods with affinity chromatography and size-exclusion chromatography (SEC). SEC analysis shows that PeKDO8PS protein existed mainly in the form of dime in solution. Glutaraldehyde cross-linking experiments confirmed that the enzyme could form dimers. Further we identified that KDO8PS at high concentration two dimers could form tetramer in aqueous solution by analytical ultracentrifuge (AUC) analysis. The pH of the catalytic reaction was between 4.0 and 9.0, the optimum pH value was 8, the thermal stability range was between 25 and 65 ℃, and the optimum temperature was about 55 ℃. The enzyme activity was inhibited by some metal ions at lower concentrations, especially in the presence of Fe3+metal ion and activated by metal protease inhibitor EDTA at low concentration.

Brain injury in preterm infants is an important reason for making the newborn disability.Neonatal cerebral injury of imaging examination method has a time lag.Looking for a simple,timely,accurate predictor of biological markers of brain injury in preterm infants is particularly important.In this paper,the role of S100B protein,glial fibrillary acidic protein and neuron-specific enolase of brain injury in preterm infants was reviewed,and the significance of early diagnosis of brain injury in preterm infants was discussed.

Objective To investigate the expression of CXCR4 and CXCL12 in the labial gland of patients with primary Sj?gren's syndrome (pSS), and to explore their role in the pathogenesis of pSS. Methods The expression of CXCR4 and CXCL12 in labial gland tissues was detected by immunohistochemistry in 32 cases of newly diagnosed pSS and 30 cases of oral mucosa cysts or trauma patients. The expression level, intensity and location were analyzed and compared statistically. χ2 test and Spearman correlation analysis were used for statistical analysis. Results The positive rate of CXCR4 in the test group was 91%(n=29), which was significantly higher than that in the control group (33%, n=10, χ2=21.77, P=0.001). The positive rate of CXCL12 in the test group was 97%(n=31), which was significantly higher than that in the control group 40%(n=12), and the difference was statistically significant ( χ2=23.57, P=0.001). Conclusion CXCR4 and CXCL12 are highly expressed in labial gland of pSS patients, this suggests that they participate in the pathological process of pSS local inflammatory response and play an important role in pSS pathogenesis.

Objective To survey and analyze the factors that may affect the results of human-ities education about master degree postgraduates, and provide the basis and reference for traditional medical humanities education reform. Methods By using the self-made questionnalre, a survey was conducted among 100 medical postgraduates of a university. Questionnalre items included basic infor-mation of the postgraduates, humanities-related extracurricular experiences, whether there had been personal experiences corresponding to these options or these experiences affected the attitude of hu-manistic education options. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number. The differences between different gender, marriage and differ-ent specialty student satisfaction were analyzed by using chi-square test or Fisher's exact test, showing no statistical significance (P>0.05). Results Respondents believed that the highest rate of the top four which supported the experiences that promoted humanistic education were clinic volunteer activi-ties, interpersonal harmony, rescuing the patient experiences and illness experiences, accounting for 95.8%(91/95), 92.6%(88/95), 89.5%(85/95) and 88.4%(84/95), respectively. On the other hand, the highest rate of the top four that impeded humanities education-related experiences were academic stress, workload, limited communication and lack of humane care, accounting for 100.0% (95/95), 95.8%(91/95), 91.6% (87/95) and 84.2% (80/95) respectively. In addition, different types of students' attitude towards experiences that may have impact on the humanistic education were not statistically significant (P>0.05). Conclusion Humanities education in medical colleges should not be limited to classroom instruction form. We should broaden humanistic education approach, flexible assessment methods of humanities, to enhance the effect of humanities education.

Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.

Autoimmune Diseases ; drug therapy ; Hepacivirus ; Hepatitis C ; drug therapy ; Humans ; Interferons ; therapeutic use

Objective To investigate the incidence of retinopathy of prematurity (ROP) in our hospital and to explore the risk factors of ROP.Methods Premature infants hospitalized in our hospital in January 2010 to December 2012 were chosen,and the gestational ages were less than 36 gestational weeks,birth weights were under 2 500 g.All the cases underwent ROP screening at two weeks after birth,and then they received regular follow-up.Children with systemic conditions and oxygen to the mother during pregnancy,oxygen,preeclampsia,placental abruption,and other factors were analyzed.Results Two hundred and fifty-five cases completed the retinal screening,terminated follow-up after the peripheral retinal neovascularization or disease degradation.We found ROP in 16 cases (26 eyes),ROP prevalence rate was 6.3％ (5.1％),including phase Ⅰ 12 cases,phase Ⅱ3 cases,phase Ⅲ 1 case.Gestational age,birth weight,inhale oxygen time,oxygen concentration,mechanical ventilation were associated with ROP (P ＜ 0.05).Mother oxygen during pregnancy,preeclampsia,placental abruption had nothing to do with the incidence of ROP.Conclusion Premature birth,high concentrations of oxygen,mechanical ventilation are major risk factors of ROP.Timely screening of ROP and found early to do the retinal laser photocoagulation in premature,can control the disease,reduce the blindness rate of premature infants.

Objective To explore the value of procalcitonin (PCT) in diagnosis and treatment of neonatal ventilator associated pneumonia(VAP).Methods Sixty neonates needed invasive mechanical ventilation admitted to our NICU from Jan 2012 to Dec 2013 were divided into VAP group (30 cases) and nonVAP group (30 cases),depending on whether the neonates developed to VAP or not in 7 days.The VAP group then was randomly divided into PCT group (15 cases) and control group(15 cases) according to random number table.The levels of serum PCT,C-reactive protein(CRP) and WBC count were detected when the neonates suspected VAP before and after mechanical ventilation.Besides,the sensitivity,specificity,positive and negative predictive values for PCT,CRP and WBC were calculated in the diagnosis of VAP.Results The serum levels of PCT in VAP group had significant difference before and after mechanical ventilation (t =1.58,P =0.000),the levels of PCT were (0.37 ± 0.25) μg/L and (2.17 ± 1.46) μg/L respectively.The levels of PCT in non-VAP group had no significant difference (t =3.67,P =0.055).The levels of CRP and WBC showed no significant differences between VAP and non-VAP group before mechanical ventilation (P ＞ 0.05).Taking PCT ≥0.40 μg/L,CRP≥ 28 mg/L and WBC ≥ 10 × 109/L as the cut off value,the sensitivity of the three indicators diagnosis of VAP were 93.3％,73.3％ and 66.7％ respectively.PCT had the highest sensitivity 93.3 ％,specificity 73.3％,positive predictive 77.8％ and negative predictive 91.7％.The antibiotic duration of PCT group was (12.6 ± 5.6) d compared with (15.1 ± 9.1) d in control group (P =0.018).Conclusion Serum PCT has high sensitivity and specificity in the diagnosis of VAP,PCT combined with clinical pulmonary infection score can improve the diagnostic accuracy of VAP,early diagnosis and timely monitoring of serum PCT is helpful in VAP.PCT guidance substantially reduces antibiotic use in VAP,so that timely surveillance of PCT is necessary for patients on ventilator.