RESUMO
BACKGROUND: Currently, there are hundreds of hematological parameters used for rapid diagnosis of neonatal sepsis, but there is no network meta-analysis to compare the diagnostic efficacy of these parameters. METHODS: We searched for literature on the diagnostic neonatal sepsis and selected 20 of the most common parameters to compare their diagnostic efficacy. We used Bayesian network meta-analysis, Frequentist network meta-analysis, and individual traditional diagnostic meta-analysis to analyze the data and verify the stability of the results. Based on the above analysis, we ranked the diagnostic efficacy of 20 parameters and searched for the optimal indicator. We also conducted subgroup analysis based on different designs. GRADE was used to evaluate the quality of evidence. RESULTS: 311 articles were included in the analysis, of which 206 articles were included in the network meta-analysis. Bayesian models fond the top three of the advantage index were P-SEP, SAA, and CD64. In Individual model, P-SEP, SAA, and CD64 had the best sensitivity; ABC, SAA, and P-SEP had the best specificity. Frequentist model showed that CD64, P-SEP, and IL-10 ranked in the top three for sensitivity, while P-SEP, ABC, and I/M in specificity. Overall, P-SEP, SAA, CD64, and PCT have good sensitivity and specificity among all the three methods. The results of subgroup analysis were consistent with the overall analysis. All evidence was mostly of moderate or low quality. CONCLUSIONS: P-SEP, SAA, CD64, and PCT have good diagnostic efficacy for neonatal sepsis. However, further studies are required to confirm these findings.
RESUMO
BACKGROUND: mRNA vaccines have been investigated in multiple tumors, but limited studies have been conducted on their use for hepatocellular carcinoma (HCC). AIM: To identify candidate mRNA vaccine antigens for HCC and suitable subpopulations for mRNA vaccination. METHODS: Gene expression profiles and clinical information of HCC datasets were obtained from International Cancer Genome Consortium and The Cancer Genome Atlas. Genes with somatic mutations and copy number variations were identified by cBioPortal analysis. The differentially expressed genes with significant prognostic value were identified by Gene Expression Profiling Interactive Analysis 2 website analysis. The Tumor Immune Estimation Resource database was used to assess the correlation between candidate antigens and the abundance of antigen-presenting cells (APCs). Tumor-associated antigens were overexpressed in tumors and associated with prognosis, genomic alterations, and APC infiltration. A consensus cluster analysis was performed with the Consensus Cluster Plus package to identify the immune subtypes. The weighted gene coexpression network analysis (WGCNA) was used to determine the candidate biomarker molecules for appropriate populations for mRNA vaccines. RESULTS: AURKA, CCNB1, CDC25C, CDK1, TRIP13, PES1, MCM3, PPM1G, NEK2, KIF2C, PTTG1, KPNA2, and PRC1 were identified as candidate HCC antigens for mRNA vaccine development. Four immune subtypes (IS1-IS4) and five immune gene modules of HCC were identified that were consistent in both patient cohorts. The immune subtypes showed distinct cellular and clinical characteristics. The IS1 and IS3 immune subtypes were immunologically "cold". The IS2 and IS4 immune subtypes were immunologically "hot", and the immune checkpoint genes and immunogenic cell death genes were upregulated in these subtypes. IS1-related modules were identified with the WGCNA algorithm. Ultimately, five hub genes (RBP4, KNG1, METTL7A, F12, and ABAT) were identified, and they might be potential biomarkers for mRNA vaccines. CONCLUSION: AURKA, CCNB1, CDC25C, CDK1, TRIP13, PES1, MCM3, PPM1G, NEK2, KIF2C, PTTG1, KPNA2, and PRC1 have been identified as candidate HCC antigens for mRNA vaccine development. The IS1 and IS3 immune subtypes are suitable populations for mRNA vaccination. RBP4, KNG1, METTL7A, F12, and ABAT are potential biomarkers for mRNA vaccines.
RESUMO
Fatty acid metabolism (FAM) is associated with prognosis and immune microenvironment remodeling in many tumors. It is currently unknown how FAM affects the immunological microenvironment and prognosis of Gastric cancer (GC). Therefore, the current work aims to categorize GC samples based on the expression status of genes involved in FAM and to identify populations that might benefit from immunotherapy. In total, 50 FAM genes associated with overall survival (OS) were determined through univariate Cox proportional hazard regression analysis by mining the public TCGA and GEO databases. The GSE84437 and TCGA-STAD cohort samples were divided into two clusters using the "NMF" R package. According to the survival curve, patients in Cluster-1 showed considerably longer OS than those in Cluster-2. Patients in Cluster-1 exhibited earlier T stages, more intestinal GCs, and were older. MSI molecular subtypes were mainly distributed in Cluster-1, while GS molecular subtypes were distributed primarily in Cluster-2. There were 227 upregulated and 22 down-regulated genes (logFC > 1 or logFC < - 1, FDR < 0.05) in Cluster-2 compared with Cluster-1. One hub module (edges = 64, nodes = 12) was identified with a module score of 11.636 through Cytoscape plug-in MCODE. KEGG and GO analysis showed that the hub genes were associated with the cell cycle and cell division. Different immune cell infiltrates profile, and immune pathway enrichment existed between the subtypes. In conclusion, the current findings showed that practically all immunological checkpoint and immunoregulatory genes were elevated in patients with Cluster-2 GC, indicating that FAM subtypes may be crucial in GC immunotherapy.
Assuntos
Neoplasias Gástricas , Humanos , Neoplasias Gástricas/genética , Metabolismo dos Lipídeos , Ciclo Celular , Divisão Celular , Ácidos Graxos , Prognóstico , Microambiente Tumoral/genéticaRESUMO
BACKGROUND: Hepatocellular carcinoma (HCC) is a highly malignant cancer that often metastasizes and has a poor prognosis. Gastrointestinal tract metastases are rare, and colon metastases are even rarer. The long-term survival of patients with multiple intrahepatic and extrahepatic metastases, especially to the colon, has not been previously reported. CASE SUMMARY: We present an atypical clinical case of a patient with liver, right lung, peritoneal, and colon metastases diagnosed successively following hepatic resection for primary HCC. Comprehensive treatment, including partial liver, lung and colon resection, palliative management such as systemic chemotherapy, trans-arterial chemoembolization, targeted therapy with sorafenib, and cryotherapy were attempted. Despite his early metastases, the patient remained relatively healthy for 8 years after diagnosis. CONCLUSION: This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC. Clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors.
RESUMO
BACKGROUND: No large-scale epidemiological survey on the prevalence of gastroesophageal reflux disease (GERD) in China has been conducted. China has a large population and a complex geographical environment. It is important to understand the prevalence and spatial distribution of GERD in China. AIM: To explore the prevalence and the spatial, temporal, and population distributions of GERD in the natural Chinese population. METHODS: We searched Chinese and English databases for literature on the prevalence of GERD in the natural Chinese population. The prevalence of GERD was pooled using a random-effects meta-analysis model. Subgroup analysis was performed according to time, region, and population. We used ArcGIS software to draw statistical maps and trend analysis charts. Spatial autocorrelation analysis was carried out using Geoda software. Spearman correlation analysis was used to assess the spatial distribution relationship between GERD and upper digestive tract tumours. RESULTS: Altogether, 70 studies involving 276014 individuals from 24 provinces of China were included. The overall pooled prevalence of GERD was 8.7% (95%CI: 7.5%-9.9%) in mainland China. Over the past two decades, the prevalence of GERD in China has increased from 6.0% to 10.6%. GERD was more common in people aged 40-60, with body mass index ≥ 24, and of Uygur ethnicity. The prevalence was higher in the west and east than in the centre, and there may be a local spatial autocorrelation between the Qinghai-Tibet Plateau and the southeast. GERD was correlated with gastric (r = 0.421, P = 0.041) and oesophageal tumours (r = 0.511, P = 0.011) in spatial distribution. CONCLUSION: GERD is becoming common in China. The prevalence differs by region and population. The development of appropriate strategies for the prevention and treatment of GERD is needed.
Assuntos
Refluxo Gastroesofágico , Humanos , Fatores de Risco , Refluxo Gastroesofágico/epidemiologia , China/epidemiologia , Prevalência , Índice de Massa CorporalRESUMO
Gastric cancer is a global health problem with high mortality. The incidence of gastric cancer has significant regional differences. Helicobacter pylori (H. pylori) infection and its interaction with epigenetics are closely related to the occurrence of gastric cancer. It is of great significance to explore the early diagnosis and effective therapeutic targets of gastric cancer. Emerging evidence indicates that antisense long non-coding RNAs (lncRNAs) are closely associated with various biological and functional aspects of gastric cancer. However, diverse antisense lncRNAs in gastric cancer have not been compiled and discussed. In this review, we summarize the predisposing factors and compile the interaction between H. pylori and epigenetics in gastric cancer. Moreover, we focus on the underlying molecular mechanism and regulatory role of each antisense lncRNA in gastric cancer. In addition, we provide a new insight into the potential diagnosis and treatment of antisense lncRNAs in gastric cancer.
Assuntos
Helicobacter pylori , RNA Longo não Codificante , Neoplasias Gástricas , Humanos , RNA Longo não Codificante/genética , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genéticaRESUMO
BACKGROUND: The spatial-temporal distribution of Helicobacter pylori infection in China is poorly understood. We aimed to study the spatial-temporal distribution of H. pylori infection in Chinese mainland and to explore its influencing factors. MATERIALS AND METHODS: We searched the relevant literature from 2001 to 2021 and applied meta-analysis to obtain the pooled prevalence estimates of all studies and subgroups. Then, we used the pooled prevalence as the dependent variable for the following analysis, including time series analysis, statistical mapping, spatial autocorrelation analysis, and influencing factor analysis based on generalized additive model and panel data model. RESULTS: A total of 726 articles and 3,407,392 people were included. The pooled prevalence was 43.7% (95% confidence interval: 42.7%-44.8%). The prevalence decreased in the past 20 years, with high in the eastern and western regions and low in the central region. Qinghai Tibet Plateau and Guizhou Plateau were the high incidence areas of this disease. The intake of vegetable oil, aquatic products, meat, milk, per capita gross domestic product, and annual average humidity were significantly correlated with H. pylori. CONCLUSIONS: The prevalence of H. pylori is decreasing in Chinese mainland, but still high in underdeveloped areas. Appropriate strategies for the prevention need greater attention.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , China/epidemiologia , Infecções por Helicobacter/epidemiologia , Humanos , Incidência , PrevalênciaRESUMO
PURPOSE: To determine the differences in mean ocular dimensions between urban and rural children and identify possible influencing factors. METHODS: This work uses previously published data from the Shandong Children Eye Study, which was based on a random cluster sampling applied to a cross-sectional school-based study design in the rural Guanxian County and Weihai city. All children underwent auto-refractometry and biometry under cycloplegia. RESULTS: The study included 3290 children (aged 9.35 ± 2.93 years), consisting of 888 pairs of boys and 757 pairs of girls matched by sex, age and refractive error (each pair matching one child from urban cohort with one from the rural cohort). Overall urban children were significantly taller and heavier than rural children (t-test; p < 0.001), which was confirmed for all age groups for weight. Urban ocular axial lengths were significantly longer by 0.23 mm compared to the rural population (t-test; p < 0.001), mostly in younger children and boys. Meanwhile, corneal curvatures were flatter in the urban cohort by 0.08 mm (p < 0.001). This association of axial length with urban vs rural region was reduced in magnitude by 69.7% after accounting for height. CONCLUSIONS: For the same, matched refractive error, children from urban regions had significantly longer eyes and flatter corneal curvature than rural children. Since corneal curvature is defined during the first 2 years of life, early environmental factors may be the source of these differences in ocular dimensions.
Assuntos
Biometria/métodos , Córnea/fisiopatologia , Refração Ocular/fisiologia , Erros de Refração/diagnóstico , População Rural , População Urbana , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Córnea/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Erros de Refração/epidemiologia , Erros de Refração/fisiopatologiaAssuntos
Comprimento Axial do Olho/patologia , Etnicidade , Cristalino/patologia , Refração Ocular , Erros de Refração/diagnóstico , Adolescente , Biometria/métodos , Criança , China/epidemiologia , Feminino , Humanos , Incidência , Cristalino/fisiopatologia , Masculino , Erros de Refração/etnologia , Erros de Refração/fisiopatologiaRESUMO
BACKGROUND: To assess the corneal diameter and its associations in children. DESIGN: Cross-sectional school-based study. PARTICIPANTS: Six thousand twenty-six children aged 4-18 years were included in the Shandong Children Eye Study. METHODS: Horizontal corneal diameter was measured by laser interferometry-based ocular biometry. MAIN OUTCOME MEASURES: Horizontal corneal diameter. RESULTS: Corneal diameter measurements were available for 5970 (99.1%) children. In multivariate analysis, larger horizontal corneal diameter (mean: 12.02 ± 0.38 mm; range: 10.1-15.0 mm) was associated with longer corneal curvature radius longer axial length, male gender, younger maternal age, rural region of habitation and lower intraocular pressure measurements. Higher prevalence of abnormally large corneas (macrocorneas; horizontal diameter ≥ 12.76 mm; mean value +2 × standard deviations; mean: 2.6%; 95% CI: 2.2, 3.0) was associated with longer corneal curvature radius, longer axial length, younger maternal age and male gender. Higher prevalence of abnormally small corneas (horizontal diameter ≤ 11.24mm; mean value -2 × standard deviations; mean: 2.4%; 95% CI: 2.0, 2.8) was correlated with shorter corneal curvature radius, shorter axial length and urban region of habitation. Neither abnormally large nor small corneas were correlated with time spent indoors/outdoors. CONCLUSIONS: In 4 to 18-year-old children, larger corneal diameter was associated most strongly with flatter corneal curvature, followed by longer axial length and male gender. Corneal diameter was independent of age beyond an age of 4 years. Abnormally large and abnormally small corneas may be defined as being ≥12.76 and ≤11.24 mm in diameter, respectively. Corneal diameter was not correlated with time spent indoors/outdoors.
Assuntos
Comprimento Axial do Olho , Córnea/anatomia & histologia , Miopia/epidemiologia , Refração Ocular/fisiologia , População Rural , População Urbana , Adolescente , Biometria , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Interferometria , Pressão Intraocular , Masculino , Prevalência , Instituições AcadêmicasRESUMO
PURPOSE: To describe prevalence and associations of anisometropia in children. METHODS: The cross-sectional school-based study included children aged 4 to 18 years. RESULTS: The study included 6025 (94.7%) of 6364 eligible children. Mean refractive anisometropia was 0.37 ± 0.57 diopters (median: 0.25 diopters; range: 0-7.88 diopters; prevalence [≥1 diopter]: 7.0% ± 0.3%). In multivariate analysis (regression coefficient r: 0.66), higher refractive anisometropia was associated with older age (P < 0.001; ß: 0.07; B: 0.01; 95% CI: 0.01-0.02), higher maternal education level (P < 0.001; ß: 0.04; B: 0.02; 95% CI: 0.01-0.03), more total time spent indoors reading or writing (P = 0.001; ß: 0.04; B: 0.01; 95% CI: 0.01-0.02), larger intereye difference in axial length (P < 0.001; ß: 0.57; B: 1.20; 95% CI: 1.15-1.24), shorter mean axial length of both eyes (P = 0.03; ß: -0.03; B: -0.02; 95% CI: -0.03 to -0.001), larger intereye difference in best corrected visual acuity (BCVA) (P < 0.001; ß: 0.14; B: 1.83; 95% CI: 1.54-2.12), and lower stereoacuity (P < 0.001; ß: 0.08; B: 0.31; 95% CI: 0.22-0.39). Refractive anisometropia showed a U-shaped correlation with refractive error. Higher anisomyopia was associated (r: 0.57) with older age (P = 0.001; ß: 0.05; B: 0.006; 95% CI: 0.002-0.009), higher level of paternal education (P = 0.001; ß: 0.01; B: 0.01; 95% CI: 0.01-0.02), more total time spent indoors reading or writing (P = 0.01; ß: 0.03; B: 0.01; 95% CI: 0.00-0.01), larger intereye difference in axial length (P < 0.001; ß: 0.22; B: 0.26; 95% CI: 0.23-0.29), greater myopic refractive error (P < 0.001; ß: -0.46; B: -0.07; 95% CI: -0.08 to -0.07), and lower corneal astigmatism (P < 0.001; ß: -0.10; B: -0.06; 95% CI: -0.08 to -0.05). In the same multivariate model, hyperopic anisometropia was not significantly associated with time spent indoors with reading (P = 0.18). Cylindrical anisometropia (mean: 0.30 ± 0.32 diopters; prevalence [≥1 diopter]: 3.7% ± 0.2%) increased with higher refractive anisometropia (P < 0.001; ß: 0.16; B: 0.09; 95% CI: 0.08-0.11), greater myopic refractive error (P < 0.001; ß: -0.06; B: -0.01; 95% CI: -0.01 to -0.01), higher corneal astigmatism (P < 0.001; ß: -0.22; B: -0.15; 95% CI: -0.17 to -0.13), and lower mean BCVA (P < 0.001; ß: 0.11; B: 0.90; 95% CI: 0.68-1.17). CONCLUSIONS: In 4- to 18-year-old children, refractive anisometropia and anisomyopia increased with systemic parameters such as age, parental education level, and lifestyle of the children, for example, more time spent indoors reading or writing. In contrast, hyperopic anisometropia and cylindrical anisometropia were not related with lifestyle parameters.
Assuntos
Anisometropia/epidemiologia , Comprimento Axial do Olho/fisiopatologia , Refração Ocular/fisiologia , População Rural , População Urbana , Acuidade Visual , Adolescente , Anisometropia/diagnóstico , Anisometropia/fisiopatologia , Comprimento Axial do Olho/patologia , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , PrevalênciaRESUMO
PURPOSE: To investigate ocular axial length (AL) in Chinese children. METHODS: The Shandong Children Eye Study included 6,364 children aged 4-18 years. RESULTS: Longer AL (mean 23.45 ± 1.20 mm, range 18.80-28.59 mm) was associated (multivariate analysis; correlation coefficient r2: 0.61) with older age (p < 0.001, standardized correlation coefficient ß = 0.35, unstandardized regression coefficient B = 0.13, 95% confidence interval [CI] 0.12, 0.15), male gender (p < 0.001, ß = -0.24, B = -0.10, 95% CI -0.29, -0.19), urban region (p < 0.001, ß = 0.10, B = 0.25, 95% CI 0.20, 0.31), body height (p < 0.001, ß = 0.22, B = 0.02, 95% CI 0.01, 0.02), maternal education (p < 0.001, ß = 0.07, B = 0.07, 95% CI 0.05, 0.10), paternal myopia (p < 0.001, ß = 0.09, B = 0.26, 95% CI 0.20, 0.33), maternal myopia (p < 0.001, ß = 0.08, B = 0.23, 95% CI 0.17, 0.30), more time spent indoors reading/writing (p < 0.001, ß = 0.05, B = 0.03, 95% CI 0.02, 0.04), less time spent outdoors (p = 0.005, ß = -0.03, B = -0.01, 95% CI -0.02, -0.003), longer corneal curvature radius (p < 0.001, ß = 0.36, B = 1.63, 95% CI 1.53, 1.74) and higher intraocular pressure (p = 0.008, ß = 0.03, B = 0.01, 95% CI 0.004, 0.02). High axial myopia (AL ≥26.0 mm) present in 202 children (3.4 ± 0.2%, 95% CI 2.92, 3.84) was associated with less time spent outdoors (p = 0.002, odds ratio 0.92, 95% CI 0.87, 0.97) in multivariate analysis. CONCLUSIONS: In children in the less developed Eastern Chinese province of Shandong, the prevalence of high axial myopia was >10% among 16-year-olds. A modifiable factor associated with higher prevalence of high axial myopia was less time spent outdoors.
Assuntos
Comprimento Axial do Olho , Miopia/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Atividades de Lazer , Masculino , Miopia/patologia , Vigilância da População , Fatores SexuaisRESUMO
PURPOSE: To examine the thickness of the macular choroid and its associations in school children aged 6 to 18 years. METHODS: The school-based cross-sectional Shandong Children Eye Study included 6026 (94.7%) of 6364 eligible children fulfilling the inclusion criterion of an age from 4 to 18 years. Spectral-domain optical coherence tomography (SD-OCT) was performed for a subgroup of 972 school children aged 6+ years. All participants underwent ocular examinations, including measurement of visual acuity, cycloplegic refractometry, biometry, and SD-OCT (enhanced depth imaging mode) for measurement of choroidal thickness. RESULTS: The study included 972 children (501 girls) with a mean age of 11.3 ± 3.3 years (range, 6-18 years) and mean axial length of 24.10 ± 1.56 mm (range, 16.57-28.82 mm). Mean choroidal thickness was thicker (P < 0.001) at 500 µm temporal to the foveola (290 ± 67 µm) than in the subfoveal region (283 ± 67 µm; range, 113-507 µm) and the region 500 µm superior to the fovea (283 ± 66 µm), where it was thicker (P < 0.001) than at 500 µm inferior of the foveola (281 ± 66 µm), and it was thinnest (P < 0.001) at 500 µm nasal of the foveola (268 ± 67 µm). In multivariate analysis, thicker SFCT was (overall correlation coefficient r: 0.51) associated with shorter axial length (P < 0.001; standardized correlation coefficient ß: -0.48; B: -23.7; 95% confidence interval [CI]: -27.2 to -20.3), male sex (P = 0.006; ß: -0.08; B: -10.7; 95% CI: -18.3 to -3.11), and younger age (P = 0.04; ß: -0.07; B: -1.46; 95% CI: -2.85 to -0.07). CONCLUSIONS: As in adults, thicker SFCT in children and teenagers was markedly associated with shorter axial length, and to a lesser degree with male sex and older age. As in adults, increasing axial myopia in teenagers is associated with choroidal thinning and development of a leptochoroid.
Assuntos
Comprimento Axial do Olho/anatomia & histologia , Biometria/métodos , Corioide/anatomia & histologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Adolescente , Envelhecimento , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Fóvea Central/anatomia & histologia , Humanos , Masculino , Serviços de Saúde Escolar , Caracteres SexuaisRESUMO
PURPOSE: To investigate the distribution of the (CCR) and its associated factors in children. METHODS: Using a random cluster sampling method, the school-based, cross-sectional Shandong Children Eye Study included children aged 4 to 18 years from the rural county of Guanxian and the city of Weihai in the province of Shandong in East China. CCR was measured by ocular biometry. RESULTS: CCR measurements were available for 5913 (92.9%) out of 6364 eligible children. Mean age was 10.0±3.3 years, and mean CCR was 7.84±0.27 mm (range: 6.98 to 9.35 mm). In multivariate linear regression analysis, longer CCR (i.e. flatter cornea) was significantly associated with the systemic parameters of male sex (P<0001; standardized regression coefficient beta: -0.08; regression coefficient B: -0.04; 95% Confidence Interval (CI): -0.05, -0.03), younger age (P<0.001; beta: -0.37; B: -0.03; 95%CI: -0.04, -0.03), taller body height (P = 0.002; beta: 0.06; B: 0.001; 95%CI: 0.000, 0.001), lower level of education of the father (P = 0.001; beta: -0.04; B: -0.01; 95%CI: -0.02, -0.01) and maternal myopia (P<0.001; beta: -0.07; B: -0.04; 95%CI: -0.06, -0.03), and with the ocular parameters of longer ocular axial length (P<0.001; beta: 0.59; B: 0.13; 95%CI: 0.12, 0.14), larger horizontal corneal diameter (P<0.001; beta: 0.19; B: 0.13; 95%CI: 0.11, 0.14), and smaller amount of cylindrical refractive error (P = 0.001; beta: -0.09; B: -0.05; 95%CI: -0.06, -0.04). CONCLUSIONS: Longer CCR (i.e., flatter corneas) (mean:7.84±0.27 mm) was correlated with male sex, younger age, taller body height, lower paternal educational level, maternal myopia, longer axial length, larger corneas (i.e., longer horizontal corneal diameter), and smaller amount of cylindrical refractive error. These findings may be of interest for elucidation of the process of emmetropization and myopization and for corneal refractive surgery.
Assuntos
Córnea/anatomia & histologia , Olho/anatomia & histologia , Erros de Refração/patologia , Adolescente , Criança , Pré-Escolar , China , Feminino , Humanos , MasculinoRESUMO
PURPOSE: To determine the effect of 1% cyclopentolate on the refractive status of children aged 4 to 18 years. METHODS: Using a random cluster sampling in a cross-sectional school-based study design, children with an age of 4-18 years were selected from kindergardens, primary schools, junior and senior high schools in a rural county and a city. Auto-refractometry was performed before and after inducing cycloplegia which was achieved by 1% cyclopentolate eye drops. RESULTS: Out of 6364 eligible children, data of 5999 (94.3%) children were included in the statistical analysis. Mean age was 10.0±3.3 years (range: 4-18 years). Mean difference between cycloplegic and non-cycloplegic refractive error (DIFF) was 0.78±0.79D (median: 0.50D; range: -1.00D to +10.75D). In univariate analysis, DIFF decreased significantly with older age (P<0.001;correlation coefficient r:-0.24), more hyperopic non-cycloplegic refractive error (P<0.001;r = 0.13) and more hyperopic cycloplegic refractive error (P<0.001;r = 0.49). In multivariate analysis, higher DIFF was associated with higher cycloplegic refractive error (P<0.001; standardized regression coefficient beta:0.50; regression coefficient B: 0.19; 95% confidence interval (CI): 0.18, 0.20), followed by lower intraocular pressure (P<0.001; beta: -0.06; B: -0.02; 95%CI: -0.03, -0.01), rural region of habitation (P = 0.001; beta: -0.04; B: -0.07; 95%CI: -0.11, -0.03), and, to a minor degree, with age (P = 0.006; beta: 0.04; B: 0.009; 95%CI: 0.003, 0.016). 66.4% of all eyes with non-cycloplegic myopia (≤-0.50D) remained myopic after cycloplegia while the remaining 33.6% of eyes became emmetropic (18.0%) or hyperopic (15.7%) under cycloplegia. Prevalence of emmetropia decreased from 37.5% before cycloplegia to 19.8% after cycloplegia while the remaining eyes became hyperopic under cycloplegia. CONCLUSIONS: The error committed by using non-cycloplegic versus cycloplegic refractometry in children with mid to dark-brown iris color decreased with older age, and in parallel manner, with more myopic cycloplegic refractive error. Non-cycloplegic refractometric measures lead to a misclassification of refractive error in a significant proportion of children.
Assuntos
Ciclopentolato/farmacologia , Midriáticos/farmacologia , Refração Ocular/efeitos dos fármacos , Erros de Refração/epidemiologia , Adolescente , Criança , Pré-Escolar , China , Estudos Transversais , Cor de Olho , Feminino , Humanos , Iris/efeitos dos fármacos , Masculino , Prevalência , Erros de Refração/diagnósticoRESUMO
PURPOSE: We examined the distribution of intraocular pressure (IOP) and its associated factors in children. METHODS: Using a random cluster sampling from kindergartens, primary schools, and junior and senior high schools from rural Guanxian County and the city of Weihai, the school-based cross-sectional Shandong Children Eye Study included children aged 4 to 18 years. All participants underwent an ocular examination, including ocular biometry, cycloplegic refractometry, and noncontact tonometry. RESULTS: Mean IOP was 17.6 ± 2.7 mm Hg (range, 10-28 mm Hg). The IOP increased up to an age of 10 years and subsequently decreased with older age. In multivariate regression analysis, higher IOP was associated with female sex (P < 0.001; standardized correlation coefficient ß, 0.06; regression coefficient ß, 0.34; 95% confidence interval [CI], 0.18, 0.50), higher body mass index (P < 0.001; correlation coefficient ß, 0.09; regression coefficient ß, 0.07; 95% CI, 0.04,0.09), younger age (P < 0.001; correlation coefficient ß, -0.15; regression coefficient ß, -0.13; 95% CI, -0.17,-0.10), maternal myopia (P < 0.001; correlation coefficient ß, 0.05; regression coefficient ß, 0.34; 95% CI, 0.15,0.53), and more time spent indoors with reading/writing (P = 0.002; correlation coefficient ß, 0.05; regression coefficient ß, 0.07; 95% CI, 0.03,0.11), and with the ocular parameters of longer axial length (P < 0.001; correlation coefficient ß, 0.14; regression coefficient ß, 0.29; 95% CI, 0.21,0.37) and smaller corneal horizontal diameter (P < 0.001; correlation coefficient ß, -0.06; regression coefficient ß, -0.31; 95% CI, -0.46,-0.15). CONCLUSIONS: In children aged 4 to 18 years, IOP showed an M-shaped association with age. Higher IOP was associated with the nonocular parameters of female sex (P < 0.001), higher body mass index (P < 0.001), younger age (P < 0.001), maternal myopia (P < 0.001), and more time spent indoors with reading/writing (P = 0.002), and with the ocular parameters of longer axial length (P < 0.001) and smaller corneal horizontal diameter (P < 0.001).
Assuntos
Córnea/patologia , Pressão Intraocular/fisiologia , Hipertensão Ocular/epidemiologia , Vigilância da População , Medição de Risco/métodos , Tonometria Ocular/métodos , Adolescente , Fatores Etários , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/fisiopatologia , Prevalência , Prognóstico , Fatores de RiscoRESUMO
PURPOSE: To examine the prevalence of refractive errors and prevalence and causes of vision loss among preschool and school children in East China. METHODS: Using a random cluster sampling in a cross-sectional school-based study design, children with an age of 4-18 years were selected from kindergartens, primary schools, and junior and senior high schools in the rural Guanxian County and the city of Weihai. All children underwent a complete ocular examination including measurement of uncorrected (UCVA) and best corrected visual acuity (BCVA) and auto-refractometry under cycloplegia. Myopia was defined as refractive error of ≤-0.5 diopters (D), high myopia as ≤ -6.0D, and amblyopia as BCVA ≤ 20/32 without any obvious reason for vision reduction and with strabismus or refractive errors as potential reasons. RESULTS: Out of 6364 eligible children, 6026 (94.7%) children participated. Prevalence of myopia (overall: 36.9 ± 0.6%;95% confidence interval (CI):36.0,38.0) increased (P<0.001) from 1.7 ± 1.2% (95%CI:0.0,4.0) in the 4-years olds to 84.6 ± 3.2% (95%CI:78.0,91.0) in 17-years olds. Myopia was associated with older age (OR:1.56;95%CI:1.52,1.60;P<0.001), female gender (OR:1.22;95%CI:1.08,1.39;P = 0.002) and urban region (OR:2.88;95%CI:2.53,3.29;P<0.001). Prevalence of high myopia (2.0 ± 0.2%) increased from 0.7 ± 0.3% (95%CI:0.1,1.3) in 10-years olds to 13.9 ± 3.0 (95%CI:7.8,19.9) in 17-years olds. It was associated with older age (OR:1.50;95%CI:1.41,1.60;P<0.001) and urban region (OR:3.11;95%CI:2.08,4.66);P<0.001). Astigmatism (≥ 0.75D) (36.3 ± 0.6%;95%CI:35.0,38.0) was associated with older age (P<0.001;OR:1.06;95%CI:1.04,1.09), more myopic refractive error (P<0.001;OR:0.94;95%CI:0.91,0.97) and urban region (P<0.001;OR:1.47;95%CI:1.31,1.64). BCVA was ≤ 20/40 in the better eye in 19 (0.32%) children. UCVA ≤ 20/40 in at least one eye was found in 2046 (34.05%) children, with undercorrected refractive error as cause in 1975 (32.9%) children. Amblyopia (BCVA ≤ 20/32) was detected in 44 (0.7%) children (11 children with bilateral amblyopia). CONCLUSIONS: In coastal East China, about 14% of the 17-years olds were highly myopic, and 80% were myopic. Prevalence of myopia increased with older age, female gender and urban region. About 0.7% of pre-school children and school children were amblyopic.
Assuntos
Cegueira/etiologia , Erros de Refração/complicações , Erros de Refração/epidemiologia , Acuidade Visual , Adolescente , Distribuição por Idade , Cegueira/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Erros de Refração/fisiopatologiaRESUMO
OBJECTIVE: To analyze the chemical constituents of the volatile oil from Viburnm schensianum leaves and investigate their antibacterial activity in vitro. METHODS: The volatile oil from Viburnm schensianum leaves were extracted by steam distillation. The chemical compositions were separated and analyzed by GC-MS. Their relative percentage content were calculated with peak area normalization method. Agar dilution method was used to determine the minimum inhibitory concentration of the volatile oil and Ciprofloxacin to the five kinds of experimental strains. RESULTS: 54 compounds were isolated and 45 compounds were identified. The volatile oil showed strong antibacterial activity against Staphyloccocus aureus, and the minimum inhibitory concentration was 0. 032 mg/mL. CONCLUSION: The main chemical constituents of the volatile oil are n-hexadecanoic acid (29.24%), 4-methy-l--(1-methylethyl)-bicyclo [3.1.0] hex-3-en-2-one (5.71%), 3-methyl-4-isopropylphenol (5.68%)and linolenyl alcohol (4.84%). The volatile oil has strong antibacterial activity against Staphyloccocus aureus.