Analysis of the registration deviation between CT and CBCT images with different breathing rates and motion amplitudes in the state of free breathing / 中华放射肿瘤学杂志

Objective:To quantify the registration deviation between CT and cone-beam computed tomography (CBCT) images with different breathing rates and motion amplitudes under free breathing state.Methods:Using the QUASAR respiratory motion phantom, breathing rate and motion amplitude in the superior-inferior (SI) direction were changed to simulate free breathing motion under different states. The CT and CBCT images were acquired under different breathing rates and motion amplitudes, and static states, then the registration errors between CT and CBCT images and CT target volume were obtained and subject to quantitative analysis.Results:Using the static CT image as a reference, the changes in breathing rate exerted no significant effect on the registration error when the motion amplitude was constant. When the motion amplitude was 0.5, 1.0, 2.0, and 3.0 cm, the average registration errors were (0.213±0.020), (0.351±0.009), (0.654±0.010), and (0.972±0.022) cm, respectively. When the motion amplitude was 0.5 and 1.0 cm, the CT target volume varied from -16.92% to 18.78%. When the motion amplitude was 2.0 and 3.0 cm, the CT target volume changed from -16.44% to 81.78%.Conclusions:The changes in breathing rate under free-breathing state has no significant effect on the registration error between CBCT and CT images. When the motion amplitude is 0.5 and 1.0 cm, the CT target volume changes and the registration errors are small. When themotion amplitude is 2.0 and 3.0 cm, the registration errors exceed 0.5 cm and the CT target volume changes may exceed 20%.

Correlation between recovery of motor function and regional glucose metabolism induced by CIMT in rats with cerebral ischemia / 复旦学报（医学版）

Objective To study the correlation between regional cerebral glucose metabolism and behavioral scores in middle cerebral artery occlusion(MCAO)model rats before and after the intervention of constraint induced movement therapy(CIMT),and the correlation between the natural recovery processand motor function recovery in MCAO model rats and the brain activation after CIMT intervention,and to further explore the mechanism of CIMT. Methods Twenty-two adult male Sprague-Dawley(SD)rats were randomly divided into an ischemic group treated with CIMT (CIMT,n=6),an ischemic group (Control,n=6),a sham-operated group(Sham,n=6),and a blank control group(Normal,n=4). The MCAO models of rats in the CIMT group and Control group were established by thread embolism method. The middle cerebral artery was not blocked during the operation for the Sham group,and the Normal group was not given any special treatment. After operation,rats in the CIMT group and Sham group were treated with CIMT. On the 7th day(d7)and the 22nd day(d22)after surgery,foot-fault test(FFT)and the beam balance and walking (BBW) test were used to evaluate the forelimb motor;micro positron emission tomography-computed tomography (micro PET/CT) imaging with fluorodeoxyglucose (18F-FDG) was used to scan the glucose metabolism in different brain regions of rats;Pearson correlation analysis was used to analyze the correlation between behavioral scores and glucose metabolism level in the CIMT group and Control group. Results On d7,the BBW score in the CIMT group and Control group was negatively correlated with glucose metabolism in the left insular cortex and the auditory cortex,and positively correlated with glucose metabolism in the right posterior hippocampus,superior colliculus,and inferior colliculus,with statistically significant differences;the FFT score was negatively correlated with glucose metabolism in the left somatosensory cortex, insular cortex and orbitofrontal cortex, and positively correlated with glucose metabolism in the right midbrain,with statistically significant differences. On d22, the BBW score in the CIMT group and Control group was positively correlated with glucose metabolism in the amygdala,caudate putamen,insular cortex and entorhinal cortex,and negatively correlated with glucose metabolism in the nucleus accumbens (Acb) core shell and caudate putamen in the right brain region,with statistically significant differences;the FFT score was negatively correlated with the entorhinal cortex in the right hemisphere and the difference was statistically significant. Conclusion The recovery of motor function promoted by CIMT was associated with the activation of both cerebral hemispheres in rats. The improvement of balance function promoted by CIMT in rats with cerebral ischemia was mainly related to the activation of Acb core shell in the right hemisphere. The recovery of fine grasping function promoted by CIMT may be related to the activation of the right entorhinal cortex.

Research progress of adaptive radiotherapy in radiotherapy of nasopharyngeal carcinoma / 国际生物医学工程杂志

Intensity-modulated radiation therapy(IMRT) is currently the main treatment method for nasopharyngeal carcinoma. During radiotherapy for nasopharyngeal carcinoma, factors such as body mass reduction, tumor regression, and organ displacement at risk can affect the precise implementation of radiation therapy. Applying adaptive radiotherapy (ART) technology to optimize the treatment plan at the appropriate timing can reduce the adverse effects caused by the above factors and enhance the accuracy of radiotherapy. There are no uniform standards for the necessity, timing, and case selection of ART. In this review, the research progress of ART in the radiotherapy of nasopharyngeal carcinoma in recent years was reviewed to provide a reference for further clinical application of ART in nasopharyngeal carcinoma.

Preliminary study of stereotactic cardiac radioablation in radiotherapy of ventricular arrhythmia / 中华放射肿瘤学杂志

Objective:To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety.Methods:Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R 50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results:Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25 Gy in a single fraction. The average volume of PTV was 71.4 cm 3(60.3-89.4 cm 3). The average time of beam delivery was 12.0 min (4.5-21.0 min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion:This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.

Effect of inhibition of IL-6 trans-signaling on sepsis-associated encephalopathy in mice / 中华麻醉学杂志

Objective:To evaluate the effect of inhibition of interleukin-6 (IL-6) trans-signaling on sepsis-associated encephalopathy (SAE) in mice.Methods:Eighty healthy male C57BL/6J mice, aged 8-10 weeks, weighing 22-24 g, were divided into 4 groups using a random number table method: sham operation group (Sham group, n=10), SAE group ( n=35), SAE plus sgp130Fc group ( n=25) and sgp130Fc group ( n=10). Sepsis was induced by cecal ligation and puncture (CLP) in anesthetized animals.Sham and sgp130Fc groups received no CLP.In group sgp130Fc and group SAE+ sgp130Fc, sgp130Fc 0.5 mg/kg was intraperitoneally injected at 1 h after sham operation or CLP.The survival rates, body weight and neurological function scores were recorded within 1-10 days after sham operation or CLP.Four mice in each group were selected at 24 h after sham operation or CLP to detect the expression of occlusin in hippocampus by Western blot.Five mice in each group were selected to measure cognitive function using Morris water maze test at day 4 after sham operation or CLP. Results:Compared with group Sham, the survival mice, body weight and neurological function scores on days 2-10 after CLP were significantly decreased, the expression of occludin was down-regulated, the frequency of crossing the original platform was decreased, and the time spent in target quadrant was shortened in group SAE ( P<0.05), and no significant change was found in the indexes mentioned above in group sgp130Fc ( P>0.05). Compared with group SAE, the survival rate and neurological function scores on days 3-10 after CLP were significantly increased, the expression of occludin was up-regulated, the frequency of crossing the original platform was increased, and the time spent in target quadrant was prolonged ( P<0.05), and no significant change was found in body weight in group SAE+ sgp130Fc ( P>0.05). Conclusions:Inhibition of IL-6 trans-signaling can reduce the damage to the blood brain barrier and SAE in mice.

Evaluation of shoulder function after repairing head and neck defects with supraclavicular flap / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the shoulder function in patients after repair of head and neck defects with supraclavicular flap. Methods: A retrospective analysis was performed on 56 patients (54 males, 2 females, aged 35-74 years old) who received the repair of head and neck defects with supraclavicular flaps at Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University in January 2013-December 2020. The areas and types of flaps, disruption or infections of the incision at the donor sites and other postoperative complications were recorded. Quick disabilities of the arm, shoulder and hand (Quick-DASH) was used for evaluating the shoulder functions in 43 patients conforming to the standard for evaluation of the clinical functions of shoulders and upper limbs, to compare the postoperative upper limb functions between patients treated with clavicular flaps and patients with acromion flaps. Meanwhile, 30 patients who received bilateral neck lymph node dissection over the same period of time were selected for a comparative evaluation of the donor sides (observation group) and the opposite sides (control group). Data were processed with SPSS 22.0. Results: The areas of obtained supraclavicular flaps were (4-10) cm × (10-18) cm. Three patients (5%) showed the defect widths of 8-10 cm at the donor sites, which couldn't be sutured directly, received the repair of their shoulder defects with partial flaps. Defects in other patients were sutured directly. After surgery, 3 patients (5%) suffered from disruption of the acromion incision, which healed after 2 weeks of local dressing. The follow-up time was 6-43 (27±14) months. All patients expressed no dissatisfaction with the appearance. Among 43 patients, 28 (65%) were clavicular type and 15 (35%) were acromion type. The acromion type showed average motor ability and Quick-DASH scores higher than the clavicular type [(average motor ability: (14.4±4.7) vs. (11.8±3.1), t=2.105, P=0.048; Quick-DASH: (16.9±11.6) vs. (12.2±7.1), t=2.284, P=0.033]. Among 30 patients who received bilateral neck lymph node dissection over the same period of time, the observation group showed higher average motor ability, local symptoms and Quick-DASH scores than the control group [average motor ability: (13.4±5.8) vs. (9.8±4.2), t=3.024, P=0.004; average local symptoms: (4.1±1.0) vs. (3.4±1.0), t=2.537, P=0.014; Quick-DASH: (15.6±14.7) vs. (5.2±11.1), t=3.106, P=0.003]. Conclusion: Shoulder dysfunction exists after treatment with supraclavicular flap, which is related to the flap type.

Advance in Mechanisms of Spasticity after Stroke (review) / 中国康复理论与实践

Spasticity is a common complication in stroke patients, which may be a result of supraspinal influences, spinal reflexs and biomechanical changes.

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Conventional Rehabilitation on Upper Extremity Function for A Patient with Complex Regional Pain Syndrome I after Distal Radius Fracture / 中国康复理论与实践

Objective:To summarize the development of a patient with complex regional pain syndrome (CRPS) after distal radius fracture and the effect of repetitive transcranial magnetic stimulation (rTMS) combined with conventional rehabilitation on it. Methods:One patient with CRPS after left distal radius fracture was treated with rTMS combined with conventional rehabilitation for three weeks. The pain degree was evaluated with Visual Analogue Score (VAS), the edema was assessed with volume of hand and circumference of finger, and motion of joint was measured with passive range of motion. The activities of daily living was assessed with modified Barthel Index (MBS). Results:Before treatment, the VAS score was 8, the volume of left hand was 330 ml, the temperature of skin was 36.8 ℃. The activity of flexion and extension of left elbow joint, pronation and supination of left forearm, the flexion, extension, ulnar deviation and temporal deviation of left wrist, and metacarpophalangeal joints (MCP), proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP) of left hand were all limited. The circumference of left finger was larger than right finger, and the score of MBI was 85. After three weeks of treatment, the VAS score was 2, the volume of the left hand was 310 ml, the temperature of the skin was 33.8 ℃. The activities of left elbow joint, left wrist joint and left MCP, PIP, and DIP were better than before. The score of MBI was 100. Conclusion:rTMS combined with conventional rehabilitation is effective on CRPS after distal radius fracture, in the range of motion and edema of upper extremity, and activities of daily living.

Therapy of Complex Regional Pain Syndrome on Single Hand post Stroke: Case Report / 中国康复理论与实践

Objective To summarize the development and treatment for complex regional pain syndrome (CRPS) type I only involving hand after stroke.Methods One patient accepted comprehensive rehabilitation for six weeks. He was assessed with Visual Analogue Scale (VAS) of pain and modified Barthel Index, his hand volume and fingers circumference, and passive range of motion (PROM) of fingers and wrist was measured, before and after treatment.Results The score of VAS, and the hand volume and the fingers circumference decreased, while PROM and the score of modified Barthel Index increased after treatment.Conclusion Post-stroke CRPS type I can only affect the wrist and hand. Comprehensive rehabilitation may improve the function and activities of daily living.

Feasibility Research of the New Fixation Device Compatible with Head and Neck Coil of MRI for Radiotherapy / 中国医疗器械杂志

MRI simulation images quality of head and neck coil scanning is better than that of radiotherapy surface coil, but currently the head and neck coil is not compatible with radiotherapy positioning devices. In this paper, a new fixation device is developed based on computer reverse engineering technology, which can be used in combination with head and neck coil. This article focuses on discussing the feasibility of the new device in radiotherapy. The obtained ACR phantom and Cat phantom 504 images were used to analyze MR and CT images quality assurance indicators. The dose attenuation of 6 MV photons was measured using the ionization chamber. The results showed each index met the clinical application requirements of intracranial tumor radiotherapy, thereby it can be used in intracranial tumor radiotherapy.

Application of A Dynamic Wrist-hand Orthosis for Upper Limb and Hand Function Rehabilitation in Chronic Stroke Patients / 中国康复理论与实践

Objective:To observe the effect of grasping training under a dynamic wrist-hand orthosis (Saebo Glove) on upper limb and hand function in chronic stroke patients. Methods:From October, 2018 to January, 2019, eleven patients with hemiplegia in upper limb and hand after chronic stroke were recruited. They received conventional rehabilitation and grasping training under dynamic wrist-hand orthosis for three weeks. They were tested surface electromyography of flexor and extensor muscle of wrist and upper limb, assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Reach Arm Test (ARAT), modified Ashworth Scale (MAS), modified Tardieu Scale (MTS) and Triple Spasticity Scale (TSS), and measured grip force, active range of motion of wrist and metacarpophalangeal joints before and after treatment. Results:The scores of FMA, ARAT and TSS, and active range of motion of wrist flexor improved after treatment (t > 2.739, P < 0.05). Conclusion:Grasping training assisted with dynamic wrist-hand orthosis can improve upper limb and hand function of motor and release spasticity in hemiplegics after chronic stroke.

Advance in Clinial and Mechanism Reseaches about Serotonin Selective Reuptake Inhibitors for Ischemic Stroke (review) / 中国康复理论与实践

Serotonin selective reuptake inhibitors (SSRIs) have been widely used for post-stroke depression. Recently, SSRIs are considered as an effective drug to improve motor function after stroke. Mechanism of SSRIs improving motor function after ischemic stroke involves extensive factors, and there is no definitive conclusion yet. While, the effects of SSRIs on motor function after stroke remains debatable. Besides, there are potential risks of SSRIs in the treatment of stroke. It is necessary to evaluate the benefits and risks of SSRIs for patients with ischemic stroke.

Effects of Scalp Acupuncture Combined with Cognitive Training on Cognitive Impairment after Traumatic Brain Injury / 中国康复理论与实践

Objective:To investigate the clinical effects of scalp acupuncture combined with cognitive therapy on cognitive impairment after traumatic brain injury. Methods:From June, 2016 to October, 2017, 60 patients with cognitive impairment after traumatic brain injury were randomly divided into scalp acupuncture group (n = 20), cognitive training group (n = 20) and combined group (n = 20), who accepted their own therapies for 40 times. They were assessed with Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and modified Barthel Index (MBI) before and after treatment. Results:All the groups improved in the scores of MMSE, MoCA and MBI after treatment (F > 21.923, P < 0.001), which were the best in the combined group (F > 3.423, P < 0.05). Conclusion:Combination of scalp acupuncture and cognitive training is more effective on cognitive impairment after traumatic brain injury.

Evaluation of the feasibility of log file-based three-dimensional independent dose verification system in quality assurance of intensity-modulated radiation therapy / 中华放射肿瘤学杂志

Objective To assess the feasibility of the log file-based three-dimensional independent dose verification system for the quality assurance of clinical radiotherapy.Methods The statistical values of the percentage depth dose,off-axis curves and output factor calculated by the Mobius system were statistically compared with the measured data by three-dimensional water tank.The three-dimensional independent dose verification in clinical radiotherapy plan and the acceleratr log file-based three-dimensional dose verification during the treatment were performed in 17 patients with nasopharyngeal cancer.The accuracy of dose calculation and reconstruction of Mobius system was assessed.A statistical analysis was performed on the intra-fractionalγpass rate (3％/3 mm) for each patient to evaluate the stability of intra-fractional radiotherapy.Results The percentage depth dose,off-axis curve and output factor statistically calculated by the Mobius system matched well with the data measured by three-dimensional water tank.The dose-volume histogram (DVH) parameters between the target area and organ at risk during clinical radiotherapy plan were statistically compared in 17 patients with nasopharyngeal cancer.The maximum deviation was-2.16％ for the three-dimensional independent dose verification in the clinical radiotherapy plan,and 0.18 Gy for the accelerator log file-based three-dimensional dose verification.The averageγpass rate for 17 nasopharyngeal cancer patients was 99.26％,and the maximum deviation of intra-fractional radiotherapy was below 0.5％.Conclusions The function of dose reconstruction and independent calculation of the Mobius system yeilds the same accuracy with the treatment planning system,which can quickly perform three-dimensional independent dose verification in the clinical radiotherapy plan and accelerator log file-based three-dimensional dose verification throughout the treatment,thereby guarantting and providing the safe and reliable technical support for clinical treatment.

Radiomics in the precision diagnosis and treatment of brain tumor:the application and challenge / 中华放射肿瘤学杂志

While emphasizing" Precision Medicine" nowadays,comprehending the specificity of patients and pathology is the key to achieving the precision diagnosis and treatment.Radiomics is a high-throughput quantitative analysis that combines the quantitative features from the region of interest on medical image and the biology and heterogeneity of tumor.It provides a non-invasive,convenient,dynamic,and quantitative method to collect the patient's specific features of pathology and gene.Radiomics holds promise for the precision diagnosis and treatment of brain tumor.It can be used for molecular pathology diagnosis,definition of tumor boundaries,prognosis,prediction of complications,and so on.It helps to develop individualized measures for the prevention,diagnosis,treatment,and prognostic monitoring based on their disease features.

Clinical Efficacy of Yangxin Dingji Capsule Combined with Metoprolol on Patients with Coronary Heart Disease Complicated with Rapid Arrhythmia / 世界科学技术-中医药现代化

Objective: To study the clinical efficacy of Yangxindingji capsule combined with metoprolol in patients with coronary heart disease complicated with rapid arrhythmia. Methods: A total of 86 cases of patients with coronary heart disease complicated with tachyarrhythmia diagnosed in our hospital from January 2017 to December 2017 were selected as the subjects of this study. All the patients were divided into a control group and a study group according to the principle of the random number table, with 43 cases in each group. The patients in the control group were received oral metoprolol for treatment, and the patients in the study group were treated with oral Yangxindingji capsule combined with Metoprolol for treatment. The treatment effect and the change of heart function and blood rheology were compared between the two groups before and after the treatment. Results: The total effective rate of treatment in the study group was 83.7％ (36/43), which was higher than that in the control group (67.4％ ) (29/43). The difference was statistically significant (P ＜ 0.05); After the treatment, the HR levels in both groups were lower than before treatment, and the study group was lower than the control group, with a significant difference (P ＜ 0.05); The LVEF levels after treatment in the two groups were higher than before treatment, and the study group was higher than the control group. The difference was statistically significant (P ＜ 0.05); The fibrinogen, high-cutting whole blood viscosity, plasma viscosity, and low-cut whole blood viscosity of the two groups after treatment were lower than before treatment, and the study group was lower than the control group. The difference was statistically significant (P ＜ 0.05). Conclusion: Yangxindingji capsule combined with metoprolol has significant effects on coronary heart disease combined with rapid arrhythmia, which can effectively relieve clinical symptoms, improve cardiac function, regulate hemorheology, correct arrhythmia, and is worthy of clinical promotion.

Inhibitory effects of anthocyanin on oxidative stress injury and epithelial-mesenchymal transition of human lens epithelial cells / 药学学报

Anthocyanin is a water-soluble flavonoid pigment which is widely found in plants. Studies showed that anthocyanin had protective effect on vision. However, whether anthocyanin has therapeutic effect on cataract remain unclear. In this study, we established the age-related and posterior capsule opacification cataract cell models through inducing oxidative damage of human lens epithelial cells (HLECs) by H2O2 and inducing epithelial-mesenchymal transition (EMT) by transforming growth factor β2 (TGF-β2). The preventative effects of anthocyanin on markers of oxidative damage and EMT were determined by respective assay kits and PCR analysis. Anthocyanin was beneficial to reduce oxidative stress of HLECs, protecting cells from H2O2 induced damage and increasing α-crystallin expression. The potential mechanisms might be that anthocyanin increased the activities of SOD and GSH-Px, which contributes to reduce cellular ROS and MDA level. Besides, anthocyanin inhibited Ca2+ overload, which contributes to protection of cell from apoptosis. Meanwhile, anthocyanin had inhibitory effect on EMT, slowed down cell proliferation, migration caused by TGF-β2 through decreasing mRNA expression levels of EMT markers including COL1A1, COL1A2, COL3, COL4, Fn and α-SMA. The results suggest that anthocyanin could protect HLECs from oxidative damage induced by H2O2 and cell proliferation, migration and EMT induced by TGF-β2, which indicated that anthocyanin may have protective and therapeutic effects on age-related cataract and posterior capsule opacification.

Advance in Mirror Therapy for Motor Rehabilitation of Stroke Patients with Hemiplegia (review) / 中国康复理论与实践

Mirror therapy (MT), was first used for phantom limb pain, and afterwards used widely for stroke and peripheral nerve injury, etc. The mechanism of MT is obscure and various, mainly included mirror neuron system, visual feedback, facili-tation of motor pathways, and so on. A large quantity of researches claimed that training of unaffected limb activated ip-silateral cortex, changed conduction of pyramid tracts, and promote motor function recovery of affected limb, which cor-rected motor deficits and improved function of patients with hemiplegia (eg. finger movement and wrist flexion-exten-tion function).

Effect of different types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Prognostic value of plasma C-reactive protein in the evaluation of paraquat poisoning patients

Objective: To investigate the prognostic value of plasma C-reactive protein (CRP) level in patients with paraquat poisoning. Methods: This study included 162 patients with paraquat poisoning. The data of plasma paraquat, CRP level and arterial blood gas were analyzed. Cox regression analysis was applied to evaluate the risk factors of prognosis. Receiver operating characteristics curve analysis and area under curve were used to calculate the predictive power of significant variable. Differences in patient survival were determined using the Kaplan-Meier method and a log-rank test. Results: Plasma CRP level was significantly increased in non-survival patients compared with survival patients ( P < 0.05), and positively correlated with plasma paraquat level ( P < 0.05). Cox regression analysis revealed that plasma CRP level was an independent prognostic marker of mortality within 30 days. The receiver operating characteristics curve analysis indicated that area under curve of plasma CRP level was 0.867 (95% CI: 0.81-0.93), and the cut-off value was 18 mg/L, and patients with CRP level over this value had a poor survival time compared with those with less than this value. Conclusions: These results suggest that plasma CRP level is distinct increased in patients with paraquat poisoning, and the plasma CRP level may be useful for the prediction of prognosis in paraquat poisoning.