Accuracy of a smartphone-assisted novel labeling method for marking target axial position in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the convenience and accuracy of a novel smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with intraocular lens(IOL)implantation.METHODS: Prospective observational study. A total of 62 cases(62 eyes)of patients with age-related cataracts who underwent cataract phacoemulsification combined with IOL implantation in our hospital from October 2021 to April 2022 were selected. They were randomly divided into two groups: 31 cases(31 eyes)in the control group were applied with the “traditional two-step method” using slit lamp to mark the target axial position of the IOL, and 31 cases(31 eyes)in the experimental group were applied with the smartphone-assisted “two-step method” to mark the target axial position of the IOL. The Callisto eye navigation system was used as a standard reference, and the deviation of the reference marking point(deviation-1), the deviation of the target axial marking point(deviation-total), and the deviation of the angle from the reference marking point to the target axial marking point(deviation-2)were calculated and recorded as the preoperative axial marking time.RESULTS:Both deviation-1 and deviation-total values were lower in the experimental group than those in the control group(1.06°±1.39° vs 2.48°±2.23°, 1.77°±1.54° vs 2.81°±1.58°, all P<0.01), but there was no significant difference in the deviation-2 values between the two groups(1.35°±1.40° vs 1.48°±1.79°, P>0.05). The preoperative axial marking took shorter time in the experimental group than in the control group(1.77±1.70 min vs 2.88±3.20 min, P<0.01).CONCLUSION: The smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with IOL implantation is simple, time-saving, and accurate compared with the “traditional two-step method”.

Efficacy and safety of Anlotinib in the treatment of advanced sarcoma / 中华肿瘤杂志

Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.

Efficacy and safety of Anlotinib in the treatment of advanced sarcoma / 中华肿瘤杂志

Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.

Effect of 28-day administration of Psoraleae Fructus water extract on early liver injury in rats / 中国中药杂志

This study aims to investigate the hepatotoxicity of Psoraleae Fructus water extract and the underlying mechanism in rats. Forty-eight rats were randomly assigned into four groups: a blank group and low-(BZGL, 6.25 g·kg~(-1)), medium-(BGZM, 12.5 g·kg~(-1)), and high-dose(BGZH, 25 g·kg~(-1)) Psoraleae Fructus water extract groups. The rats were treated for 28 days, and toxicity and mortality were observed daily. After 28 days, the rats were sacrificed, and the body weight, liver index, and liver-to-brain ratio were calculated. The morphological changes in the liver tissue were observed, and the serum levels of related biochemical indicators were measured. The results showed that compared with the blank group, Psoraleae Fructus water extracts of different doses decreased the body weight, increased the liver index and liver-to-brain ratio, and caused liver hypertrophy and pathological changes. Pathological examination revealed that the rats in Psoraleae Fructus water extract groups had bile duct hyperplasia, inflammatory cell infiltration, and liver cell fibrosis. Compared with the blank group, BGZL elevated the levels of alanine transaminase(ALT), α-glutathione S-transferase(α-GST), and total bile acid(TBA)(P<0.05), and BGZM and BGZH elevated the levels of ALT, TBA, α-GST, γ-glutamyl transferase(γ-GT), purine nucleoside phosphorylase(PNP), ornithine carbamoyltransferase(OCT), and arginase(ArgI)(P<0.05). Compared with the blank group, Psoraleae Fructus water extracts of different doses down-regulated the mRNA and protein levels of bile salt export pump(BSEP) and farnesoid X receptor(FXR) and up-regulated the mRNA and protein levels of tumor necrosis factor-α(TNF-α), nuclear factor kappaB(NF-κB), and cholesterol 7 alpha-hydroxylase(CYP7A1)(P<0.05). The results suggested that Psoraleae Fructus water extract caused toxicity in rats, showing a dose-toxicity relationship. Psoraleae Fructus water extract may cause liver damage, which may be due to its effect on liver bile acid secretion and induction of inflammation.

Demethylenetetrahydroberberine protects dopaminergic neurons in a mouse model of Parkinson's disease / 中国天然药物

Parkinson's disease (PD) is a multifactorial disorder of the nervous system where a progressive loss of dopaminergic neurons exist. However, the pathogenesis of PD remains undefined, which becomes the main limitation for the development of clinical PD treatment. Demethylenetetrahydroberberine (DMTHB) is a novel derivative of natural product berberine. This study was aimed to explore the neuroprotective effects and pharmacological mechanism of DMTHB on Parkinson's disease using C57BL/6 mice. A PD model of mice was induced by administration of MPTP (20 mg·kg-1) and probenecid (200 mg·kg-1) twice per week for five weeks. The mice were administered with DMTHB daily by gavage at the dose of 5 and 50 mg·kg-1 for one- week prophylactic treatment and five-week theraputic treatment. The therapeutic effects of DMTHB were evaluated by behavior tests (the open field, rotarod and pole tests), immunohistochemical staining of tyrosine hydroxylase (TH), Nissl staining and biochemical assays. The molecular mechanisms of DMTHB on the key biomarkers of PD pathological states were analyzed by Western blot (WB) and qRT-PCR. DMTHB treatment alleviated the behavioral disorder induced by MPTP-probenecid. Nissl staining and TH staining showed that the damage of dopaminergic neurons in the substantia nigra was remarkably suppressed by DMTHB treatment. Western blot results showed that the ratio of Bcl-2/Bax and TH increased, but the level of α-synuclein (α-syn) was remarkably reduced, which indicated that the apoptosis of dopaminergic neurons in mice was significantly reduced. The protein phosphorylation of p-PI3K, p-AKT and p-mTOR also increased about 2-fold, compared with the model group. Furthermore, qRT-PCR results demonstrated that the mRNA levels of pro-inflammatory cytokines, IL-1β and TNF-α, were reduced, but the level of anti-inflammatory cytokine IL-10 increased after DMTHB treatment. Finally, the cellular assay displayed that DMTHB was also a strong antioxidant to protect neuron cell line PC12 by scavenging ROS. In this study, we demonstrated DMTHB alleviates the behavioral disorder and protects dopaminergic neurons through multiple-target effects includubg anti-apoptotic, anti-inflammatory and antioxidant effects.

Effect of hepatocellular carcinoma cell-derived exosomes on M2 polarization of tumor-associated macrophages / 临床肝胆病杂志

Objective To investigate the effect of exosomes derived from hepatocellular carcinoma cells on the polarization of tumor-associated macrophages (TAMs), and to reveal the novel mechanism of hepatocellular carcinoma formation. Methods Hepatocellular carcinoma cell-derived exosomes were isolated by ultracentrifugation, and the characteristics of exosomes were identified by transmission electron microscope (TEM), Dynamic Light Scattering (DLS), and Western blotting. The model of macrophage polarization was induced and verified by quantitative real-time PCR and Western blotting. The t -test was used for comparison of normally distributed continuous data between two groups. A one-way analysis of variance was used for comparison between multiple groups, and the LSD- t -test was used for further comparison between two groups. Results TEM showed that hepatocellular carcinoma cell-derived exosomes were round or oval vesicles, LDS showed that the exosomes had a particle size of 172.65±2.34 nm, and Western blotting showed highly positive expression of the biomarkers TSG101 and CD63 in exosomes. There was a significant increase in the expression of CD68 after the addition of 15 ng phorbol ester to induce human-derived mononuclear macrophages for 24 hours to achieve adherent growth (1.00±0.25 vs 6.67±0.98, t =11.20, P < 0.001). Western blotting showed that compared with the control group (L02 cell-derived exosomes), the hepatocellular carcinoma cell-derived exosomes (at low, middle, and high doses) induced M2 polarization of macrophages and increased the expression of the markers Arg-1 and CD163 (all P < 0.05). Conclusion Hepatocellular carcinoma cell-derived exosomes promote M2 polarization of TAMs.

Effectiveness and safety evaluation of lidocaine hydrochloride ophthalmic gel for ocular anesthesia: a multicenter randomized double-blind trial / 中华实验眼科杂志

Objective:To evaluate the effectiveness and safety of 3.5% lidocaine hydrochloride ophthalmic gel for eye surface anesthesia.Methods:A multicenter, randomized, double-blind, placebo controlled clinical trial was conducted in 10 hospitals in China from August 2018 to April 2019 under the approval of an Ethics Committee of Beijing Hospital (No.2018BJYYEC-014-02). A total of 220 fellow eyes of 220 subjects who received ocular surgery in one eye were actually enrolled according to a same included criteria in different institutes.The 220 eyes were randomly divided into control group and trail group.Two drops of lidocaine hydrochloride gel were dropped at about 5 mm away from corneal limbus at 6 o'clock direction of experimental eye of the trail group, and the blank gel was used in the eyes of the control group in the same way.The pain sensation was assessed with a 0.3 mm toothless micro forceps on conjunctiva within a specified time, and ''pain'' or ''no pain'' was answered by the subjects.The primary effective indexes, namely the number of eyes and percentage of ''no pain'' within 5 minutes following dropping, as well as the secondary indexes including the onset time point of the drug and the duration of anesthesia were recorded and evaluated.Safety evaluation took ocular and system adverse events into account.Results:Within 5 minutes after dropping, ''no pain'' occurred in 104 eyes (94.55%) and 29 eyes (26.36%) in the trail group and control group, respectively, showing a significant difference between the two groups ( χ2=106.948, P<0.001). And there was a significant difference in anesthesia onset time between the trail group and control group (40.0 seconds vs. 300.0 seconds) ( Z=-15.17, P<0.001). The duration of anesthesia was 860.5 (577.5, 1 180.0) seconds in the trail group and 676.0 (280.0, 1 401.0) seconds in the control group, with no statistically significant difference between the two groups ( Z=0.898, P>0.05). The incidence of adverse events in the trail group and control group were 5.45% (6/110) and 4.55% (5/110), respectively, without statistical significance between them ( P=1.000). Conclusions:The 3.5% lidocaine hydrochloride is a safe, effective, easy to use and high-quality surface anesthesia drug for eye surgery.

Imaging Features of Abnormal Neural Connectivity in Autistic Children / 中国康复理论与实践

Objective:To analyze the structure and function of white matter in autistic children by using diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS), to explore the imaging features of abnormal neural connectivity in children with autism. Methods:Autism group (n = 14) and control group (n = 8), aged two to nine years, underwent DTI and MRS scan. Bilateral frontal lobe, hippocampus, genu and splenium of corpus callosum and cerebellum white matter were selected as regions of interest. The data of DTI and MRS were processed by Functool 2.6 software of GEAW4.2 workstation. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of DTI, the absolute concentrations of N-acetylaspartate (NAA), choline (Cho), creatinine (Cr) and the ratios of NAA/Cr and Cho/Cr were recorded respectively. Results:Compared with the control group, the FA of left hippocampus (F = 5.922, P = 0.033) and the absolute concentration of Cr in left and right hippocampus (F > 4.715, P < 0.05) decreased significantly in the autism group. The FA was lower in left corpus callosum genu than in the right one (F = -2.335, P = 0.042), and the ADC was higher in left corpus callosum splenium than in the right one (F = 3.520, P < 0.01) in the autism group. The absolute concentration of NAA, Cho and Cr in left frontal lobe (|t| > 2.648, P < 0.05), the absolute concentration of NAA in left corpus callosum splenium (t = -3.076, P = 0.009) and Cho/Cr in left cerebellum (t = -2.225, P = 0.044) were significantly lower than those in the right cerebral hemisphere in the autism group. The DTI and MRS indexes were not different between left and right hemispheres in the control group (P > 0.05). Conclusion:Abnormal metabolite or functional alternations were found in the frontal lobe, hippocampus, cerebellum and the genu and splenium of the corpus callosum in autistic children, suggesting underconnectivity intra- or inter-hemispheric neural, especially in left hemisphere.

Advance in Repeatitive Transcranial Magnetic Stimulation for Dysphagia after Stroke (review) / 中国康复理论与实践

Repeatitive transcranial magnetic stimulation can adjust cortical excitability and improve swallowing function in patients with dysphagia after stroke. High frequency stimulations with 90% to 130% resting motor threshold (rMT) in the early stage, as well as low frequency stimulations with 100% to 130% rMT for 1200 pulse in the recovery period, may be beneficial to the recovery of swallowing function, and bilateral stimulation may be more effective.

Retrospective Clinical Analysis on Treatment of Coronavirus Disease 2019 with Traditional Chinese Medicine Lianhua Qingwen / 中国实验方剂学杂志

Objective:To analyze the clinical effect of traditional Chinese medicine Lianhua Qingwen in the treatment of coronavirus disease 2019 (COVID-19) and provide the basis for medication guides through a retrospective study in a cohort of COVID-19 confirmed patients. Method:A retrospective analysis of clinical records was conducted in COVID-19 confirmed patients at The Ninth Hospital of Wuhan and CR&WISCO General Hospital including the treatment group (21 patients, basic treatment in combination with Lianhua Qingwen granules, 1 packet/time, 3 times/day) and the control group (21 patients, basic treatment). Comparison between the two groups was made in terms of the disappearance rates of cardinal symptoms (fever, cough and weakness), duration of fever, and disappearance rates of other symptoms (muscle pain, expectoration, nasal obstruction, running nose, dry throat, pharyngalgia, shortness of breath, chest distress, dyspnea, dizziness, headache, nausea, vomiting, loss of appetite and diarrhea). Result:The baseline data were similar between the two groups. When compared with the control group, patients in the treatment group had the higher clinical effect, including the disappearance rate of fever (85.7% vs 57.1%, χ2=4.200, P=0.040), the disappearance rate of cough (46.7% vs 5.6%, P=0.012), the disappearance rate expectoration (64.3% vs 9.1%, P=0.012), the disappearance rate of shortness of breath (77.8% vs 0, P=0.021), and the duration of fever [(4.6±3.2) d vs (6.1±3.1) d, P=0.218]. Conclusion:Lianhua Qingwen can significantly relieve cardinal symptoms in COVID-19 confirmed patients by inhibiting fever and cough, reducing their duration, as well as improving individual symptoms. All these results provide preliminary clinical evidence for Lianhua Qingwen granules in the COVID-19 treatment.

Application of lung ultrasonography score on clinical evaluating in patients with acute respiratory distress syndrome / 中华急诊医学杂志

Objective:To evaluate the value of lung ultrasound (LUS) in the early assessment of patients with acute respiratory distress syndrome (ARDS).Methods:A prospective double-blind cohort study was conducted. Patients with ARDS conformed to the Berlin diagnosis criteria admitted to the Intensive Care Unit (ICU) of Ningbo Yinzhou People’s Hospital from July 2016 to January 2020. According to the oxygenation index (OI), the patients were divided into the mild to moderate group (100 mmHg<OI≤300 mmHg) and the severe group (OI≤100 mmHg); Patients underwent LUS and transpulmonary thermodilution technique (TPTD) monitoring and chest CT on the first day after diagnosis. Acute physiology and chronic health status (APACHEⅡ) score, lung injury score (LIS), and PaO 2/FiO 2 (OI) were recorded at admission. LUS score, EVLWI, OI, APACHEⅡ score and LIS were compared. The correlation between LUS and EVLWI, OI, APACHEⅡ score and LIS score was measured by Pearson linear correlation anaysis. Receiver operating characteristic (ROC) curve were used to evaluate LUS score in predicting ARDS. Results:A total of 52 patients with ARDS were enrolled, 34 patients in the mild to moderate group and 18 patients in the severe group. Compared with chest CT scans, the accuracy of LUS diagnosis was 93.12%, the sensitivity was 91.33%, the specificity was 95.31%, the positive predictive value was 95.95%, and the negative predictive value was 90.03%. Pearson linear correlation analysis showed that LUS was positively correlatied with EVLWI ( r=0.756, P<0.01), LIS score ( r=0.817, P<0.01), and APACHEⅡ score ( r=0.655, P<0.01), while was negatively correlated with OI ( r=-0.823, P<0.01). The areas under the receiver operating characteristic curves of LUS and EVLWI measured by TPTD were 0.922 ( P<0.01) and 0.972 ( P<0.01), LUS score threshold value of 19.5 had the sensitivity of 0.833 and specificity of 0.791 for prediction of severe ARDS. Conclusions:LUS is convenient and easy to perform, and LUS score has a high value, which is a better prognostic indicator for early assessment of ARDS patients.

Study on the relationship between tear ferning image and the abnormality of tear lipid layer in dry eye patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical significance of outer zona pellucid in tear ferning image in dry eye patients and explore a new method for evaluation tear lipid layer. <p>METHODS:Forty-seven patients were randomly selected from the outpatient department of ophthalmology, He Eye hospital, Shenyang from May 2018 to July 2019. The right eye was selected as the study object. All patients were investigated by the ocular surface disease index(OSDI)questionnaire and performed lipid layer classification by DR-1 tear interferometry, NIBUT and tear meniscus height examination by OCULUS Keratograph. Then tears were collected and tear ferning tests was performed. The whole tear crystallization images were observed and photographed by microscopy, then measured by Digimizer software and the area ratios of outer transparent belt were calculated. Pearson correlation analysis were performed between area ratios of outer transparent belt and OSDI scores, lipid layer levels, tear meniscus height values, NIBUT values. <p>RESULTS: The area ratios of outer transparent belt were negatively correlated with OSDI scores(<i>r</i>=-0.764, <i>P</i><0.05), negatively correlated with lipid layer levels(<i>r</i>=-0.838, <i>P</i><0.05), positively correlated with NIBUT values(<i>r</i>=0.575, <i>P</i><0.05)and the correlation between tear meniscus height values was not significantly(<i>r</i>=-0.237, <i>P</i>=0.112). <p>CONCLUSION: The outer transparent belt in tear crystallization image can be used to evaluate the lipid layer of tear film; the larger area ratios of outer transparent belt, the thicker the lipid layer. This method has the advantages of quantified results, good repeatability, low requirement on equipment, and is worth popularizing.

Evaluation of continuous metabolic syndrome score as a screening tool for metabolic syndrome in Xinjiang urban population aged 15-18 years / 中国学校卫生

Objective@#The purpose of the present study was to evaluate of continuous metabolic syndrome score (cMetS) in screening metabolic syndrome (MetS) and to determine the cut-off values in a representative sample of Xinjiang population aged 15 to 18 years old.@*Methods@#A stratified cluster sampling was used to select participants aged 15-18 years from 13 cities in Xinjiang. cMetS was calculated by summing up the Zscores of standardized waist circumference, mean arterial pressure, high-density lipoprotein, triglyceride, and fasting blood glucose by age and gender.@*Results@#Totally 16.3% of subjects were overweight, and 5.2% were obese. The proportion of overweight and obesity in males was significantly higher than that in females (18.1% vs 13.8%)(6.0% vs. 4.1%)(χ2=15.36，7.89，P<0.05). The prevalence of total MetS was 6.1%, with 6.6% and 5.4% for men and women, respectively. There was a correlation between cMetS and MetS components, and the average cMetS value increased with increasing MetS component(P<0.05). The total cut-off value of cMetS was 0.99 (sensitivity 68.0%, specificity 80.7%), and the area under the ROC curve was 84.9%. The cMetS scores for boys and girls were 0.80 and 1.48, respectively.@*Conclusion@#Compared with MetS, cMetS shows more accuracy in screening MetS among youth aged 15-18 years in both gender.

Preliminary application study of using tele-ultrasound robot system in volunteers / 中华超声影像学杂志

Objective To explore the accuracy of ultrasonic diagnosis using the tele-ultrasound robot system . Methods During the period from May to June 2018 ,42 volunteers were consecutive selected to participate in this study ,and their digestive system and urinary system were examined using the robot method manufactured by GI Tech Co . ,Ltd ,Shenzhen and the traditional method . The results including the ultrasound diagnosis and the inspection time of two methods in each patient were compared . The ultrasonographic diagnosis of each volunteer was obtained by two methods and the time was recorded . The ultrasound images of the two methods were mixed together ,and the quality of the images was evaluated double-blindly by two senior doctors . Results There were actually 25 positive lesions in 42 volunteers . In the ultrasonic diagnosis of the two methods ,22 lesions were positive detected by robot method ,with 5 lesions misdiagnosed . In the traditional method , 24 lesions were positive detected , with 1 lesions misdiagnosed . Using the Wilcoxon signed rank test of paired sample comparison ,the score obtained by the robot method was 4 .79 ± 0 .57 ,and the score obtained by the traditional method was 4 .81 ± 0 .54 ( Z =0 .775 ,P= 0 .439) ,the difference was not statistically significant . There was no statistically significant difference in the images'qulity between the robot method and the traditional method using the chi-square test of the four-grid data( P >0 .05) . The check time for volunteers with negative result was ( 8 .64 ± 2 .95) min in robotic method and ( 2 .55 ± 0 .74 ) min in the traditional method ,the difference was statistically significant ( t =15 .161 , P =0 .000) . Conclusions The robot method has high value in common disease diagnosis and high quality in image acquisition ,and can be used in real-time diagnosis of the remote areas or community medical .

Study on the Influence of Medical Insurance Differentiation Reimbursement Policy on Patients' Flow / 中国卫生经济

Objective:The elasticity and correlation analysis were applied to analyze the influence of medical insurance differentiation reimbursement policy to guide the flow of patients,as well as the implementation of the policy of hierarchical medical system to find the problem,and then make policy recommendations for hierarchical diagnosis and health care.Methods:Yanqing District(Beijing),Mishan and Hulin(Heilongjiang) and Longxi County(Gansu) were selected as four research sites to collect each site's New Rural Cooperative Medical System(NCMS) annual data for quantitative analysis.The sample areas' NCMS annual data (from 2013 to 2015)were collected for correlation analysis and elasticity calculation by SPSS 23.0.Results:(1) Each site patients' elasticity of income and medical service price was low,the elasticity of outpatient volume-hospital service price was high.(2) Patients' behavior of choosing medical institutions to seek medical advice had low correlation with their income level and medical service prices,which had formed stable medical habits.Conclusion:Medicare differentiated reimbursement policy had a certain effect on guiding the flow of patients,but the effect was not obvious in the county.The main obstacles to implement basic initial diagnosis were the weak capacity of grassroots medical institutions and policy support was not in place.It was suggested that the health insurance differentiation reimbursement policy should be combined with the disease restriction policy,strengthen the grassroots capacity building,establish and improve the supporting policy.

The relationship between genetic polymorphisms of key enzymes in folate metabolism and nonsyndromic cleft of lip with or without palate / 医学研究生学报

Nonsyndromic cleft of lip with or without palate ( NSCL/P ) is one of the most common congenital birth defects in the maxillofacial region and it is related to genetic factors and environment .Folic acid deficiency , metabolic disorder and the genetic polymorphisms of key metabolic enzymes may be the important factors contributing to NSCL /P .Maternal folic acid intake may reduce the risk of non syndrome cleft lip and palate .This article will review the relationship among the metabolism of folic acid , the genetic polymorphisms of key enzymes in folate metabolism and NSCL /P .

Comparison analysis of clinical characteristic of non-organic dyspnea and asthma both with a complaint of dyspnea / 上海交通大学学报（医学版）

Objective·To investigate and compare the clinical characteristic of non-organic dyspnea and asthma both with complaint of dyspnea.Methods·Seventy-four consecutive patients with non-organic dyspnea,and 74 age-,height-,weight and sex-matched patients with asthma were recruited for investigation in the study.The self-assessment surveys were conducted for the two groups by means of Hospital Anxiety and Depression Scale,Nijmegen Questionnaire and Athens Insomnia Scale.The words for describing dyspnea,clinical symptoms,effective sleep hours and items of pulmonary function test were collected and analyzed Results·Non-organic dyspnea patients tended to describe psychogenic aspects.Asthma patients tended to describe airflow limitation.Non-organic dyspnea group mainly performed psychogenic symptoms.The sleeping time in non-organic dyspnea group was significantly lower than that in asthma group(P＜0.05).The score of anxiety,depression,Nijmegen Questionnaire,Athens Insomnia Scale,FEV1,FEV1％Pred,FVC％Pred,FEV1/FVC in non-organic dyspnea group were significantly higher than those in asthma group (P＜0.05).There was no significant difference in FVC between two groups(P＞0.05).Conclusion·The non-organic group feel more anxiety,depressed and insomnic than the asthma group.Lung function test of asthma group is often abnormal.To discriminate non-organic dyspnea with asthma,clinicians should pay more attention to emotion,sleep,somatoform symptoms,medical history and so on,and do pulmonary function test,improve the understanding of the characteristics of the two diseases,decrease misdiagnosis and wrong diagnosis.

The value of end-tidal carbon dioxide partial pressure combined passive leg raising test on volume responsiveness assessment in shocked patients post cardiac operation / 中华危重病急救医学

Objective To assess the value of end-tidal carbon dioxide partial pressure (PETCO2) combined passive leg raising (PLR) test on volume responsiveness assessment in shocked patients post cardiac operation.Methods A prospective,self-controlled,and observational study was conducted.The shocked patients post cardiac operation undergoing complete mechanical ventilation admitted to Department of Critical Care Medicine of First Affiliated Hospital of College of Medicine,Zhejiang University from June 2014 to October 2015 were enrolled.PETCO2 and hemodynamic parameters including stroke volume variation (SVV),cardiac index (CI),mean arterial pressure (MAP) monitored by a pulse indicator continuous cardiac output (PiCCO) were determined before and after PLR and volume expansion (VE).Volume responsiveness was defined as an increase in CI (△ CI) of 15％ or greater after VE,namely response group (△ CI ≥ 15％) and non-response group (△ CI ＜ 15％).The value of PLR-induced PETCO2 change (△PETCO2 PLH) to predict volume responsiveness was evaluated by receiver operating.characteristic curves (ROC).Results Among the 41 patients enrolled,21 had volume responsiveness (response group),and 20 had no responsiveness (non-response group).After PLR,the changes in CI and PETCO2 were both significantly increased in the response group compared with non-response group [△ CI:(13.5 ± 4.6)％ vs.(3.6± 3.5)％,△ PETCO2:(7.4 ± 3.4)％ vs.(2.8 ± 2.5)％,both P ＜ 0.05].△ PETCO2 PLR and baseline SVV were positively correlated with PLR-induced CI change (△ CI PLR) (r1 =0.50,r2 =0.38,both P ＜ 0.05).VE-induced PETCO2 change (△ PETCO2 VE),baseline SVV and △ CI PLR were positively correlated with VE-induced CI (△ CI VE) (r1 =0.58,r2 =0.56 and r3 =0.84,all P ＜ 0.01).The area under ROC curve (AUC) of △ PETCO2 PLR was 0.875±0.054 [95％ confidence interval (95％CI) =0.769-0.981,P ＜ 0.05].△ PETCO2 PLR ≥ 5.8％ predicted volume responsiveness with sensitivity of 76.2％ and specificity of 90.0％.AUC of △CI PLR was 0.933±0.036 (95％CI =0.862-1.000,P ＜ 0.05).△CI PLR ≥ 10.4％ predicted volume responsiveness with sensitivity of 81.0％ and specificity of 90.0％.AUC of baseline SVV was 0.831 ±0.066 (95％CI =0.702-0.960,P ＜ 0.05).Baseline SVV ≥ 12.5％ predicted volume responsiveness with sensitivity of 85.7％ and specificity of 75.0％.Conclusion The change in PETCO2 induced by PLR is a convenient,reliable and non-invasive indicator to predict volume responsiveness in shocked patients post cardiac operation with mechanical ventilation.

The correlation study between the level of high-sensitivity C-reactive protein in acute phase of ischemic ;stroke and progressive stroke / 实用医学杂志

Objective To study the correlation of the level of high-sensitivity C-reactive protein (Hs-CRP) in the acute phase of ischemic stroke and progressive stroke. Methods 101 patients with acute ischemic stroke were collected. Serum Hs-CRP of all patients were measured at 24 hours after admission , the onset of 48 hours, the onset of 72 hours by latex enhanced immune turbidity method. According to their serum Hs-CRP lev-els, the patients were divided into the group of Hs-CRP sustained growth (n = 35) and the group of non Hs-CRP sustained growth (n = 66). The NIHSS scores were assessed on two groups of patients , Logistic regression analysis was made to screen the related factors of Hs-CRP increase and the possible risky factors for progressive ischemic stroke. Results There was a significant difference of serum Hs-CRP level between the two groups (P <0.001). The incidence of progressive stroke in the group of Hs-CRP sustained growth was significantly higher than that in the group of non Hs-CRP sustained growth (χ2 = 32.710, P < 0.001). Logistic regression analysis showed blood glucose , white blood cell count , triglyceride level and NIHSS scores at admission were associated with sustained growth of Hs-CRP and the factors that they included Hs-CRP sustained growth , admission NIHSS scores, diabetes mellitus and pulmonary infection were regarded as independent risk factors. Conclusion The sustained growth of Hs-CRP in the acute phase of ischemic stroke is an independent predictor of progressive stroke.

Effect of Meibomian gland massage before phacoemulsification on ocular surface after surgery in patients with Meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

?AIM:To study the changes of ocular surface in cataract patients with Meibomian gland dysfunction ( MGD) who treated with Meibomian gland massage before surgery.?METHODS: Totally 90 patients ( 93 eyes ) with cataract and MGD were randomly divided into two groups. Patients in experimental group were treated with hot compress and Meibomian gland massage every day before surgery, while the patients in the control group were not taken. Two groups of patients received phacoemulsification combined with intraocular lens implantation. Lid margin abnormalities, secretion characteristics, Schimer I test ( SⅠt) and tear film break-up time ( BUT ) were recorded and compared between two groups using slit lamp microscope inspection preoperatively and postoperatively 1wk.?RESULTS:In the control group, the postoperative score of eyelid margin and Meibomian gland secretion was increased significantly than preoperative, while the value of BUT and SⅠt was down significantly. Compared with control group, the postoperative score of eyelid margin shape and Meibomian gland secretion in the experimental group was decreased significantly, while the value of BUT and SIT improved significantly (P<0. 05).?CONCLUSION: Phacoemulsification can aggravate the Meibomian gland dysfunction and have some extent of effects on the ocular surface. Meibomian gland massage before surgery can significantly improve the function of Meibomian gland and the state of ocular surface in patients with MDG.