AIM: To evaluate the effects of 3% diquafosol ophthalmic solution(DQS)on the ocular surface and tear film in adolescents with mild dry eye syndrome during the early stage of wearing orthokeratology lenses.METHODS: Prospective study. Totally 60 myopic adolescents(120 eyes)with mild dry eye syndrome who were fitted with orthokeratology lenses for the first time in our hospital from January 2023 to September 2023 were enrolled in this study. They were randomly divided into control group and observation group. Both groups wore the same brand of orthokeratology lenses for 8-9 h a day and 7 d a week. In the control group(30 cases, 60 eyes), the patients were treated by routine eyelid cleaning and warm compresses from the day of fitting. In addition to the control group's treatment, patients in the observation group(30 cases, 60 eyes)were given DQS 6 times a day for 3 mo, and follow-up for 6 mo after discontinuation of DQS. According to the follow-up requirements of orthokeratology lens, uncorrected visual acuity(UCVA), corneal curvature, corneal topography, and corneal fluorescein staining were rechecked. The ocular surface disease index(OSDI)scores, tear meniscus height(TMH)of lower eyelid, non-invasive tear film break-up time [first and average, NIBUT(f)and NIBUT(av)] and corneal fluorescein staining were measured at baseline, 1, 2 and 3 mo after treatment, and 3 and 6 mo after DQS discontinuation.RESULTS: All patients completed follow-up. The NIBUT(f), NIBUT(av)and TMH of lower eyelid in the observation group were higher than those in the control group at 2 and 3 mo after treatment and at 3 and 6 mo after discontinuation of DQ3(all P<0.05). The OSDI scores for both groups decreased significantly at 2 mo after treatment(all P<0.05). At 3 mo after treatment and 3 and 6 mo after discontinuation of DQS, the OSDI scores in the observation group was significantly lower than the control group(all P<0.01). There was no significant difference of corneal fluorescein staining between the two groups(P=0.731).CONCLUSION: The combination of DQS with eyelid hygiene and warm compresses shows better efficacy in enhancing the stability of the tear film for adolescents with mild dry eye syndrome while wearing orthokeratology lenses.

Objective:To evaluate the effect of short-term very low-calorie restriction(VLCR) on glycemic control in overweight/obese patients with type 2 diabetes, and to explore mechanisms through identifying markers of gut microbiota.Methods:This trial was conducted in 14 adult overweight/obese patients with type 2 diabetes. They received VLCR for 9 days in the hospital(calorie intake 300-600 kcal/d). Before and after VLCR, body weight(BW), waist circumference(WC), blood pressure(BP), and heart rate(HR) were measured, and body mass index(BMI) was calculated according to their height and weight. Fasting blood glucose(FBG), 2 h postprandial blood glucose(2hPBG), fasting insulin(FINS), triglycerides(TG), total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C), and low-density lipoprotein-cholesterol(LDL-C) were determined, and yielded the homeostasis model assessment for insulin resistance(HOMA-IR). Additional lab tests such as liver and kidney function and electrolytes were performed. The estimated glomerular filtration rate(eGFR) was calculated to evaluate renal function. All data were analyzed using the SPSS Sample Power software. Feces samples were collected before and after VLCR. Fecal samples were tested for microbial diversity using 16S rDNA technology. Professional software was used to analyze the differences of gut microbiota in feces before and after VLCR.Results:After 9 days of VLCR, BW, BMI, WC, BP, HR, FBG, 2hPBG, FINS, HOMA-IR, alkaline phosphatase, TG, and blood urea nitrogen of 14 overweight/obese patients with type 2 diabetes were significantly reduced( P<0.05). No effect was seen on serum alanine aminotransferase, aspartate amino transferase, gamma glutamyl transferase, TC, HDL-C, LDL-C, creatinine, eGFR, uric acid, albumin, calcium, and phosphorus( P>0.05). The gut microbiota diversity did not differ before and after VLCR. The abundance of Bacteroidetes increased significantly, and the Firmicutes/Bacteroidetes ratio decreased from 11.79 to 4.20. Between groups analysis showed the abundance of Parabacteroides distasonis increased significantly after VLCR. Conclusion:VLCR can improve body weight and glucose and lipid metabolism in overweight/obese patients with type 2 diabetes, with no serious adverse events. Parabacteroides distasonis may be a marker of VLCR.

Objective: To understand the vaccination coverage and associated factors among children under 7 years old in rural areas of Ningxia in 2019, so as to provide a basis for better immunization plans and corresponding strategies in this region. Methods: A multi-stage stratified cluster random sampling method was adopted to select 1 144 children under 7 years old and their families in three rural counties of Ningxia. Demographic information, as well as primary and secondary immunization was investigated. Multivariate Logistic regression analysis was conducted on the relevant factors. Results: In Ningxia, the coverage rate of primary vaccines for children under 7 years of age for hepatitis B vaccine, BCG vaccine and dpt vaccine was above 95%, polio vaccine 83.7%, measles vaccine 38.6%, "five vaccines" 33.8%, and the coverage rate of secondary vaccines was only 4.9%. There were statistically significant differences in the total vaccination rates of "five seedlings" in different ages, per capita annual income of different families, and whether they had received a health examination in the past year (χ2=33.60,13.17,29.96,P<0.05). There were statistically significant differences in the vaccination rates of secondary vaccines among different age groups, different inoculation units and whether received a physical examination in the last year (χ2=18.58, 8.45, 60.04, P<0.05). Multivariate analysis showed that the age of children and whether received physical examination in the last year were the relevant factors affecting the total inoculation of five seedlings(P<0.05). Age of children and inoculation unit were the relevant influencing factors affecting the secondary immunization(P<0.05). Conclusion The primary vaccination rate for children under the age of 7 in rural areas of Ningxia is kept at a high level, but the secondary vaccination rate is relatively low. It is suggested to strengthen publicity and education and establish effective mechanisms to improve the vaccination rate and protect the health of children in rural areas.

Objective:To investigate the role of peptidyl arginine deiminase 4 (PAD4) in anti-β 2GP1/β 2GP1 complex-induced formation of neutrophil extracellular trapping networks (NETs). Methods:Peripheral blood neutrophils were isolated from healthy humans by density gradient centrifugation. PAD4 expression was detected by Western blot after the neutrophils were incubated with anti-β 2GP1/β 2GP1 complex (100 μg/ml) for a certain period of time. PAD4 inhibitor Cl-amidine (10 μmol/L) was used to pretreat neutrophils. Changes in the expression of citrullinated histone 3 (CitH3) at protein level and the relative content of myeloperoxidase (MPO)-DNA were detected by Western blot and ELISA, respectively. A mouse thrombus model of antiphospholipid syndrome (APS) was established by inferior vena cava stenosis. Intervention experiments were performed by intraperitoneal injection of Cl-amidine (50 mg/kg). The expression of CitH3 at protein level in plasma was detected by Western blot. The concentration of circulating free DNA (cf-DNA) in plasma was measured with fluorescent staining. Thrombus in inferior vena cava was collected and weighted to evaluate whether inhibiting the activity of PAD4 would suppress the APS-IgG-induced formation of NETs and thrombosis. Differences among groups were analyzed by t test or one-way analysis of variance (ANOVA). Results:The expression of PAD4 induced by anti-β 2GP1/β 2GP1 complex was significantly down-regulated in the cytoplasm, but increased in the nucleus [(3.67±0.32) vs (1.47±0.19), t=10.22, P<0.05; (0.57±0.19) vs (2.97±0.31), t=11.49, P<0.05]. Cl-amidine significantly inhibited the anti-β 2GP1/β 2GP1 complex-induced expression of CitH3 protein by neutrophils [(2.46±0.47) vs (0.46±0.13), t=12.24, P<0.01], and reduced the MPO-DNA content in the culture supernatants [(4.09±0.94) vs (2.80±0.57), t=4.23, P<0.05]. In vivo, Cl-amidine significantly inhibited the expression of CitH3 protein [(3.97±0.56) vs (1.09±0.45), t=11.83, P<0.01] and decreased the content of cf-DNA [(2 685.0±735.8) vs (1 784.0±577.0), t=3.93, P<0.05] in plasma of APS mice. Compared with the experimental APS mice in the control group, the weight of thrombus in the APS mice pretreated with Cl-amidine was significantly reduced [(8.22±3.06) vs (4.89±1.90), t=2.27, P<0.05]. Conclusions:PAD4 was involved in the formation of NETs induced by anti-β 2GP1/β 2GP1 complex, which might play an important role in APS thrombosis.

This study aimed at investigating the effects of Chinese herbal compound Qi Kui granules on urine protein and inflammatory markers in patients with type 2 diabetic nephropathy (DN) based on the treatment of regular western medication.A randomized,parallel controlled method was involved in the present trial,and patients diagnosed with type 2 DN were randomly divided into the Chinese herb group and the control group.Regular treatment of angiotensin Ⅱ receptor blocker (ARB) in western medicine was administered in the two groups with the additional treatment of Qi Kui granules for the Chinese herb group.All the patients revisited the doctor every 4 weeks during the observation period within a 12-week course of the observation.Urinary albumin to creatinine ratio (UACR),urinary albumin excretion rate (UAER) and inflammatory cytokines in the two groups were determined.As a result,seventy-two patients in aggregate were included in the study,while 32 patients of the control group and 31 patients of the Chinese herb group effectively accomplished the observation.After the 12-week treatments,UACR and UAER were significantly decreased in the two groups (P ＜ 0.01),while the efficacy of the Chinese herb group was better than that of the control group (P ＜ 0.05).Compared with the control group,the levels of serum IL-6,tumor necrosis factor α (TNF-α),transforming growth factor f1 (TGF-f1) and urinary monocyte chemoattractant protein (MCP-1) / Cr significantly decreased after the 12-week treatment (P ＜ 0.01).It was concluded that the Chinese herbal compound Qi Kui granules successfully mitigated proteinuria in DN patients.The improvement of glomerular inflammation for renoprotection should be the mechanism behind this.

A method of direct injection and liquid chromatography coupled with tandem mass spectrometric (LC-MS / MS) was developed for simultaneous determination of 5 aniline compounds including aniline, 3-nitroaniline, 4-nitroaniline, 2,6-dichloro-4-nitroaniline and hexanitrodiphenylamine in drinking water and source water. The samples were filtered using a 0. 22-μm polyethersulfone membrane prior to HPLC analysis. Five target compounds were chromatographically separated on an HSS T3 column with gradient elution. Chromatographic data were acquired by tandem mass spectrometric detection in multiple reaction monitoring (MRM) mode, and thus favorable resolutions of all target compounds were achieved within 4 min. Under the optimal analytical conditions, the peak area of each analyte and its concentration had a good correlation within the linear range (R≥0. 995). The limit of detection (LOD) and limit of quantification (LOQ) of the method were 0. 773-1. 88 μg / L (S / N=3) and 2. 58-6. 27 μg / L (S / N=10), respectively. The intra- and inter-day relative standard deviations ( RSDs) of the mix standard solution were 0. 8% -1. 9% and 3. 3% -4. 9% , respectively. The spiked recoveries of the analytes were 84. 1% -105% and the RSDs of the spiked samples were 1. 0% -3. 1% . This proposed method was applied in the analysis of 35 samples from drinking water, source water and surface water, which indicated that the novel LC-MS / MS method could detect 5 aniline compounds in water without any complicated sample pretreatment in an accurate, sensitive and rapid way, and it also could provide technique support for evaluation of the contamination caused by aniline compounds.

Objective Toinvestigate the related risk factors of newly diagnosed diabetes among residents aged over 40 years in Nanjing City , and to provide evidence for diabetes prevention. Methods The clinical data were collected from the diabetes epidemiologic investigation among residents aged 40 -79 years from 6 communities in Nanjing City. Univariate and multiple logistic regression analyses were performed to analyze the potential risk factors for newly diagnosed diabetes. Results The prevalence rate of new diagnosed diabetes from 8039 subjects was 10.87%. A higher prevalence rate of new diagnosed diabetes was found in male than that in female (13.15% vs. 9.74%, P < 0.01). Multiple logistic regression analyses revealed that the main risk factors for newly diagnosed diabetes were male, age, family history, body mass index (BMI) and less physical activity after adjusting other factors (adjusted OR 1.339-1.862, P < 0.05). Conclusions Male, age, family history, body mass index (BMI) and less physical activity may be the main risk factors for diabetes among residents in Nanjing City.

Objective Hypoalbuminemia is a typical symptom of nephrotic syndrome ( NS) , which may result from the loss of much protein with urine.Hyperbilirubinemia is also a common symptom in patients with NS.This study is intended to reveal the relationship between hypoalbuminemia and hyperbilirubinemia in patients with NS by investigating urine bilirubin, albumin( ALB ) and 24-hour urine protein in the NS group, chronic glomerulonephritis ( CGN ) group and postoperative gastroparesis syndrome ( PGS) group ( ALB<35 g/L) .Methods Totally 187 patients with NS, 70 patients with CGN and 64 patients with PGS ( ALB <35 g/L ) were recruited before ALB, urinary protein ( UPR ) , urinary microalbuminuria/creatinine(Umalb/cr) and total bilirubin(TBIL) were detected.SPSS 17.0 Software was used to analyze the difference between the three groups and to reveal the correlations between TBIL and UPR, ALB.Results TBIL, ALB, UPR and Umalb/Cr levels were significantly different between NS, CGN and PGS groups ( one-way ANOVA test, P <0.05), and TBIL was positively correlated with ALB but negatively correlated UPR and Umalb/Cr in both NS and CGN groups (Spearman′s rho test,P<0.05);but no correlation was found between these items in PGS group (Spearman′s rho test,P>0.05) .Conclusion Serum bilirubin of patients with NS is at a low level and shows significant correlations with serum albumin and urinary protein levels.No similar association is found with the other two groups.The results in this study show that the causes of low serum bilirubin in patients with NS may related to the large amount of protein lost in urine.

Objective To analyse the relationship between T lymphocyte subsets and NK cells expression and dynamic changes in lung cancer patients 'peripheral blood and the occurrence and development of cancer,and investigate their clinical significances.Methods Flow cytometry was applied to detect 66 patients with lung cancer,60 patients with pulmonary tuberculosis and 60 healthy persons peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression.Lung cancer group peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression were also detected on 3rd,7th and 20th day before and after chemotherapy.Results Lung cancer group CD+3,CD+3CD+4,Th/Ts,CD+16CD+56 expression decreased significantly [(54.23±10.37)％,(34.23±8.03)％,1.35±0.20,(25.18±4.34)％] and had significant differences compared with pulmonary tuberculosis group [(63.09±9.19)％,(39.46±12.74)％,1.51±0.41,(26.45±3.96)％] and healthy group [(69.68±8.31)％,(42.31±13.29)％,1.89±0.48,(29.44±2.51)％](P ＜ 0.05),but CD+3CD+8 expression showed no significant difference(P ＞ 0.05).In chemotherapy group,comparing with before chemotherapy,remission group CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression decreased significantly (P ＜ 0.01)on 3rd day after chemotherapy,while CD+3CD+8expression increased significantly(P ＜ 0.01).On 7th day,each index recovered to the level of before chemotherapy basically.On 20th day,CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression increased significantly(P ＜ 0.05)compared with before chemotherapy,while CD+3CD+8 expression significantly decreased(P ＜ 0.05).Chemotherapy unease group had no significant difference (P ＞ 0.05).Lung cancer of stage Ⅲ A and Ⅲ B compared with stage Ⅰ A,and lymph node metastasis in N3 group compared with N0 group,CD+3,CD+3CD+4,CD+3CD+8,Th/Ts and CD+16CD+56 expression had significant differences (P ＜ 0.05).Compared with their pathological types,each index had no significant difference(P ＞ 0.05).Conclusion Monitoring the peripheral blood T lymphocyte subsets and NK cells dynamic of lung cancer patients can guide the clinical diagnosis and treatment,and contribute to the assessment of immune function.

Objective To investigate the clinical efficiency,safety,adverse reactions and healthrelated life quality of transdermal fentanyl patches for pain management in terminal cancer patients with hepatic and renal dysfunction and ascites.Methods 98 terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal dysfunction were randomly divided into two groups.Group Ⅰ (n=56)received transdermal fentany patches.Group Ⅱ,the control group (n=42),received morphine controlledrelease tablets.Terms of pain intensity,function of renal and liver,adverse reactions and heath-related quality of life were assessed before and after treatment.Results Patients were satisfied with their pain management in both groups,and no significant difference in pain release was observed between the groups (x2 =0.01,0.07,0.01,0.04,P ＞ 0.05).The incidences of constipation and dysuresia were significantly less in the group Ⅰ compared with that of the group Ⅱ (x2 =7.32,3.96,P ＜ 0.05).The incidences of hypersomnia,dizzy,nausea and vomiting were similar betwecn the two groups (x2 =0.12,0.54,0.54,0.02,P ＞ 0.05).Most of the adverse reactions would relieve or disappear after symptomatic treatment.Values of BUN,CR,ALT,AST were similar before and after treatment in group Ⅰ (t =1.43,1.67,0.91,0.11,P＞ 0.05).However,in group Ⅱ,these values were significantly increased after treatment (t =17.59,49.17,42.12,36.23,P ＜ 0.05).The heathrelated life quality (appetite,spirit,somnus,fatigue,daily life and countenance) were significantly improved after treatment in both groups (the group Ⅰ t =3.37,4.40,2.07,5.66,4.48,P ＜ 0.05; the group Ⅱ t =2.03,2.27,3.59,4.16,2.79,P ＜ 0.05),the spirit group Ⅰ improved more obviously compared with group Ⅱ (t =2.93,P ＜ 0.05).Conclusion Transdermal fentanyl patches provides equal pain relief compared with Morphine controlled-release tablets in the terminal cancer patients with abnormal hepatic and renal function and ascites.Transdermal fentanyl patches significantly improve health-related quality with less hepatic and renal function influence and low incidence of adverse reaction.It should be recommended in the treatment terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal function and ascites.