Objective To analyze the factors affecting the prognosis of elderly patients with severe craniocerebral injury.Methods Retrospective analysis of the clinical data of 1 047 elderly patients with severe craniocerebral injury admitted to the department of neurosurgery of Tianjin First Central Hospital from January 1997 to December 2021,including gender,Glasgow coma scale(GCS),injury factors and injury types,and treatment after admission.According to Glasgow outcome scale(GOS),good condition,mild disability,severe disability are considered as effective treatment,while persistent vegetative state and death are considered as ineffective treatment.Univariate and multivariate Logistic analysis of risk factors affecting the prognosis of patients with severe craniocerebral injury.Results Among the 1 047 patients,612(58.45%)were effectively treated,and 435(41.55%)were ineffective.The inefficiency of treatment in patients with intracranial hematoma was significantly higher than that of patients without intracranial hematoma[53.8%(342/636)vs.22.6%(93/411)],the treatment inefficiency of patients with complex injuries was significantly higher than that of patients with simple craniocerebral injury[62.4%(249/399)vs.28.7%(186/648)],the treatment inefficiency of patients with GCS scores of 3-5 was significantly higher than that of patients with GCS scores of 6-8[64.8%(243/375)vs.28.6%(192/672)],all differences were statistically significant(all P<0.05).There was no significant difference in the treatment inefficiency between males and females,or between patients with and without skull fractures[42.2%(294/696)vs.40.2%(141/351)and 37.9%(69/182)vs.42.3%(366/865),respectively,all P>0.05].Multivariate Logistic analysis showed that intracranial hematoma[odds ratio(OR)= 2.266,95%confidence interval(95%CI)was 1.656-3.103],type of injury(OR = 1.816,95%CI was 1.279-2.578)and GCS score(OR = 2.262,95%CI was 1.582-3.234)were independent prognostic factors for elderly patients with craniocerebral injury(all P<0.05).Conclusion To reduce the morbidity and mortality,it is crucial to address the factors that impact the prognosis of elderly patients with severe craniocerebral injury,by reducing the occurrence of intracranial hematoma and multiple injuries,as well as closely monitoring GCS scores,patient outcomes can be improved to a certain extent.

Objective:To explore the expression of long non-coding RNA(lncRNA)ZIM2-AS1 in hepatocellular carcinoma(HCC)and its clinical significance as well as diagnostic value using the data obtained from the Cancer Genome Atlas(TCGA).Meth-ods:The transcriptome sequencing(RNA-seq)data and clinical information of 374 HCC tissues and 50 paired paracancerous tissues were gathered from the TCGA database,then the expression trends of ZIM2-AS1 in HCC and its correlation with clinicopathological features,prognosis,immune cell infiltration,as well as diagnostic value was inspected by bioinformatics analysis using relevant R packages.The expression of ZIM2-AS1 in human normal liver cell line and HCC cell lines was examined by qRT-PCR.Results:The ex-pression of ZIM2-AS1 was highly expressed in HCC tissues(P<0.001),and its expression level was significantly correlated with age,gender,N stage,histologic grade and AFP level(P all<0.05).The overall survival(OS)and disease specific survival(DSS)of patients with high ZIM2-AS1 expression were significantly shorter than those of patients with low expression(P<0.05),and ZIM2-AS1 was an in-dependent risk factor affecting OS.Immune cell infiltration analysis showed that ZIM2-AS1 was closely related to the infiltration of Th2 cells,CD56brightNK cells,follicular helper T cells(Tfh),neutrophils and plasmacytoid dendritic cells(pDC)(|Spearman's r|>0.1,P<0.05)in HCC.ROC curve analysis revealed that the expression level of ZIM2-AS1 possesse potential diagnostic value in HCC,N0 stage,histologic grade G1 and G2,OS and DSS(AUC all>0.50).qRT-PCR results showed that the expression level of ZIM2-AS1 in HCC cell lines was significantly higher than that in human normal liver cells(P all<0.05).Conclusion:The elevated expression of lncRNA ZIM2-AS1 is an independent risk factor for poor prognosis of HCC patient and has potential application value as a biomarker for HCC diagnosis,prognosis as well as tumor immune microenvironment assessment.

Objective:To analyze the prevalence of poor vision and spatial distribution characteristics among primary school students in Shenzhen.Methods:A cross-sectional study was conducted.Vision screening among primary school students in Shenzhen was carried out by myopia screening hospitals organized by Shenzhen Myopia Prevention and Control Center for Children and Adolescents using the logarithmic visual acuity chart in 2019.The prevalence of poor vision in different districts, different genders and different grades was calculated.Spatial distribution of the prevalence of poor vision was analyzed with Arcgis 10.2 software.This study adhered to the Declaration of Helsinki.Written informed consent was obtained from guardian of each subject.The study protocol was approved by an Ethics Committee of Shenzhen Eye Hospital (No.20201230-06).Results:A total of 1 044 545 students received the visual acuity examination.The prevalence of poor vision among primary school students in Shenzhen in 2019 was 53.4%(557 748/1 044 545). The prevalence of poor vision among primary school students in the former Shenzhen Special Economic Zone was 56.7%(172 771/304 532), which was higher than 52.0%(384 977/740 013) in areas outside the former Shenzhen Special Economic Zone, and the prevalence of poor vision among girls was 56.7%(268 201/473 164), which was higher than 50.7%(289 547/571 381) among boys, and the differences were statistically significant ( χ2=192.412, 375.434; both at P<0.001). As the grade increased, the prevalence of poor vision firstly decreased and then increased, showing an increasing tendency in general.The prevalence rate of poor vision among primary school students among grade 1 to 6 was 49.8%(99 615/200 203), 44.0%(86 521/196 800), 47.2%(82 848/175 331), 54.5%(89 737/164 731), 60.8%(96 271/158 298), and 68.9%(102 756/149 182), respectively, and a significant difference was found ( χ2=2 871.017, P<0.001). The global Moran I index in Shenzhen was 0.278.The local Moran I index and Geary coefficient in Guangming District were 0.933 and 0.78, respectively.The prevalence of poor vision in Guangming District and its surrounding areas was a low-low cluster. Conclusions:The prevalence of poor vision among primary school students in Shenzhen is spatially aggregated.

Objective    To explore the predictive value of N-terminal-pro-brain natriuretic peptide (NT-ProBNP) for postoperative early outcomes in infants with aortic coarctation (CoA). Methods    A retrospective study was conducted in 344 children with CoA admitted to our hospital from September 2014 to October 2017, including 206 males (59.9%) and 138 females (40.1%), with an average age of 0.2-60.0 (7.1±10.6) months. The levels of NT-proBNP, clinical characteristics, imaging data and early follow-up results were collected and analyzed. Results    Compared with the normal NT-proBNP group, there were statistical differences in age, the proportion of RACHS-1≥3, the proportion of preoperative pneumonia and dysplastic aortic arch, preoperative cardiac function, left ventricular wall thickness, left ventricular dilatation, hospital stay, ICU duration, ventilator duration, duration of vasoactive drugs use, delayed chest closure, nasal continuous positive airway pressure (nCPAP), postoperative cardiac insufficiency in the abnormal NT-proBNP group (P<0.05). According to multivariate logistic regression analysis, NT-proBNP level (>3 000 pg/mL) was an independent risk factor for prolonged ICU duration [OR=3.17, 95%CI (1.61, 6.23)], prolonged ventilator duration [OR=5.84, 95%CI (2.86, 11.95)], prolonged use of vasoactive drugs [OR=2.22, 95%CI (1.22, 4.02)], postoperative cardiac insufficiency [OR=3.10, 95%CI (1.64, 5.85)]; NT-proBNP level (> 5 000 pg/mL) was an independent risk factor for delayed chest closure [OR=3.55, 95%CI (1.48, 8.50)]. Conclusion    NT-proBNP level in children with CoA can be affected by  many factors, including age, complexity of congenital heart disease, preoperative cardiac insufficiency, et al. The level of NT-proBNP has predictive value for postoperative early outcomes.

Objective    To explore the role of increased preoperative ventricular-arterial stiffening in hypertensive infants with coarctation of the aorta (CoA). Methods    A retrospective study was conducted in 314 infants with CoA (CoA group, 193 males and 121 females, aged 5.4±2.2 months), and 314 infants receiving tumor chemotherapy with normal cardiovascular function and without pneumonia (control group, 189 males and 125 females, aged 4.4±3.8 months), who were admitted to our hospital from 2015 to 2017. The clinical data of the two groups were compared. Results    There were statistical differences in effective aortic elastance index (Eai), effective left ventricular end-systolic elasticity index (Eesi), ventricle-artery coupling index (VACi), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and ratios of left ventricular hypertrophy, dilation and systolic dysfunction between the two groups (P<0.05). Compared with non-hypertensive CoA infants, CoA infants with hypertension had higher Eai, Eesi, NT-ProBNP level and proportion of left ventricular hypertrophy (P<0.05). Compared with concomitant ventricular septal defect, infants with isolated CoA had higher Eai, Eesi, NT-proBNP level, incidence of hypertension and higher proportion of left ventricular hypertrophy, dilation and systolic dysfunction (P<0.05). Eai and Eesi were positively correlated with NT-proBNP level, left ventricular hypertrophy and fractional shortening of left ventricle (P<0.05), while Eai and Eesi were negatively correlated with left ventricular end diastolic volume index, left ventricular end systolic volume index and concomitant ventricular septal  defect (P<0.05). Hypertension was related to preoperative left ventricular hypertrophy, Eai, Eesi and NT-ProBNP. Eai was an independent risk factor for hypertension. Conclusion    Preoperative ventricular-arterial stiffening is increased in infants with aortic coarctation, which is related to the occurrence of hypertension. Isolated CoA shows more significant increase in ventricular-arterial stiffening, higher ventricular overload and incidence of hypertension.

Objective    Pulmonary vein banding was used to establish a piglet model of pulmonary vein stenosis. We investigated the pathomorphological alterations of pulmonary veins in the model and compared it with the vascular tissue of recurrent stenosis after total anomalous pulmonary venous connection (TAPVC). Methods    Ten pigs of 6 weeks old were selected and randomly divided into 2 groups: 5 in a sham operation group and 5 in a pulmonary vein banding group. The operation had two stages, in which thoracotomies through intercostal space were done respectively on both sides. Biocompatible materials were applied around the pulmonary veins in the experimental group. The same method was used in the sham group. But the pulmonary veins were not banded. Six weeks after the operation, the pulmonary veins of the animals were harvested for hematoxylin-eosin staining and immunofluorescence staining to observe the pathological alterations of pulmonary veins. The proliferative tissues of patients with recurrent stenosis after TAPVC repair were collected and observed by hematoxylin-eosin staining and immunofluorescence staining. Results    Both the sham operation group and the pulmonary vein banding group survived. But the pulmonary vein banding group had obvious clinical manifestations of pulmonary venous stenosis. Compared with the sham group, the pulmonary vein banding group showed intimal hyperplasia, decreased expression of endothelial marker and increased expression of mesenchymal markers, and co-expression of endothelial and mesenchymal markers in intimal cells. Human pathology also showed intimal hyperplasia and co-expression of endothelial and mesenchymal markers in intimal cells. Conclusion    The surgical pulmonary vein stenosis in piglets shows intimal hyperplasia and myofibroblasts, which was consistent with clinical pathology.

Objective: To investigate the clinical effects of Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme in the treatment of advanced ovarian carcinoma in elderly patients. Methods: A total of 218 elderly patients with advanced ovarian carcinoma in our hospital were randomly divided into the observation and control group, 109 in each group. The control group was treated by TP scheme, while the observation group was treated by Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme. Both groups received 1 chemotherapy cycle at 3 weeks, and a total of 4 cycles of chemotherapy were followed up for 2 years. Quality of life was assessed by Functional Assessment of Cancer Therapy- ovarian Cancer v4.0 (FACT-OV4). Enzyme-linked immunosorbent assay (ELISA) was used to detect tumor markers, including Integrin-Linked Kinase (ILK), Hypoxic Inducible Factor-α (HIF-α), Human Epididymal Protein (HE4) and Epithelial-type calcium mucin (E-cadherin). The toxic and side effects of two groups were observed and the clinical efficacy was evaluated. The survival rate, total survival time and disease-free survival time were observed and recorded during follow-up. Results: The control rate and effective rate of the observation group were 90.8% (99/109) and 41.3% (45/109), respectively, and those of the control group were 64.2% (70/109) and 28.4% (31/109), respectively. The comparison of control rate and effective rate between the two groups were statistically significant (Z value were 4.002, 3.401, respectively, all Ps<0.05). After treatment, the ILK (12.31 ± 1.15 ng/L vs. 23.57 ± 2.32 ng/L, t=3.245), HIF-α (2.41 ± 0.22 mg/L vs. 6.67 ± 0.67 mg/L, t=3.596), HE4 (0.34 ± 0.03 pg/L vs. 1.24 ± 0.12 pg/L, t=3.621) levels in the observation group are significantly lower than those in the control group (P<0.05), while the E-cadherin (5.25 ± 0.56 ng/L vs. 2.52 ± 0.26 ng/L, t=3.434) was significantly higher than that in the control group (P<0.05). After treatment, the scores of functional status and social/family status in the observation group were significantly higher than those in the control group (t values were 3.282, 3.214, all Ps<0.05), and the scores of additional attention, emotional status and physiological status were significantly lower than those in the control group (t values were 3.121, 3.512, 3.526, all Ps<0.05). During the treatment period, the incidence of cardiac toxicity, liver toxicity, renal toxicity, bone marrow suppression, nausea and vomiting, abdominal pain and diarrhea in the observation group were significantly lower than those in the control group (χ² value were 4.947, 4.893, 4.525, 4.692, 4.637, 4.905, respectively, all Ps<0.05). During the follow-up, the 1, 2 year survival rate in the observation group was higher than those in the control group (χ² value were 3.782, 3.893, respectively, all Ps<0.05). Conclusions The Kangai-Guben-Xiaozheng decoction based on the theory of cancer pathogenesis, combined with TP regimen show effectiveness for the Ⅳ stage of ovarian cancer of the elderly patients.

Objective In order to evaluate the clinical curative effect of Guizhi-Fuling pill combined with conventional therapy for the patients with oviduct obstructive infertility.Methods In this study,102 patients with oviduct obstructive infertility (OO1) that accorded with the inclusion criteria were randomly divided into two groups according to the order of treatment.During the study,a total of 5 patients were lost in the two groups,and so 49 in the treatment group and 48 in the control group completed the protocol.The control group was given fallopian tube recanalization under the hysteroscopy,and the treatment group was given oral Guizhi-Fuling pill at day 2 after surgery on the basis of the control group treatment.Both groups were observed for 6 months.Before and after treatment,TCM symptom score was conducted,and IL-6 level was determined by radioimmunoassay;the uterine fallopian tube was examined after the 6th month of treatment,and pregnancy rate was observed and recorded.Results After treatment,abdominal pain degree (0.6 ± 0.1 vs.1.3 ± 0.1,t=3.612),the low back pain (0.9 ± 0.2 vs.1.6 ± 0.2,t=2.553),abdominal distension (0.5 ± 0.0 vs.1.0 ± 0.8,t=2.364),menstrual blood clots (0.5 ± 0.1 vs.1.0 ± 0.1,t=2.331) in the treatment group were significantly lower than those in the control group (Ps＜0.05).After treatment,the rate of oviduct patency was 75.5％ (37/49) in thetreatment group,50.0％ (24/48) in the control group,and the comparison difference between the two groups was statistically significant (x2=8.075,P=0.044).After 6 months of treatment,the pregnancy rate of the treatment group was 63.3％ (31/49),and that of the control group was 37.5％ (18/48),the difference of pregnancy rate between the two groups was statistically significant (x2=6.724,P=0.035).After treatment,serum IL-6 (31.04 ± 2.47 ng/ml vs.42.71 ± 2.52 ng/ml,t=7.593) in the treatment group was signicantly lower than the control group (P＜0.05).Conelusions Guizhi-Fuling pill combined with conventional therapy can reduce IL-6 level,promote fallopian tube recanalization,improve the intrauterine pregnancy rate,and improve the clinical symptoms of OOI patients.

Objective:To evaluate the anxiety and depression symptoms of burning mouth syndrome (BMS), and to explore risk factors to BMS.Method:In this case-control study,147 patients with BMS and 140 sex-and age-matched healthy volunteers were recruited.Three questionnaires were used to collect information of psychical and mental condition.The Self-Rating Anxiety Scale (SAS)and Self-Rating Depression Scale (SDS)were applied to evaluate symptoms of anxiety and depression.The scores of SAS and SDS were statistically analyzed by t-test.The risk factors of BMS were statistically analyzed by Chi-square test and logistic regression analysis.Result:The scores of SAS and SDS were higher in the patients with BMS than in the controls [SAS:(44.4 ±9.9)vs. (35.7 ±6.2);SDS:(48.1 ±11.6)vs.(37.5 ±8.9)].The risk factors of BMS included ischemic stroke (OR =4.46,95%CI:1.87 -10.95),low level of education (OR =1.91,95%CI:1.04 -3.49),anxiety symptom (OR =8.12,95%CI:2.60 -25.37)and depression symptom (OR =2.57,95%CI:1.26 -5.27).Conclusion:BMS is a multi-factorial disease.It indicates that ischemic stroke,lower level of education,anxiety symptom and depression symptom are the risk factors of BMS.A positive association could be established between psychological alterations and BMS.According to these findings it can be assumed that mental factors should be taking into account in the etiologyof BMS.It should be advocated to treat BMS patients by psychotherapy.