OBJECTIVES: To investigate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in the treatment of retinopathy of prematurity (ROP) and the risk factors for recurrence. METHODS: A retrospective analysis was performed on the medical data of 159 infants with ROP who were born in the First Affiliated Hospital of Zhengzhou University and underwent anti-VEGF treatment from January 2016 to December 2021. According to the presence or absence of recurrence within the follow-up period after initial anti-VEGF treatment, they were divided into a recurrence group with 24 infants and a non-recurrence group with 135 infants. The medical data were compared between the two groups, and a multivariate logistic regression analysis was used to investigate the risk factors for the recurrence of ROP after anti-VEGF treatment. RESULTS: After one-time anti-VEGF treatment, all 159 infants showed regression of plus disease. Recurrence was observed in 24 infants (15.1%) after anti-VEGF treatment, with a mean interval of (8.4±2.6) weeks from treatment to recurrence. The multivariate logistic regression analysis showed that preoperative fundus hemorrhage and prolonged total oxygen supply time were risk factors for the recurrence of ROP (P<0.05), while gestational hypertension was a protective factor (P<0.05). CONCLUSIONS Intravitreal anti-VEGF injection is effective for ROP. Preoperative fundus hemorrhage and long duration of oxygen therapy may increase the risk of ROP recurrence, and further studies are needed to investigate the influence of gestational hypertension on the recurrence of ROP.
Female ; Humans ; Infant ; Infant, Newborn ; Pregnancy ; Angiogenesis Inhibitors/therapeutic use* ; Endothelial Growth Factors/therapeutic use* ; Hemorrhage ; Hypertension, Pregnancy-Induced ; Oxygen/therapeutic use* ; Retinopathy of Prematurity/drug therapy* ; Retrospective Studies ; Risk Factors ; Vascular Endothelial Growth Factor A

Objective: To investigate death and attrition in HIV-infected children under initial antiretroviral therapy (ART) and associated factors in Guangxi Zhuang autonomous region. Methods: This retrospective cohort study was conducted in HIV-infected children under initial ART in Guangxi from 2004 to 2019, data from ART information system of National comprehensive AIDS prevention and treatment information system. Cox proportional hazards models were used to assess factors associated with the death and attrition. Results: In 943 HIV-infected children, the overall mortality and attrition rates were 1.00/100 person-years and 0.77/100 person-years, respectively. The mortality and attrition rates within the first year of ART were 3.90/100 person-years and 1.67/100 person-years, respectively. The cumulative survival rate during the first, second, fifth and tenth year after ART was 96.14%, 95.80%, 93.68% and 91.54%, respectively. Multivariate Cox proportional hazards models results showed that being female (aHR=2.00, 95%CI: 1.17-3.40), CD4⁺T lymphocytes (CD4) counts before ART <200 cells/μl (aHR=2.79, 95%CI: 1.54-5.06), weight-for-age Z score before ART <-2 (aHR=2.38, 95%CI: 1.32-4.26), hemoglobin before ART <80 g/L (aHR=2.47, 95%CI: 1.24-4.92), initial ART with LPV/r (aHR=5.05, 95%CI: 1.15-22.12) were significantly associated with death; being female (aHR=2.23, 95%CI: 1.22-4.07) and initial ART with LPV/r (aHR=2.02, 95%CI: 1.07-3.79) were significantly associated with attrition. Conclusions: The effect of ART in HIV-infected children in Guangxi was better, but the mortality and attrition rates were high within the first year of treatment. It is necessary to strengthen the training in medical staff and health education in HIV-infected children and their parents in order to improve the treatment effect.
Anti-HIV Agents/therapeutic use* ; Child ; China/epidemiology* ; Female ; HIV Infections/drug therapy* ; Humans ; Male ; Proportional Hazards Models ; Retrospective Studies

BACKGROUND: The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images. METHODS: Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists. RESULTS: The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%). CONCLUSIONS: The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists. TRIAL REGISTRATION Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.
Area Under Curve ; Breast/diagnostic imaging* ; Breast Neoplasms/diagnostic imaging* ; China ; Deep Learning ; Humans ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE To explore the effect of water extract of notopterygium incisum (WN) on neuropathic pain and its molecular biological mechanism.METHODS Pain behavior test to detect the effects of WN on thermal hyperalgesia and me-chanical hyperalgesia in acute pain and chronic constriction injury(CCI)induced neuropathic pain model.Immunohistochemis-try and qPCR were used to detect the expression of TRPV1 .Calcium imaging was used to detect calcium influx of capsaicin (TRPV1 agonist) in CCI mice after oral administration of WN.RESULTS WN significantly reduced the thermal hyperalgesia and mechanical hyperalgesia in acute pain model and CCI model (P<0.001).The expression of TRPV1 in protein level and mRNA level in DRG neurons were significantly inhibited by administration of WN(P<0.05).The response of DRG neurons to capsaicin was significantly inhibited by the treatment of WN(P<0.001).CONCLUSION WN alleviated CCI-induced me-chanical allodynia and thermal hypersensitivity via modulating TRPV1 .Our results revealed a new molecular biological mecha-nism of analgesia effect to traditional Chinese medicine.

Objective: To verify the health advisory for short-term exposure to phenol. Methods: The method of this validation experiment was the same as the US Environmental Protection Agency (EPA) methodology for toxicology experiments used to determine phenol drinking water equivalent level (DWEL). Pregnant female Sprague-Dawley rats were administered phenol in distilled water by gavage at daily doses of 15, 30, 60, 120, and 240 mg/kg body weight (b.w.) from implantation (the 6th day post-mating) to the day prior to the scheduled caesarean section (the 20th day of pregnancy). The following information was recorded: general behavior; body weight; number of corpus luteum, live birth, fetus, stillbirth, and implantation; fetal gender; body weight; body length; tail length; and abnormalities and pathomorphological changes in the dams. Results: In the 60 mg/kg b.w. dose group, the mortality of pregnant rats increased with increasing doses, suggesting maternal toxicity. Fetal and placental weights decreased as phenol dose increased from 30 mg/kg b.w., and were significantly different compared those in the vehicle control group, which suggested developmental toxicity in the fetuses. However, the phenol-exposed groups showed no significant change in other parameters compared with the vehicle control group ( > 0.05). Conclusion Despite using the same method as the US EPA, a different NOEAL of 15 mg/(kg·d) was obtained in this study.
Animals ; Dose-Response Relationship, Drug ; Environmental Pollutants ; toxicity ; Female ; Fetal Development ; drug effects ; Phenol ; toxicity ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Toxicity Tests, Acute

Objective To investigate the efficacy of intravitreal injection of monoclonal antibody in the treatment of patients with exudative age-related macular degeneration (AMD).Methods Together 33 patients (33 eyes) with exudative AMD from February 2010 to May 2015 selected in this study were treated with intravitreal injection of ranibizumab,followed by examination of the best corrected visual acuity before and after surgery by international standard logarithmic visual acuity chart.The differences in ophthalmic artery (OA),central retinal artery (CRA) and ciliary artery hemodynamic parameters before and after operation were compared,and fundus fluorescein angiography (FFA) was used to measure and calculate the changes in choroidal neovascularization (CNV) fluorescein leakage area before and after operation.Results The best corrected visual acuity was significantly improved 1 week after operation when compared with preoperative data [(0.29 ± 0.18) vs.(0.16 ± 0.15)],with significant difference (P =0.002).And 7 days after operation,the area of CNV fluorescein leakage was less than that of postoperative data [(8.48 ± 6.13)mm2 vs.(11.39 ± 6.12)mm2],and the difference was statistically significant (P =0.029).However,there was no difference in OA,CRA,the peak systolic velocity (PSV),end diastolic blood flow velocity (EDV)and resistance index (RI),pulsatility index (PI) in the treatment eyes between before operation and 1,4 weeks after operation (all P ＞ 0.05).Conelusion Intravitreal injection of ranibizumab in the treatment of exudative AMD is safe and effective and can effectively improve the visual acuity and alleviate CNV leakage,without adveme effects on patients' hemodynamics.

OBJECTIVE:To investigate the effects of Danshen chuanxiongqin injection combined with hyperbaric oxygen on the prevention of early complications in patients with acute spinal cord injury (ASCI).METHODS:A total of 89 ASCI patients were divided into control group (n=44) and combination group (n =45) according to random number table.Control group received routine symptomatic treatment combined with hyperbaric oxygen therapy.Combination group was additionally given Danshen chuanxiongqin intravenous injection 10 mL added into 250 mL 0.9％ Sodium chloride injection intravenously,bid,on the basis of control group.Both group was treated for 2 weeks.The changes of spinal cord function recovery index (Botsford score,FIM score),coagulation indexes [prothrombin time (PT),activated partial thromboplastin time (APTT)],hemodynamic indexes (high-shear blood viscosity,plasma viscosity,erythrocyte aggregation indexes) and inflammatory indexes [D-dimer (D-D),C reactive protein (CRP)] were compared between 2 groups before and after treatment.After 1 month of follow-up,the incidence of early complications as deep venous thrombosis and pulmonary embolism were compared between 2 groups.RESULTS:Two cases lost in control group and three cases lost in combination group;42 cases were included in each group.Before treatment,there was no statistical significance between these indexes between 2 groups (P＞0.05).After 2 weeks of treatment,Botsford score,FIM score,PT and APTT of 2 groups were enhanced significantly compared to before treatment;high-shear blood viscosity,plasma viscosity,erythrocyte aggregation indexes,D-D,CRP level were decreased significantly compared to before treatment;each index of combination group was significantly better than those of control group,with statistical significance (P＜0.05 or P＜0.01).The incidence of early complications in combination group was 16.7％,which was significantly lower than 35.7％ in control group,with statistical significance (P＜0.05).CONCLUSIONS:The application of Danshen chuanxiongqin injection combined with hyperbaric oxygen in the clinical treatment of ASCI can effectively reduce the risk of deep venous thrombosis,pulmonary embolism and other early complications.It has positive effects on alleviating inflammatory reactions,promoting blood microcirculation and improving prognosis of patients.

BACKGROUND: Bronchial tuberculosis is a common complication of pulmonary tuberculosis. The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis, when the drug and endoscopic treatment were no effect. METHODS: Reviewed the clinical-pathological records documenting the surgical outcomes in 36 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 2000 and February 2016. Pneumonectomy in 8 cases, lobectomy in 23 cases, sleeve resection in 5 cases. RESULTS: No intraoperative or early postoperative death occurred. Six patients developed complications. All 6 cases recovered well after treatment. CONCLUSIONS Surgical treatment is still the recommended treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its good results. It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed.
Adolescent ; Adult ; Bronchi ; surgery ; Bronchoscopy ; Female ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Retrospective Studies ; Tuberculosis, Pulmonary ; surgery ; Young Adult

AIM:To explore efficacy of the different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation.METHODS:Totally 280 patients (280 eyes) with xerophthalmia after operation in our hospital from January 2015 to June 2016 were selected.According to the different treatment methods, they were divided into control group (n=70;treated with tobramycin and dexamethasone eye ointment 3 times per day for 1wk, levofloxacin eye drops 3 times per day for 1wk, pranoprofen eye drops 4 times per day for 1mo), polyacrylic acid group (n=70;besides the treatment of control group, polyacrylic acid was used 4 times per for 1mo), polyethylene glycol group(n=70;besides the treatment of control group, polyethylene glycol was used 4 times per for 1mo) and sodium hyaluronate group (n=70;besides the treatment of control group, sodium hyaluronate was used 4 times per for 1mo).The tear film break up time (BUT), Schirmer Ⅰ test (SⅠt), symptoms of dry eye and corneal staining in four groups were observed.RESULTS:(1) BUT:The BUT of the four groups significantly increased after treatment(P<0.05);that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05);the BUT in sodium hyaluronate group was significantly higher than the other groups after 2wk of treatment(P<0.05).(2) SⅠt:SⅠt of the four groups significant increased after treatment(P<0.05);that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05);and the SⅠt in sodium hyaluronate group was significantly higher than other groups (P<0.05).(3) Xeroma score:the scores of dry eye significantly decreased after treatment in the four groups(P<0.05);that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05);and the scores of the sodium hyaluronate group after 3wk was significantly lower compared with other groups(P<0.05).(4) Corneal staining score:the scores significantly decreased after treatment in the four groups(P<0.05);at 1 and 2wk after treatment the corneal staining score had not statistically different among the four groups (P>0.05);sodium hyaluronate group was significant lower than other groups in corneal staining score at 3wk and 1mo after treatment(P<0.05).CONCLUSION:Artificial tears in the treatment of xerophthalmia after cataract phacoemulsification combined with intraocular lens implantation has better clinical efficacy, which contains sodium hyaluronate may be the better than others.