1.Investigation and analysis of the current situation of pharmaceutical care demand and payment willingness of inpatients in Hubei Province
Xiaochun YE ; Chengcheng LI ; Lulu LI ; Tiying DENG ; Yangcong LIU ; Di LI ; Shaohui ZHANG
China Pharmacy 2025;36(18):2226-2231
OBJECTIVE To provide empirical basis for promoting the dynamic adjustment of the pharmaceutical care catalogue and the formulation of policies such as hierarchical payment of medical insurance. METHODS A multicenter cross- sectional survey method was adopted to conduct a questionnaire survey among 424 inpatients in 22 tertiary medical institutions in 12 prefecture-level cities of Hubei Province to evaluate their demand for pharmaceutical care, willingness to pay and preference for service forms. Combined with univariate and multivariate Logistic regression analysis, the influencing factors and key factors that affect patients’ willingness to pay for pharmaceutical care were identified. RESULTS Only 39.86% of the patients were aware of pharmaceutical care or pharmacists, and 89.62% of the patients hope to receive pharmaceutical care. Among the 16 types of pharmaceutical care, the patients surveyed had a relatively high recognition rate for guidance on drug usage and dosage, notification of medication precautions, and the identification, prevention and handling of adverse drug reactions. 96.70%, 95.30%, and 94.12% respectively expressed strong approval and approval. The demand for services such as insurance-related policy consultation, popular science on the mechanism of drug action, and assessment of the combined use of traditional Chinese and Western medicines was relatively low, with 61.65%, 68.47%, and 68.47% expressing strong approval and approval respectively. The positive influencing factors of willingness to pay were household monthly income > 5 000 yuan (OR=1.742), awareness of pharmaceutical care or pharmacists (OR=3.620), and the desire to receive pharmaceutical care (OR=4.686) (P<0.05), while self-rating health as “good” (OR=0.390) was a negative influencing factor (P<0.05). Cardiovascular and cerebrovascular diseases (54.48%) and antihypertensive drugs (45.05%) were the service scenarios that the surveyed patients most hope to be covered. 85.14% of the patients preferred “service when xiaochnye@126.com needed”, with a single service duration of less than 10 minutes being appropriate (84.43%), and the willingness to pay within 20 yuan being the main type (85.38%). CONCLUSIONS Based on the characteristics of patients’ needs and payment behaviors, it is suggested that our country could consider establishing a hierarchical payment mechanism for pharmaceutical care, and focus on differentiated design in combination with diseases and medication situations. At the same time, the rights, responsibilities and service standards of resident pharmacists in the links such as medication reorganization and medical order review should be further clarified to comprehensively enhance the clinical value and policy operability of pharmaceutical care.
2.Efficacy of Differential Dosage of Pueraria in Gegen Qinliantang on Acute Enteritis Model in Mice
Ruiying ZHANG ; Ping WANG ; Di ZHANG ; Hongfa CHENG ; Ying ZHANG ; Zhu DENG ; Hui FENG ; Min LIU ; Yang TANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):197-204
ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis (AE) model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group,model group,single Puerariae Lobatae Radix group,non-Puerariae Lobatae Radix group,regular dose Gegen Qinliantang group (regular dose group),half-dose Puerariae Lobatae Radix group,and doubled-dose Puerariae Lobatae Radix group, with 16 mice in each group. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 (a protein in the tight junction) and Occludin in the colon tissue, as well as the changes of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). ResultsCompared with the blank group,the DAI scores of the mice in the model group were significantly higher (P<0.05),and the histopathological sections of their colon tissues showed mucosal damage,glandular atrophy,disordered arrangement,and a large number of inflammatory cells infiltration,and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated (P<0.05,P<0.01). The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated (P<0.05,P<0.01). Compared with the model group,the DAI scores of mice in all dosing groups decreased significantly (P<0.05),with the most significant effect in the regular dose group. After 7 d of drug administration,the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α (P<0.05) and significantly up-regulated the expression of ZO-1 protein (P<0.05). The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein (P<0.01),and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration,the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α (P<0.01). Meanwhile,the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein (P<0.01). The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein (P<0.05) and up-regulated ZO-1 protein expression (P<0.05). ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue, protect the barrier function and structure of intestinal epithelial cells, and reduce the expression of inflammatory factors, so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents, Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.
3.Efficacy of Differential Dosage of Pueraria in Gegen Qinliantang on Acute Enteritis Model in Mice
Ruiying ZHANG ; Ping WANG ; Di ZHANG ; Hongfa CHENG ; Ying ZHANG ; Zhu DENG ; Hui FENG ; Min LIU ; Yang TANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):197-204
ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis (AE) model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group,model group,single Puerariae Lobatae Radix group,non-Puerariae Lobatae Radix group,regular dose Gegen Qinliantang group (regular dose group),half-dose Puerariae Lobatae Radix group,and doubled-dose Puerariae Lobatae Radix group, with 16 mice in each group. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 (a protein in the tight junction) and Occludin in the colon tissue, as well as the changes of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). ResultsCompared with the blank group,the DAI scores of the mice in the model group were significantly higher (P<0.05),and the histopathological sections of their colon tissues showed mucosal damage,glandular atrophy,disordered arrangement,and a large number of inflammatory cells infiltration,and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated (P<0.05,P<0.01). The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated (P<0.05,P<0.01). Compared with the model group,the DAI scores of mice in all dosing groups decreased significantly (P<0.05),with the most significant effect in the regular dose group. After 7 d of drug administration,the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α (P<0.05) and significantly up-regulated the expression of ZO-1 protein (P<0.05). The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein (P<0.01),and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration,the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α (P<0.01). Meanwhile,the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein (P<0.01). The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein (P<0.05) and up-regulated ZO-1 protein expression (P<0.05). ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue, protect the barrier function and structure of intestinal epithelial cells, and reduce the expression of inflammatory factors, so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents, Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.
4.Reflection and prospect on mechanism of dopamine reward system involvement in depression loop and traditional Chinese medicine intervention research
Zhuo-Xian LI ; Liu-Chang ZHOU ; Li-Hong YE ; Di DENG ; Jin-Lan ZHAO ; Ya-Fei SHI ; Rong ZHANG
Chinese Pharmacological Bulletin 2024;40(8):1424-1429
In the process of seeking new strategies to improve the efficacy of antidepressants,traditional Chinese medicine inter-vention has gradually revealed its unique prevention and treat-ment advantages.The dopamine reward system is closely in-volved in the pathological occurrence and development of depres-sion.Currently,research has mostly focused on the functional mechanism of a specific nucleus in the dopamine reward system,and there is less research focused on the functional mechanism of the neural circuit.In the current micro research on reward cir-cuits,the association between abnormal reward circuits and neg-ative emotions such as anxiety and depression has been widely recognized.Traditional Chinese medicine intervention can exert antidepressant effects by influencing reward circuits.This article provides a review on the loop mechanism of dopamine reward system involvement in depression and research on traditional Chinese medicine intervention.
5.Relationship between skin injury outcome and urinary arsenic methylation metabolites levels in people exposed to arsenic through drinking water
Xinye LI ; Danyu DENG ; Fan ZHAO ; Cong LIU ; Mengxin LI ; Zhen DI ; Na CUI ; Yijun LIU ; Chang KONG ; Binggan WEI ; Yanhong LI ; Yajuan XIA ; Zhiwei GUO
Chinese Journal of Endemiology 2024;43(6):446-451
Objective:To investigate the relationship between the outcome of skin injury and urinary arsenic methylation metabolism levels in people exposed to arsenic through drinking water.Methods:Using cluster sampling method, permanent residents from drinking-water-borne endemic arsenic poisoning areas in Bayannur City, Inner Mongolia Autonomous Region were selected as survey subjects in 2004 (before water improvement). In 2017 (after water improvement), 74 survey subjects from 2004 were tracked and followed up. Urine samples were collected from survey subjects and high-performance liquid chromatography inductively coupled plasma mass spectrometry was used to detect the levels of arsenic methylation metabolites in urine. According to the "Diagnosis of Endemic Arsenic Poisoning" (WS/T 211-2015), the clinical grading (normal, suspicious, mild, moderate and severe) of skin injury of the survey subjects and the outcome of 2017 (improved, unchanged, aggravated) were assessed. A database was established and SPSS 25.0 software was used for statistical analysis.Results:The clinical grading ratios of skin injuries among survey subjects in 2004 and 2017 were compared, the differences were statistically significant (normal, suspicious, mild, moderate and severe: 38, 18, 4, 14 cases in 2004 and 27, 31, 3, 13 cases in 2017, χ 2 = 53.02, P < 0.001). Compared with 2004, in 2017, the levels of total arsenic (tAs), inorganic arsenic (iAs), monomethylarsenic (MMA), dimethylarsenic (DMA), percentage of inorganic arsenic (iAs%), and ratio of monomethylarsenic to dimethylarsenic (MMA/DMA) in the urine of survey subjects were low, and the differences were statistically significant ( Z = - 8.24, - 9.07, - 7.81, - 8.04, - 8.24, - 3.56, P < 0.001). The levels of dimethylarsenic percentage (DMA%), monomethylation rate (PMI) and dimethylation rate (SMI) were higher, and the differences were statistically significant ( Z = - 6.39, - 8.24, - 3.52, P < 0.001). In 2004, patients with different clinical grading of skin injuries had different outcomes in 2017 (χ 2 = 30.80, P < 0.001). There were statistically significant differences in tAs, iAs, MMA and DMA variation in urine among skin injury patients with different outcomes ( H = 10.62, 9.35, 8.80, 9.13, P < 0.05). Conclusions:Improving water can significantly reduce the levels of tAs, iAs, MMA, and DMA in the urine of arsenic exposed individuals. The outcome of skin injury in individuals exposed to arsenic through drinking water is related to the variation of urinary arsenic methylation metabolites tAs, iAs, MMA, and DMA.
6.Percutaneous minimally invasive treatment of Sanders Ⅱ and Ⅲ calcaneal fractures assisted by a self-made distractor
Xiong LIAO ; Jianliang DENG ; Wei LIU ; Di YOU
Chinese Journal of Orthopaedic Trauma 2024;26(10):842-849
Objective:To investigate the efficacy of our self-made distractor in assistance of percutaneous minimally invasive treatment of Sanders Ⅱ and Ⅲ calcaneal fractures.Method:A retrospective study was conducted to analyze the clinical data of 51 patients with calcaneal fracture who had been treated from March 2020 to August 2022 at Department of Orthopedic Trauma, Changsha Central Hospital Affiliated to University of South China. There were 42 males and 9 females with an age of (44.6±10.2) years. All the 34 Sanders type Ⅱ fractures and 17 Sanders type Ⅲ fractures were isolated unilateral ones which were treated by percutaneous reduction and fixation with percutaneous screws assissted by our self-made calcaneal distractor. All patients were evaluated both clinically and radiologically. The interval from injury to surgery, surgery duration, hospitalization period, fracture union, complications, reduction of the posterior inferior articular surface, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and visual analog scale (VAS) pain score were recorded. The length, width, height, B?hler angle, and Gissane angle of the calcaneus were measured and compared between pre-surgery and the last follow-up.Results:All patients in this cohort were followed up after uneventfull surgery for 21 (18, 24) months. The interval from injury to surgery was 0 (0, 1) d, the surgery duration 38 (35, 40) min, and the hospitalization period 4 (3, 4) d. All the surgical incisions healed smoothly without any wound-related complications. All fractures got united by the 12-week postoperative assessment with normal alignment of the posterior foot and no varus or valgus. One patient developed symptoms of sural nerve injury after surgery, and one patient experienced a screw rupture after surgery. Evaluation of the posterior subtalar articular surfaces revealed an anatomic reduction rate of 66.7% (34/51), a near-anatomical reduction rate of 33.3% (17/51), and no cases of approximate reduction or failure in articular surface reduction. The last follow-up found no loss of reduction. At the last follow-up, the AOFAS ankle-hindfoot score was 91.3 (87.0, 98.0) points, giving 32 excellent, 17 good, and 2 fair cases, resulting in an excellent and good rate of 96.1%, and the VAS pain score 0 (0, 1) point. At the last follow-up, the width [34.0 (32.6, 34.9) mm], height [49.6 (47.1, 50.4) mm], B?hler angle [35.8 (34.0, 37.8)°], and Gissane angle [129.0 (124.2, 135.6)°] of the calcaneus were all significantly improved compared with the preoperative values [(41.0±2.1) mm, 39.3 (37.9, 40.2) mm, -5.7 (-20.4, 4.6)°, 94.5 (80.4, 104.0)°] ( P < 0.05). There was no statistically significant difference in the length of the calcaneus between pre-surgery and post-surgery ( P > 0.05). Conclusion:In the percutaneous minimally invasive treatment of Sanders Ⅱ and Ⅲ calcaneal fractures, use of our self-made calcaneal distractor has demonstrated favorable clinical outcomes, making the surgery minimally invasive and efficient.
7.Comparison of Cultivated and Wild-simulated Astragali Radix Based on Traditional Quality Evaluation
Jiachen ZHAO ; Yapeng WANG ; Yihan WANG ; Jinxiu QIAN ; Aiping DENG ; Tiegui NAN ; Liping KANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):21-30
ObjectiveBased on the traditional quality evaluation methods summarized in previous dynasties, this paper systematically contrasted cultivated Astragali Radix(CA) and wild-simulated Astragali Radix(WA) from the aspects of character, microstructure and chemical composition by modern technological means. MethodThe collected CA and WA were compared in characters and microscopic characteristics in cross section, and comparative analysis were performed on the contents of cellulose, extracts, carbohydrate, total flavonoids, total saponins, etc. Then ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometer(UPLC-Q-TOF-MS) and desorption electrospray ionization mass spectrometry imaging(DESI-MSI) were used to comparatively analyze the secondary metabolites and their spatial distributions in the xylem and phloem of CA and WA. ResultIn terms of characters, the characters and sectional features of WA was consistent with the characteristics of high-quality Astragali Radix, while the CA was quite different from the traditional high-quality Astragali Radix. In terms of microscopy, the phellem layer of CA was thin, and the section fissures were mostly distributed through the cambium in a long strip shape without obvious growth ring characteristics. The cork layer of WA was thick, and the cracks in the section were distributed in the center of the xylem and the outer edge of the phloem in an irregular cavity shape. The cambium was tight without cracks, and had obvious characteristics of a growth ring. In terms of chemical composition, the contents of water-soluble extract, 80% ethanol extract and sucrose of CA was significantly higher than those of WA, while the contents of total saponins, lignin and hemicellulose were significantly lower than those of WA. And the contents of 100% ethanol extract, total polysaccharides and total flavonoids in both of them were generally similar, but slightly higher in WA. The contents of 2 kinds of monoacyl-substituted flavonoid glycosides in the xylem of WA was significantly higher than those of CA, while the contents of 2 kinds of flavonoid aglycones and one flavonoid glycoside were on the contrary. The contents of 7 saponins in phloem of WA were significantly higher than those of CA. ConclusionThere are significant differences between CA and WA in characters, microstructure and chemical components, in which CA has a fast growth rate and a short planting period, and the primary metabolites such as water-soluble extracts and sucrose are more enriched, which is the reason for its firm texture and sweetness being significantly higher than those of WA. However, the contents of lignin, hemicellulose and some secondary metabolites in WA are significantly higher than those in the CA, which are close to the traditional description of characters and quality. Based on the results of this study, it is suggested to strengthen the production of WA, improve the supply capacity of WA, and gradually upgrade the current standard. It is recommended to increase the contents of monoacyl-substituted flavonoid glycosides, total saponins and other indicators that can characterize different production methods, so as to guide the high-quality production of Astragali Radix.
8.Improvement of Depression-like Behavior of Depression Model Mice by Sinisan via Regulating GSK-3β/A20/C/EBPβ to Inhibit Activation of Microglia
Hongyun CHEN ; Dongying YANG ; Huiqing LIAO ; Yanyan ZENG ; Linke PAN ; Shasha BAI ; Di DENG ; Yafei SHI ; Rong ZHANG ; Lei YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):16-23
ObjectiveTo investigate the antidepressant effect of Sinisan (SNS) by regulating glycogen aynthase kinase-3β (GSK-3β)/tumor necrosis factor alpha-induced protein 3(A20)/CCAAT enhancer binding protein β(C/EBPβ) to inhibit the activation of microglia. MethodA total of 72 male C57/6J mice were randomly divided into the normal group, model group, fluoxetine group (5.0 mg·kg-1), low-dose Sinisan group (4.9 g·kg-1), medium-dose Sinisan group (9.8 g·kg-1), and high-dose Sinisan group (19.6 g·kg-1), with 12 mice in each group. After one week of adaptive feeding, chronic unpredictable mild stress (CUMS) was performed to establish the depression model. In the fifth week, drug treatment was conducted for four weeks. In the ninth week, behavioral tests were performed, including sucrose preference test (SPT), open field test (OPT), elevated plus maze (EPM) test, and forced swimming test (FST). Western blot was used to detect the expression levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), nitric oxide synthase (iNOS), GSK-3β, A20, and C/EBPβ in the cortex. The expression of M1-polarized ionized calcium-binding adapter molecule 1 (Iba1) and cluster of differentiation 68 (CD68) in microglia was detected by immunofluorescence. ResultAfter eight weeks of CUMS, compared with the normal group, the mice in the model group had a significantly reduced sucrose preference rate (P<0.01), and the activity in the central area of the OPT was significantly reduced (P<0.01). The activity in the open arm area of the EPM test was significantly reduced (P<0.05), and the immobility time of FST was increased (P<0.01). The expression levels of inflammatory proteins IL-1β, IL-6, and iNOS were increased (P<0.01), and the fluorescence co-localization index of Iba1 and CD68 was increased (P<0.05). The protein expression levels of GSK-3β and C/EBPβ were significantly increased (P<0.05, P<0.01). After four weeks of SNS intervention, compared with the model group, the mice in the SNS group had significantly increased sucrose preference rate (P<0.01), significantly increased activities in the central area and the open arm area in the OPT and the EPM test (P<0.05), and significantly reduced immobility time in the FST (P< 0.01). The protein expression levels of IL-1β, IL-6, and iNOS were significantly decreased (P<0.05), and the fluorescence co-localization index of Iba1 and CD68 was decreased in the high-dose SNS group (P<0.05). The protein expression levels of GSK-3β and C/EBPβ in the medium-dose and high-dose SNS groups were significantly decreased (P<0.01), and that of A20 was significantly increased (P<0.01). ConclusionThe antidepressant effect of SNS is related to the regulation of GSK-3β/A20/C/EBPβ protein expression and the inhibition of M1-type activation of microglia.
9.Efficacy and safety of transepithelial photorefractive keratectomy combined with accelerated corneal cross-linking for refractive error in thin or irregular cornea
Linli ZHANG ; Yu DI ; Ying LI ; Hongli DENG ; Yan REN ; Lu WANG
Chinese Journal of Experimental Ophthalmology 2024;42(4):361-366
Objective:To evaluate the efficacy and safety of transepithelial photorefractive keratectomy (Trans-PRK) combined with accelerated corneal cross-linking (CXL) for refractive error in patients with thin or irregular corneas, excluding keratoconus.Methods:An observational case series study was performed.Fifty-five right eyes of 55 myopic patients diagnosed with thin or irregular corneas, who underwent Trans-PRK combined with prophylactic CXL surgery, were included at Baotou Chaoju Eye Ophthalmic Hospital from August 2017 to July 2018.Uncorrected distance visual acuity (UDVA) of the operated eye was measured using international standard visual acuity charts, and refractive diopters were measured by computer and comprehensive refraction before surgery and at 1 week, 1, 3, 6, and 12 months after surgery.Corneal morphology was assessed with the Pentacam anterior segment analyzer before surgery and at 3, 6, and 12 months after surgery.Intraocular pressure (IOP) was measured with a non-contact tonometer before surgery and at 1, 3, 6, and 12 months after surgery.The incidence of postoperative complications was recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Baotou Chaoju Ophthalmic Hospital (No.btcj-u-1). Written informed consent was obtained from each subject.Results:Preoperative, 1-week, 1-, 3-, 6-, and 12-month postoperative UDVA (LogMAR) were 0.52(0.55, 0.78), 0.22(0.12, 0.17), 0.10(0.04, 0.07), 0.00(-0.04, -0.16), -0.08(-0.05, -0.03) and -0.08(-0.06, -0.04), respectively, showing a statistically significant overall difference ( Z=249.44, P<0.001). UDVA at each postoperative time point was improved compared to preoperative, and UDVA at 3, 6, and 12 months postoperatively was significantly improved compared to 1 week and 1 month postoperatively (all at P<0.001). The spherical diopter at each postoperative time point decreased significantly compared to preoperative, with the spherical diopter at 1, 3, 6, and 12 months postoperatively being lower than that at 1 week postoperatively, and the 12-month postoperative spherical diopter being lower than that at 3 and 6 months postoperatively, showing statistically significant differences (all at P<0.001). The cylindrical degree at 1, 3, 6, and 12 months postoperatively was lower than that at preoperative and 1 week postoperatively, with statistically significant differences (all at P<0.05). After the operation, the spherical equivalent of the operated eye gradually decreased with time, tending toward emmetropia.The spherical equivalent at each postoperative time point decreased compared to preoperative, with the spherical equivalent at 1, 3, 6, and 12 months postoperatively being lower than that at 1 week postoperatively, and the spherical equivalent at 12 months postoperatively being lower than that at 3 and 6 months postoperatively, showing statistically significant differences (all at P<0.001). The corneal K1 and K2 values at 3, 6, and 12 months postoperatively were significantly lower than preoperatively (all at P<0.001), and the corneal K1 and K2 values at 3 months postoperatively tended to stabilize.The IOP of the operated eye at 3, 6, and 12 months postoperatively was significantly lower than preoperatively, and the IOP at 6 and 12 months postoperatively was lower than that at 1 and 3 months postoperatively, with statistically significant differences (all at P<0.001). One eye developed grade 0.5 corneal haze at 1 week postoperatively, which spontaneously resolved to transparency at 1 month postoperatively. Conclusions:Trans-PRK combined with accelerated CXL has good efficacy, stability and safety for refractive error patients with thin or irregular corneas, except for keratoconus.
10.Influencing factors of arsenic metabolism pattern of population in drinking-water-borne endemic arsenic poisoning areas
Mengxin LI ; Xinye LI ; Fan ZHAO ; Cong LIU ; Danyu DENG ; Zhen DI ; Na CUI ; Yijun LIU ; Chang KONG ; Binggan WEI ; Yanhong LI ; Yajuan XIA ; Zhiwei GUO
Chinese Journal of Endemiology 2024;43(3):184-189
Objective:To investigate the arsenic metabolism pattern and possible influencing factors in the population in drinking-water-borne endemic arsenic poisoning (drinking-water-borne arsenic poisoning for short) areas.Methods:In December 2004, a cluster sampling method was used to select arsenic poisoning population (arsenic poisoning group) and healthy population (control group) in drinking-water-borne arsenic poisoning area of Bayannur City, Inner Mongolia Autonomous Region as the survey subjects. A questionnaire survey was conducted. Arsenic content in drinking water at home of survey subjects, the levels of urinary arsenic and its metabolites, including [trivalent arsenic (As Ⅲ), inorganic arsenic (iAs), monomethylarsenic acid (pentavalent, MMA V), dimethylarsenic acid (pentavalent, DMA V), total arsenic (tAs), percentage of inorganic arsenic (iAs%), percentage of monomethylarsenic acid (MMA%), percentage of dimethylarsenic acid (DMA%), primary methylation index (PMI), secondary methylation index (SMI)] were tested using high performance liquid chromatography-inductively coupled plasma mass spectrometry; nail arsenic and nail selenium levels were tested using atomic fluorescence spectrometer. The influencing factors of arsenic metabolism pattern were analyzed by multiple linear regression. Results:A total of 536 survey subjects were included, including 155 individuals in the arsenic poisoning group and 381 in the control group. The water arsenic level ranged from 0.0 to 825.7 μg/L. Compared with the control group, there was no significant difference in the distribution of gender, education level and dental fluorosis in the arsenic poisoning group ( P > 0.05), but there were significant differences in the distribution of age, marital status, smoking, drinking and water arsenic ( P < 0.05). Compared with the control group, the levels of urinary As Ⅲ, iAs, MMA V, DMA V, tAs, MMA%, MMA/DMA and nail arsenic in the arsenic poisoning group were higher ( P < 0.05), while the levels of urinary DMA%, SMI and nail selenium were lower ( P < 0.05); but there was no statistically significant difference in the levels of urinary iAs% and PMI ( P > 0.05). Gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic were the influencing factors of urinary As Ⅲ (β = - 19.82, - 23.83, 0.61, 0.21, 7.26, 2.98, P < 0.05). Age, depth of wells, water arsenic and nail arsenic were the influencing factors of urinary tAs (β = 3.18, 3.25, 1.31, 15.59, P < 0.05). Gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic were the influencing factors of urinary iAs (β = - 20.47, - 25.90, 0.64, 0.25, 7.87, 3.11, P < 0.05). Age, gender, education level, water arsenic and nail arsenic were the influencing factors of urinary MMA V (β = 0.52, - 17.07, - 21.84, 0.22, 2.77, P < 0.05). Age, depth of wells, water arsenic and nail arsenic were the influencing factors of urinary DMA V (β = 2.35, 2.47, 0.85, 9.22, P < 0.05). Conclusions:Compared with healthy individuals, there are differences in arsenic metabolism pattern among individuals with drinking-water-borne arsenic poisoning. Age, gender, education level, depth of wells, water arsenic, total number of wells and nail arsenic may be influencing factors of different arsenic metabolism patterns.

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