AIM: To explore the risk factors for visual field defect in patients with normal tension glaucoma.METHODS: The general data of 164 patients(164 eyes)with normal tension glaucoma diagnosed and treated in our hospital from July 2022 to January 2025 were retrospectively analyzed. According to the visual field defect, the patients were divided into visual field defect group(93 eyes)and no visual field defect group(71 eyes). The clinical data of the two groups were compared, and the risk factors of visual field defect in patients with normal intraocular pressure glaucoma were analyzed by Logistic regression.RESULTS: Totally 93 eyes had visual field defect among 164 eyes with normal tension glaucoma, with an incidence rate of 57%. The age, proportion of high myopia, intraocular pressure, intraocular pressure fluctuation and resistance index(RI)in the visual field defect group were higher than those in the non-visual field defect group(all P<0.01), while the retinal nerve fiber layer thickness, the optic disc vascular density, peak systolic blood flow velocity(PSV)and end diastolic blood flow velocity(EDV)in the visual field defect group were lower than those in the non-visual field defect group(all P<0.01). Multivariate Logistic regression showed that advanced age(OR=1.171), high myopia(OR=2.316), ocular hypertension(OR=1.662), high intraocular pressure fluctuation(OR=1.770), low retinal nerve fiber layer thickness(OR=0.744), low optic disc vascular density(OR=0.547), low PSV(OR=0.618), low EDV(OR=0.577)and high RI(OR=1.980)were all risk factors for visual field defect in patients with normal tension glaucoma(all P<0.01).CONCLUSION: The age, high myopia, intraocular pressure, intraocular pressure fluctuation, retinal nerve fiber layer thickness, optic disc vascular density, PSV, EDV and RI are influence factors for visual field defect in patients with normal tension glaucoma.

Objective:To study the correlation between the acute-phase characteristics of motor evoked potential (MEP) and severities of spinal cord injury in patients with acute cervical hyperextension injury and central cord syndrome (CCS).Methods:Retrospectively analyzed were the data of 45 patients with acute cervical hyperextension injury and CCS (observation group) who had been admitted to Department of Orthopedics, Tongji Hospital Affiliated to Tongji University from December 2018 to July 2021 and 20 healthy controls. Examination of transcranial magnetic stimulation-induced MEP was performed in patients with CCS and healthy controls using a magpro x100 magnetic stimulator, and recording was conducted in bilateral abductor pollicis brevis (APB). The characteristics of MEP waveform latency, amplitude and motor threshold were described and compared between the healthy control and observation groups; the correlations were analyzed between the MEP latency and the severity of spinal cord injury [American Spinal Injury Association (ASIA) total score and motor function of Upper Extremity Motor Subscores (UEMS)] in the observation group. According to different MEP-induced states, the patients in the observation group were divided into a resting group ( n=19), a facilitation group ( n=18), and a no-waveform group ( n=8). The severity of spinal cord injury (ASIA total score) and the functional independence of the spinal cord (SCIM-Ⅲ score) were compared among the 3 groups to analyze the correlation between the MEP-induced state and the severity of spinal cord injury (ASIA total score). Results:The observation group had a significantly longer MEP latency [(30.16±6.32) ms], a significantly smaller amplitude [(0.54±0.30) mV] and a significantly higher motor threshold [(65%±11%)] than the healthy control group (all P<0.05). The MEP latency in the observation group was significantly correlated with ASIA total score ( r=-0.730, P<0.001) and UEMS ( r=-0.740, P<0.001). The ASIA total score and SCIM-Ⅲ score were significantly different among the 3 groups ( P<0.05), and the MEP-induced state was significantly correlated with the severity of spinal cord injury (ASIA total score) ( r=0.668, P<0.001). Conclusions:In patients with acute cervical hyperextension injury and CCS, the MEP latency is prolonged, the amplitude lowered, and the motor threshold enhanced. The MEP latency is strongly correlated with the severity of spinal cord injury and upper limb motor function. The MEP-induced state is also closely related to the severity of spinal cord injury.

COVID-19 is an emerging infectious disease caused by SARS-CoV-2. After the infection of the virus, the host immune system is stimulated to produce multifarious specific antibodies to decrease or eliminate effects of the pathogen. Study of the specific antibodies dynamic characteristics in patients with COVID-19 is very important for the understanding and diagnosis of the disease, research and development of vaccine, and planning of prevention and control strategy. This paper reviews and summarizes the domestic and oversea research on dynamic characteristics of specific antibodies of COVID-19 patients, including the antibody producing, duration and level, and its possible influencing factors in order to improve the understanding of the immunological characteristics of COVID-19.

Extracorporeal membrane oxygenation(ECMO) is a type of technique which can be used to replace patients' pulmonary function and cardiac function effectively. Since 2000s,the technique began to apply in pediatric patients but still developed very slowly. As well,patients transport with ECMO is another problem for the pediatricians. So,it is necessary to raise the conception of pediatric ECMO transport network and construction of the network. In this paper,the concept of pediatric ECMO transport network,current status of transport,the characteristics and constitution of pediatric ECMO transport network,indication for transport of pediatric ECMO,the problems in the construction of network were introduced to promote the construction of the network.

Objective To investigate the operating strategies and essentials of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) with tubular channel (Spotlight) to treat single-level lumbar degenerative diseases. Methods From November 2013 to December 2015, 97 patients (47 males and 50 females) underwent single-level lumbar degenerative diseases fol-lowing MIS-TLIF with Spotlight were analyzed, whose age were from 35-82 years old with the average age of 57.6±12.3 years old. The preoperative diagnosis was lumbar spinal stenosis in 63 cases, lumbar spondylolisthesis in 25 cases, and lumbar instability in 9 cases. The affected level was L3,4 in 9 cases, L4,5 in 66 cases, and L5S1 in 22 cases. According to distinct clinical manifestations and radiological characteristics, different approaches of Spotlight channels were employed. Unilateral decompression via unilateral channel was performed in 52 cases, bilateral decompression via unilateral channel was performed in 22 cases, and bilateral decom-pression via bilateral channel was performed in 23 cases. Clinical outcomes included operation duration, surgical blood loss, post-operative drainage volume and complications was recorded. Average intervertebral height, lumbar and surgical Cobb angle were utilized to evaluate the reduction of intervertebral height and lumbar lordosis. The low back and leg pain were represented as Visu-al Analogue Scale (VAS) score. The preoperative and postoperative Oswestry Disability Index (ODI) score were recorded individu-ally to evaluate patients'functional recovery. Besides, the Bridwell criterion was introduced to define the extent of the lumbar fu-sion. The MacNab criterion was used for assessment of postoperative efficacy. Results The operation duration was 189.8 ± 41.3 min, the volume of surgical blood loss was 143.9 ± 102.0 ml and the volume of postoperative drainage 75.0 ± 59.0 ml in all cases. Among them, operation time was 165.0±24.2 min, surgical blood loss was 99.5±54.1 ml and postoperative drainage was 48.4±27.6 ml in the operation group of unilateral decompression via unilateral channel. The date in the group of Bilateral decompression via unilateral channel were 208.9 ± 46.0 min, 151.4 ± 96.3 ml, 88.0 ± 51.3 ml and in the group of bilateral decompression via bilateral channel were 225.4±32.0 min, 236.0±126.3 ml, 122.8±81.7 ml. All the patients were followed up for 16-42 months, the average follow-up time was 24.9 ± 7.0 months. Low back VAS reduced from 6.10 ± 0.84 preoperatively to 1.59 ± 0.49 at the final follow-up, leg VAS decreased from 6.56±0.85 preoperatively to 1.59±0.57 at the last follow-up, and ODI reduced from 59.36％±5.52％preop-eratively to 15.89％±2.90％at the final follow-up, compared with preoperative, the differences were significant. Average interverte-bral height improved from 9.92±2.25 mm preoperatively to 12.24±1.78 mm at latest follow-up time, which had statistically signifi-cant difference. Operative segment and lumbar Cobb angle were 13.81°±6.10° and 32.32°±11.97° preoperative, at the time of lat-est follow-up improved to 14.25° ± 5.57° and 35.83° ± 9.89° , Compared with preoperative, lumbar Cobb angle was significantly in-creased but operative segment Cobb had no significant difference. According to the criteria of Bridwell, intervertebral fusion at fi-nal follow-up of I and II grades were 90 cases in total (92.8％). The MacNab criteria was used to evaluate the clinical efficacy, which 69 were excellent, 23 were good, and 5 were acceptable, the excellent and good rate was 94.8％. Conclusion The tech-nique of MIS-TLIF with the tubular channel (Spotlight) is safe and efficient for the treatment of single segment lumbar degener-ative diseases. Different strategies can be selected by different preoperative clinical manifestations and radiological features.

Eccrine spiradenoma usually occurs as solitary tender nodules. However, it rarely occurs as multifocal localized tumors or has zosteriform distribution. We report the case of a 32-year-old woman with a 20-year history of itchy lesions on the left side of the back and forearm with a zosteriform distribution. Before disease onset, almost no patients have inducing factors, but our patient received an injection beforehand; however, whether this was coincidental or causative remains unknown. The lesions became very itchy after perspiration or eating spicy food, which has never been reported. A literature search revealed 22 cases of multiple segmental eccrine spiradenoma; we summarized the clinical characteristic in order to aid diagnosis and treatment selection.
Adult ; Diagnosis ; Eating ; Female ; Forearm ; Humans

Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.

Objective To analyse the effect of recombinant endostatin on Treg, CD8 +T cells, tumor specific growth factor (TSGF) in peripheral blood of patients with advanced esophageal gastric junction adenocarcinoma and clinical efficacy observation.Methods 52 patients who were diagnosed with acute cerebral infarction in our hospital were collected.All patients were randomly divided into experimental group and control group, 26 cases in each group.The control group was given OLF chemotherapy, the experimental group was treated with OLF chemotherapy regimen combined with recombinant endostatin.21 days was 1 cycle, a total of 4 cycles.After treatment, the levels of Treg, CD8 +T cells, serum TSGF and clinical efficacy were detected in all patients.ResuIts After treatment, compared with control group,the peripheral blood Treg was significantly lower in the experimental group (P<0.05); the peripheral blood CD8 +T cells level in the experimental group was significantly higher (P<0.05);the serum TSGF level in the experimental group was significantly lower ( P<0.05 ); the effective of patients in the experimental group was higher ( P<0.05 ) . ConcIusion Recombinant endostatin can significantly reduce the levels of Treg and serum TSGF in patients with advanced esophageal gastric junction adenocarcinoma, improve the level of CD8 +T cells, and improve the efficiency of treatment, have guiding significance to clinical.

Objective To explore the effect of α-zearalanol (α-ZAL) on β-amyloid (Aβ) induced mice and the mechanism. Methods The model was induced by intracerebroventricular injection of Aβ25-35. The mice were divided randomly into sham group, model group, estradiol benzoate (EB) group (Aβ+EB) as a positive control and α-ZAL (Aβ+α-ZAL) group. Morris water maze was used to evaluate the learning and memory ability. The levels of antioxidant enzymes and nitric oxide system in the brain tissue were detected with spectrophotometric and sotopic method. Results The escape latency was longer in the model group than in the control group (P<0.01), and was shorter in the EB group and α-ZAL group than in the model group (P<0.05). Compared with the control group, the level of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) decreased, and the level of malonaldehyde (MDA), constitutive nitric oxide synthase (cNOS), inducible nitrous oxide synthesis (iNOS), and nitric oxide (NO) increased in the model group (P<0.05); compared with the model group, the level of SOD and GSH-Px increased, and the level of MDA, cNOS, iNOS and NO decreased in the EB group and α-ZAL group (P<0.05), except the level of SOD and cNOS in hippocampus in α-ZAL group (P>0.05). There was no significant difference between EB group and α-ZAL group (P>0.05). Conclusion α-ZAL could improve the cognitive behavior in Aβ25- 35 induced mice by increasing the antioxidant activities and decreasing the lipid peroxidation.

Traditional Chinese medicine (TCM) have unique efficacy and advantages for treating diseases of central nervous system. In recent years, some researches focused on neural stem cells and neurogenesis. The researches about TCM for influencing neural stem cells biological characteristics and common neurological diseases were reviewed.