AIM: To assess the clinical efficacy of visual therapy in children with abnormal visual functions and asthenopia.METHODS: Retrospective case study. The data of 57 patients(114 eyes), aged 8.25±1.94 years, who underwent visual training at the optometry center of Xi'an Children's Hospital between January 2022 and April 2023, were collected. Patient assessments before and after training included refractive errors, a visual fatigue scale questionnaire, and visual function tests. These tests included the Worth 4 Dot for binocular vision, the Von Graefe method for measuring latent strabismus at distance and near, the gradient method for assessing the accommodative convergence/accommodation(AC/A)ratio, the push-up test for convergence near point, the negative lens method for amplitude of accommodation, the cross-cylinder test for accommodative response, and the flipper test for accommodative flexibility. Training programs were tailored based on the initial assessments of visual function and asthenopia. Comparisons were made between pre-training, 1 and 3 mo post-training evaluations.RESULTS: At baseline and 1 mo post-training, the visual fatigue scores were 26.00±6.77 and 19.57±8.90, respectively(P<0.05). Significant enhancements were observed in near phoria, convergence near point, and accommodative amplitude in both eyes, both negative relative accommodation(NRA)and positive relative accommodation(PRA), as well as accommodative flexibility in both eyes at 1 mo after therapy(all P<0.05), while no significant changes were found in distance phoria or accommodative response(all P>0.05). Furthermore, no significant differences were noted in the binocular amplitude of accommodation, NRA, PRA, and near phoria between 1 and 3 mo after training(all P>0.05). The visual function parameters of 30 patients with low myopia(SE: -1.99±1.22 D), 3 patients with low hyperopia(SE: +1.01±0.13 D)and 24 patients with emmetropia(SE: +0.25±0.11 D)were not statistically significant before training and at 1 mo after training(all P>0.05). Certain visual functions significantly improved at 1 mo after training, and most had returned normal by 3 mo.CONCLUSION: Vision therapy significantly enhances binocular visual function and alleviates symptoms of asthenopia in children with visual dysfunction. It is an effective, straightforward, and easily applicable method for relieving children's visual fatigue.

The chloroplast genome encodes many key proteins involved in photosynthesis and other metabolic processes, and metabolites synthesized in chloroplasts are essential for normal plant growth and development. Root-UVB (ultraviolet radiation B)-sensitive (RUS) family proteins composed of highly conserved DUF647 domain belong to chloroplast proteins. They play an important role in the regulation of various life activities such as plant morphogenesis, material transport and energy metabolism. This article summarizes the recent advances of the RUS family proteins in the growth and development of plants such as embryonic development, photomorphological construction, VB6 homeostasis, auxin transport and anther development, with the aim to facilitate further study of its molecular regulation mechanism in plant growth and development.
Female ; Pregnancy ; Humans ; Ultraviolet Rays ; Biological Transport ; Chloroplasts/genetics* ; Embryonic Development ; Plant Development/genetics*

Objective By using the computational fluid mechanic(CFD)method the tandem carotid artery stenosis(TCAS)was simulated on the model,and to compare the postoperative hemodynamic changes of different surgical procedures.Methods One patient with tandem stenosis of internal carotid artery(ICA)and common carotid artery(CCA)was selected.CFD technique was used to establish four three-dimensional(3-D)models of the carotid bifurcations,including one model of a real patient and three models of presumptive surgery.The hemodynamic analysis was performed with these models so as to explore the development mechanism of TCAS and to discuss the selection of suitable surgical plan.Results In tandem stenosis,the stenosis was preferentially formed in CCA and subsequently led to ICA stenosis.The local hemodynamic situation in TCAS was more complex and more risky than in single carotid artery stenosis.In tandem stenosis,the treatment of one stenosis site would affect the blood flow at the next stenosis site and cause restenosis or plaque rupture.Conclusion In treating patients with TCAS,CFD simulation examination should be performed when the surgical plan is formulated,which can help clinicians to predict the postoperative changes in blood flow and to choose the appropriate surgical plan.

To analyze the correlation of ADH4 exon rs1126671 and ADH7 exon rs971074 polymorphisms with risky drinking behaviors and alcoholic liver disease. The patients with alcoholic liver disease diagnosed in the Gastroenterology Department of the People′s Hospital of Hechi from November 2021 to June 2022, including 52 cases of alcoholic liver disease with positive risky drinking behaviors, 103 cases of non-alcoholic liver disease with positive risky drinking behaviors of the same gender and age, and 105 healthy subjects with no risky drinking behaviors as control groups were retrospectively analyzed. The serum total protein and albumin are detected by immunoturbidimetry and globulin is calculated by the difference method; the serum total bilirubin and direct bilirubin are detected by the nitrite oxidation method and indirect bilirubin is calculated by the difference method; alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transferase are detected by the substrate method. The results revealed that all 52 patients with alcoholic liver disease were male. The non-parametric independent sample Kruskal-Wallis test was adopted to analyze the baseline of twelve liver functions among the alcoholic liver disease group, the risky drinking behavior group and the healthy control group, and it was found there was statistical significance in ten major liver function indicators in the difference comparison among the three groups like serum total protein (g/L) 65.0 (60.1, 71.4), 73.4 (70.3, 76.3), 72.4 (69.2, 76.2) ( H=37.130, P<0.001); albumin (g/L) 36.1 (28.6, 42.9), 47.2 (45.0, 49.2), 47.5 (45.9, 49.5) ( H=14.503, P=0.001); direct bilirubin (μmol/L) 10.1 (35.6, 34.0.1), 3.8 (3.1, 5.45), 4.2 (2.9, 6.0) ( H=26.608, P<0.001); alkaline phosphatase (U/L) 106.0 (71.0, 164.0), 68.0 (57.5, 82.0), 70.0 (59.0, 87.0) ( H=27.904, P<0.001); albumin to globulin 1.34 (0.91, 1.88), 1.82 (1.65, 2.00), 1.89 (1.68, 2.07) ( H=11.047, P=0.004); direct bilirubin to indirect bilirubin 0.91 (0.69, 1.91), 0.41 (0.35, 0.54), 0.42 (0.34, 0.54) ( H=19.478, P<0.001); serum total bilirubin (μmol/L) 23.9 (13.7, 51.0), 13.8 (10.2, 17.9), 13.0 (10.1, 17.4) ( H=18.375, P<0.001); aspartate aminotransferase (U/L) 74.0 (39.0, 122.0), 22.0 (19.0, 28.0), 23.0 (19.0, 30.0) ( H=76.365, P<0.001); alanine aminotransferase (U/L) 37.0 (25.0, 55.0), 23.0 (17.0, 30.0), 24.0 (17.0, 33.8) ( H=57.041, P<0.001); γ-glutamyl transferase (U/L) 135.0 (45.0, 364.0), 33.0 (23.5, 49.5), 32.0 (19.0, 49.0) ( H=82.558, P<0.001); however, there were no statistical significance in the pairwise comparisons between risky drinking and healthy groups. The two loci of ADH4 and ADH7 were in genetic linkage equilibrium. In the three groups of samples, the ADH4 gene rs1126671 locus was comprised primarily of the CC homozygous genotype, and there was no TT genotype. The ADH7 gene rs971074 genotype had statistical difference in the comparison of the three groups ( χ2=9.370, P<0.05). Compared with the CC genotype, the CT genotype had no statistical difference in the pairwise comparison between the risky drinking behavior group and alcoholic liver disease group, and the healthy group and alcoholic liver disease group. There was a statistical difference in that between the healthy group and the risky drinking behavior group ( χ2=6.372, P=0.012). The analysis display of mode of inheritance between RD group and HA group was statistically significant in the difference of the superdominance inheritance mode ( OR=2.92, 95% CI:1.22-6.98; P=0.012), the dominant inheritance mode ( OR=2.90, 95% CI:1.26-6.64; P=0.008), the co-dominant inheritance mode ( OR=2.96, 95% CI:1.24-7.08; P=0.032) and the additive mode ( OR=2.46, 95% CI:1.16-5.22; P=0.013). In general, the CT genotype of ADH7 gene rs971074 is a risk factor for positive risky drinking behavior, and the ADH family may still increase the susceptibility of people with a potential alcoholic liver disease protection background through the correlation between ADH7 and risky drinking behavior.

To analyze the correlation of ADH4 exon rs1126671 and ADH7 exon rs971074 polymorphisms with risky drinking behaviors and alcoholic liver disease. The patients with alcoholic liver disease diagnosed in the Gastroenterology Department of the People′s Hospital of Hechi from November 2021 to June 2022, including 52 cases of alcoholic liver disease with positive risky drinking behaviors, 103 cases of non-alcoholic liver disease with positive risky drinking behaviors of the same gender and age, and 105 healthy subjects with no risky drinking behaviors as control groups were retrospectively analyzed. The serum total protein and albumin are detected by immunoturbidimetry and globulin is calculated by the difference method; the serum total bilirubin and direct bilirubin are detected by the nitrite oxidation method and indirect bilirubin is calculated by the difference method; alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transferase are detected by the substrate method. The results revealed that all 52 patients with alcoholic liver disease were male. The non-parametric independent sample Kruskal-Wallis test was adopted to analyze the baseline of twelve liver functions among the alcoholic liver disease group, the risky drinking behavior group and the healthy control group, and it was found there was statistical significance in ten major liver function indicators in the difference comparison among the three groups like serum total protein (g/L) 65.0 (60.1, 71.4), 73.4 (70.3, 76.3), 72.4 (69.2, 76.2) ( H=37.130, P<0.001); albumin (g/L) 36.1 (28.6, 42.9), 47.2 (45.0, 49.2), 47.5 (45.9, 49.5) ( H=14.503, P=0.001); direct bilirubin (μmol/L) 10.1 (35.6, 34.0.1), 3.8 (3.1, 5.45), 4.2 (2.9, 6.0) ( H=26.608, P<0.001); alkaline phosphatase (U/L) 106.0 (71.0, 164.0), 68.0 (57.5, 82.0), 70.0 (59.0, 87.0) ( H=27.904, P<0.001); albumin to globulin 1.34 (0.91, 1.88), 1.82 (1.65, 2.00), 1.89 (1.68, 2.07) ( H=11.047, P=0.004); direct bilirubin to indirect bilirubin 0.91 (0.69, 1.91), 0.41 (0.35, 0.54), 0.42 (0.34, 0.54) ( H=19.478, P<0.001); serum total bilirubin (μmol/L) 23.9 (13.7, 51.0), 13.8 (10.2, 17.9), 13.0 (10.1, 17.4) ( H=18.375, P<0.001); aspartate aminotransferase (U/L) 74.0 (39.0, 122.0), 22.0 (19.0, 28.0), 23.0 (19.0, 30.0) ( H=76.365, P<0.001); alanine aminotransferase (U/L) 37.0 (25.0, 55.0), 23.0 (17.0, 30.0), 24.0 (17.0, 33.8) ( H=57.041, P<0.001); γ-glutamyl transferase (U/L) 135.0 (45.0, 364.0), 33.0 (23.5, 49.5), 32.0 (19.0, 49.0) ( H=82.558, P<0.001); however, there were no statistical significance in the pairwise comparisons between risky drinking and healthy groups. The two loci of ADH4 and ADH7 were in genetic linkage equilibrium. In the three groups of samples, the ADH4 gene rs1126671 locus was comprised primarily of the CC homozygous genotype, and there was no TT genotype. The ADH7 gene rs971074 genotype had statistical difference in the comparison of the three groups ( χ2=9.370, P<0.05). Compared with the CC genotype, the CT genotype had no statistical difference in the pairwise comparison between the risky drinking behavior group and alcoholic liver disease group, and the healthy group and alcoholic liver disease group. There was a statistical difference in that between the healthy group and the risky drinking behavior group ( χ2=6.372, P=0.012). The analysis display of mode of inheritance between RD group and HA group was statistically significant in the difference of the superdominance inheritance mode ( OR=2.92, 95% CI:1.22-6.98; P=0.012), the dominant inheritance mode ( OR=2.90, 95% CI:1.26-6.64; P=0.008), the co-dominant inheritance mode ( OR=2.96, 95% CI:1.24-7.08; P=0.032) and the additive mode ( OR=2.46, 95% CI:1.16-5.22; P=0.013). In general, the CT genotype of ADH7 gene rs971074 is a risk factor for positive risky drinking behavior, and the ADH family may still increase the susceptibility of people with a potential alcoholic liver disease protection background through the correlation between ADH7 and risky drinking behavior.

Objective:To explore the technique and clinical effects of free medial plantar flap on reconstruction of the severe defect of thumb caused by electric burn.Methods:Surgical techniques and clinical effects were explored in reconstruction with free medial plantar flap for treatment of severe electric burns of thumbs. From July 2016 to July 2021, 18 patients suffered from severe electric burns of thumbs were admitted in the Department of Burn, Zhengzhou First People's Hospital. All the wounds were the entrance of electric burns. After thorough debridement, the arteries, nerves, tendons, phalanges and interphalangeal joints were exposed to various degrees. Damaged digital proper palmar arteries were ligated and defected proper palmar digital nerves were marked and further anastomosed with the nerves carried by the flap. Palmaris longus tendon grafts were employed to reconstruct the defects of flexor pollicis longus tendon. Wounds were closed by transfer of free medial plantar flaps, and the flap donor sites were closed by inguinal skin grafts. Survival of the flap was observed 1 week after surgery, and the survival of the skin graft in the foot donor site 12 days after surgery. Outpatient follow-up including observation of the appearance and texture of the flap, evaluation of sensory function, thumb alignment and finger flexion according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association. Evaluate the scar hyperplasia in the foot donor site and the standing and walking functions of the donor foot.Results:All flaps survived,at 1 week after surgery. On the 12th day after surgery, all 16 foot flap survived, and 2 patients had local necrosis, and the necrosis healed completely after dressing change for 10 days, the wound healed completely. Among them, 3 patients without tendon transfer experienced a rupture of the flexor pollicis longus tendon at 2 months after surgery, and underwent another palmaris longus tendon transfer. After the surgery, functional exercise was performed with the palm and flexor fingers. After 6-12 months of follow-up, the blood supply, appearance, and texture of the flap were good and similar to that of the palmar skin of the thumb, with varying degrees of recovery in sensation. The TPD was 6-11 mm, and the thumb was restored to varying degrees. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 13 cases in excellent and 5 cases in good. Mild scar hyperplasia remains in the flap site of donor feet, which does not affect the standing and walking functions of the donor foot.Conclusion:The texture of medial plantar skin is similar to that of palmar skin, with good wear resistance and good sensation. Furthermore, it causes a little damage to the donor site and without obvious complication. The medial plantar flap is ideal for reconstruction of a severe wound caused by electric burn in thumb.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

Objective To investigate the prevalence and characteristics of adverse reactions to cosmetics in China,and to provide a basis for further supervision.Methods The diagnosis of adverse reactions to cosmetics was according to 7 national standards (GB17149.1-7-1997) including the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Data regarding gender,age,occupation,educational background,disease types,cosmetic types,and so on,were collected from patients with adverse reactions to cosmetics at 13 surveillance sites in China during 2005-2014.A descriptive statistical analysis was carried out.Results During 2005-2014,a total of 13 534 cases of adverse reactions to cosmetics were reported to the monitoring system.Of these cases,95.40％ (12 912/13 534) were female,and 80.85％ were young or middle-aged (20-44 years).Finally,5 446 cases were confirmed to be adverse reactions to cosmetics,among which,94.66％ (5 155/5 466) were contact dermatitis to cosmetics,and 132 were other types that were not included in the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Among these confirmed cases,14 209 cosmetic products were involved,and ordinary skin care products predominated in these products.The proportion of imported cosmetic products (48.79％,6 932/14 209) was slightly higher than that of domestic products (43.21％,6 139/14 209).The number of reported eases increased by 13.16％ per year from 2005 to 2009,but decreased by 17.96％ per year from 2010 to 2014.Conclusion Adverse reactions to cosmetics are a complicated and important public health issue,and effective measures should be taken based on their characteristics.

Objective To determine the clinical value of hypergammaglobulinemia as a sentinel for autoimmune pancreatitis and avoid unnecessary pancreas resection.Methods All 14 patients with autoimmune pancreatitis or related pancreatic diseases underwent routine examinations,including liver function,CA199 and imaging.Measurement of serum IgG or IgG4 was performed for patients with clinically suspected or pathologically proved autoimmune pancreatitis.Clinical features were retrospectively compared between the AIP and non-AIP patients using x2 statistics with Yates correction or Fisher exact test.Results Ten cases were finally confirmed as autoimmune pancreatitis.All patients with autoimmune pancreatitis had elevated levels of serum γ-globulins,while only one case without autoimmune pancreatitis had elevated levels of serum γ-globulins.It was proved by subsequent antibody tests that serum IgG/IgG4 and γ-globulins were simultaneously increased.Conclusions Hypergammaglobulinemia can be used as a preoperative sentinel indicator for differentiating autoimmune pancreatitis from pancreatic malignancies and avoiding unnecessary pancreas operation.