AIM: To compare the control effect of spherical and toric orthokeratology on low-to-moderate myopia with astigmatism(-1.00--1.50 DC)in adolescents.METHODS: The clinical data of 119 cases(119 eyes)of low-to-moderate myopia with astigmatism(-1.00--1.50 DC)adolescents who were treated and fitted with orthokeratology in the ophthalmology department of Sichuan Provincial People's Hospital from June 2021 to January 2022 were retrospectively analyzed. They were divided into spherical group, with 65 cases(65 eyes), and toric group, with 54 cases(54 eyes)according to the type of orthokeratology. The changes of uncorrected visual acuity(UCVA), axial length and corneal astigmatism before and after wearing lenses were recorded to evaluate the therapeutic effect.RESULTS: The UCVA of both the groups significantly improved at 1 and 2 a after wearing lenses(all P<0.01); corneal astigmatism decreased, but there was no significant difference(all P>0.05); the axial length was longer than that before wearing lenses(P<0.01). There were no statistical significant differences in the UCVA and corneal astigmatism between the spherical group and the toric group(Fintergroup=0.829,Pintergroup=0.364; Fintergroup=0.997,Pintergroup=0.320); and there were no statistical significant differences in the axial length growth between the spherical group and the toric group after wearing lenses for 1 a(0.18±0.11 mm vs 0.17±0.14 mm), and 2 a(0.17±0.10 mm vs 0.16±0.10 mm; all P>0.05).CONCLUSION: Both orthokeratology lenses can improve the UCVA, reduce corneal astigmatism, and delay axial length growth of adolescents with low-to-moderate myopia with astigmatism(-1.00--1.50 DC), and there are no significant differences in the control effect of spherical design orthokeratology and the toric design orthokeratology on myopia.

Objective To investigate the effect of smoking on the semen quality in infertile men.Methods A total of 360 male infertility patients were enrolled and divided into the smoking group(n=190)and non-smoking group(n=170)based on whether they smoked or not.Furthermore,the smoking group was subdivided into group A(≤10 sticks/d,n=63),group B(11～20 sticks/d,n=80),and group C(>20 sticks/d group,n=47)according to the amount of smoking.Semen volume,liquefaction time,sperm concentration,motility,DNA fragmentation rate and normal morphological rate were observed and compared between and within the groups.Results There were significant differences in semen volume,liquefaction time,sperm motility,normal morphological rate and DNA fragmentation rate between the smoking group and the non-smoking group(P<0.05).The semen volume,sperm motility and normal morphological rate of the smoking group were lower than those in the non-smoking group,and the DNA fragmentation rate and semen liquefaction time were higher than those in the non-smoking group.And with the increase of smoking volume,sperm motility and normal morphological rate decreased,semen liquefaction time and DNA fragmentation rate increased,and there was no significant difference in the sperm concentration between the smoking group and non-smoking group(P>0.05).There was no significant difference in the semen volume between the three groups with different smoking amounts(P>0.05).Conclusion Smoking has a negative impact on the sperm quality parameters such as semen volume,sperm motility,normal morphological rate,sperm motility,liquefaction time and DNA fragmentation,and the effect of heavy smoking is particularly obvious.We should strengthen the comprehensive health education,promote the healthy lifestyles and reduce smoking.

[Objective]To distinguish and analyze the provisions of the word"belly"mentioned in Synopsis of the Golden Chamber,and to explore the similarities and differences in the usage of"belly"and"abdomen"during the period when Synopsis of the Golden Chamber was written,and clarify the specific meanings of"cold in the belly"and"heat in the belly".[Methods]By analyzing the meaning of the articles related to"belly"and verifying the original meaning of the words"belly"and"abdomen"in the era when ZHANG Zhongjing wrote the book,combined with the articles in Treatise on Febrile Diseases and Synopsis of the Golden Chamber that were similar to the diseases"syncope due to pathogenic cold"and"jaundice"described in the articles,the usage of"belly"in the articles was summarized.[Results]Throughout history,there had been various interpretations of"belly",such as considering it as the spleen,a part of the spleen meridian,and a reference to the abdomen.After examining the original meanings of the two characters"belly","abdomen"was first born in"belly",and its meaning and word making ability were higher than"belly"."Belly"was first seen in the Western Han Dynasty,and it mostly referred to the stomach of animals.Through verifying ZHANG Zhongjing's analysis of the principles and methods of"syncope due to pathogenic cold"and"jaundice"diseases,it was found that in Synopsis of the Golden Chamber,"belly"referred to the stomach and intestines,which was applied in the expression of Yangming disease.[Conclusion]The meanings of"belly"and"abdomen"in Synopsis of the Golden Chamber are different,and"belly"is not a mutual use of"abdomen".

Continuous arterial blood pressure monitoring by radial artery catheterization is an indispensable monitoring technique for children in the perioperative period and critical care, and the factors that affect the success of catheterization have always been the focus of clinical researches. This study reviewed the research progress on the factors related to the success of radial artery catheterization in children from the perspectives of operator's factors, patient's factors, and operation equipment and materials.

Objective:To explore the mediating effects of parental psychological control and psychological resilience in adolescents between parental marital conflict and early adolescent depression, loneliness.Methods:From October to December 2022, a total of 805 adolescents from three middle schools in Luzhou City, Sichuan Province and Chongqing City were surveyed with children's perception of interparental conflict scale, the parental psychological control scale, Connor-Davidson resilience scale, the center for epidemiological studies depression scale, UCLA loneliness scale.SPSS 26.0 software was used for descriptive analysis, correlation analysis.Mplus 7.0 software was used for chain mediating model construction, the mediating effects were tested by Bootstrap method.Results:(1)Parental marital conflict (2.05±0.51), parental psychological control (2.53±0.88), early adolescent depression (0.84±0.62) and loneliness (2.02±0.59) were significantly and positively correlated with each other ( r=0.47-0.78, all P<0.01), while psychological resilience in adolescents(2.42±0.66) was significantly and negatively correlated with marital conflict, parental psychological control, early adolescent depression and loneliness ( r=-0.60--0.36, all P<0.01). (2)The direct effects of parental marital conflict on early adolescent depression and loneliness were 0.183, 0.170, accounting for 34.08%, 32.82% of the total effects.There were three paths of the indirect effects between parental marital conflict and early adolescent depression, loneliness.The specific indirect effects of parental psychological control were 0.148, 0.127, accounting for 27.56%, 24.52% of the total effects.The specific indirect effects of psychological resilience were 0.186, 0.199, accounting for 34.64%, 38.41% of the total effects.The chain mediating effects of parental psychological control and psychological resilience were 0.020, 0.022, accounting for 3.72%, 4.25% of the total effects. Conclusion:Parental marital conflict can directly affect early adolescent depression, loneliness, and can indirectly affect early adolescent depression, loneliness through parental psychological control and psychological resilience in adolescents.

Heterotrophic nitrification-aerobic denitrification (HN-AD) bacteria are aerobic microorganisms that can remove nitrogen under high-salt conditions, but their performance in practical applications are not satisfactory. As a compatible solute, trehalose helps microorganisms to cope with high salt stress by participating in the regulation of cellular osmotic pressure, and plays an important role in promoting the nitrogen removal efficiency of microbial populations in the high-salt environment. We investigated the mechanism of exogenous-trehalose-enhanced metabolism of HN-AD community under high-salt stress by starting up a membrane aerobic biofilm reactor (MABR) to enrich HN-AD bacteria, and designed a C₁₅₀ experimental group with 150 μmol/L trehalose addition and a C₀ control group without trehalose. The reactor performance and the community structure showed that NH₄⁺-N, total nitrogen (TN) and chemical oxygen demand (COD) removal efficiency were increased by 29.7%, 28.0% and 29.1%, respectively. The total relative abundance of salt-tolerant HN-AD bacteria (with Acinetobacter and Pseudofulvimonas as the dominant genus) in the C₁₅₀ group reached 66.8%, an 18.2% increase compared with that of the C₀ group. This demonstrated that trehalose addition promoted the enrichment of salt-tolerant HN-AD bacteria in the high-salt environment to enhance the nitrogen removal performance of the system. In-depth metabolomics analysis showed that the exogenous trehalose was utilized by microorganisms to improve proline synthesis to increase resistance to high-salt stress. By regulating the activity of cell proliferation signaling pathways (cGMP-PKG, PI3K-Akt), phospholipid metabolism pathway and aminoacyl-tRNA synthesis pathway, the abundances of phosphoethanolamine, which was one of the glycerophospholipid metabolites, and purine and pyrimidine were up-regulated to stimulate bacterial aggregation and cell proliferation to promote the growth of HN-AD bacteria in the high-salt environment. Meanwhile, the addition of trehalose accelerated the tricarboxylic acid (TCA) cycle, which might provide more electron donors and energy to the carbon and nitrogen metabolisms of HN-AD bacteria and promote the nitrogen removal performance of the system. These results may facilitate using HN-AD bacteria in the treatment of high-salt and high-nitrogen wastewater.
Nitrification ; Denitrification ; Trehalose ; Phosphatidylinositol 3-Kinases/metabolism* ; Heterotrophic Processes ; Salt Stress ; Nitrogen/metabolism* ; Aerobiosis ; Bioreactors/microbiology*

Developmental exposure to bisphenol A (BPA), an endocrine-disrupting contaminant, impairs cognitive function in both animals and humans. However, whether BPA affects the development of primary sensory systems, which are the first to mature in the cortex, remains largely unclear. Using the rat as a model, we aimed to record the physiological and structural changes in the primary auditory cortex (A1) following lactational BPA exposure and their possible effects on behavioral outcomes. We found that BPA-exposed rats showed significant behavioral impairments when performing a sound temporal rate discrimination test. A significant alteration in spectral and temporal processing was also recorded in their A1, manifested as degraded frequency selectivity and diminished stimulus rate-following by neurons. These post-exposure effects were accompanied by changes in the density and maturity of dendritic spines in A1. Our findings demonstrated developmental impacts of BPA on auditory cortical processing and auditory-related discrimination, particularly in the temporal domain. Thus, the health implications for humans associated with early exposure to endocrine disruptors such as BPA merit more careful examination.
Humans ; Rats ; Animals ; Benzhydryl Compounds/toxicity* ; Phenols/toxicity* ; Auditory Perception/physiology* ; Neurons/physiology*

Objective:To explore the value of cell division cycle 42 (CDC42) in the efficacy and prognosis evaluation of arterial infusion chemotherapy for pancreatic cancer.Methods:The clinical data of 100 patients with pancreatic cancer who underwent arterial infusion chemotherapy from January 2018 to January 2020 at Second People's Hospital of Wuhu were retrospectively analyzed, and all patients were divided into effective group (the complete remission and partial remission) and ineffective group (the stable disease and the progressive disease) according to the chemotherapy efficacy determined by CT. The clinicopathological characteristics of both groups were compared. The influencing factors of chemotherapy efficacy were determined by using multivariate logistic regression model analysis. The efficacy evaluated by CT examination was treated as the gold standard. The receiver operating characteristic (ROC) curve was used to analyze the value of CDC42 level predicting the efficacy of arterial infusion chemotherapy for pancreatic cancer patients before infusion chemotherapy. Survival analysis was performed by using Kaplan-Meier and log-rank test was also performed.Results:Among 100 patients with pancreatic cancer, there were 13 cases of complete remission, 30 cases of partial remission, 20 cases of stable disease, 37 cases of progressive disease; 43 cases in effective group and 57 cases in ineffective group. The proportions of tumor long diameter > 4 cm, TNM staging Ⅲ-Ⅳ, carcinoembryonic antigen (CA)199 > 37 U/ml, carcino-embryonic antigen (CEA) > 5 ng/ml, neutrophil-to-lymphocyte (NLR) > 2.8, serum total bilirubin > 34.2 μmol/L before infusion, CDC42 ≤ 1.11 μg/L, low differentiation degree and vascular invasion in ineffective group were higher than those in effective group (all P < 0.05). Tumor long diameter > 4 cm, TNM staging Ⅲ-Ⅳ, CA199 > 37 U/ml, CEA > 5 ng/ml before infusion, low differentiation degree, vascular invasion, and CDC42 ≤ 1.11 μg/L were independent risk factors for effectiveness of arterial infusion chemotherapy (all P < 0.05). The area under the ROC curve of CDC42 predicting the ineffectiveness of arterial infusion chemotherapy was 0.810 (95% CI 0.781-0.839, P <0.01), and the optimal cut-off value was 1.11 μg/L, the sensitivity was 96.25%, and the specificity was 63.13%. Survival curve analysis showed that the 2-year overall survival rate of patients with CDC42 > 1.11 μg/L was 58.93% which was greater than that of patients with CDC42 ≤ 1.11 μg/L (22.73%), and the difference was statistically significant ( χ2 = 14.99, P<0.001). Conclusion:CDC42 level is an independent influencing factor for the efficacy of arterial infusion chemotherapy in patients with pancreatic cancer, and it can effectively predict the prognosis of patients.

Objective:To investigate the clinicopathological characteristics, immunophenotype, molecular characteristics, differential diagnosis, clinical treatment and prognosis of mixed carcinoma of cervix with adenoid cystic pattern.Methods:Three cases of mixed cervical carcinoma with adenoid cystic pattern were collected at the Affiliated Hospital of Xuzhou University Medical School from 2018 to 2021.The clinicopathological characteristics were analyzed, immunohistochemistry (IHC) and in situ hybridization (ISH) were performed. The related literature was reviewed.Results:The three patients were postmenopausal women with a median age of 74.7 years. The clinical symptom was vaginal bleeding without obvious causes. One case was an endophytic tumor, and the others were exophytic. The median diameter of the three cases was 3.3 cm. Two patients underwent hysterectomy, the tumors infiltrated the external 1/3 and middle 1/3 of the cervix respectively. All the lymph nodes were negative. One patient had a previous biopsy. Microscopically, all three tumors were characterized by a cribriform structure, which were filled with basophilic myxoid substance and surrounded by tubules lined by two layers of cells. The tumor cells had scanty cytoplasm and showed the characteristics of cervical basal-like cells. All three cases were accompanied by high-grade squamous intraepithelial lesions and squamous cell carcinoma, and one also showed a non-specific spindle cell sarcomatoid component. Within the double-layered epithelial structure, the outer epithelium was positive for p63, CD117, p16 INK4a (clone E6H4) and MYB protein and negative for S-100 by IHC. The combined positive score of PD-L1 (clone 22C3) was less than 1 in all three cases. Human papillomavirus (HPV) types 16 and 18 were detected in one patient preoperatively, while high-risk HPV were positive in the other two patients by RNAscope ISH postoperatively. None of the three cases showed MYB gene rearrangement by FISH. The mean follow-up time was 23.3 months (36, 28 and 6 months, respectively). Two patients underwent hysterectomy and radiotherapy survived without disease. One patient survived with tumor just by radiotherapy and drug therapy. Conclusions:Mixed cervical carcinoma with adenoid cystic pattern is extremely rare. It is a high-grade malignancy with poor prognosis. The tumor is associated with high-risk HPV infection, without MYB gene rearrangement, and with low PD-L1 immunoreactivity. Radical surgery combined with radiotherapy and chemotherapy is the mainstay of treatment at present.

Objective:To explore the clinical value of the geriatric potentially inappropriate medication(PIM)evaluation system in elderly inpatients.Methods:As a prospective cohort study, 203 elderly inpatients with polypharmacy were randomly divided into the control group and experimental group.Geriatric PIM evaluation system(based on the criteria for judging potential inappropriate drug use in Chinese elderly 2017 edition)on wechat platform was applied to patients of experimental group.During the 6 months, the number of elderly syndromes, types of drugs, the days in hospitalization, readmission rates and all-cause mortality were compared between two groups.Results:The age of 203 elderly inpatients ranged from 60 to 94(77.30±10.34)years, including 121 males and 82 females.The morbidity proportion of top five diseases were 69.95%(142/203)in cerebral infarction(non-acute phase), 62.07%(126/203)in hypertension, 24.14%(49/203)in coronary heart disease, 9.85%(20/203)in atrial fibrillation, and 6.40%(13/203)in cardiac insufficiency.The 97.53%(198/203)of elderly hospitalized patients had at least one senile syndrome, the average was 4.3±2.0.Insomnia, fall and frailty accounted for 32.87%(15/198), 28.45%(56/198)and 13.66%(27/198)respectively.Compared with the control group, the average length of stay in hospital in the experimental group significantly decreased[(16.38±4.29) vs.(21.32±6.10)d, t=2.438、 P=0.025], the number of senile syndrome, the score of fall, weakness and the re-admission rate were also decreased significantly(3.11±2.14 vs.4.32±1.50, t=0.854、 P=0.032; 6.19±1.35 vs.8.61±3.22, t=4.078、 P=0.044; 3.94±1.92 vs.5.65±1.34, t=2.843、 P=0.038; 9.81%(10/102) vs.1.98%(2/101), χ2=4.772、 P=0.029), and the frequency of PIM was significantly different between two groups(417.36±49.21 vs.210.25±38.23, t=2.136、 P=0.034). Conclusions:After making the drug adjustment on the elderly inpatients with multiple drugs, PIM evaluation system for the elderly are able to reduce the incidence of geriatric syndrome, shorten the length of stay in hospital, improve the rational use of drugs, and enhance the quality of life of the elderly patients.