AIM: To investigate the prognostic factors of idiopathic choroidal neovascularization treated with anti-vascular endothelial growth factor(VEGF)drugs and construct predictive model.METHODS:A total of 57 patients(57 eyes)with idiopathic choroidal neovascularization who received the treatment of anti-VEGF in our hospital from January 2020 to June 2023 were retrospectively included and grouped according to regression or recurrence of the disease. Univariate and multivariate analysis was performed on the influencing factor of regression or recurrence of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs. Clinical prediction model was constructed for the regression of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs.RESULTS:After treatment, the lesions disappeared in 17 eyes and recurred in 13 eyes, with incidence rates of 30% and 23%, respectively. The results of univariate analysis showed that the course of disease, baseline best corrected visual acuity, and baseline macular fovea retinal thickness may all be related to the regression or recurrence of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs(all P<0.05). Logistic multivariate analysis showed that the course of the disease, baseline best corrected visual acuity level, and baseline macular fovea retinal thickness may all be related to the regression of idiopathic choroidal neovascularization treated with anti-VEGF drugs(all P<0.05), while those factors were not related to the recurrence of idiopathic choroidal neovascularization treated with anti-VEGF drugs(all P>0.05). The influencing factors of the regression model and the P-value prediction probability were used to predict the regression of idiopathic choroidal neovascular lesions treated with anti-VEGF drugs, and the Youden index was 83.00%, 75.74%, 45.47% and 85.00%, respectively.CONCLUSION:The regression of idiopathic choroidal neovascularization treated with anti-VEGF drugs was closely related to the course of disease, baseline best corrected visual acuity level and baseline macular foveal retinal thickness, while the risk of recurrence has not been determined by corresponding influencing factors. The data model constructed by the above three factors has shown good efficiency in predicting the regression of patients with idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs.

Antibodies, Neutralizing/immunology* ; Antibodies, Viral/immunology* ; COVID-19/virology* ; COVID-19 Vaccines/immunology* ; Humans ; SARS-CoV-2/pathogenicity* ; Spike Glycoprotein, Coronavirus/immunology* ; Vaccines, Inactivated/immunology*

Objective: To explore the effect of working memory intervention training on working memory and literacy of children with developmental dyslexia,so as to provide a preference for practice of the trianing of working memory among children with dyslexia. Methods: A total of 32 children with dyslexia of grade 3-5 in a primary school in Guiyang were randomly divided into two groups: the study group (n=16) and the control group (n=16),and the software of training exercises of working memory was applied to conduct interventional trainings of different durations to 2 gruops of children. Results: Through the intervention training of working memory, the scores of literacy and working memory tasks in the study group (2 217.88±252.32, 105.13±7.68) were significantly higher than those in the control group (1 907.69 ± 545.15, 96.50 ± 11.04) (t=2.06, 2.56, P<0.05). Conclusion The working memory ability of children with dyslexia can be improved by working memory intervention training for a certain period of time. The intervention effect is not only significant in the trained working memory task, but also can be extended to other untrained contents such as literacy.

Glaucoma is the leading cause of irreversible blindness, but its early symptoms are not obvious and are easily overlooked, so early screening for glaucoma is particularly important. The cup to disc ratio is an important indicator for clinical glaucoma screening, and accurate segmentation of the optic cup and disc is the key to calculating the cup to disc ratio. In this paper, a full convolutional neural network with residual multi-scale convolution module was proposed for the optic cup and disc segmentation. First, the fundus image was contrast enhanced and polar transformation was introduced. Subsequently, W-Net was used as the backbone network, which replaced the standard convolution unit with the residual multi-scale full convolution module, the input port was added to the image pyramid to construct the multi-scale input, and the side output layer was used as the early classifier to generate the local prediction output. Finally, a new multi-tag loss function was proposed to guide network segmentation. The mean intersection over union of the optic cup and disc segmentation in the REFUGE dataset was 0.904 0 and 0.955 3 respectively, and the overlapping error was 0.178 0 and 0.066 5 respectively. The results show that this method not only realizes the joint segmentation of cup and disc, but also improves the segmentation accuracy effectively, which could be helpful for the promotion of large-scale early glaucoma screening.
Diagnostic Techniques, Ophthalmological ; Fundus Oculi ; Glaucoma/diagnostic imaging* ; Humans ; Neural Networks, Computer ; Optic Disk/diagnostic imaging*

Objective:To investigate the expression of eukaryotic translation initiation 2α (p-elF2α) and activated translation factor 4 (ATF4) in liver tissues of patients with chronic hepatitis B and their correlation with liver fibrosis.Methods:From Jan.2016 to Jan.2019, 158 cases of chronic hepatitis B patients were enrolled in our hospital. The expression levels of p-elF2α and ATF4 in different stages of liver fibrosis were evaluated by hematoxy-eosin (HE) and immunohistochemical staining, and the correlation was analyzed by Spearman rank correlation.Results:The pathological results of liver specimens showed that there were 19 normal controls (S0), 29 S1, 42 S2, 35 S3 and 33 S4 in each stage of fibrosis. The levels of p-eIF2α and ATF4 in fibrosis group were significantly higher than those in normal control group ( P< 0.001). Additionally, the levels of p-eIF2α and ATF4 in different stages of fibrosis were significantly different. The grade of hepatic fibrosis was positively correlated with the scores of p-eIF2α and ATF4 staining in liver tissues, and the correlation coefficients were 0.473 and 0.422 respectively ( P< 0.05). Conclusions:Hepatic fibrosis in patients with chronic hepatitis B is positively correlated with p-eIF2α and ATF4. p-eIF2α-ATF4 pathway may involve in the process of chronic hepatitis B-induced hepatic fibrosis.

Objective: To explore the genes that may be regulated by cell division cycle 25A (CDC25A) with gene chip technology, and to elucidate and verify that CDC25A has a regulatory effect on the expression of liver cancer related genes. Methods: CDC25A expression in human liver cancer HepG2 cells was silenced by siRNA interference technology and a nude mouse xenograft model of liver cancer was successfully constructed in our previous research. Affymetrix human gene expression profiling microarray was used to further screen differentially expressed genes (DEGs) after silencing CDC25A in liver cancer xenografts, and GO analysis and KEGG analysis were performed. Some of the DEGs were verified by qPCR. Results: The chip screened 188 DEGs in liver cancer xenograft tissues after CDC25A silence, including 78 up-regulated genes and 110 down-regulated genes. These DEGs mainly involved in cell proliferation, apoptosis, protein complex binding, extracellular space, etc., and associated with the changes in pathways such as focal adhesions and extracellular matrix (ECM) receptor interactions. qPCR showed that the expression of HIPK2 mRNA was up-regulated and the mRNA expressions of (microfibrillar-associated protein 5(MFAP5) and cyclin D1 (CCND1) were down-regulated, which were consistent with the results of microarray detection. Conclusion: Using human gene expression profiling chip, the DEGs in liver cancer xenograft tissues in nude mice after silencing CDC25Awere successfully screened, providing effective clues for exploring the effect of CDC25Aon the growth of liver cancer.

Objective To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. Methods A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days. The clinical data of patients in the two groups were collected including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, underlying disease, nutritional indicators, nutritional support, and complications. The outcome of withdrawal within 7 days was served as a dependent variable, all observed indicators were served as independent variables, and Logistic regression analysis was carried out to screen the influencing factors of the weaning results within 7 days. Results 235 patients undergoing MV were enrolled, 128 patients were successfully withdrawn within 7 days, and 107 were unsuccessfully withdrawn. Compared with the successful weaning group, the patients of weaning failure group were older, and had higher APACHEⅡ score and lower albumin (Alb) and hemoglobin (Hb), more patients with internal medical underlying diseases and receiving parenteral nutrition (PN) and mixed nutrition, and the incidences of secondary infection, vomiting, abdominal distension, abnormal bowel sound, gastric retention, and diarrhea were higher. However, there was no statistical significance in gender between the two groups. The variables of statistical significance in univariate analysis were enrolled in the multifactor analysis model showing that age [odds ratio (OR) = 1.269, 95% confidence interval (95%CI) = 1.119-1.439, P < 0.001], APACHEⅡ score (OR = 1.643, 95%CI = 1.423-1.897, P < 0.001), internal medical underlying diseases (OR = 6.298, 95%CI = 4.012-9.887, P < 0.001), secondary infection (OR = 8.323, 95%CI = 2.568-26.975, P < 0.001), abdominal distension (OR = 3.368, 95%CI = 1.586-7.152, P = 0.002), abnormal bowel sounds (OR = 2.856, 95%CI = 1.215-6.713, P = 0.017), gastric retention (OR = 1.996, 95%CI = 1.183-3.368, P = 0.010), diarrhea (OR = 3.035, 95%CI = 1.337-6.890, P = 0.008) were risk factors for unsuccessful weaning,and compared with PN, enteral nutrition (EN; OR = 0.191, 95%CI = 0.098-0.372, P < 0.001) and mixed nutrition (OR = 0.375, 95%CI = 0.150-0.938, P = 0.037) were protective factors of successful weaning. The gender, Alb and Hb before and after MV, vomiting, gastrointestinal hemorrhage were not associated with weaning outcome within 7 days. Conclusions Elder, high APACHEⅡ score, internal medical underlying diseases, or secondary infection, abdominal distension, abnormal bowel sounds, gastric retention, diarrhea were risk factors of weaning failure within 7 days in patients undergoing MV. Compared with PN, EN and mixed nutrition were protective factors for successful weaning. For patients undergoing MV, EN should be performed early in the case of full recovery, hemodynamic stability, and serious metabolic disorders.

Objective To study the impact of sucrose analgesia on pain response and salivary cortisol levels in preterm infants.Method Preterm infants admitted to our hospital between January 2014 and October 2016 with gestational age ＜ 34 weeks,birth weight ＜ 2 000 grams,and length of hospital stay ≥ 14 days were prospectively assigned into two groups.The intervention group received 0.3 ～ 0.5 ml of 12％ sucrose solution two minutes before each painful procedure,while the control group received none.At time of discharge and at 8 months of corrected age (CA),pain response was measured,saliva samples were collected and salivary cortisol levels were assayed using Enzyme Immunoassay Kit before and after pain stimulus.Result A total of 82 infants were included in our study,42 in the intervention group,and 40 in the control group.There were no statistically significant differences between two groups in pain response at discharge and 8 months of CA.At time of discharge and at 8 months of CA,infants in intervention group had higher salivary cortisol levels than in control group at time of discharge and 8 months of CA after pain stimulus [6.8 (5.6,11.7) ng/ml vs.5.4 (2.6,10.8) ng/ml,5.0 (3.3,5.6) ng/ml vs.4.8 (3.0,5.5) ng/ml] after log transformation,two groups were statistically significant (P ＜ 0.05).However,before the pain stimulus,no differences were found between two groups.Multiple stepwise regressions analysis showed that salivary cortisol level post pain stimulus was negatively related to the total number of pain stimulus,and positively related to sucrose analgesia at discharge and 8 months of CA.Conclusion Sucrose analgesia may mitigate the negative effect of repeated pain stimulus on cortisol regulation in preterm infants,however,may have no influence on pain response of them.

This research is to explore the feasibility of construction of real-time network teach-ing platform in anesthesia resident standardization training. The real-time network teaching were car-ried out by platformconstruction and teaching organization. The teaching effect was evaluated. Using the real-time network teaching platform with the four functions of learning knowledge, cultivating ability, communication and supervision can achieve good teaching effect. It was a beneficial supplement of traditional teaching.

Objective To investigate the effect of continuous veno-venous hemofiltration (CVVH) on pulmonary vascular permeability in the early stage of septic shock.Methods Fifty-one patients of septic shock admitted in intensive care unit of the First Affiliated Hopsital of Medical College,Zhejiang University between June 2010 and December 2011 were randomized into two groups by simple random method.Routine treatment was carried out to patients in group A,and routine treatment plus CVVH to patients in group B in the first 72 hours.Repeated respiratory mechanic hemodynamic measurements were done at baseline (Tb) before treatment,at 48 hours (T48) and 72 hours (T72) after the treatment.Pulmonary compliance (Cst),platform pressure (Pplat),oxygenation index (PaO2/FiO2),extravascular lung water index (EVLWI) and E-selectin determined at each time point were recorded in two groups.Results (1) Pplat were decreased significantly after treatment in two groups,and the Pplat in group B were all lower than those in group A at T48 and T72 (t =2.215,P ＜ 0.05 ; t =4.266,P ＜ 0.01).Cst were elevated after treatment in two groups,and Cst in group B were all higher than those in group A at T48 and T72 (t =2.516,P ＜0.05 ; t =3.052,P ＜ 0.01).(2) Compared to before treatment,PaO2/FiO2 increased significantly after treatment in two groups,and PaO2/FiO2 in group B were all higher than those in group A at T48 and T72 (t =2.732,P ＜0.01 ; t =3.511,P ＜0.01).(3) EVLWI were decreased significantly after treatment in two groups,and the EVLWI in group B were all lower than those in group A at T48 and T72 (t =2.597,P ＜0.05; t =2.125,P ＜ 0.05).ITBVI,CI,SVRI and MAP did not change over time in two groups compared with those at Tb (all P ＞ 0.05).(4) E-selectin were decreased significantly after treatment in two groups,and the E-selectin in group B were all lower than those in group A at T48 and T72 (t =2.154,P ＜0.05 ; t =3.581,P ＜ 0.01).Conclusion CVVH in early stage of septic shock can improve pulmonary vascular permeability and oxygenation,increase Cst,and decline EVLWI,with neither increased hemodynamics.