1.Mechanisms of Mahuang Lianqiao Chixiaodoutang in Improving Obesity-type Polycystic Ovary Syndrome in Rats Based on PI3K/Akt Signaling Pathway
Shiwei HU ; Biran ZHU ; Jinrong ZHANG ; Luyao RUAN ; Ji KUANG ; Jianghuan HUA ; Zhe LIU ; Yanyue YAO ; Ji WANG ; Min ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):21-31
ObjectiveTo investigate the mechanisms by which Mahuang Lianqiao Chixiaodoutang (MLC) improves obesity-type polycystic ovary syndrome (PCOS) through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsThirty-six female Sprague-Dawley (SD) rats were randomly divided into a blank control group (Con) and an obesity-type PCOS model preparation group. The model was induced by gavage with letrozole (1 mg·kg-1) combined with a high-fat diet (HFD). After model establishment, the obesity-type PCOS model preparation group was further divided into the model group (Mod, normal saline), metformin group (Met, 0.3 g·kg-1), low-dose MLC group (MLC-L, 4.3 g·kg-1), medium-dose MLC group (MLC-M, 8.6 g·kg-1), and high-dose MLC group (MLC-H, 17.2 g·kg-1). Active components of MLC and targets of obesity-type PCOS were screened from databases, a protein-protein interaction (PPI) network was constructed, and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. The gut microbiota structure was analyzed based on 16S rRNA sequencing and correlated with network pharmacology pathways. Body weight and estrous cycle were dynamically monitored. Ovarian morphology was observed by hematoxylin-eosin (HE) staining. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Enzyme-linked immunosorbent assay (ELISA) was used to detect levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), testosterone (T), and estradiol (E2). Western blot was used to detect the protein expression levels of phosphorylated PI3K/PI3K (p-PI3K/PI3K), phosphorylated Akt/Akt (p-Akt/Akt), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax). ResultsNetwork pharmacology screening identified 124 active components of MLC and 408 overlapping targets between the herbal formula and the disease. Core targets such as Akt1 and Bcl-2 were revealed. As indicated by 16S rRNA sequencing, the abundances of Lachnospiraceae, Lachnoclostridium, and Dorea were increased in the MLC groups (P<0.05), while the abundance of Veillonella was decreased (P<0.05). KEGG correlation analysis integrating network pharmacology and gut microbiota data showed significant enrichment of the PI3K/Akt signaling pathway. Animal experiments showed that, compared with the Mod group, body weight decreased to normal levels in the Met, MLC-M, and MLC-H groups. The estrous cycle became regular. The number of corpora lutea increased and cystic follicles decreased. Serum levels of T, FSH, and LH/FSH were reduced (P<0.05, P<0.01), while the E2 level was increased (P<0.01). Ovarian cell apoptosis was reduced (P<0.01), and the protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and Bcl-2 in ovarian tissue were significantly increased, whereas Bax protein expression was significantly decreased (P<0.05, P<0.01). ConclusionMLC can regulate gut microbiota structure, effectively improve ovarian pathology in rats with obesity-type PCOS, and inhibit ovarian granulosa cell apoptosis. The mechanism may be associated with upregulation of the PI3K/Akt signaling pathway.
2.Mechanisms of Mahuang Lianqiao Chixiaodoutang in Improving Obesity-type Polycystic Ovary Syndrome in Rats Based on PI3K/Akt Signaling Pathway
Shiwei HU ; Biran ZHU ; Jinrong ZHANG ; Luyao RUAN ; Ji KUANG ; Jianghuan HUA ; Zhe LIU ; Yanyue YAO ; Ji WANG ; Min ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):21-31
ObjectiveTo investigate the mechanisms by which Mahuang Lianqiao Chixiaodoutang (MLC) improves obesity-type polycystic ovary syndrome (PCOS) through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsThirty-six female Sprague-Dawley (SD) rats were randomly divided into a blank control group (Con) and an obesity-type PCOS model preparation group. The model was induced by gavage with letrozole (1 mg·kg-1) combined with a high-fat diet (HFD). After model establishment, the obesity-type PCOS model preparation group was further divided into the model group (Mod, normal saline), metformin group (Met, 0.3 g·kg-1), low-dose MLC group (MLC-L, 4.3 g·kg-1), medium-dose MLC group (MLC-M, 8.6 g·kg-1), and high-dose MLC group (MLC-H, 17.2 g·kg-1). Active components of MLC and targets of obesity-type PCOS were screened from databases, a protein-protein interaction (PPI) network was constructed, and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. The gut microbiota structure was analyzed based on 16S rRNA sequencing and correlated with network pharmacology pathways. Body weight and estrous cycle were dynamically monitored. Ovarian morphology was observed by hematoxylin-eosin (HE) staining. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Enzyme-linked immunosorbent assay (ELISA) was used to detect levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), testosterone (T), and estradiol (E2). Western blot was used to detect the protein expression levels of phosphorylated PI3K/PI3K (p-PI3K/PI3K), phosphorylated Akt/Akt (p-Akt/Akt), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax). ResultsNetwork pharmacology screening identified 124 active components of MLC and 408 overlapping targets between the herbal formula and the disease. Core targets such as Akt1 and Bcl-2 were revealed. As indicated by 16S rRNA sequencing, the abundances of Lachnospiraceae, Lachnoclostridium, and Dorea were increased in the MLC groups (P<0.05), while the abundance of Veillonella was decreased (P<0.05). KEGG correlation analysis integrating network pharmacology and gut microbiota data showed significant enrichment of the PI3K/Akt signaling pathway. Animal experiments showed that, compared with the Mod group, body weight decreased to normal levels in the Met, MLC-M, and MLC-H groups. The estrous cycle became regular. The number of corpora lutea increased and cystic follicles decreased. Serum levels of T, FSH, and LH/FSH were reduced (P<0.05, P<0.01), while the E2 level was increased (P<0.01). Ovarian cell apoptosis was reduced (P<0.01), and the protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and Bcl-2 in ovarian tissue were significantly increased, whereas Bax protein expression was significantly decreased (P<0.05, P<0.01). ConclusionMLC can regulate gut microbiota structure, effectively improve ovarian pathology in rats with obesity-type PCOS, and inhibit ovarian granulosa cell apoptosis. The mechanism may be associated with upregulation of the PI3K/Akt signaling pathway.
3.Analysis of OCTA parameters for prognostic assessment following vitrectomy in patients with idiopathic macular epiretinal membrane
Lulu BAO ; Li WANG ; Mingliang WANG ; Min CHEN ; Zhe LIU
International Eye Science 2026;26(5):873-878
AIM: To investigate the differences in morphological structure and retinal blood perfusion between the affected eye and the contralateral healthy eye using optical coherence tomography angiography(OCTA)in patients with idiopathic macular epiretinal membrane(IMEM)before and after surgery, and to evaluate the association of these parameters with functional and anatomical outcomes to inform prognostic assessment. METHODS:A prospective study was conducted at Zhejiang Provincial People's Hospital between January 2023 and December 2024. Consecutive patients diagnosed with unilateral IMEM were enrolled; the fellow eye served as an internal control. All participants underwent standardized ophthalmic evaluations, including optical coherence tomography(OCT), OCTA, and color fundus photography. Key quantitative parameters assessed included best-corrected visual acuity(BCVA), central macular thickness(CMT), foveal avascular zone(FAZ)area, vessel density in the inner capillary plexus(ICP), superficial capillary plexus(SCP), deep capillary plexus(DCP), and choroidal capillary perfusion area(CCPA). Measurements were obtained preoperatively and at 1 and 3 mo postoperatively. Correlation analyses were performed between the above parameters and postoperative BCVA and CMT.RESULTS: This study enrolled 30 patients(60 eyes)diagnosed with IMEM, comprising 14 males and 16 females, with a mean age of 65.4±10.8 y.At baseline, IMEM-affected eyes demonstrated significantly reduced BCVA, DCP density, and FAZ area, alongside significantly increased CMT and CCPA, compared with contralateral controls. Following vitrectomy with membrane peeling, CMT decreased significantly at both 1 and 3 mo(both P<0.05)postoperatively; DCP density and BCVA showed significant improvement(both P<0.05). No significant change in FAZ area was observed postoperatively(P>0.05). At 3 mo postoperatively, BCVA of the affected eye was negatively correlated with CMT(r=-0.549, P=0.022). At 1 mo postoperatively, CMT was negatively correlated with preoperative DCP and FAZ, positively correlated with preoperative CMT, and positively correlated with ICP and SCP at 1 mo postoperatively, and negatively correlated with FAZ at 1 mo postoperatively(all P<0.05). Furthermore, CMT at 3 mo postoperatively was negatively correlated with preoperative DCP(r=-0.498,P=0.042).CONCLUSION:In patients with IMEM, the affected eyes exhibit significantly reduced DCP density and FAZ area, alongside increased CMT and CCPA. Following vitrectomy with membrane peeling, CMT decreased progressively, DCP density demonstrated partial restoration, and vision improved gradually. Preoperatively, smaller CMT larger DCP, and FAZ were associated with more favorable surgical outcomes; postoperatively, smaller ICP and SCP densities—combined with a larger FAZ—also correlated with better functional recovery.
4.A qualitative research on psychological experience of operating room nurses participating in organ transplant surgery
Zhe WANG ; Chunling WANG ; Xiaoyun NI ; Min LIU ; Chengyao GUO ; Minwei SHEN ; Li ZHANG ; Chenwei ZHANG
Chinese Journal of Clinical Medicine 2026;33(4):675-682
Objective To explore the psychological experiences of operating room nurses participating in organ transplant surgeries, providing a basis for medical institutions to develop targeted psychological support programs. Methods Using a phenomenological research method, semi-structured, in-depth, face-to-face interviews were conducted from January to March 2026 with 17 operating room nurses who had participated in organ transplant surgeries at a tertiary hospital in Shanghai. Interviews were recorded, and observations were made. The interview data were analyzed, summarized, and themes were refined using Colaizzi’s seven-step analysis method. Results The psychological experiences of operating room nurses participating in organ transplant surgeries were identified as 5 main themes and 14 sub-themes: emotional impact and empathy load (shock and grief confronting life and death, deep empathy for patients and families, awe and gratitude towards organ donors); pressure experience and physical-mental exhaustion (urgency under time pressure, load of operational precision requirements, excessive consumption of physical and mental resources); cognitive appraisal and meaning construction (reappraisal of professional value, deep reflection on the meaning of life, positioning and identification of one’s role); coping strategies and adjustment process (active learning and experiential reflection, self-emotional regulation and social support); growth experience and psychological transformation (enhancement of psychological resilience, establishment of professional confidence, deepening of professional mission). Conclusions Operating room nurses undergo complex and profound psychological experiences while participating in organ transplant surgeries, enduring strong emotional impact and physical-mental stress while also achieving psychological growth and deepening professional identity through practice. Nursing managers should pay attention to the mental health of this group and construct a multi-level support system to promote their physical and psychological well-being.
5.Analysis of Volatile Component Variations in Coptidis Rhizoma Processed with Euodiae Fructus Juice by HS-SPME-GC-MS Combined with Chemometrics and ROAV
Lin YAN ; Yun WANG ; Puling LI ; Lingbang MENG ; Zhe JIA ; Ying LI ; Ying LIU ; Min JIN ; Cun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):218-225
ObjectiveTo analyze the volatile components in raw Coptidis Rhizoma, Euodiae Fructus juice-processed Coptidis Rhizoma (Yuhuanglian), and the processing adjuvant Euodiae Fructus juice, identify marker volatile components in the processed product, and elucidate the material basis changes during the processing with Euodiae Fructus juice. MethodsHeadspace solid-phase microextraction coupled with gas chromatography-quadrupole-time-of-flight mass spectrometry (HS-SPME-GC-Q-TOF-MS) was employed to analyze the volatile components in raw Coptidis Rhizoma, Yuhuanglian, and Euodiae Fructus juice. Chemometric analysis was performed to compare volatile components among samples and screen the marker components. Finally, the relative odor activity value (ROAV) was calculated to investigate odor characteristics. ResultsA total of 127 components were detected, with 27, 75, 84 volatile components identified in Euodiae Fructus juice, raw Coptidis Rhizoma, and Yuhuanglian, respectively. Processing with Euodiae Fructus juice significantly increased the number and content of volatile components. Chemometric analysis revealed significant changes in volatile components among the three sample types, allowing clear discrimination. After processing, 39 components such as methyl octanoate and allyl propionate were introduced, while 34 components including furfural and hexanoic acid increased in content, and 11 components including butyric acid and octanal decreased. Additionally, eight components, including zingiberene, 6-methyl-6-hepten-2-one, and 5-methyl-2-hexanone, were screened as marker components of Yuhuanglian. Moreover, processing enhanced the ROAV values of 2,5-dimethylpyrazine (roasted, nutty, coffee-like aroma), 3-ethylphenol, and guaiacol (smoky, woody aroma). Additionally, it incorporated 1-hepten-3-one from Euodiae Fructus juice and the newly generated 1-hexen-3-one, contributing mushroom and cucumber-like odors. The sensory profile of Yuhuanglian integrated nutty, roasted, smoky, and woody notes with the citrus and fruity aroma originally contributed by octanal. ConclusionThe processing with Euodiae Fructus juice introduced components from adjuvant, significantly altering the volatile component profile and enhancing the sensory odor characteristics of Yuhuanglian. This study provides a valuable reference for exploring the material basis of volatile components and establishing processing specifications for Yuhuanglian.
6.Analysis of Volatile Component Variations in Coptidis Rhizoma Processed with Euodiae Fructus Juice by HS-SPME-GC-MS Combined with Chemometrics and ROAV
Lin YAN ; Yun WANG ; Puling LI ; Lingbang MENG ; Zhe JIA ; Ying LI ; Ying LIU ; Min JIN ; Cun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):218-225
ObjectiveTo analyze the volatile components in raw Coptidis Rhizoma, Euodiae Fructus juice-processed Coptidis Rhizoma (Yuhuanglian), and the processing adjuvant Euodiae Fructus juice, identify marker volatile components in the processed product, and elucidate the material basis changes during the processing with Euodiae Fructus juice. MethodsHeadspace solid-phase microextraction coupled with gas chromatography-quadrupole-time-of-flight mass spectrometry (HS-SPME-GC-Q-TOF-MS) was employed to analyze the volatile components in raw Coptidis Rhizoma, Yuhuanglian, and Euodiae Fructus juice. Chemometric analysis was performed to compare volatile components among samples and screen the marker components. Finally, the relative odor activity value (ROAV) was calculated to investigate odor characteristics. ResultsA total of 127 components were detected, with 27, 75, 84 volatile components identified in Euodiae Fructus juice, raw Coptidis Rhizoma, and Yuhuanglian, respectively. Processing with Euodiae Fructus juice significantly increased the number and content of volatile components. Chemometric analysis revealed significant changes in volatile components among the three sample types, allowing clear discrimination. After processing, 39 components such as methyl octanoate and allyl propionate were introduced, while 34 components including furfural and hexanoic acid increased in content, and 11 components including butyric acid and octanal decreased. Additionally, eight components, including zingiberene, 6-methyl-6-hepten-2-one, and 5-methyl-2-hexanone, were screened as marker components of Yuhuanglian. Moreover, processing enhanced the ROAV values of 2,5-dimethylpyrazine (roasted, nutty, coffee-like aroma), 3-ethylphenol, and guaiacol (smoky, woody aroma). Additionally, it incorporated 1-hepten-3-one from Euodiae Fructus juice and the newly generated 1-hexen-3-one, contributing mushroom and cucumber-like odors. The sensory profile of Yuhuanglian integrated nutty, roasted, smoky, and woody notes with the citrus and fruity aroma originally contributed by octanal. ConclusionThe processing with Euodiae Fructus juice introduced components from adjuvant, significantly altering the volatile component profile and enhancing the sensory odor characteristics of Yuhuanglian. This study provides a valuable reference for exploring the material basis of volatile components and establishing processing specifications for Yuhuanglian.
7.Ditantang Ameliorates MAFLD in Rats Through UDPG-S1P-SREBP Axis-mediated Glycogen Synthesis
Lu PAN ; Zhe ZHAND ; Nan SONG ; Dongyu MIN ; Jiaxin WANG ; Yuanguang DONG ; Yang HONG ; Meiling ZHANG ; Xiaofei SUN ; Jiaru WANG ; Yunfei GAO ; Yupeng PEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):40-50
ObjectiveTo investigate the effects of Ditantang on metabolic dysfunction-associated fatty liver disease (MAFLD) in rats by focusing on the regulation of glycogen synthesis mediated by the uridine diphosphate glucose (UDPG)-site-1-protease (S1P)-sterol regulatory element-binding protein (SREBP) axis. MethodsMAFLD was modeled in SD rats by feeding a high-fat diet for 12 weeks. Rats were randomized into a control group, a model group, low-, medium-, and high-dose (2.68, 5.36, and 10.72 g·kg-1·d-1, respectively) Ditantang groups, and a positive control (Yishanfu, 0.18 g·kg-1·d-1) group. Starting from week 9 of modeling, each treatment group received corresponding drug interventions via gavage. After the experiment, the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. The levels of TG, non-esterified fatty acids (NEFA), glycogen, glucose-6-phosphate (G6P), glucose-1-phosphate (G1P), and UDPG in the liver tissue samples were measured by biochemical assay kits. Liver pathological morphology and lipid/glycogen deposition were observed via hematoxylin-eosin (HE) staining, oil red O staining, and Periodic acid-Schiff (PAS) staining. Immunofluorescence assay was conducted to detect the expression and localization of phosphoglucomutase-1 (Pgm1) and UDP-glucose pyrophosphorylase 2 (Ugp2) in the rat liver. Real-time PCR and Western blot were employed to quantify mRNA and protein levels, respectively, of key glycogen synthesis enzymes (Pgm1 and Ugp2), key lipogenesis-related transcription factor SREBP and its target genes [acetyl-CoA carboxylase (ACC), fatty acid synthetase (FASN), and stearoyl-CoA desaturase (SCD1)], as well as S1P. ResultsCompared with the control group, the model group exhibited elevated levels of TC, TG, LDL-C in the serum and TG and NEFA in the liver, decreased serum HDL-C level (P<0.01), reduced hepatic levels of G1P, G6P, UDPG, and glycogen (P<0.01), appearance of fat vacuoles of varying sizes and abundant red lipid droplets, with prominent lipid deposition and reduced areas of deep glycogen staining in the liver tissue, upregulated mRNA and protein levels of SREBP1, S1P, ACC, FASN, and SCD1 (P<0.01), and downregulated mRNA and protein levels of Pgm1 and Ugp2 (P<0.01). Compared with the model group, all doses of Ditantang reduced the levels of TC and TG in the serum and TG and NEFA in the liver, while elevating the serum HDL-C level. Additionally, medium- and high-dose Ditantang reducted the LDL-C level (P<0.05). Ditantang at all doses increased the hepatic levels of G1P, G6P, UDPG, and glycogen, alleviated hepatic steatosis and lipid deposition, enhanced glycogen storage, downregulated the mRNA and protein levels of SREBP1, S1P, ACC, FASN, and SCD1 (P<0.05), while upregulating the expression of Pgm1 and Ugp2 (P<0.01). Immunofluorescence analysis revealed decreased fluorescence intensity of S1P and enhanced fluorescence intensity of Ugp2 (P<0.01). ConclusionDitantang can regulate glycogen synthesis through the UDPG-S1P-SREBP axis to prevent and treat MAFLD.
8.Research on the prevalence of overweight and obesity among children
Xinyi LIANG ; Jingnan CHEN ; Xuelian ZHOU ; Ruimin CHEN ; Jingsi LUO ; Rongxiu ZHENG ; Chunxiu GONG ; Chunlin WANG ; Zhe SU ; Mireguli MAIMAITI ; Yan LIANG ; Hui YAO ; Haiyan WEI ; Hongwei DU ; Shaoke CHEN ; Yu YANG ; Feihong LUO ; Pin LI ; Min ZHU ; Wei WU ; Ke HUANG ; Guanping DONG ; Junfen FU
Chinese Journal of Pediatrics 2025;63(6):612-619
Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.
9.Analysis of optic disc morphology changes and related factors in children and adolescents with high myopia
Shanshan WANG ; Jun ZHU ; Yingying ZHOU ; Shuya JIA ; Jinmei WU ; Lei SUN ; Min XU ; Zhe LI ; Fang CHEN
Chinese Journal of Ocular Fundus Diseases 2025;41(7):534-541
Objective:To investigate the incidence and influencing factors of optic disc changes in children and adolescents with high myopia.Methods:A clinical cross-sectional study. A total of 162 children and adolescents with high myopia (162 eyes) who visited Department of Ophthalmology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January to April 2025 were included in this study. Myopia refractive error ≥6.00 D and/or axial length (AL) ≥26 mm. All participants underwent best-corrected visual acuity, refraction, fundus color photography, swept-source optical coherence tomography (SS-OCT), and AL measurement. Subfoveal choroidal thickness (ChT) was measured within 1 mm using SS-OCT. Optic disc changes assessed included tilt, rotation, peripapillary atrophy (PPA), and peripapillary hyperreflective ovoid mass-like structures (PHOMS). The patients were divided into the children group (4-11 years old) and the adolescents group (12-18 years old) based on age, with 63 (38.9%, 63/162) and 99 (61.1%, 99/162) cases respectively. The incidence of ocular features and optic disc morphology changes in the two groups was compared and observed. According to the myopia diopter, the patients were divided into the high diopter long axial group (myopia diopter ≥6.00 D, AL≥26 mm) and the low diopter long axial group (myopia diopter <6.00 D, AL≥26 mm), with 85 (52.5%, 85/162) and 77 (47.5%, 77/162) eyes respectively. The incidence of optic disc morphological changes in the two groups was compared and observed. The comparison of quantitative data between groups was conducted using the Mann-Whitney U test. Multivariate logistic regression was used to analyze the correlations between PPA, optic disc tilt, PHOMS occurrence and gender, age, diopter, AL, and ChT. Results:Among the 162 patients, 103 were male and 59 were female. Age was 12 (10.5, 13.5) years old. Among the 162 eyes, the optic disc morphology changed in 152 eyes (93.8%, 152/162). Among them, the PPA, optic disc tilt, PHOMS, and optic disc rotation were 148 (91.4%, 148/162), 95 (58.6%, 95/162), 62 (38.3%, 62/162), and 35 (21.6%, 35/162) eyes respectively. Myopic macular degeneration in 137 eyes. There were 56 eyes with peripheral retinopathy. There was no statistically significant difference in myopia diopter, AL and ChT between the children group and the adolescent group ( Z=-1.201, -1.934, ?0.761; P=0.230, 0.053, 0.447). There was no statistically significant difference in the incidences of PPA, optic disc tilt and optic disc rotation ( χ2=0.293, 2.618, 0.398; P>0.05). There was no statistically significant difference in the incidence of optic disc morphological changes between the low diopter long axial group and the high diopter long axial group ( χ2=0.000, P>0.05). The results of multivariate logistic regression analysis showed that the thinner the ChT, the higher the risk of PPA [odds ratio (OR) =0.98, 95% confidence interval ( CI) 0.97-0.99, P<0.001]. Female ( OR=2.3, 95% CI 1.04-5.07, P=0.039), older age ( OR=1.17, 95% CI 1.01-1.37, P=0.043), thinner ChT ( OR=0.99, 95% CI 0.99-1.00, P=0.012), the higher the risk of optic disc tilt. The older the age, the higher the risk of developing PHOMS ( OR=1.22, 95% CI 1.06-1.40, P=0.006). Conclusions:Optic disc morphology changes may be the most common fundus alterations in children and adolescents with high myopia. The influencing factors of optic disc morphological changes (including PPA, optic disc tilt, and PHOMS) are female sex, advanced age, and ChT thinning.
10.Efficacy of combined sufentanil and remifentanil in pediatric ear, nose, and throat surgeries
Chinese Journal of Primary Medicine and Pharmacy 2025;32(2):228-233
Objective:To investigate the efficacy of combined sufentanil and remifentanil in pediatric ear, nose, and throat surgeries.Methods:This study used a prospective study design. A total of 110 pediatric children who underwent elective ear, nose, and throat surgery at Xi'an Children's Hospital from January 2022 to December 2023 were included in this study. The patients were randomly divided into a control group ( n = 55) and an observation group ( n = 55) using a random number table method. In the control group, only sufentanil was used for general anesthesia, while the observation group received both sufentanil and remifentanil during the anesthesia process. The changes in average arterial pressure and heart rate were compared between the two groups at five time points: T1 (before anesthesia induction), T2 (during tracheal intubation), T3 (at the start of surgery), T4 (5 min after the start of surgery), and T5 (immediately after surgery). Additionally, the recovery time for spontaneous breathing, the time to open eyes, extubation time, and adverse reactions were compared between the two groups. Ramsay sedation scores were compared between the two groups at three time points: T6 (5 min after extubation), T7 (15 min after extubation), and T8 (30 min after extubation). Pain Visual Analog Score was compared between the two groups at T8 (30 min after extubation), T9 (60 min after extubation), and T10 (90 min after extubation). Results:The differences in average arterial pressure and heart rate between the two groups at time points T1-T5, as well as Ramsay sedation scores at T6-T8 and Visual Analog Score scores at T8-T10, were all statistically significant ( F = 152.93, 2 718.29, 2 347.47, 751.77, all P < 0.05). In the observation group, the recovery time for spontaneous breathing [(5.37 ± 2.18) min vs. (6.74 ± 2.42) min], the time to open eyes [(9.03 ± 2.02) min vs. (10.84 ± 3.11) min], and extubation time [(13.22 ± 4.22) min vs. (16.47 ± 5.14) min] were significantly shorter in the observation group than in the control group ( t = 3.11, 3.62, 3.62, all P < 0.001). The incidence of adverse reactions was significantly lower in the observation group than in the control group [3.64% (2/55) vs. 16.36% (9/55), χ2 = 4.94, P < 0.05]. Conclusions:Both sufentanil alone and in combination with remifentanil yield effective anesthesia outcomes in pediatric ear, nose, and throat surgeries. However, the combination of sufentanil and remifentanil significantly shortens the recovery time for spontaneous breathing, the time to open eyes, and extubation time. This combined approach also lowers the incidence of adverse reactions, improves surgical outcomes, and promotes postoperative recovery of children.

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