Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Objective:To evaluate the effect of maternal depressed mood at pregnancy and postpartum on the risk of emotional or behavioral disorders of offspring by meta-analysis. Methods:The following Mesh words and free words were searched in 7 online databases, including the PubMed, Embase, Web of Knowledge, PsycINFO, Cochrane, WanFang databases and China National Knowledge Infrastructure from January 1, 2000 to October 31, 2020: " maternal" AND " depression" AND " child OR offspring" AND " neuropsychology" . According to the inclusion and exclusion criteria, case-control and cohort studies reporting the effect of maternal depressed mood during pregnancy or postpartum on the risk of emotional or behavioral disorders of offspring were reviewed. Meta-analysis was performed by RevMan 5.3. Results:Fourteen studies involving 3 914 in the case group and 17 016 in the control group were included.Children whose mother with depressed mood during pregnancy or postpartum had 2.03 times risk of emotional or behavioral disorders than those whose mothers without depressed mood ( OR=2.03, 95% CI: 1.55-2.65). Both depressed mood at pregnancy and postpartum could increase the incidence of emotional or behavioral disorders in children, but there was no significant difference between these two periods ( Z=-0.371, 95% CI: 0.796-1.168). Moreover, the effect of maternal depressed mood on emotional or behavioral disorders in offspring could last to the preschool and school period, and the children in the school period may have higher incidence of emotional or behavioral disorders than those during the preschool period ( Z=-2.340, 95% CI: 0.643-0.962). Conclusions:Maternal depressed mood can increase the incidence of emotional or behavioral disorders in offspring, which are long-lasting and do not decrease with age.

Objective:To analyze the epidemiological and clinical characteristics of hospitalized patients with dengue fever in Guangdong Province in 2019, so as to provide reference for clinical diagnosis and treatment of dengue fever.Methods:The general data, laboratory examination data, clinical manifestations and prognosis data of 480 inpatients with dengue fever admitted to Eight People′s Hospital Affiliated to Guangzhou Medical University between January 4 and October 31, 2019 were analyzed retrospectively. The clinical and onset characteristics of patients with dengue fever were described.Results:Among 480 dengue patients, 442(92.1%) were dengue fever, 38(7.9%) were severe dengue, and 136(28.3%) had underlying diseases. The peak age of onset was mainly in young adults aged 20 to 49 years old, accounting for 66.0%(317/480) in total. The seasonal peak was mainly in August to October. There were 399(83.1%) local cases and 61(12.7%) imported cases. The most common clinical manifestations were fever (98.1%, 471/480), chills (72.9%, 350/480), headache (58.5%, 281/480) and bone/joint/muscle pain (67.1%, 322/480), followed by digestive tract symptoms and respiratory tract symptoms. Among 446 serum samples, 358 (80.3%) were dengue virus (DENV)-1, 54 (12.1%) were DENV-2, 34 (7.6%) were DENV-3. The main laboratory tests of the patients were leucopenia (65.8%, 316/480), low hematocrit (30.2%, 145/480), thrombocytopenia (48.3%, 232/480), neutropenia (44.8%, 215/480), elevated alanine aminotransferase (ALT) (37.7%, 181/480) and aspartate aminotransferase (AST) (59.4%, 285/480). Treatment mainly adopted symptomatic support treatment and active prevention of complications. The length of stay was (5.8±3.1) days (range 1.0-38.0 days). A total of 461(96.0%) patients were cured or improved.Conclusions:In 2019, the majority of dengue fever patients in Guangdong Province are young adults aged 20 to 49 years old, and the proportion of severe patients is high, with DENV-1 infection as the main type. After symptomatic support treatment and active prevention of complications, most of the dengue fever patients have a good prognosis.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

Objective: To evaluate the clinical value of the the hypopharynx and chest esophageal carcinoma. Methods: 20 patients surgical treatment data of the hypopharynx and chest esophageal carcinoma from January 2013 to July 2019 were reviewed. Results: The simultaneous hypopharynx and esophageal carcinoma 11 cases. The heterochronic hypopharynx and chest esophageal carcinoma 9 cases. 20 cases are all squamous cell carcinoma. The synchronus operation included total pharyngolaryngo esophagectomy, gastric tube interposition pharyngo gastric anastomic, neck and mediastinal lymph nodes dissection, tracheostomy. The heterochronic operation included the first stage radical hypopharygealectomy, the second stage radical esophagealectomy. Postoperative complications included in hospital death in one, double pneumonia in 3 and anastomosis stricture in one case. Pharynx gastric fistula in 2. Swallowing function were all recovered. Conclusion Although laryngo pharyngo esophagectomy and pharyngogastric anastomoses for the hypopharynx and chest esophageal carcinoma is a simple and acceptable procedure, the quality of life is not satisfactory. And although colon interpasation for esophageal replacement is complicated the quality of life is the best.

Objective To evaluate the application value of early lung ultrasound score(LUS)in the eval-uation of severity and prognosis of severe pneumonia and investigate its correlations with oxygenation index(OI), alveolar-arterial oxygen difference(A-aDO2),lymphocyte count(LYM),positive end-expiratory pressure(PEEP), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,and clinical pulmonary infection score (CPIS). Methods Thirty severe pneumonia patients admitted to intensive care unit(ICU)of Guangzhou Eighth People's Hospital from May 2015 to July 2017 were enrolled,including 14 cases with low PEEP and 16 cases with high PEEP. Among them,17 patients were diagnosed with non-viral pneumonia and 13 ones with viral pneumonia;15 of them survived,and 15 died. The clinical data and cores of all patients were recorded by one observer,including baseline date,OI,A-aDO2,LYM,PEEP,and APACHEⅡ and CPIS score. The other observer was specifically responsible for pulmonary ultrasonography and LUS. The correlation between LUS and OI,A-aDO2,LYM,PEEP, as well as APACHEⅡand CPIS scores was analyzed by bivariate correlation analysis. Receiver operator character-istic curves(ROC)were plotted,and the prediction value,sensitivity and specificity of high PEEP and mortality by LUS were calculated respectively. Results LUS had a negative correlation with OI(r =-0.755,P = 0.000) and LYM(r =-0.518,P = 0.03),and a good positive correlation with A-aDO2(r = 0.642,P = 0.000),PEEP (r = 0.583,P = 0.001),APACHEⅡ(r = 0.461,P = 0.010)and CPIS(r = 0.595,P = 0.001)was respectively found. LUS in the survival group was significantly lower than the death group(15.00 ± 5.90 vs. 22.27 ± 4.68,P<0.01),low PEEP group was obviously lower than high PEEP group(14.23 ± 5.40 vs. 22.00 ± 4.98,P < 0.01), and there was no significant difference between non-viral pneumonia group and viral pneumonia group(18.59 ± 6.49 vs. 18.69 ± 6.56,P > 0.05). The area under ROC cure(AUC)was calculated:the predictive value for high PEEP by LUS was 19,with the sensitivity of 77% and specificity of 92%,and the patients with LUS > 17 had a high mortality,with the sensitivity for predicting death of 87% and specificity of 67%. Conclusion Bedside lung ultrasound can easily evaluate the changes in pulmonary ventilation area ,and early LUS has important clinical application value in assessing the severity and prognosis of severe pneumonia patients.

Objective To assess the effect of psychological group on improving the learning attitude of interns in the pediatric clinical practice.Methods This study included 67 medical students who enrolled during 2012 to 2013 and had done the clinical pediatrics in the Second Affiliated Hospital of Shantou University Medical College.The students carried out pediatric clinical practice as requested.Based on the practice of pediatric practice,the psychological group counseling was conducted by voluntary participation.Each psychological group consisted of 5 or 6 students and performed once a week.Each time of psychological group lasted for 1.5 hours and 6 times in total.The students were divided into intervention group and non-intervention group according to whether they participated in psychological group.Each student filled in the Pediatric Clinical Internship Attitude Assessment Form and the College Student Personality Questionnaire at the first week and the last week of pediatric clinical practice.SPSS 17.0 was applied to conduct Chi square test and t test.Results There were 33 students in the intervention group and 40 students in the non-intervention group.The effective rate of questionnaires for intervention group and non-intervention group were 100％ and 85％,respectively.The mental state of pediatric interns between two groups was not different before and after the pediatric clinical practice (P＞0.05).Before pediatric clinical practice,the learning attitude score between two groups was not different [(83.82 ± 8.39) vs.(84.39 ± 8.29),t=-0.28,P=0.781].After pediatric clinical practice,the learning attitude score of pediatric interns who used psychological group teaching model was better than that of pediatric interns who used traditional teaching model [(88.91 ± 7.40) vs.(75.03 ± 11.19),t=-5.969,P=0.000].Conclusion Psychological group can help medical students to develop empathy toward sick children and their parents,and then improve their learning attitude in pediatric practice.The results of this study can provide a preliminary basis for the popularization of psychological group in the whole process of medical internship.

Objective:To investigate the influence of propofol combined with sevoflurane anesthesia on nitric oxide/endothelin-1 ratio in the patients with hepatic lobectomy. Methods:Totally 84 patients with hepatic lobectomy were divided into two groups by the digital random method. Among them,42 patients received propofol combined with sevoflurane anesthesia as the observation group,and another 42 patients received midazolam anesthesia as the control group. Nitric oxide,endothelin-1,liver function indices(AST,ALT) and inflammatory factors (IL-1,IL-10,TNF-α) were detected respectively before hepatic portal occlusion,after hepatic portal occlu-sion and on postoperative third day. Results: Before hepatic portal occlusion, there were no significant differences between the two groups in above indicators (P >0.05). After hepatic portal occlusion, NO and IL-10 decreased significantly, while endothelin-1, AST,ALT,IL-1 and TNF-α increased significantly in the two groups.The differences between the two groups were statistically signifi-cant (P<0.01). All indices at postoperative 3 d in two groups recovered to the level before hepatic portal occlusion.Conclusion:Propofol combined with sevoflurane anesthesia contributes to adjusting nitric oxide/endothelin-1 ratio in the patients with hepatic lobec-tomy,which can improve liver function and inhibit the release of inflammatory cytokines.

Objective To explore the effect of cytoglobin (CYGB) low expression on the proliferation of glioma cells and its mechanism.Methods Glioma samples were chosen from patients accepted glioma resection in our hospital from June 2012 to December 2015;primary glioma cells extracted from these samples were cultured and performed purity identification.The nominated cells were divided into transfection of 24 h group,transfection of 48 h group,transfection of 72 h group,and negative control group;cells,excepted from negative control group,were transfected by CYGB shRNA for 24,48 and 72 h,respectively,to inhibit the CYGB expression.CCK-8 assay was used to observe the proliferation of glioma cells after different transfection times (0,1,2,3,4 and 5 d after cell culture).The expressions of CYGB,phosphatidylinositol 3 kinase (PI3K),total alanine aminotransferase (Akt) and phosphorylated (p)-Akt were detected by Western blotting,and the levels of interleukin (IL)-6,IL-10,tumor necrosis factor (TNF)-α,transforming growth factor (TGF)-β and vascular endothelial growth factor (VEGF) were examined by ELISA.Results (1) The proliferation of glioma cells was enhanced at different times after CYGB shRNA transfection,and the optical density showed significant differences at different times after CYGB shRNA transfection (P＜0.05);as compared with those in the negative control group,the cell proliferative capacity and optical density in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group were significantly increased (P＜0.05).As compared with those in the negative control group,the CYGB protein expression was significantly d ecreased and PI3K and p-Akt protein expressions were significantly increased in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group,accordingly (P＜0.05),while no significant difference was noted in the total Akt protein expression (P＞0.05).The levels of IL6,IL10,TNF-α,TGF-β,and VEGF were successively increased in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group as compared with those in the negative control group (P＜0.05).Spearman correlation analysis showed that the expression of CYGB in the glioma was negatively correlated with PI3K and p-Akt expressions,and IL-6,IL-10,TNF-α,TGF-β,and VEGF levels (P＜0.05).Conclusion The effect of cytoglobin on proliferation of glioma cells may be related to the signal pathway of PI3K-Akt.