OBJECTIVES: To compare the efficacy of toric implantable collamer lens (Toric-ICL) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia correction in patients with moderate to high myopia complicated with astigmatism. METHODS: We retrospectively collected data from 64 patients (aged 18-42 years) with moderate to high myopia complicated with astigmatism (128 eyes) undergoing either Toric-ICL (28 patients/56 eyes) or FS-LASIK (36 patients/72 eyes) at our department between January, 2019 and December, 2020. The changes of uncorrected distance visual acuity (UCVA), spherical equivalent (SE), mean astigmatism correction index (CI), corneal endothelial cell density (ECD) and intraocular pressure (IOP) following the procedures were compared between the two groups. RESULTS: In FS-LASIK group, all the eyes (72/72) achieved an UCVA≥1.0, similar to the rate in Toric-ICL group (55/56 eyes; P=0.2374). The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups [0.43±0.06 D (range: -1.0 to 1.50 D) vs 0.38±0.05 D (range: -0.75 to 1.00 D); P=0.56]. The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group (0.8561 vs 0.7176; P<0.0001), and 88.89% of the eyes in FS-LASIK group and 69.64% in Toric-ICL group had postoperative astigmatism ≤0.50 D. No significant changes were observed in postoperative corneal ECD in FS-LASIK group, whereas ECD decreased significantly after the procedure in Toric-ICL group (P=0.0057). The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP, but the patients receiving FS-LASIK had significantly reduced IOP after the procedure (P<0.001). CONCLUSIONS Although the patients included in Toric-ICL group had higher myopia and astigmatism, Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group. Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
Humans ; Astigmatism/complications* ; Myopia/complications* ; Keratomileusis, Laser In Situ/methods* ; Retrospective Studies ; Adult ; Visual Acuity ; Adolescent ; Young Adult ; Treatment Outcome ; Male ; Lens Implantation, Intraocular/methods* ; Female ; Phakic Intraocular Lenses ; Intraocular Pressure

Objective:To study the expression of serum microRNA (miRNA)-335 and miRNA-375 in patients with papillary thyroid carcinoma (PTC) and their relationship with pathological features and prognosis.Methods:Using a case-control study method, 94 PTC patients admitted to Huaian Hospital of Huaian City from March 2021 to March 2023 were selected as PTC group. Another 73 healthy individuals who underwent physical examinations during the same period were selected as control group. Quantitative real-time PCR was used to determine the relative expression levels of serum miRNA-335 and miRNA-375. PTC patients were followed up until September 30, 2024, and the patient's prognosis was record. The relative expression levels of serum miRNA-335 and miRNA-375 were compared between the two groups, among different pathological features, and among patients with different prognoses. Multivariate logistic regression analysis was performed to identify independent risk factors for prognosis in PTC patients.Results:The relative expression level of serum miRNA-335 in the PTC group (2.35 ± 0.68) was higher than that in the control group (0.98 ± 0.04), while the relative expression level of miRNA-375 (0.65 ± 0.21) was lower than that in the control group (1.01 ± 0.02, P < 0.001). There was no statistically significant differences in the relative expression levels of serum miRNA-335 and miRNA-375 among PTC patients with different tumor diameters, tumor locations, tumor numbers, and vascular invasion ( P > 0.05). The relative expression level of serum miRNA-335 in TNM stages Ⅲ - Ⅳ was higher than that in stages Ⅰ - Ⅱ, while the relative expression level of miRNA-375 in TNM stages Ⅲ - Ⅳ was lower than that in stages Ⅰ - Ⅱ ( P < 0.001). The relative expression level of serum miRNA-335 of patients with lymph node metastasis was higher than that of patients without lymph node metastasis, while the relative expression level of serum miRNA-375 of patients with lymph node metastasis was lower than that of patients without lymph node metastasis ( P < 0.001). The relative expression level of serum miRNA-335 in the poor prognosis group was higher than that in the good prognosis group, while the relative expression level of miRNA-375 in the poor prognosis group was lower than that in the good prognosis group ( P < 0.001). Vascular invasion, lymph node metastasis, high expression of miRNA-335, and low expression of miRNA-375 were all independent risk factors for prognosis in PTC patients ( P < 0.05). Conclusion:Patients with PTC have high serum miRNA-335 expression and low miRNA-375 expression, and the expression of miRNA-335 and miRNA-375 is closely related to TNM staging, lymph node metastasis, and prognosis, which deserves clinical attention.

Objective:To study the expression of serum microRNA (miRNA)-335 and miRNA-375 in patients with papillary thyroid carcinoma (PTC) and their relationship with pathological features and prognosis.Methods:Using a case-control study method, 94 PTC patients admitted to Huaian Hospital of Huaian City from March 2021 to March 2023 were selected as PTC group. Another 73 healthy individuals who underwent physical examinations during the same period were selected as control group. Quantitative real-time PCR was used to determine the relative expression levels of serum miRNA-335 and miRNA-375. PTC patients were followed up until September 30, 2024, and the patient's prognosis was record. The relative expression levels of serum miRNA-335 and miRNA-375 were compared between the two groups, among different pathological features, and among patients with different prognoses. Multivariate logistic regression analysis was performed to identify independent risk factors for prognosis in PTC patients.Results:The relative expression level of serum miRNA-335 in the PTC group (2.35 ± 0.68) was higher than that in the control group (0.98 ± 0.04), while the relative expression level of miRNA-375 (0.65 ± 0.21) was lower than that in the control group (1.01 ± 0.02, P < 0.001). There was no statistically significant differences in the relative expression levels of serum miRNA-335 and miRNA-375 among PTC patients with different tumor diameters, tumor locations, tumor numbers, and vascular invasion ( P > 0.05). The relative expression level of serum miRNA-335 in TNM stages Ⅲ - Ⅳ was higher than that in stages Ⅰ - Ⅱ, while the relative expression level of miRNA-375 in TNM stages Ⅲ - Ⅳ was lower than that in stages Ⅰ - Ⅱ ( P < 0.001). The relative expression level of serum miRNA-335 of patients with lymph node metastasis was higher than that of patients without lymph node metastasis, while the relative expression level of serum miRNA-375 of patients with lymph node metastasis was lower than that of patients without lymph node metastasis ( P < 0.001). The relative expression level of serum miRNA-335 in the poor prognosis group was higher than that in the good prognosis group, while the relative expression level of miRNA-375 in the poor prognosis group was lower than that in the good prognosis group ( P < 0.001). Vascular invasion, lymph node metastasis, high expression of miRNA-335, and low expression of miRNA-375 were all independent risk factors for prognosis in PTC patients ( P < 0.05). Conclusion:Patients with PTC have high serum miRNA-335 expression and low miRNA-375 expression, and the expression of miRNA-335 and miRNA-375 is closely related to TNM staging, lymph node metastasis, and prognosis, which deserves clinical attention.

Objective:To explore the effect of dialectical diet on traditional Chinese medicine (TCM) syndrome score of cirrhotic ascites patients based on "Gu Ben Kai Qu" theory.Methods:From March 2019 to January 2020, 84 patients with liver cirrhosis and ascites admitted to Shuguang Hospital Affiliated to Shanghai University of TCM were randomly divided into two groups according to the different dialectical types of the subjects, 14 cases in each group. Three non-syndrome differentiation diet groups were given routine nursing care of liver cirrhosis ascites. On the basis of routine nursing, the corresponding medicinal diet was selected according to syndrome differentiation based on "Gu Ben Kai Qu" theory. Patients with spleen and kidney yang deficiency syndrome selected Shenqi lean meat decoction. Patients with Yin deficiency of liver and kidney selected Wolfberry and ophiopogon spareribs decoction. Patients with qi stagnation and blood stasis syndrome selected Danggui Sanqi spareribs decoction. The TCM syndrome score scale for liver disease and the curative effect evaluation of cirrhosis ascites were used to evaluate the effect.Results:Eighty effective cases were included. On the first day of admission, the 14th day and the second week after discharge, the TCM syndrome scores of liver disease were as follows: the group (a1b1) with the spleen and kidney yang deficiency syndrome was 46.38±8.56, 34.20±8.42, 31.40±4.22, respectively. The group (a1b2) with the liver kidney yin deficiency syndrome was 41.50±8.71, 31.35±8.63, 31.12±4.94. The group(a1b3) with the qi stagnation and blood stasis syndrome was 45.92±7.86, 35.17±7.57, 30.83±7.32, respectively. The non-syndrome differentiation diet group (a2b1) with the spleen and kidney yang deficiency syndrome was 46.29±8.38, 39.79±7.65, 36.64±6.83, respectively. The non-syndrome differentiation diet group (a2b2) with the liver and kidney yin deficiency syndrome was 40.50±8.12, 38.10±8.93, 35.38±8.24, respectively. The non-syndrome differentiation diet group (a2b3) with the qi stagnation and blood stasis syndrome was 45.62±7.99, 41.83±7.31, 38.83±7.96, respectively. The comparison of TCM syndrome scores of liver disease at three time points was statistically significant ( χ2 value was 63.998, P<0.05), and the comparison between groups was statistically significant ( χ2 value was 20.993, P<0.05). On the 14th day and the second week after discharge, there were significant differences between the groups with the syndrome differentiation diet and another three groups with non-syndrome differentiation diet ( F values were 3.244, 3.489, all P<0.05). Conclusions:Based on the theory of "strengthening the foundation and opening channels", the syndrome differentiation group can effectively reduce the TCM syndrome score of patients with cirrhosis ascites, improve the symptoms and enhance the curative effect. With the development of time, the score of TCM syndrome in patients with liver disease become lower. On the 14th day of admission, patients with Yin deficiency of liver and kidney given medicated diets had significant effect; patients with spleen kidney yang deficiency syndrome or qi stagnation and blood stasis had significant effect in 2 weeks after discharge; which can effectively improve the clinical symptoms of patients with cirrhosis ascites to worthy of clinical application.

Objective:To explore the therapeutic mechanism of fractional laser combined with pulsed dye laser and multi-point microinjection of triamcinolone in the treatment of hypertrophic scars in rabbit ears.Methods:In this study, 80 hypertrophic scar models of rabbit ears were made and randomly divided into 4 groups: control group, laser combined group, laser combined multi-point microinjection group, simple traditional injection group, 20 scar models in each group.The control group was not given treatment; the laser combined group was treated with pulsed dye laser first, followed by fractional laser at the same time; the laser combined with multi-point microinjection group was treated with pulsed dye laser and fractional laser first, followed by multi-point microinjection of triamcinolone in the scar immediately after laser treatment; the traditional injection group was injected with triamcinolone in the scar.The gross appearance of hypertrophic scars was observed and recorded in 4 groups. At 7 days and 2 months after treatment, the hypertrophic scars were cut and the histological study were performed by HE staining; the expression of collagen was observed by Masson staining and the volume fraction of collagen was measured; the number of micro-vessels was observed by CD31 staining and the micro-vessel density was measured.One way ANOVA was used to show the difference between groups, LSD posthoc test was used to compare between groups, and Pearson correlation coefficient was used to analyze collagen volume fraction and micro-vessel density.Results:Two months after the treatment, the histological results showed that the scar thickness of the laser combined group and the laser combined with multi-point microinjection group was significantly thinner than that of the control group, the texture of the scar was softened, the red color gradually became lighter, and approached to the color of the surrounding skin. Compared with the control group, the scar in the traditional injection group was thinner, softer and lighter. The scar thickness of laser combined with multi-point microinjection group was thinner than that of laser combined group and simple traditional injection group.Masson staining was used to calculate the collagen volume fraction (CVF): the expression of CVF in hypertrophic scar tissue of each group was reduced. The CVF values of each group at the 7th day and the 2nd month were compared. There was statistically significant difference between the laser combined group, the laser combined multi-point microinjection group and the simple traditional injection group ( P<0.05), but there was no statistical difference between the control group ( P>0.05). The CVF value of each group was further compared at 2 months after treatment, the laser combined multi-point microinjection group 0.05). 2 months after treatment, the MVD values of each group were compared with the result as the laser combined with multi-point microinjection group < laser combined group < simple traditional injection group, but there was no statistical difference between the laser combined with multi-point microinjection group and the laser combined group ( P>0.05). There was statistical difference between the laser combined with multi-point microinjection group and the laser combined group and the simple traditional injection group ( P< 0.05). The Pearson correlation coefficient was r=0.972, which indicated that there was a positive correlation between the collagen content and the number of micro-vessels. Conclusions:The use of fractional laser combined with pulsed dye laser and multi-point microinjection of triamcinolone in the treatment of hypertrophic scars in rabbit ears can evenly reduce the number of fibroblasts, promote the normalization of collagen density and arrangement, and reduce collagen volume fraction and micro-vessel density. The curative effect is better than fractional laser combined with pulse dye laser therapy and simple traditional triamcinolone injection therapy. There is a positive correlation between collagen content and micro-vessel density in hypertrophic scars. Simultaneously inhibiting the proliferating blood vessels can improve the therapeutic effectiveness.

Objective:To explore the therapeutic mechanism of fractional laser combined with pulsed dye laser and multi-point microinjection of triamcinolone in the treatment of hypertrophic scars in rabbit ears.Methods:In this study, 80 hypertrophic scar models of rabbit ears were made and randomly divided into 4 groups: control group, laser combined group, laser combined multi-point microinjection group, simple traditional injection group, 20 scar models in each group.The control group was not given treatment; the laser combined group was treated with pulsed dye laser first, followed by fractional laser at the same time; the laser combined with multi-point microinjection group was treated with pulsed dye laser and fractional laser first, followed by multi-point microinjection of triamcinolone in the scar immediately after laser treatment; the traditional injection group was injected with triamcinolone in the scar.The gross appearance of hypertrophic scars was observed and recorded in 4 groups. At 7 days and 2 months after treatment, the hypertrophic scars were cut and the histological study were performed by HE staining; the expression of collagen was observed by Masson staining and the volume fraction of collagen was measured; the number of micro-vessels was observed by CD31 staining and the micro-vessel density was measured.One way ANOVA was used to show the difference between groups, LSD posthoc test was used to compare between groups, and Pearson correlation coefficient was used to analyze collagen volume fraction and micro-vessel density.Results:Two months after the treatment, the histological results showed that the scar thickness of the laser combined group and the laser combined with multi-point microinjection group was significantly thinner than that of the control group, the texture of the scar was softened, the red color gradually became lighter, and approached to the color of the surrounding skin. Compared with the control group, the scar in the traditional injection group was thinner, softer and lighter. The scar thickness of laser combined with multi-point microinjection group was thinner than that of laser combined group and simple traditional injection group.Masson staining was used to calculate the collagen volume fraction (CVF): the expression of CVF in hypertrophic scar tissue of each group was reduced. The CVF values of each group at the 7th day and the 2nd month were compared. There was statistically significant difference between the laser combined group, the laser combined multi-point microinjection group and the simple traditional injection group ( P<0.05), but there was no statistical difference between the control group ( P>0.05). The CVF value of each group was further compared at 2 months after treatment, the laser combined multi-point microinjection group 0.05). 2 months after treatment, the MVD values of each group were compared with the result as the laser combined with multi-point microinjection group < laser combined group < simple traditional injection group, but there was no statistical difference between the laser combined with multi-point microinjection group and the laser combined group ( P>0.05). There was statistical difference between the laser combined with multi-point microinjection group and the laser combined group and the simple traditional injection group ( P< 0.05). The Pearson correlation coefficient was r=0.972, which indicated that there was a positive correlation between the collagen content and the number of micro-vessels. Conclusions:The use of fractional laser combined with pulsed dye laser and multi-point microinjection of triamcinolone in the treatment of hypertrophic scars in rabbit ears can evenly reduce the number of fibroblasts, promote the normalization of collagen density and arrangement, and reduce collagen volume fraction and micro-vessel density. The curative effect is better than fractional laser combined with pulse dye laser therapy and simple traditional triamcinolone injection therapy. There is a positive correlation between collagen content and micro-vessel density in hypertrophic scars. Simultaneously inhibiting the proliferating blood vessels can improve the therapeutic effectiveness.

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on"Gu Ben Kai Qu"theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group (35 cases) and control group(35 cases).The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on "Gu Ben Kai Qu" theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively(1.90±0.52)L,(2.09±0.56)L,(2.02±0.35)L,(59.36±8.19)kg,(89.56±7.24)cm,while they were(1.63±0.36)L,(1.79±0.40)L,(1.82±0.38)L,(63.33±8.21)kg,(93.57±7.56)cm in the control group,the difference between the two groups was statistically significant (F=6.083, 6.484, 5.030, 4.108, 5.144,all P<0.05). The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%(14/35),improved 42.9%(15/35),not cured 17.1%(6/35),while they were cured 22.9%(8/35),improved 40.0%(14/35),not cured 37.1%(13/35),the difference between the two groups was statistically significant (Z=2.012,P<0.05). The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%(13/35),valid 45.7% (16/35),invalid 17.2%(6/35)],[significant effect 60.0%(21/35),valid 28.6%(10/35),invalid 11.4%(4/35)], while they were respectively [significant effect 20.0%(7/35), valid 42.9%(15/35), invalid 37.1%(13/35)], [significant effect 40.0%(14/35),valid 25.7%(9/35),invalid 34.3%(12/35)],the difference between the two groups was statistically significant(Z=2.065,2.104,all P<0.05). Conclusions Based on"Gu Ben Kai Qu"theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.

OBJECTIVE:To provide reference for better carrying out safe medication intervention for the empty-nest elderly.METHODS:Two communities with different levels of income and culture were collected from Pudong New District of Shanghai,i.e.new community A and traditional community B.By cluster sampling,69 and 110 empty-nest elderly were selected as respondents respectively.The questionnaire survey about drug storage and medication habits of the elderly was conducted.The data of the survey were analyzed statistically.RESULTS:A total of 69 and 110 questionnaires were sent out,and 44 and 63 questionnaires were recovered with effective recovery rate of 63.8％ and 57.3％,respectively.The rate of drug storage in families from traditional community B was higher than new community A (100％ vs.88.6％,P=0.010).The proportions of residents in two communities storing their drugs in special drawers were the highest (59.0％ and 57.1％).Nearly half of the surveyed households in 2 communities did not form the habit of regularly clearing stored drugs.The frequency of residents who cleared stored drugs in traditional community B was higher than those in new community A (P=0.009).Nearly more than 70％ of the residents threw their expired drugs to garbage and only 11％ to drug stores or community health service center.The proportion of residents who were used to reading drug instructions in new community A was higher than traditional community B (95.5％ vs.77.8％,P=0.024).The proportion of the residents consulted community doctors when they were puzzled by drug use in new community A was lower than traditional community B (56.8％ vs.76.2％);The proportion of the residents consulted physicians in major hospitals was higher than traditional community B (34.1％ vs.9.5 ％);there was statistical significance (P=0.034).The most popular health service for the residents in the new community A was the hotline for the drug use (65.9％),while the residents in traditional community B needed blood pressure and sugar monitoring service and set up the health records (41.3％).The proportion of the residents' following demands in new community A was higher than traditional community B:opening drug use hotline,publicizing the knowledge of diseases and medication and conducting lectures (P＜0.001,P=0.006,P=0.018).CONCLUSIONS:The proportion of drug storage in empty-nest families of two communities is in very high level,but drug storage methods,cleaning frequency are not satisfactory.There are still a small number of elderly people who do not have the habit of reading drug instructions.There are some differences between the old and new communities.At the same time,the needs of health services in new and old communities are different.

Biological Therapy ; Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms