AIM: To investigate the influence of relevant inflammatory markers in peripheral blood on the progression of neovascular glaucoma(NVG)secondary to diabetic retinopathy(DR)patients.METHODS: Retrospective case-control study. Patients were categorized into two groups based on the presence or absence of NVG: those with proliferative diabetic retinopathy(PDR)alone(PDR group, n=148)and those with NVG secondary to PDR(NVG secondary to PDR group, n=142). Peripheral blood inflammatory markers were evaluated, including white blood cell-related indices, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), monocyte-to-lymphocyte ratio(MLR), and systemic immune-inflammation index(SII). The distinctions in peripheral blood inflammatory markers between the two groups of patients and their relationships with NVG secondary to PDR were analyzed.RESULTS:No statistically significant differences were observed in basic characteristics between the two groups, confirming their comparability. However, significant differences were found in eosinophil percentage and MLR between the PDR group and the NVG secondary to PDR group(all P<0.05), with both values being significantly higher in the NVG secondary to PDR group. Multivariate Logistic regression analysis revealed that the eosinophil percentage and the MLR were factors influencing the development of patients with NVG secondary to PDR.CONCLUSION: Eosinophil percentage and MLR may be associated with the progression of PDR to NVG, and could serve as potential predictive markers for NVG development in PDR patients.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To explore the effect of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva.Methods:The data of patients received double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva in Department of Medical Aesthetic Surgery, People’s Hospital of Rizhao, and Department of Plastic Surgery, Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao from January 2021 to June 2022 were retrospectively analyzed. Before the operation, the double eyelid line was designed and 5 points were evenly marked along the line as A, B, C, D and E (from the lateral to the internal). During the operation, 10 ml needle was used to puncture the 5 points marked on the double eyelid line. Starting from the outermost point A, the needle was inserted obliquely inward on the skin surface, and then the upper eyelid was turned over, and the stitches was stabed-out from the conjunctival surface of the upper margin of tarsus. The stitches was inserted again from the original point pierced on the conjunctival surface, and the stitches was stabed-out diagonally inward through the skin surface at the point B. The same method was used to penetrate points C, D and E successively. Then E, D, C, B and A points were penetrated in turn from the inside to the outside. The two suture ends were passed through the 3/8 arc round stitches, which was inserted from the point A and stabed-out skin surface of the outer orbital margin above the double eyelid line through the deep. The tightness was adjusted and tied the knotted. After the surgery, the surgical results and complications were observed, and patients’ satisfaction was evaluated before and 6 months after the surgery, which included four factors: eyelid curvature, width, smoothness, and symmetry, with a maximum score of 100. Higher scores indicated greater patients’ satisfaction. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare the satisfaction of the same patient before and after surgery. P<0.05 indicated statistically significant difference. Results:A total of 82 patients with 160 eyes were included, including 75 females and 7 males. The age ranged from 18 to 32 years old, with a mean of 25.4 years old. 78 cases were treated with both eyes and 4 with one eye. In the early postoperative period, 8 patients had local cyanosis and slight swelling of eyelid, which was improved after routine cold compress treatment. Two cases reported a foreign body sensation in the eyeball, which improved with application of levofloxacin for 1 week. The remaining patients had good eyelid morphology with no significant swelling or foreign body sensation. A total of 60 patients were followed up for 6 months, and their eyelid morphology appeared natural and aesthetically pleasing. The eyelid crease was smooth when opened, and there were no obvious surgical scars when closed. Only one patient had a shallow eyelid crease, which was satisfactorily repaired with additional suturing. None of the patients experienced external suture exposure or subcutaneous nodules. The patient satisfaction score was (58.15±5.07) before operation and (98.68±1.69) 6 months after operation, the difference was statistically significant ( t=-70.33, P<0.001). Conclusion:Double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva has the advantages of minimally invasion, simple performence, direct vision operation, with natural appearance of double eyelid, and high patient satisfaction.

Objective:To explore the effect of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva.Methods:The data of patients received double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva in Department of Medical Aesthetic Surgery, People’s Hospital of Rizhao, and Department of Plastic Surgery, Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao from January 2021 to June 2022 were retrospectively analyzed. Before the operation, the double eyelid line was designed and 5 points were evenly marked along the line as A, B, C, D and E (from the lateral to the internal). During the operation, 10 ml needle was used to puncture the 5 points marked on the double eyelid line. Starting from the outermost point A, the needle was inserted obliquely inward on the skin surface, and then the upper eyelid was turned over, and the stitches was stabed-out from the conjunctival surface of the upper margin of tarsus. The stitches was inserted again from the original point pierced on the conjunctival surface, and the stitches was stabed-out diagonally inward through the skin surface at the point B. The same method was used to penetrate points C, D and E successively. Then E, D, C, B and A points were penetrated in turn from the inside to the outside. The two suture ends were passed through the 3/8 arc round stitches, which was inserted from the point A and stabed-out skin surface of the outer orbital margin above the double eyelid line through the deep. The tightness was adjusted and tied the knotted. After the surgery, the surgical results and complications were observed, and patients’ satisfaction was evaluated before and 6 months after the surgery, which included four factors: eyelid curvature, width, smoothness, and symmetry, with a maximum score of 100. Higher scores indicated greater patients’ satisfaction. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare the satisfaction of the same patient before and after surgery. P<0.05 indicated statistically significant difference. Results:A total of 82 patients with 160 eyes were included, including 75 females and 7 males. The age ranged from 18 to 32 years old, with a mean of 25.4 years old. 78 cases were treated with both eyes and 4 with one eye. In the early postoperative period, 8 patients had local cyanosis and slight swelling of eyelid, which was improved after routine cold compress treatment. Two cases reported a foreign body sensation in the eyeball, which improved with application of levofloxacin for 1 week. The remaining patients had good eyelid morphology with no significant swelling or foreign body sensation. A total of 60 patients were followed up for 6 months, and their eyelid morphology appeared natural and aesthetically pleasing. The eyelid crease was smooth when opened, and there were no obvious surgical scars when closed. Only one patient had a shallow eyelid crease, which was satisfactorily repaired with additional suturing. None of the patients experienced external suture exposure or subcutaneous nodules. The patient satisfaction score was (58.15±5.07) before operation and (98.68±1.69) 6 months after operation, the difference was statistically significant ( t=-70.33, P<0.001). Conclusion:Double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva has the advantages of minimally invasion, simple performence, direct vision operation, with natural appearance of double eyelid, and high patient satisfaction.

Objective:To evaluate the effect of propofol and remifentanil in different target-controlled infusion(TCI) sequences on hypotension during induction of general anesthesia in hypertensive patients.Methods:A total of 132 patients with hypertension of both sexes, aged 50-75 yr, of American Society of Anesthesiologists Physical Status classificationⅡ or Ⅲ, with body mass index of 18-30 kg/m 2, scheduled for elective tracheal intubation under general anesthesia, were divided into 3 groups( n=44 each) using a random number table method: group C, PR group and RP group. In group C, propofol(target effect-site concentration 5 μg/ml) and remifentanil(target effect-site concentration 5 ng/ml) were simultaneously given by TCI. Propofol was given by TCI followed by TCI of remifentanil in PR group. Remifentanil was given by TCI followed by TCI of propofol in RP group. The development of hypotension was observed within 10 min after induction of general anesthesia, and the consumption of propofol, remifentanil and ephedrine, time of loss of consciousness, time of tracheal intubation and adverse reactions during the perioperative period were recorded. Results:Compared with group C, the incidence of hypotension during induction was significantly decreased, the consumption of propofol and ephedrine was decreased, and the BIS value was increased when consciousness disappeared, the time of loss of consciousness and time of tracheal intubation were prolonged, the BIS value was increased at loss of consciousness in PR group, and the consumption of ephedrine was significantly decreased, and the time of loss of consciousness and time of tracheal intubation were prolonged in RP group( P<0.05). Compared with PR group, the consumption of ephedrine was significantly decreased, and the time of loss of consciousness was prolonged in RP group( P<0.05). There was no significant difference in the incidence of responses to tracheal intubation, injection pain, bucking, inhibition ratio, postoperative delirium, postoperative nausea and vomiting, and intraoperative awareness during induction among the three groups( P>0.05). Conclusions:TCI of remifentanil followed by TCI of propofol can decrease the development of hypotension during induction of general anesthesia in hypertensive patients.

ObjectiveTo investigate the mental health status of the front-line anti-epidemic medical staff during the COVID-19 outbreak， so as to provide references for the targeted psychological intervention and improvement of mental health status. MethodsA total of 162 front-line medical staff who worked in Lanzhou Heavy Particles Hospital of Gansu Province from October to December 2021 were were enrolled， and assessed using self-designed general information questionnaire， Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）. ResultsA total of 144 medical staff completed the valid questionnaire survey， and 17 （11.81%） and 19 （13.19%） cases were found to have anxiety and depression， respectively. The detection rate of anxiety yielded statistical difference among medical staff with different anti-epidemic working hours （χ²=10.602， P<0.01）， and the detection rate of depression demonstrated statistical differences among medical staff with different occupations， family history of depression and anti-epidemic working hours （χ²=5.486， 4.039， 7.526， P<0.05）. ConclusionDuring the COVID-19 outbreak， front-line medical staff develop varying degrees of anxiety and depression. Furthermore， the detection rate of anxiety is relatively high among the staff with long anti-epidemic working hours， and the detection rate of depression is relatively high among the doctors， the staff with family history of depression and long anti-epidemic working hours.

Objective:To compare the result of nucleic acid detection between anal swabs and nasal swabs in confirmed cases of COVID-19.Methods:The result of nucleic acid detection between anal swabs and nasal swabs collected simultaneously at various time points after illness onset were analyzed retrospectively.Results:Totally, 46 matched result of anal swabs and nasal swabs in confirmed cases of COVID-19 collected at various intervals after illness onset in 31 patients were analyzed. All the result of nucleic acid detection were positive for anal swabs. The highest concordance rate of nucleic acid positive of COVID-19 (80%) between anal swabs and nasal swabs was observed 0-3 days after illness onset; while the value declined to 28.57% ≥16 days after illness onset. The longer the interval between sampling and illness onset, the lower the concordance rate.Conclusions:Besides two negative result from respiratory tract specimens, the negative result of anal swabs should be added as an important reference of releasing from quarantine.

Objective:To explore the differential protein expressions in papillary thyroid carcinoma (PTC) with or without Hashimoto′s thyroiditis (HT).Methods:Tissue microarray was prepared and the protein expression levels of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF), vascular endothelial growth factor (VEGF), cyclinD1, mesothelial cell (MC) , CD56 and Galectin3 in the PTC tissues with or without HT were detected by immunohistochemical staining.Results:The positive expression rates of BRAF protein in the PTC tissues with or without HT groups were 55.4% (36/65) and 63.6% (42/66), respectively, without significant difference ( P=0.336). The positive expression rates of VEGF protein in the PTC tissues with or without HT groups were 25.7% (19/74) and 25.8%(17/66), respectively, without significant difference ( P=0.991). The positive expression rates of cyclin D1 protein in the PTC tissues with or without HT groups were 93.4% (71/76) and 97.6% (80/82), without significant difference ( P=0.206). The positive expression rates of MC protein in the PTC tissues with or without HT groups were 86.1% (62/72) and 83.5%(71/85), without significant difference ( P=0.654). The positive expression rates of Galectin3 protein in the PTC tissues with or without HT groups were 98.7% (76/77) and 97.5% (78/80), without significant difference ( P=0.583). The positive expression rates of CD56 in the PTC tissues and adjacent thyroid follicular epithelial cells were 27.4% (32/117) and 65.0% (76/117), respectively, and the difference was statistically significant ( P=0.001). The positive expression rates of CD56 in PTC tissues with or without HT were 35.5% (24/68) and 16.5% (13/79), respectively, and the difference was statistically significant ( P=0.009). Conclusions:There are no significant differences in the expressions of BRAF, VEGF, CyclinD1, MC and Galectin3 between the PTC tissues with or without HT. However, the significantly differential expression of CD56 between the two group suggests that CD56 may be related to the pathogenesis of PTC with HT. CD56 may be used as a potential molecular marker in PTC diagnosis.

Objective:To investigate the therapeutic mechanism of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating mild amnestic cognitive impairment (aMCI).Methods:Twenty-five patients with aMCI were randomly divided into an observation group of 13 and a control group of 12. The observation group was given 10-Hz rTMS over the left dorsolateral prefrontal cortex at 80% of the motor threshold-400 pulses a day, 5 times a week for 4 consecutive weeks. The control group received sham stimulation on the same schedule. Before and after the experiment, both groups were evaluated using the Montreal cognitive assessment (MoCA) and received fMRI scans.Results:After the intervention, the average MoCA score of the observation group had improved significantly more compared with that of the control group and compared with before the intervention. According to the fMRI results, regional homogeneity in the right middle frontal gyrus of the observation group had increased significantly, while that of the control group both there and in the left precuneus had decreased significantly.Conclusions:High-frequency rTMS can effectively improve the cognitive function of patients with aMCI and synchronize neuron activity in cognition-related brain regions.

TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.