Objective: To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability. Methods: From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated. Results: The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2. Conclusions Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

BACKGROUND: Previous studies have found the lincRNAs play important roles in the occurrence and development of lung adenocarcinoma, but their regulated mechanims are still unclear. The aim of this study is to evaluate the relationship between DNA methylation and lincRNA expression, and the effect of prognosis in lung adenocarcinoma. METHODS: The whole genome Illumina Methylation 450 DNA methylatiuon data and RNAseq for lung adenocarcinoma were download from TCGA. DNA methylation around lincRNA and their relationship to gene expression were analyzed. Their contribution to lung adenocarcinoma were further analyzed by comparing DNA methylation and lincRNA expression in tumor and adjacent tissues. RESULTS: The methylation level in promoter region was lower than other positions in lincRNA, and was negatively correlated with gene expression. There were 427 lincRNA genes showed differential DNA methylation in their promoter regions in tumor and adjacent tissues. Among these, 15 lincRNA genes showed differential gene expression and negatively correlated with DNA methylation, including FENDRR (a tumor progression and metastasis gene) whose high methylation in its promoter showed poor survival in lung adenocarcinoma. CONCLUSIONS The expression of lincRNA can be regulated by DNA methylation in their promoter regions, and the level of DNA methylation is related to patient prognosis in lung adenocarcinoma.
Adenocarcinoma ; diagnosis ; genetics ; Adenocarcinoma of Lung ; Computational Biology ; DNA Methylation ; Humans ; Lung Neoplasms ; diagnosis ; genetics ; Prognosis ; Promoter Regions, Genetic ; genetics ; RNA, Long Noncoding ; genetics ; Survival Analysis

BACKGROUND: Integrin α5β1 has been shown to be related to acetabular cartilage degeneration due to developmental dysplasia of the hip.OBJECTIVE: To investigate the expression of integrin α5β1 in differently degenerated cartilage tissues of the knee after knee osteoarthritis.METHODS: Seventy-five degenerated articular cartilage specimens at the weight-bearing surface of femoral lateral and medial condyles were removed from patients with knee osteoarthritis who underwent total knee replacement, and were then allotted to four groups based on Mankin's grading system: normal (n=6), mild degeneration (n=24), moderate degeneration (n=26) and severe degeneration (n=19) groups. The expression of integrin α5β1 in each group was detected using real-time PCR, immunohistochemistry and western blot assay.RESULTS AND CONCLUSION: The detected results were consistent in the three kinds of assays, and the expression level of integrin α5β1 was ranked as follows: severe degeneration group > moderate degeneration group > mild degeneration group > normal group (P < 0.05). To conclude, differential expression levels of integrin α5β1 are found in different degenerative degrees of articular cartilage in knee osteoarthritis. Furthermore, the expression level of integrin α5β1 is increased with the degenerative severity.

PURPOSE: Mitofusin2 gene (Mfn2, also named Hyperplasia suppressive gene, HSG) is very important in the origin and development of hypertension. However, the mechanism of Mfn2/HSG expression regulation was not uncovered. This study was designed to explore the association of a novel 5'-uncoding region (UCR) -1248 A>G variation of HSG/Mfn2 gene and hypertension. MATERIALS AND METHODS: 472 healthy, normotensive subjects [normotension (NT) group], 454 prehypertensive subjects [prehypertension (PH) group] and 978 hypertensive patients [essential hypertension (EH) group] were screened for an association study between 5'-UCR -1248 A>G of Mfn2/HSG and hypertension by polymerase chain reaction and DNA sequencing after venous blood was drawn and DNA was extracted. RESULTS: When comparing the A and G frequency in EH, PH and NT groups, in total, NT group significantly had higher A frequency than in PH group [odds ratio (OR)=1.605, confidence interval (CI) 95%=1.063-2.242, p=0.025] and EH group (OR=5.395, CI 95%=3.783-7.695, p<0.01). When subgrouped by gender, A frequency in NT group was still significantly higher than in EH group (male: OR=4.264, CI 95%=2.780-6.543, p<0.01; female: OR=8.897, CI 95%=4.686-16.891, p<0.01), but not from PH group, either in male group or in female group. Ordinal Logistic Regression analysis showed that A>G variation was significantly related with blood pressure level (B=-1.271, Wald=40.914, CI 95%=-1.660 - -0.881, p<0.01). CONCLUSION: 5'-UCR -1248 A>G variation of Mfn2/HSG gene was a novel variation and may be associated with hypertension in Chinese.
China ; Female ; GTP Phosphohydrolases/*genetics ; Gene Expression Regulation ; Genetic Association Studies ; Genotype ; Humans ; Hypertension/*genetics ; Logistic Models ; Male ; Mitochondrial Proteins/*genetics ; *Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

Two hundred and fourteen patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) underwent percutaneous coronary intervention (PCI).Serum ischemic modified albumin (IMA) levels were measured in patients at admission.The major adverse cardiac events (MACE),including cardiac death,nonfatal myocardial infarction (MI) and recurrent ischemia leading to urgent revascularization were observed during 1-y period of follow-up.Receiver operating characteristic (ROC) curves,Kaplan-Meier analysis and Cox regression were used to assess the prognostic value of IMA for 1-y MACE.Twenty one patients experienced major adverse cardiac events during 1-y follow up period,including 6 cases of cardiac death,8 cases of new or recurrent MI,7 cases of target vessel/lesion revascularization or coronary artery bypass grafting (CABG).ROC showed that the area under the ROC curve (AUC) was 0.667,and when IMA was used to predict 1-y major adverse cardiac events,the cut-off value of 65.3 kU/L was most effective.Kaplan-Meier analysis showed that IMA was significantly correlated with the occurrence of 1-y MACE(P ＜ 0.01).But Cox regression model showed that IMA levels were not independent risk factor for 1-y MACE in NSTEACS patients,when adjusted with other risk factors.

The data is taken from Chinese Longitudinal Healthy Longevity Survey(CLHLS)between 2005 and 2008 to study health insurance’s impact on Chinese rural elders’ health demand. It found that health insurance significantly increased Chinese rural elders’ total health expenditure by 19%; however, it could neither significantly lengthen life expectancy nor decrease the risk of death. Chinese rural elders’ excessive demand induced by health insurance is probably inefficient. Therefore, to insure Chinese rural elders’ diseases could be treated, the government should improve medical security and control unreasonable increases in health service price.

Adjuvant treatment after deifnitive surgery is an integral part of the management of locoregionally advanced squamous cell carcinoma of the head and neck (HNSCC). Earlier stage HNSCC with N+disease may require adjuvant radiotherapy, while locoregionally advanced disease requires postoperative chemoradiation therapy for eradicating subclinical residual disease. Tri-modality with surgery followed by concurrent chemoradiation can improve the local control, disease free survival, and overall survival rates in patients with advanced HNSCC as compare to surgery or surgery plus radiation. However, treatment induced adverse-effects should be addressed when deciding on the treatment options. Molecular targeted therapy is a new treatment modality and its efifcacy when used in concurrent with radiation as a deifnitive treatment has been suggested. However, adjuvant use of radiation and targeted therapy requires further investigation before it can be recommended routinely in clinical practice. The association between HPV and HNSCC, as well as the clinical implication of such association require further study as well.

Objective To observe the serum inflammatory factors level in patients with obstructive sleep apnea syndrome (OSAS) and coronary heart disease (CHD).Methods Venous blood was collected at 6 AM from 53 natiems with both OSAS and CHD and 37 simple snorers following a full night polysomnography (PSG) test.Serum MMP-9、TIMP-1 test were conducted.Results MMP-9,TIMP-1 level in patients with OSAS and CHD was significantiv higher than that of the simple snorers (P<0.05).Conclusion serum MMP-9 and TIMP-1 level increase in patients with OSAS and CHD.It is suggested that elevated level of serum MMP-9 and TIMP-1 might play an important role in the development of CHD in patients with OSAS.