Immediate versus delayed sequential bilateral ICL implantation: A retrospective comparison of vault height and visual outcomes.

PURPOSE: To compare the visual outcomes and risks of suboptimal vault-related complications between immediate sequential bilateral ICL surgery (ISBICLS) and delayed sequential bilateral ICL surgery (DSBICLS). DESIGN: A retrospective cohort study. METHODS: Patients who underwent bilateral ICL implantation between November 2014 and December 2021 at the Eye and ENT Hospital of Fudan University (Shanghai, China) were included and divided into two groups: (1) ISBICLS: both eye surgeries performed on the same day, and (2) DSBICLS: second eye surgery performed < 7 days following the first one. Propensity score matching (PSM) was performed to compare the visual outcomes. Multivariable logistic regression models were used to estimate the odds ratios (ORs) of the suboptimal vaults. RESULTS: Finally, 10,985 eyes were included. After PSM, 204 first surgery eyes and 162 s surgery eyes with complete postoperative data were matched. The safety and efficacy indices did not statistically differ between groups (all > 1.00), except that ISBICLS first surgery eyes achieved better efficacy index than DSBICLS group (1.03 ± 0.26 vs. 1.08 ± 0.23, P = 0.034). Excessive vault was observed in eight (4.06 %) ISBICLS first eyes, one (0.50 %) DSBICLS first eye, and none in the second surgery eye in either group. An insufficient vault was observed in one second eye and one DSBICLS second eye. We found no evidence of differences in the rate of excessive vault (OR = 0.831, 95 % CI: 0.426-1.622, P = 0.588) or insufficient vault (OR = 0.609, 95 % CI:0.062-5.850, P = 0.668). CONCLUSION: ISBICLS provided safety, efficacy, and refraction predictability comparable to DSBICLS without increasing the risk of suboptimal vault-related complications.

Evaluation of rational use of intravenous iron in patients with iron deficient anemia and abnormal uterine bleeding in gynaecology / 中国药师

Objective To investigate the application of intravenous iron in patients with abnormal uterine bleeding(AUD)and iron deficiency anemia(IDA)in gynecology,to establish the drug utilization evaluation(DUE)standard,and to comprehensively evaluate the rationality of the clinical application of intravenous iron by analytic hierarchy process(AHP),so as to provide reference for the rational use of intravenous iron in clinical practice.Methods The medical records of patients with AUD and IDA from January to December 2022 in the First Affiliated Hospital of Anhui University of Science and Technology were collected,and the special rationality of the drug was evaluated from the aspects of indications,route and frequency of administration,daily dosage,solvent,combination medication,and contraindications of iron sucrose injection,and the DUE standard of the drug was formulated.AHP was used to analyze and evaluate 113 archived cases of intravenous iron in gynecology from January to December 2022.Results A total of 113 patients were treated with iron sucrose injection,and the indications,route of administration,solvent,contraindications,and allergic reactions were reasonable.The main unreasonableness was that the frequency of administration was inappropriate,the daily dose was inappropriate,the combination was not appropriate,the total iron supplement was not up to standard,and there was no continuous drug monitoring after medication.The case scores 90～100,70～<90 and 60～<70 were 6(5.31%),106(93.81%)and 1(0.88%),respectively.Conclusion Patients with AUD and IDA should pay attention to the dosage,total amount of iron supplementation,combined application of drugs and continuous medication monitoring after intravenous iron supplementation,so as to improve the rationality of their use.

Application of PCNE classification system in pharmaceutical monitoring of patients with respiratory diseases / 中国药师

Objective To provide pharmaceutical monitoring using the Pharmaceutical Care Network Europe(PCNE)for patients with respiratory diseases,to explore effective pharmaceutical monitoring models in the department of respiratory,and to promote clinical rational drug use.Methods Inpatients diagnosed with chronic obstructive pulmonary disease(COPD)and lung infections in 2022 at the First Affiliated Hospital of Anhui University of Science and Technology were selected and divided into a simple group and an intervention group.According to the PCNE classification system,the types,causes,interventions,acceptance of interventions,and resolution status of drug-related problems(DRPs)were analyzed.Results A total of 120 cases were included,60 cases in the simple group and 60 cases in the intervention group.Regarding the number of DRPs,there were 15 cases in the simple group and 45 cases in the intervention group,and there was a significant difference between the two groups(P<0.05).There were a total of 82 DRPs,which were mainly related to therapeutic efficacy(51.22%)and safety(46.34%),and the reasons for this were that patients'incorrect medication usage method,inappropriate usage and dosage,and unscheduled safety monitoring,etc.The pharmacist interventions were 75(91.46%)at the drug level,38(46.34%)at the physician level,and 43(52.44%)at the patient level;after the pharmacist interventions,the acceptance rate was in the range of 97.56%,and 74.39%of the DRPs were resolved.Conclusion PCNE classification system helps clinical pharmacists to enhance their ability to find and deal with DRPs,reduce the risk of clinical adverse events and promote reasonable and safe drug use.Meanwhile,it is conducive to the standardization of pharmaceutical care records for patients with respiratory diseases and provides reference for pharmaceutical service models for patients in the department of respiratory.

Intracellular free heme concentration detection versus high-risk human papillomavirus detection in screening cervical cancer and precancerous lesions / 中国基层医药

Objective:To compare the application value of intracellular free heme concentration (FH) detection and high-risk human papillomavirus (HPV) detection in screening cervical cancer and precancerous lesions.Methods:A total of 238 patients with cervical abnormalities who received FH and HPV detection in Huainan First People's Hospital, China from October 2017 to October 2019 were included in this study. Taking liquid-based ThinPrep cytologic test (TCT) results and pathological biopsy results as gold standard, the diagnostic value of FH detection and TCT detection for cervical cancer and precancerous lesions were compared.Results:TCT results revealed normal/inflammatory diagnosis in 97 patients, and atypical squamous cells of undetermined significance (ASCUS) or higher grade diagnosis in 141 patients. Pathological biopsy results reported cervical intraepithelial neoplasia (CIN) grade II or above in 70 out of the 141 patients. The detection rate of FH detection for CIN grade II or above cervical lesions was 92.86% (65/70) and the detection rate of high-risk HPV detection was 95.71% (67/70). The sensitivity and specificity of FH detection in the screening CIN grade II or above cervical lesions were 82.86% (58/70) and 85.92% (60/70), respectively and they were 94.29% (66/70) and 98.59% (69/70) for high-risk HPV detection. There were significant differences in diagnostic sensitivity and specificity between FH dection and high-risk HPV detection ( χ2 = 4.52, 10.25, both P < 0.05). Conclusion:High-risk HPV detection is of high application value in the diagnosis of cervical cancer and precancerous lesions. It has higher sensitivty and specificity in screening cervical cancer and precancerous lesions than FH detection. But FH detection is simpler, more economical and easier to use and is more suitable for large-scale screening of cervical cancer and precancerous lesions than high-risk HPV detection.

Construction and analysis of a predictive model for posthepatectomy recurrence in patients with hepatocellular carcinoma based on preoperative CXCL13 measurement / 临床肝胆病杂志

ObjectiveTo investigate the serological markers associated with posthepatectomy recurrence in patients with hepatocellular carcinoma, and to establish a prognostic model to evaluate whether palliative hepatectomy is suitable for such patients. MethodsA total of 111 patients with hepatocellular carcinoma who underwent hepatectomy in the Affiliated Cancer Hospital of Zhengzhou University from February 2009 to July 2013 and received follow-up were enrolled. Basic clinical data were collected and the patients were divided into recurrence group and non-recurrence group according to whether recurrence was observed during follow-up. The t-test was used for comparison of normally distributed continuous data between two groups and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Survival curves were plotted using the Kaplan-Meier method, and survival differences were analyzed using the log-rank test. A Cox regression analysis was used to perform univariate and multivariate analyses, and the area under the ROC curve (AUC) was used to evaluate prediction efficiency. ResultsThe Kaplan-Meier survival curves showed that the patients with low alpha-fetoprotein (AFP), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), and fibrinogen and high CXCL13 had a longer median time to recurrence (P＜0.05). AFP (hazard ratio ［HR］［95%CI］=1.69(1.03~2.79), P=0.039), GGT (HR［95%CI］=1.89(1.14~3.14), P=0.014), and CXCL13 (HR［95%CI］=0.54(0.33~0.89), P=0.015) were independent factors associated with posthepatectomy recurrence. The prognostic index PI=0.526×AFP+0.637×GGT-0.616×CXCL13 established based on these factors had an AUC of 0.87, a sensitivity of 93.75%, and a specificity of 63.64% in predicting recurrence within 0-3 months after palliative hepatectomy, with a significant reduction in prediction efficiency for recurrence within 0-6 months (AUC=0.68) or a longer period of time. The recurrence prediction efficiency of this model for palliative hepatectomy was significantly higher than that for radical resection. ConclusionThe prognostic model established based on CXCL13, AFP, and GGT can be used to evaluate the risk of early recurrence after palliative hepatectomy and thus helps clinicians to make diagnosis and treatment decisions based on patients’ benefits.

Association between miR146a(rs2910164)G>C polymorphism and susceptibility to acute lymphoblastic leuke-mia in children / 中华实用儿科临床杂志

Objective To investigate the association between miR146a(rs2910164)G>C polymorphism and susceptibility to acute lymphoblastic leukemia(ALL)in children.Methods Two hundred blood specimens were ob-tained from children with ALL as patient group and 100 blood specimens were obtained from healthy children as healthy control group,who were all from Baoding First Central Hospital between March 2010 and October 2016.There were no significant differences in sex and age between patient group and healthy control group(χ2=0.430,P=0.512;χ2=2.839,P=0.092).The distribution of gene frequency of patient group and healthy control group conformed to Hardy-Weinberg equilibrium.miR146a(rs2910164)G>C polymorphism was identified by adopting restriction fragment length polymorphism(RFLP).The relation of genotype and ALL was demonstrated by odds ratio(OR)and 95% credibility interval(CI). Results Gene frequency of miR146a(rs2910164)GG,GC and CC genotypes in patient group and healthy control group was 16.0%,44.5%,39.5% and 29.0%,41.0%,30.0%,respectively.The GC/CC genotypes were significantly higher in patient group than those in healthy control group(GG genotype as reference,GC genotype:OR=1.967,95%CI:1.054-3.672,P=0.037;CC genotype:OR=2.386,95%CI:1.239-4.595,P =0.012). Conclusion miR146a(rs2910164)G>C polymorphism is significantly associated with susceptibility to ALL in chil-dren.

Clinical trial of simplified drilling method for dental implant site preparation / 中华口腔医学杂志

Objective@#To investigate the clinical effect of simplified drilling method and conventional drilling method in implants.@*Methods@#A total of 46 patients (62 implants) were enrolled in this study that with dentition defect from May 2015 to May 2016 in the Implant department of Xi'an Jiao Tong University. The experimental group and the control group were randomly assigned according to the random number method, 23 cases in each group. The experimental group used the simplified drilling method (guided drill+ final drill), the control group using the conventional drilling method (step by step drill). The operation time, implant stability, marginal bone resorption rate and implant retention rate were compared between the two drilling methods.@*Results@#The retention of the experiment group was 97% (31/32), the the control group was 100% (30/30). The operative time in the experiment group [(4.9±0.5) min] was significantly lower from the control group [(8.9±2.0) min] (P=0.000). There was no significant difference between the two methods in bone resorption (P=0.197), implant stability (P>0.05) and implant survival rate (P=0.492).@*Conclusions@#The simplified drilling method can significantly reduce the operation time without compromising the clinical outcomes, and the osseointegration is well. The simplified drilling method should be used when sufficient bone mass, careful use in class II bone, forbidden in class I bone.

Expressions of ICAM-1,VCAM-1 and I-FABP in Lupus Enteropathy in Mice / 胃肠病学

Background:The prognosis of systemic lupus erythematosus complicated with lupus enteropathy is poor. At present, studies on pathogenesis of lupus enteropathy are rare. Aims:To investigate the expressions of intercellular adhesion molecule-1 (ICAM-1),vascular cell adhesion molecule-1 (VCAM-1)and intestinal fatty acid binding protein (I-FABP) in lupus enteropathy in mice. Methods:Twenty MRL/ lpr lupus mice were randomly divided into two groups:lupus enteropathy group and control group. Lupus enteropathy model was established by administration with TNBS enema. Histological score was assessed,expressions of ICAM-1,VCAM-1 and I-FABP were determined by immunohistochemistry, and correlations with histological score were analyzed. Results:Compared with control group,histological score was significantly increased (8. 1 ± 5. 8 vs. 0. 8 ± 0. 5,P = 0. 000),expressions of ICAM-1 (9. 4% ± 2. 1% vs. 6. 2% ± 1. 1%),VCAM-1 (15. 1% ± 2. 1% vs. 12. 2% ± 1. 9%)and I-FABP (17. 5% ± 2. 5% vs. 6. 1% ± 0. 9%)were significantly increased (P < 0. 05)in lupus enteropathy group. Expressions of ICAM-1,VCAM-1 and I-FABP in colon tissue in lupus enteropathy group were positively correlated with histological score (r = 0. 870,P = 0. 010;r = 0. 881,P =0. 010;r = 1. 000,P = 0. 000). Conclusions:ICAM-1,VCAM-1 and I-FABP may be associated with pathogenesis of lupus enteropathy.

Risk factors for development of succinylcholine-induced postoperative myalgia / 中华麻醉学杂志

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Process solution of autoantibodies in patients of autoimmune hemolytic anemia / 国际检验医学杂志

Objective Serological characteristic analysis for patients with autoimmune hemolytic anemia(AIHA)who has cold and warm auto‐antibody when undergoing blood type and cross‐matching .Methods Choosed 3 donors of red blood cells of group O to absorb autoantibodies of the patient′s serum(by using the methods of cold absorption) and used 2‐mercaptoethanol(2‐Me) to de‐stroyed the IgM antibody .Results The patient of AIHA blood type was B+ .There was cold and warm auto‐antibody in the pa‐tient′s serum ,and the result of cross‐matching is incompatible .Conclusion The patient′s serum contains cold and warm auto‐anti‐body which interferes blood type and cross‐matching .In emergency ,considering the patients condition ,blood transfusion combined with the drug treatment could achieve good effects .

δ-opioid receptors protect neurons against neuronal injury induced by oxygen-glucose deprivation / 复旦学报（医学版）

Objective To investigate the effect of cortical 8-opioid receptor (DOR) on oxygen-glucose deprivation-induced (OGD-induced) neuronal injury. Methods Primary cultured cortical neurons incubated with selective DOR agonist (TAN-67) and antagonist (naltrindole) or PKC inhibitor (chelerythrine, CHE) were exposed to OGD. Lactate dehydrogenase (LDH) release was detected after 24 h reperfusion. The expression levels of DOR were measured by Western blot. Results Compared with OGD group, TAN-67 significantly decreased OGD-indueed LDH release, and increased the expression levels of DOR, while nahrindole aggravated neuronal injury and decreased the DOR protein expression. CHE could abolish the LDH down-regulation induced by TAN-67 plus OGD (P< 0.05, compared with TAN-67 treated group). Conclusions DOR activation protects neurons against OGD injury. PKC might take part in the neuroprotection pathways of DOR.

Circular Stapling Procedure for the Treatment of Internal Rectal Mucosal Prolapse / 中国医师杂志

Objective To explore the new approach of operatively treating internal rectal mucosal prolapse. Methods 42 patients with internal rectal mucosal prolapse were treated with circular stapling procedure, and followed-up for 2～24 months after operation. Results Mean operative time circular stapling procedure was 18 minutes, and mean hospitalization time of the patients was 3 days. The clinical symptoms were obviously improved after operation. Anastomotic stoma bleeding was found in 9 patients (21.4 %) during operation. Urinary retension was found in 17 patients (40.5%), who needed catheterization. Sensation of rectal tenesmus occurred in 6 patients(14.3%). Infection, anal incontinence and rectovaginal fistula were not found in all the patients. Conclusion Circular stapling procedure is safe, simple and effective technique for treating internal rectal mucosal prolapse with the advantages of minimal invasion.