AIM:To observe the defocus state and myopia control in myopic children wearing single-vision, defocus, and orthokeratology lenses using multispectral refraction topography(MRT).METHODS: A total of 279 myopic patients aged 8-14 years old, with a spherical equivalent(SE)from -7.00 to -0.50 D, treated at the Chengdu Aier Eye Hospital from June 2022 to December 2023. Patients who volunteered for the study were assigned to three groups. A total of 94 cases were provided with single-vision spectacle lenses(SVL group), 90 cases received individualized ocular refraction customization(IORC group), and 95 cases received orthokeratology lenses(OK group). Simultaneously, the three groups were further categorized into low(-3.00 to -0.50 D), moderate(-6.00 to -3.25 D), and high myopia(-7.00 to -6.25 D)groups according to different SE. MRT was used to measure and compare the defocus changes of the retina in supperior, inferior, nasal, and temporal quadrants(RDV-S, RDV-I, RDV-N, RDV-T), and three angles of field of view, including 0-15°, 15°-30°, and 30°-45°(RDV-15, RDV-30, RDV-45)in the three groups(the data divide for the connected regions is grouped to the latter group). A one-way analysis of variance was used for intergroup comparisons. Univariate and multivariate linear regression analyses were used to analyze the factors related to changes in the axial length(AL)at 1 a after intervention.RESULTS:There were significant differences in 1-year SE and AL growth among patients in the SVL, IORC, and OK groups before and after intervention(P<0.001). The 1-year SE and the difference of AL growth in patients with low myopia was significantly different among SVL, IORC, and OK groups(P<0.001); however, there was no significant difference between the IORC and OK groups(P>0.05); there were significant differences in the SE and AL growth changes between the OK group and the IORC and SVL groups in moderate myopia(P<0.001); and there were significant differences between the OK group and the IORC and SVL groups in SE and AL growth of high myopia group after wearing lenses for 1 a(P<0.001), while there were no significant differences between the IORC and SVL groups(P>0.05). In addition, there were significant differences in the relative peripheral refractive errors(RPRE)of 4 quadrants and 3 eccentric regions among the three groups of patients in different degrees of myopia groups(P<0.001). Pair-wise comparison of the growth difference of eccentric D-RDV-15 in low myopia group after wearing lenses for 1 a showed significant differences between the SVL, IORC, and OK groups(P<0.001), but no significant differences between the IORC and OK groups(P>0.05). The angle of field of view D-RDV-30 in moderate myopia subgroups was statistically different between the SVL group and the IORC and OK groups after wearing lenses for 1 a(P<0.001), while the IORC and OK groups showed no significant differences(P>0.05); the angle of field of view D-RDV-15 in high myopia subgroups was statistically different between the OK group and the IORC and SVL groups after wearing lenses for 1 a(P<0.001), but there was no significant difference between the IORC and SVL groups(P>0.05). Univariate and multivariate linear regression model analysis showed that the changes in D-TRVD, D-RDV-45, D-RDV-N, and D-RDV-I correlated with the increase in the difference in 1 a AL.CONCLUSION: MRT can be used to guide the clinical control of myopia. Myopia development is related to the peripheral retinal defocus state, and the difference of defocus quantity in the inferior nasal side at 30°-45° eccentricity may be a factor regulating the rapid progression of myopia.

The incidence of bladder cancer is increasing in China. Each year, nearly one third of newly diagnosed cases are muscle invasive bladder cancer (MIBC). The standard treatment for patients with MIBC is radical cystectomy (RC) with pelvic lymphadenectomy. Orthotopic neobladder (ONB) surgery is the primary method of urinary diversion after RC. However, ONB surgery is associated with many post-operative complications related to the urinary tract, intestine, and incision site. Here, we review the mechanism, prevention, and treatment measures of incision complications after ONB surgery.

To investigate the current status of the postpartum weight retention (PPWR) in Kaifu District of Changsha, and explore the influential factors with PPWR based on the generalized estimating equation model.
 Methods: A cluster sampling method was applied to select women who gave birth at the health service centers of 3 street communities in Kaifu District of Changsha during 2015. According to the inclusion and exclusion criteria, 783 cases were finally included in the study. Data on PPWR were collected prospectively by using the self-made questionnaire at 1, 3, 6 and 8 months after childbirth. Analysis were performed to investigate the associations between PPWR and its potential factors with generalized estimation equation model.
 Results: The mean PPWR of women was gradually decreased with the increase of postpartum time, and 34.6% of them have returned to the pre-pregnancy weight in the 8 months postpartum. Our findings revealed that gestation weight gain (GWG), pre-pregnancy body mass index, feeding patterns, and delivery mode were significantly associated with maternal PPWR (P<0.05). In contrast, maternal age, educational level, per capita income of family, parity and postpartum depression were not contributed to PPWR (P>0.05).
 Conclusion: GWG is one of the most important predictors for PPWR. The key to reducing PPWR is to control GWG systematically. Early targeted interventions and health education should be taken to prevent women from excessive PPWR at the first-year postpartum, in particular to the women who underwent cesarean deliveries and breastfed their infants. It is conducive to reduce the risks of overweight or obesity caused by PPWR.
Body Mass Index ; Female ; Gestational Weight Gain ; Humans ; Obesity ; Overweight ; Postpartum Period ; Pregnancy

Objective:To determine influential factors for delayed breastfeeding initiation.Methods:Using questionnaires to collect the data of 950 pregnant women and infants' feeding practices in Changsha,Hunan,logistic regression and decision tree model were used to determine influential factors for delayed breastfeeding initiation.Results:Mothers with timely breastfeeding initiation were 594 (62.5％),and those with delayed breastfeeding initiation accounted for 356 (37.5％).Mothers with timely breastfeeding initiation were more likely to use exclusive breastfeeding than those with delayed breastfeeding initiation (P＜0.05).Four risk factors were found by logistic regression model and decision tree model,including cesarean delivery,using feeding-bottle before breastfeeding initiation,falling ill,and vomiting during pregnancy.Receiver operating characteristic curve showed no significant difference in the predictive effect of the 2 models (Z=0.142,P=0.889).Conclusion:Cesarean delivery,using feeding-bottle before initiation of breastfeeding,and poor physical condition during pregnancy exert negatively effects on breastfeeding initiation.Health workers should help mother to timely initiate breastfeeding and enhance their confidence in exclusive breastfeeding.

Objective To evaluate the curative effect of conjoined tendon transfer for coracoclavicular ligament reconstruction in the treatment of Rockwood grades Ⅲ-Ⅳ acromioclavicular joint dislocation,c Methods A retrospective case control study was performed for 64 cases of acromioclavicular joint dislocation admitted from October 2007 to August 2014.There were 53 males and 11 females,with age of (43.8 ± 10.5) years (range,23 to 65 years).Rockwood grade Ⅲ was seen in 27 cases and grade-Ⅳ in 37.According to the treatments,26 cases underwent proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction combined with clavicular hook plate (ligament reconstruction group) and 38 cases only treated with clavicular hook plate (internal fixation group).Visual analogue scale (VAS),Constant shoulder score and postoperative complications were compared between the two groups before and after operation.Results All patients were available for a mean follow-up of 3.7 months (range,2 to 4 months).VAS was (7.58 ± 1.03) points in ligament reconstruction group and (7.15 ± 1.03)points in internal fixation group before surgery (P ＞0.05),and was (2.38±0.94)points in ligament reconstruction group and (2.08 ± 0.99) points in internal fixation group 3 months after operation (P ＞ 0.05).Constant shoulder score was (86.46 ± 6.59) points in ligament reconstruction group and (87.68 ± 6.59) points in internal fixation group after operation (P ＞ 0.05).Six cases (16％) had recurrent joint dislocation in internal fixation group,while none of the patients in ligament reconstruction group had recurrence (P ＜ 0.05).Conclusion Improved procedure of proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction can effectively reduce the recurrence rate of acromioclavicular joint dislocation.

Objective:To investigate the current status of the postpartum depression in Kaifu District in Changsha,and to explore the influential factors for postpartum depression.Methods:We selected the mothers,who had a delivery and met the inclusion criteria in Changsha during 2015,as the participants and established a prospective birth cohort study.The social demographic characteristics and health-related information for the mothers and their families were collected by using self-made questionnaire.The mothers' depression symptoms after one month postpartum were assessed by the Edinburgh Postnatal Depression Scale.We used the structural equation model to analyze the influential factors for postpartum depression.Results:A total of 961 cases were investigated.82 of them whose scores of EPDS were ≥ 9 points,and the incidence of PPD was 8.2％.The results of structural equation model revealed the influential factors and their correlations with postpartum depression.It has been shown that maternal age,maternal education level,per capita income of family,intention of pregnancy,pregnancy-related complications,mode of conception,mode of delivery,feeding patterns,birth weight,baby gender,and infant illness could exert effects on postpartum depression.Conclusion:The incidence of postpartum depression in Kaifu District is at a low level and the structural equation model can be applied to analyze the influential factors and their relations with postpartum depression.

Objective To investigate the application of pediatric early warning score (PEWS) in neurology department.Methods The clinical data and PEWS of 1,158 children with neurologic diseases (764 febrile seizures,259 viral encephalitis and 135 bacterial meningitis) admitted into neurology department from August 2013 to November 2016 were analyzed retrospectively.PEWS was compared among the three different diseases.According to the disease severity,cases were categorized into no-monitor-required group (n =996,697 febrile seizures,203 viral encephalitis and 96 bacterial meningitis),monitor-required group (n =138,67 febrile seizures,41 viral encephalitis and 30 bacterial meningitis) and PICU group (n =24,0 febrile seizures,15 viral encephalitis and 9 bacterial meningitis).PEWS was assessed at admission in both no-monitor-required group and monitorrequired group.PEWS was recorded 12 hours before PICU transfer in PICU group.Then PEWS was compared among all groups in different diseases respectively.Results The median (minimum ～ maximum) of PEWS in febrile seizures,viral encephalitis and bacterial meningitis was 0 (0 ～ 3),2(0 ～ 8) and 2(0 ～ 8),respectively and there was significant difference among three diseases (P ＜ 0.01).No patient of febrile seizures was transferred to PICU.PEWS of febrile seizures in monitor-required group was higher than that in no-monitor-required group (P ＜ 0.01).For both viral encephalitis and bacterial meningitis,PEWS in monitor-required group was higher than that in no-monitorrequired group,and the score in PICU group was higher than that in monitor-required group.The difference was significant (P ＜ 0.01).Conclusion PEWS is effective for the assessment of illness severity of hospitalized children in neurology department,and can be used for the prediction PICU transfer as an excellent screening tool.

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

OBJECTIVE: To explore the clinical signification of screening 16 target deafness mutations in GJB2, GJB3, SLC26A4, WFS1 and mitochondrial DNA 12S rRNA in 135 children patients with non-syndromic sensorineural hearing loss (NSHL) in Zibo City, Shandong province. METHOD: Peripheral blood samples of 135 subjects in the study diagnosed as NSHL were collected; Polymerase chain reaction (PCR) and direct sequencing were used to analyze the 16 mutation spots. RESULT: Sixty-two cases of 135 patients (45.9%, 62/135) were found out to be carries of at least one pathogenic gene mutation. Among them, 24 cases (17.8%, 24/135) had two mutated alleles (homozygote and compound heterozygote), and 38 cases (28.1%, 38/135) were single mutant carriers. Among all the children patients, 30 cases (22. 2%, 30/135) had SLC26A4 mutations, and 19 cases (14.1%, 19/135) had GJB2 mutations. In the study 86 Mutant alleles were detected, and the allele frequency of SLC26A4 c. 766_2A > G and GJB2 c. 235delC was 11.11% (30/270) and 8.5% (23/270) respectively. The allele frequency of SLC26A4 c. 2168A > G and WFS1 c. 2158A > G is 2.6% (7/270). CONCLUSION SLC26A4 mutation is the primary cause of the patients with NSHL in this study, and GJB2 mutation is the secondary. The most common mutant form is c. 766_2A of SLC26A4, and the second is c. 235delC of GJB2. GJB3 and WFS1 mutations were detected, whereas mtDNA mutations were not found out in this study.
Alleles ; Child ; Connexins ; DNA Mutational Analysis ; DNA, Mitochondrial ; Deafness ; Gene Frequency ; Hearing Loss ; Hearing Loss, Sensorineural ; genetics ; Heterozygote ; Homozygote ; Humans ; Mitochondria ; Mutation ; Polymerase Chain Reaction ; RNA, Ribosomal

Artemisnin is a novel sesquiterpene lactone with an internal peroxide bridge structure, which is extracted from traditional Chinese herb Artemisia annua L. (Qinghao). Recommended by World Health Organization, artemisinin is the first-line drug in the treatment of encephalic and chloroquine-resistant malaria. In the present study, transgenic A. annua plants were developed by overexpressing the key enzymes involved in the biosynthetic pathway of artemisinin. Based on Agrobacterium-mediated transformation methods, transgenic plants of A. annua with overexpression of both HDR and ADS were obtained through hygromycin screening. The genomic PCR analysis confirmed six transgenic lines in which both HDR and ADS were integrated into genome. The gene expression analysis given by real-time quantitative PCR showed that all the transgenic lines had higher expression levels of HDR and ADS than the non-transgenic control (except ah3 in which the expression level of ADS showed no significant difference compared with control); and the HPLC analysis of artemisinin demonstrated that transgenic A. annua plants produced artemisinin at significantly higher level than non-transgenic plants. Especially, the highest content of artemisinin was found in transgenic line ah70, in which the artemisinin content was 3.48 times compared with that in non-transgenic lines. In summary, overexpression of HDR and ADS facilitated artemisinin biosynthesis and this method could be applied to develop transgenic plants of A. annua with higher yield of artemisinin.