Objective To investigate the effects of different doses of recombinant human growth hormone(rhGH)on idiopathic short stature in boys and its impact on serum metabolic biomarkers,insulin-like growth factor 1(IGF-1),and insulin-like growth factor binding protein 3(IGFBP-3).Methods Eighty boys with idiopathic short stature who were admitted to Jiangyin Hospital of Traditional Chinese Medicine from April 2020 to April 2023 were enrolled.They were assigned to low-dose group(0.26 mg/kg per week,n=29),medium-dose group(0.35 mg/kg per week,n=27),and high-dose group(0.41 mg/kg per week,n=24)according to the therapeutic dose of rhGH.The treatment lasted for 1-2 years.Height,weight,growth velocity,height standard score,bone density,bone age,bone metabolisms(serum 25-hydroxyvitamin D[25(OH)-D],bone alkaline phosphatase[BAP],and osteocalcin[OC]),thyroid function(free triiodothyronine[FT3],free thyroxine[FT4],and thyroid-stimulating hormone[TSH]),IGF-1,and IGFBP-3 were compared among groups before and after treatment.Results The height,weight,growth velocity,height standard score,bone density,and bone age were increased in all the three groups after treatment(PTime<0.05).Serum 25(OH)-D,BAP,and osteocalcin were also significantly increased(PGroup<0.05,PTime<0.05).As the treatment progressed,serum IGF-1 and IGFBP-3 levels increased(PTime<0.05).The incidence of adverse reaction(joint pain,injection site edema,and hyperglycemia)in the high-dose group(25.00%)was higher than that in the low-dose group(13.79%)and medium-dose group(18.52%).Conclusion Medium and high doses of rhGH can more effectively improve bone density,serum IGF-1,and IGFBP-3 in boys with idiopathic short stature.It is recommended to choose an appropriate dose of rhGH based on the specific condition of boys with idiopathic short stature under the precondition of safety.

Objective To investigate the effect and mechanism of Shuangzhu Kangxian Prescription(Astragali Radix,bran-fried Atractylodis Macrocephalae Rhizoma,vinegar-prepared Rhizoma Curcumae,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,Litchi Semen)on improving hepatitic fibrosis induced by carbon tetrachloride(CCl4)in rats based on the Wnt/β-catenin signaling pathway.Methods The rat model of hepatitic fibrosis was replicated by subcutaneous injection of 3.0 mL·kg-1 40%CCl4 twice a week for 8 weeks.SD rats were randomly divided into blank control group(n=8),model group(n=7),positive control group(n=7,intragastric administration of 43.19 mg·kg-1 silymarin),low-dose Chinese medicine group(n=6,intragastric administration of 4.3 g·kg-1Shuangzhu Kangxian Prescription),medium-dose Chinese medicine group(n=6,intragastric administration of 8.6 g·kg-1Shuangzhu Kangxian Prescription),high-dose Chinese medicine group(n=7,intragastric administration of 17.2 g·kg-1Shuangzhu Kangxian Prescription).The continuous intragastric administration was given once a day for 4 consective weeks,in addition to the blank control group,the other groups continued to be subcutaneously injected with CCl4 at the same time.The pathological changes of liver tissue were observed by HE and Masson staining.The levels of serum type Ⅳ collagen(Col Ⅳ),type Ⅲ procollagen(PC Ⅲ),hyaluronic acid(HA)and laminin(LN)were detected by ELISA.The protein expression levels of Wnt1,β-catenin and PPAR-γ in liver tissue were detected by Western Blot.The mRNA expression levels of Wnt1,β-catenin and PPAR-γ in liver tissue were detected by qPCR.Results Compared with the blank control group,the liver of the model group showed partial necrosis of liver cells,the normal hepatic lobule structure was destroyed,the arrangement of liver cell cords was disordered,the central vein or portal area was enlarged,and a large number of inflammatory cells infiltrated to form bridging necrosis.The collagen fibers in the central vein or portal area of the liver proliferated significantly,forming fibrous septa,and the fibrosis score were significantly increased(P＜0.05).The levels of serum Col IV,PC Ⅲ,HA and LN were significantly increased(P＜0.05).The protein and mRNA expression levels of Wnt1 and β-catenin in liver tissue were significantly increased(P＜0.05),and the protein and mRNA expression levels of PPAR-γ were significantly decreased(P＜0.05).Compared with the model group,the steatosis of hepatocytes in the positive control group and the medium-and high-dose groups of Chinese medicine was improved,and the necrosis and inflammatory cell infiltration were reduced.The degree of hepatitic fibrosis was improved,the liver collagen fibers were reduced,and the fibrosis score was significantly reduced(P＜0.05).The levels of serum Col Ⅳ,PC Ⅲ,HA and LN were significantly decreased(P＜0.05).The protein and mRNA expression levels of Wnt1 and β-catenin in liver tissue were significantly decreased(P＜0.05),and the protein and mRNA expression levels of PPAR-γ were significantly increased(P＜0.05).Conclusion Shuangzhu Kangxian Prescription has the effect of anti CCl4-induced hepatitic fibrosis in rats,and its mechanism may be related to the inhibition of Wnt/β-catenin signaling pathway and up-regulation of PPAR-γ expression.

Chronic rhinosinusitis（CRS） is an inflammatory disease involving the mucosa of the nasal and paranasal sinuses for more than 12 weeks and can be classified as CRS with nasal polyp（CRSwNP） and CRS without nasal polyp（CRSsNP） depending on the phenotype. Clinical treatments reveal significant differences in disease prognosis and improvement in quality of life in patients with the same clinical phenotype. Inflammatory cells infiltration and inflammatory mediators are important factors driving CRS endotypes. In particular, CRS with predominantly eosinophilic infiltration and type 2 CRS present severe clinical symptoms, comorbidities, and high recurrence rates. CRS endotype-oriented treatment methods may better contribute to improving patient prognosis and quality of life. This article summarizes the current progress of CRS endotype research and reviews the endotype-oriented treatment options.
Humans ; Rhinitis/therapy* ; Nasal Polyps/diagnosis* ; Quality of Life ; Sinusitis/diagnosis* ; Eosinophilia ; Chronic Disease

AlM:To provide a proper assessment of the clinical use of orthokeratology by observing and analyzing the ocular biometric changes of the eyes and the stereopsis of the myopia.
METHODS:Sixty eyes from 30 myopia ( from 8 to 17 years old) were fitted with orthokeratology. Stereopsis, visual acuity, near visual acuity, central corneal thickness, anterior chamber depth, average anterior corneal refractive power ( K value ) , and intraocular pressure were measured before the orthokeratology treatment and 3mo after it. Refraction was expressed as spherical equivalent ( SE) , and the subjects were divided into 3 groups according to refraction: low myopia group (SE<-3.00D), moderate myopia group (-3. 00D≤SE<-6. 00D), and high myopia group (SE≥-6. 00D).
RESULTS:All subjects had significant improvements in visual acuity and near visual acuity 3mo after the orthokeratology treatment (P<0. 01). ln the comparisons of any pair of the groups, there was no significant difference in the near visual acuity ( P>0. 05 ). Three months after the orthokeratology treatment, Naked eye near stereoacuity values of all subjects were decreased (P<0. 01). There was no significant difference in the comparisons of the differences of stereopsis between any pair of the groups ( P> 0. 05 ). There was significant correlation in stereopsis and anisometropia ( Pearson coefficient r = 0. 778, P < 0. 01 ). And with greater anisometropia, the stereopsis was higher. All subjects had significantly lower K values than before 3mo after the orthokeratology treatment ( P< 0. 01 ). There was no significant difference in central corneal thickness, anterior chamber depth, and intraocular pressure (P>0. 05).
CONCLUSlON:Orthokeratology could lower K value in a short time and change the corneal curvature to correct myopia, to improve visual acuity and near visual acuity. lt also has an influence on improving stereopsis. There are no obviously changes in patients' central corneal thickness, anterior chamber depth or intraocular pressure after the orthokeratology treatment, making it a safe and effective treatment for adolescent.

Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.

Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.

Objective To evaluate the impact of acute hyperglycemia on the short-term prognosis in patients with primary intracerebral hemorrhage (ICH) with meta-analysis. Methods The prospective or retrospective cohort studies or case-control studies of the relationship between baseline blood glucose levels and short-term prognosis (at least were followed up to discharge or 1 month) in patients with ICH within 24 hours were searched and reported. A meta-analysis software package (RevMan 4. 2) was used to pool data for the literatures in accordance with the inclusion criteria. The publication bias was analyzed and the sensitivity analysis was used to evaluate the stability of the results. Results The risk of mortality at the end of the follow up in the normoglycemia group was significantly lower than that in the hyperglycemia group (odds ratio 0. 24,95% CI 0. 19-0. 30; P <0. 000 01); the baseline plasma glucose level was significantly lower than that in the survival group (weighted mean difference -2. 30,95% CI -2. 36- -2.23; P< 0.000 01). Conclusions Acute hyperglycemia can significantly increase the risks of short-term mortality in patients with primary ICH. It is necessary to conduct a prospective randomized trial in order to investigate the effect of intensive glucose control on the prognosis of the patients with ICH.

AIM:To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation.METHODS:Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed,including 3 cases of optic nerve injury;3 cases of foreign object of optic behind the eyeball;1 case of retrobulbar tumor(angeioma).RESULTS:The preoperative preparatory time would take 15 minutes,including coordination,head holder localization,conventional instrument registration.In our cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm.The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures.No complication occurred.CONCLUSION:Nasal endoscope combined with imageguidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field.It is possible for surgeons to observe important anatomical structures during endoscopic surgery.It could increase the effectiveness and decrease surgical complications,especially in complicated cases.