AIM: To explore the therapeutic effect of oral Xuefu Zhuyu Pill combined with intravitreal injection of aflibercept in the treatment of retinal vein occlusion(RVO).METHODS: A total of 80 patients(80 eyes)with RVO admitted to our hospital from January 2021 to March 2024 were prospectively selected. According to the treatment method, they were divided into a control group of 40 patients treated with intravitreal injection of aflibercept, and an observation group of 40 patients treated with oral Xuefu Zhuyu Pill combined with intravitreal injection of aflibercept. The efficacy, TCM syndrome score, retinal microcirculation parameters, macular edema(ME), and adverse reactions were compared between the two groups of patients in the treatment of RVO.RESULTS: All patients have completed follow-up. The clinical effective rate of the observation group after treatment was 95%, obviously higher than that of the control group(80%; χ2=4.114, P=0.043). After treatment for 3 mo, the traditional Chinese medicine syndrome scores, foveal avascular area(FAZ)area, FAZ circumference, macular central retinal thickness, and neovascularization leakage area of both groups decreased, the overall blood flow density of the superficial capillary plexus(SCP)and deep capillary plexuses(DCP)increased, and the observation group showed better results than the control group(all P<0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups during the treatment period(P>0.05).CONCLUSION: Oral administration of Xuefu Zhuyu Pill combined with intravitreal injection of aflibercept in the treatment of RVO can improve retinal microcirculation, enhance vision, restore ocular blood circulation, improve bleeding, promote ME absorption, and improve clinical efficacy.

BACKGROUND: Human neutrophil lipocalin (HNL) has been used extensively to differentiate acute bacterial infection from febrile diseases as a biomarker to reflect the activation of the neutrophil. The serum HNL levels in the adult-onset Still's disease (AOSD) patients with and without infection, as well as the healthy controls (HCs), were analyzed statistically in this study to evaluate the value of HNL for the diagnosis of AOSD. METHODS: A total of 129 AOSD patients were enrolled, from whom blood samples were drawn and the AOSD diagnosis was confirmed through the review of the medical records, where the systemic score, demographic characteristics, clinical manifestations, and laboratory parameters were also collected for the patients; in addition, a total of 40 HCs were recruited among the blood donors from the healthcare center with the relevant information collected. The HNL test was done for the blood samples with the enzyme-linked immunosorbent assay and the analyses were done for the correlations of HNL with clinical manifestations and diagnostic effectiveness. RESULTS: The serum HNL increased significantly in the patients with only AOSD as compared with that in the HCs (139.76 ± 8.99 ng/mL vs . 55.92 ± 6.12 ng/mL; P  < 0.001). The serum HNL level was correlated with the white blood cell (WBC) count ( r  = 0.335, P  < 0.001), neutrophil count ( r  = 0.334, P  < 0.001), erythrocyte sedimentation rate ( r  = 0.241, P  = 0.022), C-reactive protein ( r  = 0.442, P  < 0.0001), and systemic score ( r  = 0.343, P  < 0.0001) in the AOSD patients significantly. Patients with fever, leukocytosis ≥15,000/mm 3 , and myalgia in the HNL-positive group were observed relatively more than those in the HNL-negative group ( P  = 0.009, P  = 0.023, and P  = 0.007, respectively). HNL was a more sensitive indicator than ferritin and C-reactive protein (CRP) to differentiate the AOSD patients with bacterial infection from AOSD-only patients, and the Youden index was 0.6 for HNL and 0.29 for CRP. CONCLUSION Serum HNL can be used as a biomarker for the diagnosis of the AOSD, and HNL is also observed to be associated with the disease activity.
Adult ; Humans ; Still's Disease, Adult-Onset/diagnosis* ; C-Reactive Protein/metabolism* ; Neutrophils/metabolism* ; Clinical Relevance ; Biomarkers ; Bacterial Infections

Objective: To describe the distribution characteristics of coronary heart disease in adult twins recruited from Chinese Twin Registry (CNTR), and provide clues and evidence for the effect of genetic and environmental influences on coronary heart disease. Methods: By using the data of CNTR during 2010-2018, a total of 34 583 twin pairs aged ≥18 years who completed questionnaire survey and had related information were included in the current study to analyze the population and area distribution characteristics of coronary heart disease. Random effect models were used to compare the differences between groups. The concordane rate of coronary heart disease were calculated respectively in monozygotic (MZ) twin pairs and dizygotic (DZ) twin pairs to estimate the heritability. Results: The twin pairs included in this analysis were aged (34.2±12.4) years. The overall prevalence rate of coronary heart disease in twin pairs was 0.7%. Twin pairs who were women, older, obese and lived in northern China had higher prevalence of coronary heart disease (P<0.05). Intra-pair analysis in the same-sex twin pairs found that the concordane rate of coronary heart disease was higher in MZ twin pairs (25.3%) than in DZ twins (7.4%), and the difference was statistically significant (P<0.001). The overall heritability of coronary heart disease was 19.3% (95%CI: 11.8%-26.8%). Stratified by gender, age and area, the concordane rate was still higher in MZ twin pairs than in DZ pairs. Participants who were women, aged 18-30 years or ≥60 years and lived in northern China had a higher heritability of coronary heart disease. Conclusion: The distribution of coronary heart disease in twin pairs differed in populations and areas. The prevalence of coronary heart disease was affected by genetic factors, but the effect varied with age, gender and area.
Adolescent ; Adult ; China/epidemiology* ; Coronary Disease/genetics* ; Diseases in Twins/genetics* ; Female ; Humans ; Male ; Twins, Dizygotic ; Twins, Monozygotic/genetics*

AIM: To analyze the effectiveness and influencing factors of phacoemulsification combined with intraocular lens(IOL)implantation in the treatment of primary angle-closure glaucoma(PACG).

METHODS: Clinical data of 75 patients(75 eyes)with PACG who received phacoemulsification and IOL implantation in our hospital from January 2017 to December 2018 were retrospectively analyzed. Postoperative intraocular pressure(IOP), best-corrected visual acuity(BCVA), changes of anterior segment and incidence of complications were counted. The patients were grouped by efficacy, and multivariate Logistic regression analysis was performed to analyze the risk factors influencing the effectiveness of phacoemulsification and IOL implantation in patients with PACG.

RESULTS: Postoperative IOP of patients with PACG was decreased while BCVA was increased, and there were statistically significant differences compared with those before operation(P<0.05). Central anterior chamber depth(ACD), angle opening distance(AOD500), trabecular iris angle(TIA500)and angle recess area(ARA)were increased significantly compared with those before operation(P<0.05). Multivariate Logistic regression analysis showed that chronic PACG and preoperative IOP were independent risk factors for efficacy of phacoemulsification and IOL implantation in patients with PACG(P<0.05).

CONCLUSION: Phacoemulsification combined with IOL implantation has good efficacy and safety in the treatment of PACG. However, it is necessary to pay attention to preoperative IOP control. What's more, it should be carefully considered whether this operation is necessary for patients with chronic PACG.

BACKGROUND: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. METHODS: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. RESULTS: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). CONCLUSION Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; China/epidemiology* ; Delivery Rooms ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Pregnancy

OBJECTIVE: To investigate the expression of Circ_cgga162 in serum of mantle cell lymphoma (MCL) patients and analyze its potential as a prognostic biomarker. METHODS: The expression of Circ_cgga162 in 86 cases of mantle cell lymphoma and 50 cases of lymph node reactive hyperplasia (RH) were detected by real-time quantitative polymerase chain reaction (qRT-PCR). The relationship between the expression of Circ_cgga162 and clinicopathological features was analyzed by univariate analysis. The relationship of Circ_cgga162 expression with progression-free survival time and overall survival time was analyzed by Kaplan-Meier. The relationship between expression of Circ_cgga162 and prognosis of patients was analyzed by univariate and multivariate analysis. RESULTS: The expression level of Circ_cgga162 in MCL patients was significantly higher than that in control (RH) group (P＜0.01). The expression of Circ_cgga162 not correlated with age, gender, B symptoms and LDH (all P＞0.05), but correlated with the expression of MCL International Prognostic Index (IPI), Ann Arbor stage, bone marrow infiltration and Ki67 (all P＜0.05). In addition, Kaplan-Meier analysis showed that the progression-free survival time and overall survival time of the MCL patients with high expression of Circ_cgga162 were significantly shorter than those of the MCL patients with low expression (P＜0.01). Univariate analysis showed that Ann Arbor stage, Circ_cgga162 expression, MIPI, bone marrow infiltration and Ki67 were the prognostic factors for MCL patients (all P＜0.05). Multivariate Cox regression analysis showed that Ann Arbor stage, Circ_cgga162 expression and MIPI were independent factors affecting the prognosis of MCL patients (all P＜0.05). CONCLUSION Circ_cgga162 is highly expressed in serum of patients MCL, which relates with the prognosis of MCL patients. Circ_cgga162 can be used as a potential prognostic marker and therapeutic target for MCL patients.
Humans ; Kaplan-Meier Estimate ; Lymphoma, Mantle-Cell ; Multivariate Analysis ; Prognosis ; RNA, Circular ; genetics

AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract.

METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(n=52, 54 affected eyes)and the study group(n=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups.

RESULTS: There was no significant difference in visual acuity between the two groups before surgery(P>0.05). The visual acuity of both groups were significantly improved after surgery(P<0.05), and the improvement in study group was better than that in control group(P<0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(P<0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(P<0.05), but there was no significant difference in intraocular pressure between the two groups(P>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(P<0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(P>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(P<0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(P<0.05).

CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.

AIM: To investigate the effect of long-term application of prostaglandin analogue eye drops on conjunctival flora in glaucoma patients.

METHODS: Totally 69 patients(113 eyes)with glaucoma treated with latanoprostaglandin from June 2016 to June 2017 were selected, and the sensitivity of conjunctival flora and staphylococcus epidermidis to antibiotics was examined after admission, 3mo and 1a.

RESULTS: The number of bacterial eyes detected at admission, 3mo and 1a were 63, 66 and 67 respectively(χ²=2.496, P=0.287). There was no difference in the detection rates of staphylococcus epidermidis, streptococcus, staphylococcus aureus, staphylococcus hominis, staphylococcus hemolyticus and moraxella at the time of admission, 3mo and 1a(P>0.05). The ratio of MRSE at 3mo was higher than that at entry(χ²=3.063, P=0.062). The ratio of MRSE at 1a was higher than that at 3mo(χ²=38.945, 24.984, all P<0.001). The susceptibility of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, tobramycin, cefmethime and erythromycin at 3mo was lower than that at the time of admission, but there was no difference(P>0.0167), while the susceptibility of staphylococcus epidermidis to chloramphenicol at 3mo was lower than that at entry(P<0.0167). The sensitivity of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, cefmethime, tobramycin, chloramphenicol and erythromycin at 1a was lower than that at 3mo(P<0.0167).

CONCLUSION: The long-term application of latanoprostaglandin will not affect the detection rate of conjunctival flora, but can increase the incidence of MRSE. Clinically, patients who need long-term application of latanoprostaglandin should be considered comprehensively to prevent the emergence of drug-resistant strains in order to prevent uncontrollable infection.

Objective: To compare the dosimetric parameters of target volumes and organs at risk between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for left sided breast cancer after breast-conserving surgery by a meta-analysis. Methods: Literature search was performed to include related studies to analyze the dosimetric parameters of target volumes and organs at risk. Results: A total of 11 studies involving 154 patients were included in meta-analysis. There were no significant differences in D_mean, HI of PTV-Whole breast and PTV-Boost. Comparing to IMRT, VMAT increased the conformity index (CI) of PTV-Whole breast (P=0.000) and PTV-Boost (P=0.002). When the mean volume of target volumes was≤634 cm³, there were no significant differences in D_mean, V₅, V₂₀ of the heart and left sided lung, V₃₀ of the heart, D_mean of the right sided lung and breast between VMAT and IMRT.When the mean volume of target volumes was>634 cm³, the D_mean(P=0.037), V₅(P=0.005) and V₂₀(P=0.030) of the heart in IMRT was lower than VMAT, but the V₃₀(P=0.001) of heart in VMAT was lower than IMRT.IMRT showed significantly lower D_mean(P=0.013), V₅(P=0.000), V₂₀(P=0.000) of the left sided lung, and D_mean(P=0.001) of the right sided lung than VMAT.There were no significant differences in D_mean of the right sided breast. Conclusions There were no significant differences in dosimetric parameters of target volumes between VMAT and IMRT.When the mean volume of target volumes was≤634 cm³, there were no significant differences in dosimetric parameters of organs at risk. When the mean volume of target volumes was>634 cm³, IMRT has some advantages in protection of the heart and lung.

Objective: To explore the therapeutic efficacy and safety of chemotherapy sequential epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for advanced non-small cell lung cancer (NSCLC) patients with EGFR-TKI acquired resistance. Methods: The clinical features of 96 advanced NSCLC patients with EGFR mutation positive and EGFR-TKI acquired resistance from January 2013 to December 2016 were retrospectively reviewed. Forty-five patients who received chemotherapy sequential EGFR-TKI were enrolled in observation group, and another fifty-one who accepted chemotherapy alone were enrolled in control group. The objective response rates, disease control rates and adverse effects were compared between two groups. Results: Compared with that of the control group, the objective response rate of the observation group was significantly higher [24.4% (11/45) vs.11.8% (6/51), P=0.037], the disease control rate was also significantly increased [77.8% (35/45) vs.52.9% (27/51), P=0.023], the progression free survival was obviously prolonged [(7.4 ± 2.0) months vs.(4.5 ± 1.2) months, P=0.029], the incidence of rash in adverse reactions was significantly increased [35.6% (16/45) vs. 7.8%(4/51), P=0.008]. There were no significant difference in the side effects between the two groups (P > 0.05). Conclusions Compared with chemotherapy alone, chemotherapy combined with sequential EGFR-TKI could bring better clinical efficacy for NSCLC patients with EGFR-TKI acquired resistance, and the adverse effects could be tolerated.