Implantable collamer lenses (ICL) implantation provides a new method for the treatment of children with high myopia, anisometropia and amblyopia, who may be spectacle aversive and unsuited to contact lens wear and corneal refractive surgery.Surgery can improve children's uncorrected visual acuity, increase contrast sensitivity, promote mental health and improve quality of life.This treatment has a significant effect on amblyopia.After ICL implantation, the refractive state is highly stable, and the stability is better than small incision lenticule extraction and laser subepithelial keratomileusis.The selection of ICL size and power is critical to the success of surgery, and preoperative prediction of vault should be made in consideration of children's eye development.Perioperative anesthesia, incision method as well as type, amount and duration of postoperative medication are different from those of adults.Furthermore, common postoperative complications in children include pupillary block glaucoma, elevation of intraocular pressure, loss of corneal endothelial cells, wound leak, and traumatic dislocation of the ICL.Implantation of ICL in children is a staged treatment during the sensitive period of refractive development.After the refractive development of both eyes is stabilized, refractive errors can be corrected by other methods.This article reviews the advantages of ICL implantation in the treatment of children with high myopia and amblyopia, and focuses on ICL selection, postoperative complications and remaining problems, to provide a reference for clinical application.

Objective To observe the clinical efficacy of neck-shoulder-waist-leg pain cataplasms combined with electroacupuncture in the treatment of acute cervical radiculopathy(CR)with qi stagnation and blood stasis syndrome;To evaluate the synergistic effect and safety of neck-shoulder-waist-leg pain cataplasms.Methods Totally 132 CR patients with qi stagnation and blood stasis type in acute stage were randomly divided into treatment group(66 cases)and control group(66 cases).The treatment group was treated with electroacupuncture combined with neck-shoulder-waist-leg pain cataplasms,and the control group was treated with electroacupuncture combined with placebo.Both groups were treated once a day for 5 days and then rested for 2 days for 3 weeks,and follow-up was performed at 1 and 2 weeks after treatment.Clinical efficacy of both groups was observed.The short-form McGill pain questionnaire(SF-MPQ)score,neck disability index(NDI)score,and the F-wave conduction velocity of the median nerve and ulnar nerve were compared before and after treatment and at follow-up.Results 5 and 7 cases were lost in the treatment group and the control group,respectively.The total effective rate of the treatment group was 91.80%(56/61),and the recovery rate was 36.07%(22/61).The total effective rate of the control group was 84.75%(50/59),and the recovery rate was 18.65%(11/59).The difference in recovery rates between the two groups was statistically significant(P<0.05).Compared with before treatment,the SF-MPQ score and NDI score in both groups improved significantly(P<0.05)after treatment and at 1 and 2 weeks of follow-up,and the F-wave conduction velocity of the median and ulnar nerves increased significantly(P<0.05)after treatment.Comparison between two groups at the same time points showed that the SF-MPQ score and NDI score of the treatment group were better than those of the control group(P<0.05)after treatment and at 1 and 2 weeks of follow-up,and the F-wave conduction velocity of the median and ulnar nerves was faster than that of the control group(P<0.05)after treatment.There were no serious adverse reactions in the two groups.Conclusion Neck-shoulder-waist-leg pain cataplasms combined with electroacupuncture can improve the clinical symptoms of CR with qi stagnation and blood stasis syndrome in acute stage.Electroacupuncture plus neck-shoulder-waist-leg pain cataplasms can speed up the recovery process of the disease,which has synergistic effect.

Radical cystectomy combined with pelvic lymph node dissection is the standard procedure for the treatment of muscle invasive bladder cancer and complex non-muscle invasive bladder cancer.Our department has routinely carried out laparoscopic radical cystectomy(ELRC)through the extraperitoneal approach in 340 cases.This article summarizes the establishment of the peritoneal space,the expansion of the peritoneal space,the operation steps of bladder resection and lymph node dissection through the peritoneal channel,and how to shorten the operation time and reduce the difficulty of the operation.During the surgery,the bladder is removed periperitoneally without destroying the peritoneum to preserve the functions of peritoneum support,secretion,protection and lubrication,which has little impact on the abdominal organs,reduces the incidence of complications,and provides favorable conditions for subsequent treatment.

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.

The pathogenesis of bipolar disorder(BD)is unknown,and objective biomarkers with clinical guidance are lacking.Extracellular vesicles(EV)are lipid bilayer-enclosed vesicles that carry cargo from originating cells,influencing the processes of recipient cells.They are capable of crossing the blood-brain barrier and reflecting the ongoing processes in the central nervous system.Compelling data indicates that EV could mediate BD pathophysiological processes such as neurocognitive impairment,neuroinflammatory diffusion,and metabolic dysfunction.Therefore,EV has the potential to become a reliable biomarker and therapy for BD,providing new ideas for revealing the pathogenesis and clinical diagnosis and treatment of BD.

Objective:To investigate the expression of solute carrier family 35 member E1 (SLC35E1) and SLC35E2B in skin lesions of patients with Mycobacterium infections. Methods:Paraffin-embedded skin tissues of 31 patients confirmedly diagnosed with Mycobacterium infections were collected from Dermatology Hospital of Southern Medical University from 2014 to 2018, including 10 cases of multibacillary leprosy, 9 of nontuberculous mycobacterial infection, 7 of cutaneous tuberculosis, and 5 of erythema induratum. Meanwhile, paraffin-embedded skin tissues of 10 healthy individuals were collected, and served as normal control group. Immunohistochemical staining was performed to determine the expression of SLC35E1 and SLC35E2B in the lesional and normal control skin specimens, and immunofluorescence staining to observe the co-expression of CD68 and S100 with SLC35E1 and SLC35E2B in the skin lesions. Results:Neither SLC35E1 nor SLC35E2B was expressed in the normal control group, but high expression of SLC35E1 and SLC35E2B was observed in the dermis of skin lesions from the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis or erythema induratum. Immunohistochemical staining showed that the expression of SLC35E1 and SLC35E2B (expressed as average optical density) was significantly higher in the multibacillary leprosy group (0.143 ± 0.010, 0.169 ± 0.004, respectively) , nontuberculous mycobacterial infection group (0.278 ± 0.015, 0.229 ± 0.088, respectively) , cutaneous tuberculosis group (0.171 ± 0.010, 0.103 ± 0.016, respectively) and erythema induratum group (0.200 ± 0.015, 0.118 ± 0.021, respectively) than in the normal control group (both 0, all P < 0.05) . Immunofluorescence staining showed co-expression of SLC35E1 and SLC35E2B with CD68 in skin lesions of the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis. Conclusion:Both SLC35E1 and SLCE2B were markedly highly expressed in skin lesions of patients with Mycobacterium infections.

Objective: To explore the association between long-term changes in blood pressure (BP) levels and the incidence of cardiovascular diseases (CVD). Methods: A total of 5 752 participants, who participated baseline examination in 1992-1993 and re-examination in 2007, were followed up till December 31, 2013 according to the study protocol of the Chinese Multi-provincial Cohort Study. Participants were stratified by baseline BP and re-examination BP and cross-combined into 9 subgroups. The 20-year incidence of acute cardiovascular events, acute coronary heart disease (CHD) and acute stroke events were analyzed and association between disease incidence and 15-year changes in BP were determined using the competing risk regression model. Results: (1) There were 523 CVD events (170 CHD, 373 stroke) during the 20 years follow up. The number of participants with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) of <130/80 mmHg (1 mmHg=0.133 kPa), 130-139/80-89 mmHg, and hypertension were 2 892 (50.3%), 1 328 (23.1%) and 1 532 (26.6%), respectively. (2) Among participants with baseline SBP of 130-139 mmHg or DBP of 80-89 mmHg, 870 (65.5%) progressed to hypertension and 279 (21.0%) maintained at the same stratum over a 15-year follow up period. (3) After adjustment for age, sex, body mass index, smoking status, diabetes, total cholesterol, and high-density lipoprotein cholesterol at baseline, participants maintained SBP/DBP at 130-139/80-89 mmHg had a higher risk of developing acute cardiovascular events, CHD and stroke with the hazard ratios (HR) and 95% confidence interval (95%CI) of 2.04 (1.16, 3.57), 3.29 (1.30, 8.35) and 1.63 (0.80, 3.33), compared with those who maintained their SBP < 130 mmHg and DBP <80 mmHg. Participants whose BP increased from 130-139/80-89 mmHg to hypertension over the follow up period had 2.81-fold (1.84, 4.29), 3.17-fold (1.43, 7.03) and 2.71-fold (1.65, 4.44) higher risk for the incidence of acute cardiovascular events, CHD, and stroke, respectively, compared with participants who maintained their SBP <130 mmHg and DBP <80 mmHg. Conclusions Participants with SBP/DBP of 130-139/80-89 mmHg have a high long-term risk for progression to hypertension. Sustained exposure to SBP/DBP of 130-139/80-89 mmHg or higher increases the risk of CVD incidence, and our results highlight the importance of early prevention for participants with this BP stratum.

OBJECTIVE:To investigate the effects of UGT1A6 and UGT1A9 gene polymorphisms on blood concentration of valproic acid in Han epileptic patients.METHODS:Totally 107 Chinese Han epileptic patients were selected from outpatient department of our hospital during Jan.2014-Apr.2015.They were given valproic acid monotherapy treatment for 3 months to 6 years.The steady state concentration ofvalproic acid was detected by EMIT.UGT1A6 (rs2070959,rs6759892) and UGT1A9 (rs13418420,rs2741045,rs2741049,rs6731242,rs72551330) genotypes were detected by MALDI-TOF-MS.The correlation of gene polymorphism with con centration dose ratios (CDR) of valproic acid was investigated.RESULTS:UGT1A9 rs72551330 mutation had not been detected,and the frequency of genotypes in other 6 sites were all in line with Hardy-Weinberg balance (P＞0.05).The CDR of valproic acid in pa tients with UGT1A6 rs2070959,rs6759892 mutation (AG+GG or TG+GG type) were significantly lower than those with wild homozy gote (AA or TT type),with statistical significance (P＜ 0.05).There was no statistical significance in CDR of valproic acid among patients with UGT1A9 rs13418420,rs2741045,rs2741049 and rs6731242 wild homozygote and mutation (P＞0.05).CONCLUSIONS:UGT1A6 rs2070959,rs6759892 gene polymorphisms of Han epileptic patients are associated with blood concentration of valproic acid,and the patients with UGT1A6 rs2070959,rs6759892 mutation need more dose ofvalproic acid.

Objective:To investigate the clinical efficacy of Zhang's acupoint pressure therapy plus electroacupuncture (EA) in treating post-traumatic knee osteoarthritis.Methods:A total of 98 eligible patients with post-traumatic knee osteoarthritis were divided into group A and B by the random number table, 49 cases in each group. Group A was intervened by Zhang's acupoint pressure therapy plus EA; group B was given medicinal fumigation. The clinical efficacies of the two groups were compared.Results:The markedly effective rate of group A was significantly higher than that of group B.Conclusion:Zhang's acupoint pressure therapy plus EA can produce a satisfactory clinical efficacy in treating post-traumatic knee osteoarthritis, and is worth promotion.

Aberrant expression of annexin A2-S100A10 heterotetramer (AIIt) associated with PML/RARα fusion protein causes lethal hyperfibrinolysis in acute promyelocytic leukemia (APL),but the mechanism is unclear.To facilitate the investigation of regulatory association between ANXA2 and promyelocytic leukemia/retinoic acid receptor α (PML/RARα) fusion protein,this work was performed to determine the transcription start site of ANXA2 promoter with rapid amplification of S'-cDNA ends analysis.Zinc-induced U937/PR9 cells expressed PML/RARα fusion protein,and resultant increases in ANXA2 transcripts and translational expressions of both ANXA2 and S100A10,while S100A10 transcripts remained constitutive.The transactivation of ANXA2 promoter by PML/RARα fusion protein was 3.29 ± 0.13 fold higher than that by control pSG5 vector or wild-type RARα.The overexpression of ANXA2 in U937 transfected with full-length ANXA2 eDNA was associated with increased S100A10 subunit,although S100A10 transcripts remained constitutive.The tPA-dependent initial rate of plasmin generation (IRPG) in zinc-treated U937/PR9 increased by 2.13-fold,and cell invasiveness increased by 27.6％.Antibodies against ANXA2,S100A10,or combination of both all remarkably inhibited the IRPG and invasiveness in U937/PR9 and NB4.Treatment of zinc-induced U937/PR9 or circulating APL blasts with all-trans retinoic acid (ATRA) significantly reduced cell surface ANXA2 and S100A10 and associated reductions in IRPG and invasiveness.Thus,PML/RARα fusion protein transactivated the ANXA2 promoter to upregulate ANXA2 and accumulate S100A10.Increased AIIt promoted IRPG and invasiveness,both of which were partly abolished by antibodies against ANXA2 and S100A10 or by ATRA.