AIM: To investigate timing of glucocorticoids use in the treatment of syphilitic uveitis.METHODS: A retrospective study was conducted in 110 patients(134 eyes)with syphilitic uveitis diagnosed from January 2008 to January 2021, of whom 24 were binocular. The time from onset to treatment was 1 d to 3 mo. They were divided into three groups according to the treatment, including 98 eyes with completed clearely fundus lesions and no abnormalities in fundus fluorescein angiography(FFA)+ indocyanine green angiography(ICGA)+ optical coherence tomography(OCT)after treated with antibiotics alone for 1 to 2 wk in single antibiotics group, 26 eyes with in completely cleared fundus lesions and retinal vessels wall staining observed by FFA or choroidal weak fluorescence observed by ICGA after standard antisyphilitic treatments for 1 to 2 wk in first antibiotics followed by hormones group, and 10 eyes treated according to uveitis at other hospital in the absence of a clear cause of disease, that was intravenously dripped with 250 mL of normal saline and 10 mg of dexamethasone once a day for 7 to 10 d in total, then clearly diagnosed as syphilitic uveitis by Treponema pallidum particle agglutination(TPPA)test after receiving treatment for 10 to 14 d in hormones followed by antibiotics group. The best corrected visual acuity, slit-lamp examination, fundus photography, OCT, FFA, ICGA and prognosis of the three groups of patients were compared.RESULTS: There were statistically significant difference in the best corrected visual acuity, optic disc, retinal vasculitis, choroidal weak fluorescence, and RPR titer before and after treatment of the three groups of patients. The prognosis of the hormones followed by antibiotics group was lower than that in the single antibiotics group and antibiotics followed by hormones group, and the proportion of “good” prognosis in the antibiotics followed by hormones group was larger than that in other groups.CONCLUSION: Early diagnosis and regular treatment of syphilitic uveitis has a good overall prognosis, and giving large doses of glucocorticoids before thorough antisyphilitic treatments is not conducive to the recovery of disease. In patients with residual lesions after standard antisyphilitic, the application of small doses of glucocorticoids is helpful for the recovery of the disease.

AIM: To investigate the onset of age, gender, profession, marital characteristics, clinical symptoms, signs, image characteristics of fundus and laser scanning features of syphilitic chorioretinitis.METHODS: Retrospective case series study. A total of 114 patients(138 eyes), 24 of whom were double eyes diagnosed with syphilitic chorioretinitis from January 2006 to January 2023 were included in this study. All of the data were collected from eye examination including the best corrected visual acuity(BCVA), intraocular pressure(IOP), fundus photography, optical coherence tomography(OCT), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), visual field, visual evoked response; and blood tests including rapid plasma reagin(RPR)test and treponema pallidum hemagglutination(TPPA)test, tuberculin test, tuberculosis spot test, human immunodeficiency virus, human leukocyte antigen-B27, rheumatism series examination.RESULTS: All patients tested positive for RPR and TPPA, while other laboratory tests were negative, confirming the diagnosis of syphilitic chorioretinopathy. The average age of onset was 44±13.1 years old, with 59 males(51.8%), 55 females(48.2%), 90 monocular cases(78.9%), and 24 binocular cases(21.1%), and there were no significant differences in gender, marriage, or occupation. The main clinical features were visual loss, hyperemia of the optic disc, grayish-yellow opacity of the central retina; FFA mainly showed early dot weak background fluorescence in the peripheral region of the macula, retinal blood vessel fluorescence leakage staining, retinal pigment epithelium(RPE)fluorescence accumulation and optic disc staining or strong fluorescence; ICGA and OCT were mainly manifested by squamous weak fluorescence of the posterior retina; and the manifestations of FFA and ICGA were symmetrical; OCT revealed hyperreflective dots and pinpoint projection of RPE.CONCLUSION: The median age of onset in patients with syphilitic chorioretinitis is 44 years old, and monocular onset is more common. The patient's gender, marriage, and occupation have no significant characteristics. The clinical manifestations mainly include decreased vision, gray white cells in the vitreous body, thickening of the posterior pole retina, and grayish yellow changes. Correctly identifying OCT, FFA, and ICGA features can reduce missed diagnosis and misdiagnosis, and make an early and correct diagnosis and treatment of patients.

Objective:To clarify peripheral Th17 level in SSc patients and its correlation with disease.Methods:Chinese databases CNKI, CBM, Wanfang and VIP, and English databases PubMed, EMBASE, Web of Science, Cochrane Library and Science Direct were searched to collect a case-control study on the content of Th17 cells in peripheral blood of patients with SSc. The papers published when the database was first developed in 25 February 2021. Meta-analysis was conducted using Stata 12.0 software, and I2 and Egger tests were used to evaluate the heterogeneity and publication bias between studies. Results:A total of 26 case-controls were included in the study, including 1 160 patients with SSc and 778 healthy controls. Overall, the percentage of Th17 cells in SSc patients was higher than in healthy controls [SMD(95% CI)=1.85 (1.33, 2.38), P<0.001], which was most significant in IL-17 +Th17 concentration [SMD(95% CI)=1.88 (1.28, 2.48), P<0.001]. As for disease activity, the proportion of Th17 cells in active SSc patients was much higher than those of patients in remission [SMD(95% CI)=1.92 (1.12, 2.71), P<0.001]. SSc patients had a reduced Th17 level after receiving DMARDs treatment [SMD(95% CI)=-0.74 (-1.05, -0.42), P=0.029]. Conclusion:The number of Th17 cells increase significantly in the peripheral blood of patients with SSc, and is related to disease activity. DMARDs can be used to treat this disease by downregulating Th17 levels.

Objective:To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected. There were 6 males and 4 females, aged from 41 to 63 years, with a median age of 54 years. Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe. Observation indicators: (1) preoperative general situations of patients; (2) surgical situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021. Measurement data with normal distribution were expressed as Mean± SD. Count data were expressed was absolute numbers. Results:(1) Preoperative general situations of patients: hepatocellular carcinoma was found in 7 cases, inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case. Three cases had tumors located in S4a segment, 2 cases had tumors located in ventral subsegment of S8 segment, 2 cases had tumors located in dorsal subsegment of S8 segment, and 3 cases had tumors across the ventral segment of S4a+S8. The diameter of tumors was (3.4±1.0)cm. (2) Surgical situation: all the 10 patients underwent R 0 resection successfully, with no intraoperative blood transfusion or conversion to open surgery. The operation time of 10 patients was (149±59)minutes, the volume of intraoperative blood loss was (294±163)mL, the minimum surgical margin of specimen was (1.1±0.2)cm. The alanine aminotransferase was (324±151)U/L on the postoperative first day, the aspartic aminotransferase was (401±113)U/L on the postoperative first day, and the duration of postoperative hospital stay was (9±4)days. No bile leakage, hemorr-hage, reoperation or other complications occurred in all patients. (3) Follow-up: 10 patients were followed up for 7?13 months, with a median follow-up time of 11 months. All patients had no margin recurrence or distant metastasis. Conclusion:It is safe and feasible to construct triangular modal for planning approach of local laparoscopic resection of liver tumors located in superior part of central liver lobe.

Objective To explore the relationship between advancing age and the risk of developing coronary artery disease(CAD) ,type 2 diabetes mellitus(T2DM ) ,and both coronary artery disease and type 2 diabetes mellitus(CAD+ T2DM ). Methods A case-control study was conducted to investigate the relationship between advancing age and the risk of CAD ,T2DM ,and CAD+ T2DM in middle-aged and elderly patients. Results Aging was independently associated with increased risk of T2DM and CAD + T2DM (P＜0.05).Compared with patients aged below 60 ,the risk of T2DM was higher in patients aged 70 or over(OR＝3.80 ,95% CI :2.39-6.04 ,P＝0.000) ;The risk of CAD+ T2DM was lower in patients aged below 60 than in patients aged 60 to 69(OR＝4.14 ,95% CI :2.60-6.60 ,P＝ 0.000)and in patients aged 70 or over (OR ＝ 11.50 ,95% CI :7.18-18.42 ,P＝ 0.000) . Patients of older ages had a 2.78 times higher risk of developing CAD+ T2DM. Conclusions The onset of T2DM ,and CAD+ T2DM is associated with age.

Objective To discuss the optical coherence tomography (OCT)characteristics in patients with syphilitic chorioretinitis.Methods This was a retrospective cohort study.58 patients (88 eyes) with syphilitic chorioretinitis were included.The fluorescence fundus angiography (FFA),indocyanine green angiography (ICGA) and OCT examination were performed,and the rapid plasma regain test (RPR) and treponema pallidum particle agglutination test (TPPA) were also made.The treatment response and follow up results were analyzed.Results In this study,87 eyes represented as needle like projections of the retinal pigment epithelium,86 eyes represented as retinal external membrane and myoid,ellipsoid structure was unclear or disappear,68 eyes represented as high reflection points within the vitreous body,16 eyes represented as shallow retinal detachment.After treatment,the needle like projections of the retinal pigment epithelium were fully restored in 79 eyes,retinal external membrane and myoid,ellipsoid structure were partial displayed in 62 eyes,and shallow retinal detachment were fully restored in 16 eyes.Conclusion The manifestations of OCT in patients with syphilitic chorioretinitis include needle like projections of the retinal pigment epithelium,unclear or disappear retinal external membrane and myoid,ellipsoid structure,high reflection points within the vitreous body and shallow retinal detachment.The above manifestations of OCT can be recovered significantly with treatment.

Objective To explore the relationship between accessory renal artery(ARA)and essential hypertension,and the possible mechanism using CT angiography(CTA).Methods The patients who underwent CTA examination on renal artery were reviewed retrospectively in our hospital.A variety of CTA reconstruction techniques were used to observe the type and number of ARA,as well as the diameter of ARA and the main renal artery.Results A total of 126 ARA(66 left ARA and 60 right ARA)were found in 253 patients. 10% of the patients had more than two ARAs.In 164 patients with essential hypertension,ARA detection rate was 40.2%(66/164).In the non-hypertension patients,the proportion of ARA was 31.5%(28/89).There was higher proportion of young(P=0.002)and male (P=0.022)patients in ARA hypertension group compared with ARA non-hypertension group.There were no significant differences on the prevalence of type(P=0.826)and number of ARA(P=0.501)between these two groups.In all of the patients with single ARA,no significant differences were detected on the ratios of diameter of ARA and main renal artery between the two groups(P=0.32). However,in ARA hypertension group,the diameter of main renal artery on the ARA side was significantly smaller than that on the opposite side(P=0.01).In non-hypertension ARA group,no statistical difference was found between the diameter of bilateral main renal arteries(P=0.06).Conclusion ARA is more prevalent in essential hypertensive patients,especially in young male.The decrease of the diameter of main renal artery in the ARA side may be a possible mechanism for essential hypertension.

Objective To evaluate the effects of nurses′standardized training and to provide basis for revision of the standardized training programme by investigating core abilities of nurses before and after standardized training and post competency of nurses after the training.Methods 198 nurses in this hospital who participated in standardized training in 2013 were selected as research objects and their core abilities before and after the training and their post competency after the training were evaluated by questionnaires with separate evaluation by themselves and others.Results After standardized training,total score of nurses′core abilities were (80.26 ±10.53),higher than the score before the training (73.73 ±9.65)(t =6.303,P <0.01).After the training,for the results of nurses′self-evaluation in post competency,dimensions of good personal characteristics (4.61 ±0.51 ),clinical nursing abilities (4.61 ±0.51 ),supporting and interpersonal communication abilities (4.33 ±0.64),critical thinking abilities (4.14 ±0.82),and professional construction and development abilities (4.27 ±0.66)were all higher than the results of evaluations by others (t =7.57, 6.11,5.52,3.22,3.22;P <0.01).Conclusions Standardized training has a positive effect on improving core abilities of nurses,which is in accordance with clinical needs;the evaluation results of nurses′post competency can provide basis for revision of the standardized training programme;person-post matching helps to motivate nurses to improve their skills.

Objective To investigate the effect of treatment with endostatin combined with siRNA targeting VEGF on rats with collagen-induced arthritis (CIA).Methods Two mg/ml bovinetype Ⅱ collagen was injected into the rat footpad to build up the animal model of CIA.The experimental animal models were treated with endostatin combined with siRNA targeting VEGF 18 days later after immunization and the treatment ended 32 day later.The efficacy was evaluated by the weight,foot and ankle volume of rats.The levels of VEGF in plasma were detected by enzyme-linked immunosorbent assay (ELISA).The VEGF distribution within synovial tissue was detected and examined by immunohistochemical technique.The pathological changes of CIA were evaluated by the pathological changes of the biopsied ankle joints.Student's t test was used to evaluate the experimental data.Results The ELISA test showed that comparing with the model group (17.5±0.3),the endostatin group (15.7±0.3) ng/L and the endostatin combined siRNA targeting VEGF group (14.7±0.5) ng/L showed a significant efficacy in the treatment of CIA in rats (P＜0.05).The endostatin group (135±27) and the endostatin combined siRNA targeting VEGF group (126±71) were different in the number of VEGF in plasma and the VEGF distribution within synovial tissue (P＜0.05),the symptoms of arthritis in these rats were reduced than the model group.Conclusion Endostatin combined siRNA targeting VEGF has good therapeutic effect on rats with CIA.

BACKGROUND: Traditional glass ion sealant has a poor abradability and a low rupture strength. The sealant on the occlusal surfaces easily fell off, and is difficult to replace resin sealant. OBJECTIVE: To observe the effects of traditional resin sealant and atraumatic restorative treatment (ART) glass ionomer-based pit and fissure sealant for the young children. METHODS: Randomized comparison method was used to compare ART glass ionomer-based pit on molars of one side with resin sealant on the opposite side in 89 3-year-old children. RESULTS AND CONCLUSION: The retention rates of ART glass ionomer sealant after 6 and 18 months were significantly lower than those of resin sealant (P < 0.05). The caducous position of ART gliass ionomer sealant was the second deciduous molar of the lower mandible, but the caducous position of resin sealant was the second deciduous molar of the upper mandible. The secondary caries rate of ART glass ionomer sealant was significantly lower than that of resin sealant at 6 months. No significant difference was determined between groups at 18 months. These suggest that ART glass ionomer pit and fissure sealant has lower drop-out rate, simple operation and low cost with excellent caries-preventing effect. Since it is economically superior to resin sealant, the method is worth popularizing in caries-preventing projects.