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In order to address the challenges of inefficiency and insufficient accuracy in the manual identification of young citrus fruits during thinning processes, this study proposes a detection methodology using the you only look once for complex backgrounds of young citrus fruits (YCCB-YOLO) approach. The method first constructs a dataset containing images of young citrus fruits in a real orchard environment. To improve the detection accuracy while maintaining the computational efficiency, the study reconstructs the detection head and backbone network using pointwise convolution (PWonv) lightweight network, which reduces the complexity of the model without affecting the performance. In addition, the ability of the model to accurately detect young citrus fruits in complex backgrounds is enhanced by integrating the fusion attention mechanism. Meanwhile, the simplified spatial pyramid pooling fast-large kernel separated attention (SimSPPF-LSKA) feature pyramid was introduced to further enhance the multi-feature extraction capability of the model. Finally, the Adam optimization function was used to strengthen the nonlinear representation and feature extraction ability of the model. The experimental results show that the model achieves 91.79% precision (P), 92.75% recall (R), and 97.32% mean average precision (mAP)on the test set, which were improved by 1.33%, 2.24%, and 1.73%, respectively, compared with the original model, and the size of the model is only 5.4 MB. This study could meet the performance requirements for citrus fruit identification, which provides technical support for fruit thinning.
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Objective:To investigate the effects of repeated high acceleration(+Gz)on implant osseointegration in SD rats.Methods:18 SD rats were divided into+Gz and control groups randomly(n=9),and 1 implant was placed in each femur of the rat's lower limb.24 hours postoperatively,the experimental rats were exposed to+Gz of 4 to 9 G with 1 G/s environment 3 times a week,while the con-trol rats were fed normally.3 rats from each of the 2 groups were sacrificed at 2,4 and 8 weeks after implantation.Micro-CT,sequential fluorescence double labeling,and histological examination were perfomed for the analysis of implant osseointegration.Results:The bone volume fraction(BV/TV),trabecular number(Tb.N),mineral apposition rate(MAR),implant-bone contact rate(BIC)and bone area in implant thread(BA)of the+Gz group were significantly lower than those of the control group at 2 weeks(P<0.05),and so as to MAR,BA at 4 weeks(P<0.05),while there was no significant difference of the parameters at 8 weeks after implantation.Conclusion:In SD rats early exposure to+Gz environment postoperatively may have a negative effect on initial osseointegration by slowing bone forma-tion.However,it will not lead to poorer bone mass when sustained over a long period.
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Objective To explore the effect of Shuanglu Tongnao Formula on neuronal ferroptosis in ischemic stroke rats and its regulatory mechanism on the silent information regulator 2 homolog 1(SIRT1)/nuclear factor erythroid 2-related fac-tor 2(Nrf2)/glutathione peroxidase 4(GPx4)signaling pathways.Methods Twenty rats were selected as sham operation group by the random number table method,and the remaining seventy rats were made ischemic stroke rat models by the middle cerebral artery occlusion method.The rats that had been successfully modeled were randomly divided into the model control group,Shuanglu Tongnao formula group,Shuanglu Tongnao formula+SIRT1 inhibitor group(Shuanglu Tongnao formula+EX527 group),with 20 rats in each group.After 14 days,the rats were scored for neurological injury;TTC staining was applied to detect the area of cerebral infarction in rats;HE staining was applied to detect pathological changes in rat brain tissue;Nissl staining was applied to detect the number of neurons in rat brain tissue;the kit was applied to detect the levels of ferri ion(Fe2+),superoxide dismutase(SOD),glutathione(GSH),and malonaldehyde(MDA)in rat brain tissue;immunohistochemistry was applied to de-tect the positive expression of acyl-CoA synthetase long-chain family member 4(ACSL4),transferrin receptor(TFR),and ferritin heavy polypeptide 1(FTH1)proteins in rat brain tissue;Western blotting method was applied to detect the expression of SIRT1,Nrf2,GPx4,and cystine/glutamate antiporter solute carrier family 7 member 11(SLC7A11)proteins in rat brain tissue.Results Compared with the sham operation group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expressions of ACSL4 and TFR in model control group were increased(P<0.05);the number of neurons,the con-tents of SOD and GSH,the protein expression of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 were all reduced(P<0.05).Compared with the model control group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expression of ACSL4 and TFR in the Shuanglu Tongnao formula group were reduced(P<0.05),and the number of neurons,the contents of SOD and GSH,the protein expressions of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 are all increased(P<0.05).The results of the SIRT1 inhibitor supplementation experiment showed that the SIRT1 inhibitor reversed the inhibitory effect of Shuan-glu Tongnao formula on neuronal ferroptosis,while also inhibited the expression of Nrf2 and GPx4(P<0.05).Conclusion The Shuanglu Tongnao formula may inhibit neuronal ferroptosis in ischemic stroke rats by activating the SIRT1/Nrf2/GPx4 signa-ling pathway.
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@#Patent foramen ovale(PFO)is a congenital heart disease with a relatively high prevalence in the population.Past studies have clarified its association with strokes and recognized the significance of PFO closure for PFO-related strokes.In recent years,research on diseases related to PFO has gradually increased and deepened our understanding.Meanwhile,the number of closure treatments for PFO in China has also significantly increased.This article reviews the latest research progress in the PFO field for the year 2023,mainly including the expansion of the spectrum of PFO-related diseases(such as epilepsy,unexplained syncope,etc.),exploration of the mechanisms of disease,and means of risk assessment.Regarding PFO closure treatment,this article introduces the latest research results concerning the effects of closure and prognosis,as well as the relationship between closure treatment and atrial fibrillation.China has always been in a leading position in the development of new devices for PFO closure,and this article also introduces the latest achievements in this area.
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Objective To observe the feasibility of cardiac MR tissue tracking(CMR-TT)technique for quantitatively evaluating myocardial strain of patients with myocardial amyloidosis(CA).Methods Cardiac MRI were collected from 20 patients of immunoglobulin amyloid light-chain CA(AL-CA,group A),20 cases of transthyretin CA(ATTR-CA,group B)and 20 healthy subjects(group C),and myocardial strain parameters were obtained using CMR-TT technique.Left ventricular cardiac function parameters were compared among 3 groups,so were strain parameters of each myocardial segment of left ventricle and global myocardium,including 3D longitudinal strain(LS),3D radial strain(RS)and 3D circumferential strain(CS).Results Compared with those in group C,significant differences of left ventricular cardiac function parameters were found in both group A and B(all P<0.01),while no statistical difference was found between group A and B(all P>0.05).Except for apical segment RS(P=0.81),strain parameters in group A and B were both lower than those in group C(all P<0.01),while no significant difference was detected between group A and B(all P>0.05).Conclusion CMR-TT technique could be used to quantitatively evaluate left ventricular myocardial strain of CA patients.
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Objective:To investigate the efficacy of arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon in the treatment of irreparable massive rotator cuff tears (IMRCT).Methods:A retrospective case series study was performed on 11 IMRCT patients who were admitted to Affiliated Fuyang Hospital of Bengbu Medical University (Fuyang People′s Hospital) from May 2020 to June 2022, including 7 males and 4 females, aged 54-74 years [(62.6±7.3)years]. All the patients were treated with arthroscopic superior capsular reconstruction using composite patch graft combined with tenodesis of the long head of the biceps tendon. The Visual Analogue Scale (VAS), Acromiohumeral Distance (AHD), Constant-Murley score and University of California Los Angeles (UCLA) score and active range of motion of the shoulder joint before, at 6 months after surgery and at the last follow-up were compared. At the last follow-up, the integrity of reconstructed superior capsule and the long head of the biceps tendon was evaluated using MRI of the shoulder joint. Postoperative complications were observed.Results:All the patients were followed up for 13-39 months [16(13, 36)months]. The VAS score, AHD, Constant-Murley score, and UCLA score were 2(2, 3)points, (9.1±1.1)mm, (56.1±5.4)points, and (19.7±2.8)points respectively at 6 months after surgery, which were all significantly improved from those before surgery [6(5, 7)points, (5.1±1.2)mm, (37.9±2.2)points, and (11.8±1.2)points] ( P<0.05). The VAS score, AHD, Constant-Murley score, and UCLA score were 0(0, 1)points, (8.4±0.9)mm, (83.6±3.8)points, and (28.2±2.3)points respectively at the last follow-up, which were all significantly improved from those before surgery ( P<0.05). At the last follow-up, the VAS score or AHD were not significantly improved from those at 6 months after surgery ( P>0.05); Constant-Murley score and UCLA score were both significantly improved from those at 6 months after surgery ( P<0.05). At 6 months after surgery, shoulder active ranges of motion in forward flexion, abduction and external rotation were (134.6±13.5)°, (124.6±18.6)° and 45(40, 50)° respectively, which were all significantly improved compared with those before surgery [(63.2±36.1)°, (65.0±23.1)°, and [30(20, 40)°] ( P<0.05). At the last follow-up, shoulder active ranges of motion in forward flexion, abduction and external rotation were (144.1±12.6)°, (139.6±15.4)° and 60(45, 65)° respectively, which were all significantly improved compared with those before surgery ( P<0.05). There were no significant differences in active range of motion of the shoulder in forward flexion, abduction and external rotation between 6 months after surgery and the last follow-up ( P>0.05). At the last follow-up, MRI revealed integrity of the reconstructed superior joint capsule and the long head of the biceps tendon in 10 patients. One patient developed resorption of the greater tuberosity and 1 showed a partial tear of the supraspinatus tendon at 1 year after surgery. Conclusion:Arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon can relieve shoulder pain, decrease upward displacement of the humerus head, improve the function and range of motion of the shoulder joint, and reduce complications in the treatment of IMRCT.
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Medical social work, as a bridge between social welfare policies and healthcare services, is an important force in meeting the diverse and multi-level needs of the people in medical and health care. Due to the particularity of the pediatric population, pediatric medical social work is becoming one of the key areas in the development of medical social work. Beijing Children′s Hospital, Capital Medical University has established a service mode of " collaborative medical and social worker team". The medical social workers acted as supporters to assist healthcare professionals to meet the psychological and social service needs of patients and their families as much as possible, and empowered medical staff′s career development as supporters. At the same time, the medical social workers assisted in the construction of a " child friendly" medical environment, and built a social support network for patients and families. The appropriateness and future prospects of pediatric medical social work were explored, in order to provide reference for its development.
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Adolescence is a critical period for sexual maturation and physical growth, and the time of the first appearance of events during puberty initiation is called puberty timing. Recent studies have shown that abnormal changes in the pubertal timing are mainly influenced by genetic, environmental, nutritional, ethnic, and early-life factors. This review focuses on the current research progress of factors influencing puberty onset phase and related disease, in order to provide theoretical basis for prevention of clinical related diseases.
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ObjectiveTo assess the impact of intraoperative plasma infusion dose and coagulation test value INR on the clinical prognosis of patients undergoing cardiac surgery, providing a basis for guiding rational blood use during cardiac surgery. MethodsThe clinical data of 305 surgical patients who received fresh frozen plasma transfusion during cardiac surgery were collected in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to December 2022. The patients were divided into low-dose group (plasma infusion dose <15 mL/kg, n = 214) and high-dose group (plasma infusion dose ≥15 mL/kg, n = 91) based on the intraoperative plasma dose. Univariate analysis, correlation analysis and logistic multivariate regression analysis were used to analyze the relationship between plasma infusion dose, changes in INR before and after plasma transfusion, and the clinical prognosis of patients undergoing cardiac surgery. ResultsThe median plasma infusion dose for all patients was 11.11 (8.17-19.05) mL/kg, while the median plasma infusion dose in the high-dose group and the low-dose group was 17.78 (15.69-20.91) mL/kg and 9.52 (7.77-11.43) mL/kg, respectively, with a statistically significant difference (P <0.001). The median INR decrease in the high-dose and low-dose groups was 0.98 (0.60-1.26) and 0.50 (0.35-0.76), respectively, with a statistically significant difference (P<0.001). Logistic multivariate regression analysis revealed that abnormally elevated preoperative INR values increased the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients (P<0.001), with an OR 95%CI of 6.757(3.068, 14.822). Additionally, it also increased the risk of postoperative in-hospital mortality (P< 0.001), with an OR 95%CI of 5.441 (2.193, 13.499). INR decrease reduced the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients (P=0.001), with an OR 95%CI of 0.244(0.107, 0.558). Correlation analysis showed positive correlation between plasma infusion dose and postoperative ICU days (rs=0.569, P<0.001) and hospital days (rs=0.302, P<0.001) in cardiac surgery patients. ConclusionAmong patients undergoing cardiac surgery who receive intraoperative plasma transfusion, high plasma infusion dose and abnormally elevated preoperative INR values are associated with poorer clinical outcomes, while patients who show a greater degree of INR correction after plasma transfusion exhibit better clinical results.
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Transcranial electrical stimulation (tES) is a non-invasive neural modulation technique known for its high safety, patient compliance, and portability. It holds promise as a potential non-pharmacological method for analgesia. However, challenges persist in utilizing tES for pain management, including inconsistent research findings and limited understanding of its analgesic mechanisms. Therefore, by summarizing the advances in the analgesic researches employing the 3 primary tES techniques, transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and transcranial random noise stimulation (tRNS), we reviewed the analgesic effects on both acute and chronic pain, as well as the neural mechanisms underlying the analgesic effect of each technique. Accumulating evidence suggests that the analgesic effects of tDCS are significant, but studies on analgesic effects of tACS and tRNS remain limited. And the exact mechanisms of pain relief through tES turned out to be not yet well established. Furthermore, we systematically discussed the limitations of analgesia-related studies employing tES techniques across various aspects, involving research design, stimulation protocol formulation, neural response observation, analgesic effect assessment, and safety considerations. To address these limitations and advance clinical translation, we emphasized utilizing promising stimulation techniques and offered practical suggestions for future research endeavors. Specifically, employing numerical simulation of electric field guided by magnetic resonance imaging (MRI) would reduce variability of outcomes due to individual differences in head anatomy. For this purpose, it is advisable to establish standardized head models based on MRI data from the Chinese populations and validate simulated electric field results in tES research to diminish confounding factors concerning anatomy. Meanwhile, novel techniques like multi-site brain stimulation and interferential stimulation (IFS) could broaden the range of stimulation sites in both scope and depth. Multi-site brain stimulation facilitates modulation of entire neural networks, enabling more sophisticated investigations into the complexity of pain. IFS can reach deep brain tissues without invasive surgical procedures, achieving more comprehensive modulation. Regarding neural response observations, establishing a tES-neuroimaging synchronized platform would enable revealing its mechanisms and personalizing protocols based on inter-subject neural response variability detected through recordings. By integrating tES with various neuroimaging techniques, such as functional MRI, electroencephalography (EEG) and magnetoencephalography, into one unified platform, researchers could examine brain activities in baseline before stimulation, dynamic changes in brain activities during stimulation, and sustained brain responses after stimulation. Additionally, collecting finer-grained data on participant characteristics and pain intensity would enhance the sensitivity of future studies. In designing clinical trials to evaluate chronic pain treatments and reporting the results, adopting the six core outcome domain measures recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) could prove beneficial. Lastly, safety considerations can never be overemphasized in future tES studies especially when combining tES with MRI and EEG techniques. These efforts may help to broaden the research scope, reconcile inconsistencies in findings and elucidate the analgesic mechanisms of tES, thus facilitating the development of pragmatic pain management strategies such as combination therapies and home therapies. Ultimately, these suggestions will maximize the clinical application value of tES in pain treatment to achieve pain relief for patients.
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【Objective】 To explore the relationship between the intraoperative plasma transfusion volume, the changes of blood coagulation test values and the clinical prognosis of surgical patients, so as to provide a theoretical basis for guiding the rational use of blood during the operation. 【Methods】 The clinical data of 556 surgical patients who received plasma infusion from January 2017 to December 2020 in Sun Yat-sen Memorial Hospital were collected. Patients were divided into low plasma dose group (<15 mL/kg) and high plasma dose group (≥15 mL/kg). The univariate regression analysis, logistic multivariate regression analysis and linear regression analysis were used to explore the relationship of plasma dose, the changes of coagulation indicators and the clinical prognosis. 【Results】 A total of 556 surgical patients were included in the study and the median (interquartile range) of plasma transfusion volume for all patients during the operation was 10.5 (8.5~14.0) mL/kg. In multivariate regression analysis, an increase of 1 mL/kg of intraoperative plasma dose resulted in an increased risk of red blood cell infusion within 24 hours after surgery[OR(95% CI) 1.16(1.01, 1.33), P<0.05], an increase in the ICU stays[Mean(95%CI) 0.19(0.03, 0.35), P<0.05] and an increase in the hospitalization days[Mean(95%CI) 0.55(0.27, 0.81), P<0.05]. The preoperative INR value increased the risk of red blood cell infusion within 24 hours after surgery[OR(95% CI) 1.82(1.33, 2.50), P<0.05], and increased the hospital mortality of postoperative patients[OR (95% CI) 2.15 (1.09, 4.24), P<0.05]; the decrease in INR reduced the risk of red blood cell infusion in patients 24 hours after surgery[OR(95% CI) 0.47(0.27, 0.84), P<0.05]and reduced hospital mortality[OR(95% CI) 0.23(0.13, 0.50), P<0.05]. 【Conclusion】 In surgical patients undergoing intraoperative plasma infusion, abnormal preoperative INR value and high intraoperative plasma infusion are related to poor clinical prognosis, while INR decrease (preoperative-postoperative) was related to better clinical results.
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Objective To explore the correlation between the incidence of foodborne diseases and meteorological factors in Jinan, and to provide targeted measures for the prevention and control of foodborne diseases. Methods Data from the reporting systems of two sentinel hospitals for active surveillance of foodborne diseases from 2013 to 2021 in Jinan were collected. The meteorological data in the same period in Jinan were also collected. The generalized additive model was used to explore the nonlinear relationship between meteorological factors and the incidence of foodborne diseases, and threshold function analysis was use to perform subsection regression. Results The incidence of foodborne diseases was positively correlated with daily average temperature (rs=0.23), relative humidity (rs=0.05), and daily average wind speed (rs=0.01), and negatively correlated with daily average air pressure (rs=-0.19). Based on the GAM results and segmented regression analysis of meteorological factors, it was found that when the daily average temperature was below or above the threshold of 24.63°C, for every 1°C increase in daily average temperature, the incidence of foodborne diseases correspondingly increased by 0.04% and 0.18%. When the daily average wind speed was above the threshold of 2.26 m/s, the incidence of foodborne diseases decreased by 0.36% for every 1 m/s increase in the daily average wind speed. Conclusion Nine years of observation and data analysis have shown that meteorological factors such as daily average temperature, relative humidity, air pressure, and wind speed are related to the incidence of foodborne diseases. These findings suggest that meteorological factors may be important factors leading to foodborne diseases, which provides an important scientific basis for formulating effective prevention and control measures.
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AIM To investigate the effects of Zhuangyao Shuanglu Tongnao Formula on neuronal apoptosis in rats with cerebral ischemia-reperfusion injury based on the study of oxidative stress and inflammatory response.METHODS The rats were randomly divided into the sham operation group,the model group,the edaravone group(3.0 mg/kg),the low,medium and high dose groups(9.0,18.0,36.0 g/kg)of Zhuangyao Shuanglu Tongnao Formula,with 18 rats in each group.The middle cerebral artery occlusion/reperfusion was conducted by thread embolism method to simulate cerebral ischemia reperfusion injury in rats followed by 6 days corresponding drugs administration.Subsequently,the rats had their neurological function deficit scored by Zeal Longa scoring method;their sizes of cerebral infarction areas measured by TTC staining;their pathological damage and apoptosis of neurons in hippocampal CA1 area of ischemic penumbra of the brain tissue detected by HE staining and TUNEL staining;their SOD activity and levels of GSH,MDA,IL-6,IL-1β,TNF-α in brain tissue detected by kits;and their protein expressions of Bax,Bcl-2,caspase-3,cleaved-capase-3,TLR4,NF-κB p65,Nrf2,HO-1 in rat brain tissue determined by Western blot.RESULTS Compared with the model group,the groups intervened with edaravone,medium and high dose of Zhuangyao Shuanglu Tongnao Formula displayed improvements in the scores of nerve function defects,the rate of cerebral infarction,the rate of neuronal apoptosis,the levels of IL-6,IL-1β,TNF-α and MDA in the ischemic penumbra of brain tissues,the protein expressions of Bax and TLR4,the ratio of cleaved-capase-3/caspase-3 and p-NF-κB p65/NF-κB p65(P<0.05),the levels of GSH,the activity of SOD and the protein expressions of Bcl-2,Nrf2 and HO-1(P<0.05).CONCLUSION Being an inhibitor of oxidative stress and inflammatory response,Zhuangyao Shuanglu Tongnao Formula can alleviate brain injury in rats with cerebral ischemia reperfusion injury through the inhibition of neuronal apoptosis and improvement of neural function mediated by the inhibition of TLR4/NF-κB signal pathway and activation of Nrf2/HO-1 signal pathway.
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To report a case of onychocytic carcinoma in China. A 76-year-old female patient presented with a subnail mass on her left thumb for 3 years. Skin examination showed thickening of the left thumb plate whose surface was partially yellow and black in color, slight curving of the distal plate, obvious telangiectasia under the nail plate, and verrucous hyperplasia under the nail plate and at the lateral edge of the nail plate. Histopathological examination showed that the tumor grew and infiltrated downward in clumps, with obvious keratosis and necrosis in the center of the mass, and many "squamous vortex" structures, atypical cells, and pathological mitotic figures could be seen. Immunohistochemical study revealed that HK31 and HK85 were positively expressed in the squamous vortex region, K6/K16 was positively expressed in the basal part of the tumor, and HK75 was strongly expressed in the whole tumor region. The diagnosis of onychocytic carcinoma was confirmed. The patient received surgical excision combined with 3 sessions of photodynamic therapy, and no recurrence was observed during 18 months of follow-up.
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Oxygen is an important guarantee for the treatment of critically ill patients in public health emergencies,and its normal guarantee and supply have become the primary issue that every hospital needs to face and solve.The fundamental reasons for the shortage of oxygen supply in hospitals during the period of public health emergencies were explored by understanding the admission of critically ill patients and the supply of oxygen.Based on the actual needs of clinical medical treatment,it was found that the main reasons for insufficient oxygen supply were limited liquid oxygen storage capacity,reduced vaporization efficiency,small diameter of delivery pipe,throttling of secondary pressure reducing boxes,etc.It was recommended the limit requirement for the volume of medical liquid oxygen storage tanks be revised to 5m3.Hospitals can adjust and allocate according to actual medical needs,optimize the design and selection of vaporizers and pipeline systems,normalize and standardize the quality control and testing of medical gas systems,and when allowed by regulations and approved by clinical physicians,use oxygen-enriched air(93%oxygen)to supply oxygen to general wards,and provide more medical oxygen(≥99.5%)to critically ill patients who require life support.
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@#Objective To investigate the occurrence and risk factors of secondary bilateral tonic-clonic seizure (biTCS) in patients with refractory temporal lobe epilepsy (TLE). Methods Data on TLE patients who underwent resective surgical treatment at our epilepsy center,between January 2012 and December 2018,were collected consecutively,and their demographic and clinical characteristics were retrospectively analyzed to determine potential risk factors for biTCS using univariate analysis and multifactorial logistic regression analysis. Results A total of 397 patients were included in this study,and 70.0% (278/397) of them had biTCS.Univariate analysis showed that epilepsy duration and MRI were associated with the occurrence of biTCS in patients with TLE (P<0.05),and multifactorial logistic regression analysis showed that epilepsy duration (OR=1.13,95%CI 1.09-1.18,P<0.001) and aura (OR=0.51,95%CI 0.31-0.85,P=0.009) were independent risk factors for biTCS in refractory TLE patients.Receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the epilepsy duration for biTCS in TLE patients was 0.74 with a cut-off value of 9.5 years (sensitivity:66.5%,specificity:75.6%).Conclusion Most patients with refractory TLE develop biTCS during the course of the disease,and absence of aura and long epilepsy duration independently predict the occurrence of biTCS.
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AIM:To assess the clinical efficacy of 5-fluorouracil(5-FU)and bandage contact lens in the pterygium excision combined with autogenous limbal stem cell transplantation(ALSCT)in treating patients with pterygium.METHODS:Random controlled clinical trial. A total of 71 patients(71 eyes)of pterygium who treated at the department of ophthalmology in Qinhuangdao Haigang Hospital between May 2021 and November 2022 were included. They were divide into three groups, including 23 eyes received pterygium excision combined with ALSCT in group A, 24 eyes that were administered with 5-FU intraoperatively and postoperatively in group B, and 24 eyes that received both bandage contact lens and 5-FU in group C. Furthermore, comfort levels at 1, 3, 7, 14d postoperatively, corneal epithelial healing at 1, 3, 7, 14d and 1mo postoperatively, treatment outcomes and complications at 3~6mo postoperatively were compared among the three groups of patients.RESULTS:The comfort levels at 1, 3 and 7d postoperatively and corneal healing at 1 and 3d postoperatively of the group C were better than those of the groups A and B. There were no statistical significant differences in the comfort levels at 14d after surgery and corneal healing at 14d and 1mo after surgery among the three groups of patients. Over a 3~6mo follow-up period, group A experienced recurrence in 3 eyes, group B had 1 recurrence, while group C had no recurrence. There were no statistically significant differences in complication rates among the three groups of patients.CONCLUSIONS: The application of 5-FU combined with bandage contact lens can enhance postoperative comfort levels, promote corneal epithelial healing, and improve the success rate in pterygium excision combined with ALSCT.
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AIM: To compare the differences and agreement of anterior segment biometric parameters of myopic patients measured by domestic Scansys and the imported Sirius based on the principle of Scheimpflug imaging technique.METHODS: In this case series study, 103 cases(103 eyes)that underwent pre-refractive surgery(including small incision lenticule extraction, femtosecond laser-assisted in situ keratomileusis, transepithelial photorefractive keratectomy and implantable contact lens implantation)at Aier Excellent Eye Hospital from May 2022 to October 2022 were recruited. Preoperative keratometry(Km), central corneal thickness(CCT), anterior chamber depth(ACDEndo.), anterior chamber angle(ACA), anterior chamber volume(ACV), white to white(WTW)of patients were recorded.RESULTS: The results of Km, CCT, ACA, and WTW measured by Scansys and Sirius were 42.88(41.54, 44.60)and 42.98(41.56, 44.52)D,(541.52±29.08)and(549.55±29.62)μm, 42.70°±2.67° and 46.63°±5.13°, 12.10±0.60 and 11.98±0.47 mm, respectively, showing the difference was statistically significant(all P<0.01). The ACV measured by Scansys and Sirius was 194.26±31.06 and 191.47±25.65 mm3, and ACDEndo. was 3.40(3.17, 3.57)and 3.43(3.19, 3.56)mm, with no statistically significant difference(all P>0.05). The range of Km, CCT, ACA, ACDEndo., ACV and WTW values measured by the two instruments was small, with an average difference close to zero, and the points percentage of 95% limits of agreement(LoA)was <5%, which is of good consistency.CONCLUSIONS: Scansys and Sirius have small differences and good agreement in the parameters, which can be replaced by each other in clinical practice. Scansys could theoretically be used to extrapolate the implantable contact lens model or could be a new option for anterior segment parameter measurements.
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Objective To understand the epidemiological and etiological characteristics of foodborne diseases in Jinan City, and to provide targeted measures for the prevention and control of foodborne diseases. Methods Data were collected from the reporting system of two sentinel hospitals for active surveillance of foodborne diseases in Jinan City from 2013 to 2021, and pathogens were detected in stool/anal swab samples of the cases. Constituent ratio was used for enumeration data, and χ2 test was used for comparison of detection rates. Results A total of 5,417 cases of foodborne diseases were reported in the two sentinel hospitals in Jinan from 2013 to 2021, and most of them were children aged 0-5 years (48.57%). The high incidence period of foodborne diseases was from May to August (53.72%). The main clinical symptoms were digestive system symptoms. Meat and meat products accounted for the largest number of suspected exposed foods (13.89%), and home-made food was the main exposure source (45.83%). The total detection rate of pathogens was 38.40%, mainly Escherichia coli (24.22%), and the detection rate of norovirus was 17.76%. There was a significant difference in the detection rate of pathogenic bacteria before and after the establishment of Healthy City (χ2=107.22, P <0.001). Conclusion The high-risk population for foodborne diseases is children aged 0 to 5 years old. Summer and fall are the high incidence seasons, with E. coli and norovirus as predominant pathogens. It is necessary to continue to strengthen the monitoring of foodborne diseases in high-risk seasons and infants, improve the food safety awareness of high-risk groups, increase monitoring sentinel hospitals, and expand the coverage. In addition, relevant departments should take corresponding prevention and control measures to reduce the occurrence of foodborne diseases.
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Objective: To analyze the trajectories of HIV testing self-efficacy among men who have sex with men (MSM) based on latent class growth model. Methods: From August 2019 to May 2021, 404 MSM were recruited in Shandong Province and subjected to a 1-year follow-up study with individual intervention (pushing intervention pictures and videos in WeChat and follow-up questionnaires) and community intervention (forwarding to friends and sharing and discussing HIV testing-related information in WeChat groups). The level of HIV testing self-efficacy among MSM was measured. The long-term trend of HIV testing self-efficacy was analyzed using the latent class growth model (LCGM), and the influencing factors of the trend were analyzed. Results: A total of 404 MSM were (28.25±8.95) years old, with the oldest being 58 and the youngest being 18. The scores of HIV testing self-efficacy M(Q1, Q3) at baseline and 4 follow-ups were 18.00 (17.00, 21.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00) and 19.00 (18.00, 22.00). The results of the freely estimated two-category LCGM model showed that the trend of HIV testing self-efficacy among MSM could be divided into two classes, "intervention response group" [255(63.1%)] and "intervention non-response group" [149(36.9%)]. The former had a higher level of HIV testing self-efficacy which tended to increase at first and then decrease over time, while the latter had a lower and more stable level. The results of the multifactorial logistic regression analysis showed that the OR values of MSM in business or service and jobless or unemployed were 0.261 (95%CI: 0.108-0.633) and 0.186 (95%CI: 0.057-0.610), respectively, using the students as the reference group. Conclusion: There is a group heterogeneity in the trend of HIV testing self-efficacy in the intervention conditions among MSM, and occupation may be an influencing factor.