[The impact of augmented reality glasses on human visual efficiency and digital eye fatigue].

Objective: To investigate the differences in reading efficiency and visual fatigue between the use of augmented reality (AR) glasses and laptops. Methods: A prospective self-controlled study was conducted. Healthy students from Capital Medical University who frequently engaged in long-term near work and used laptops and other digital display devices were recruited as subjects at Beijing Tongren Hospital, Capital Medical University between November 1 and November 15, 2023. LogMAR visual acuity, visual functions (accommodation, convergence, and fusion), and visual fatigue scores (Likert visual fatigue scale) of the participants were assessed. The order of using the laptop and AR glasses for each participant was determined by a coin toss. Reading efficiency (reading speed and error rate multiplied by the detection rate of incorrect numbers) with different devices for 10 minutes at the same time on different dates and visual fatigue scores after watching a 20-minute video were measured. Statistical analyses were performed using paired t-tests and Wilcoxon signed-rank tests. Results: A total of 20 eligible subjects were included, comprising 7 males and 13 females, with a mean age of (25.45±2.27) years. There was no significant change in binocular visual acuity before and after using AR glasses and laptops (both P>0.05). The reading speed and reading efficiency of using AR glasses [(34.03±9.25) and (29.19±7.62) digits/min, respectively] were significantly lower than those of using laptops [(39.43±10.36) and (35.67±9.87) digits/min, respectively] (t=4.36, P<0.001), while the difference in error detection rate was not statistically significant (t=1.29, P=0.213). There was no statistically significant difference in visual fatigue scores before watching videos with the two devices (Z=-0.71, P=0.480). However, the visual fatigue score after watching videos with AR glasses [(20.55±5.04) points] was significantly higher than that with laptops [16.50 (13.00, 19.75) points] (Z=-2.85, P=0.004). The visual fatigue scores after watching videos with both devices were significantly higher than before (P<0.05), with a more significant increase observed with AR glasses [(6.05±3.50) points] (Z=-3.41, P<0.001). Conclusion: Compared with using laptops, the reading speed and efficiency were lower, and the visual fatigue was more pronounced with the use of AR glasses at the current technical level. Further optimization and improvement of AR glasses are warranted.

Dynamic stabilization of ablative Rayleigh-Taylor instability in the presence of a temporally modulated laser pulse.

This paper presents a numeric study of the dynamic stabilization of the ablative Rayleigh-Taylor instability (ARTI) in the presence of a temporally modulated laser pulse. The results show that the specially modulated laser produces a dynamically stabilized configuration near the ablation front. The physical features of the relevant laser-driven parameters in the unperturbed ablative flows have been analyzed to reveal the inherent stability mechanism underlying the dynamically stabilized configuration. A single-mode ARTI for the modulated laser pulse is first compared with that of the unmodulated laser pulse. The results show that the modulated laser stabilizes the surface perturbations and reduces the linear growth rate and enhancement of the cutoff wavelength. For multimode perturbations, the dynamic stabilization effect of the modulated laser pulse contributes to suppress the small-scale structure and reduce the width of the mixing layer. Moreover, the results show that the stabilization effect of the modulated laser pulse decreases as the maximum wavelength increases.

Sarcopenia and its clinical correlation in elderly chronic obstructive pulmonary disease: a prospective cohort study.

OBJECTIVE: The aim of this study was to examine the effects of sarcopenia on clinical characteristics and short-term outcomes in elderly chronic obstructive pulmonary disease (COPD) patients. PATIENTS AND METHODS: One hundred twenty elderly COPD patients (age>60) recruited from Beijing Shijingshan Hospital were divided into sarcopenia and non-sarcopenia groups according to the severity of sarcopenia at the first admission. Baseline data, geriatric syndrome, laboratory indicators and body composition analysis were analyzed. One year followed-up by outpatient visits was focused on clinical characteristics and telephone follow-ups for collecting all-cause deaths and acute exacerbations of chronic obstructive pulmonary disease as end-point events. The risk factors for sarcopenia were analyzed by univariate analysis and multivariate logical regression. The proportional hazards model (COX) regression was performed to determine the effect of sarcopenia on COPD patients' prognoses. RESULTS: One hundred twenty patients (76 men and 44 women) with an average age of 76.7±8.78 years were included, of which 63 patients (52.5%) were diagnosed with sarcopenia. Compared to the non-sarcopenia group, the sarcopenia group exhibited worse lung function and more severe geriatric syndromes with significantly higher incidence ratios of somnipathy and frailty. The sarcopenia group also showed worse muscle indicators and declined body composition. Multivariate analysis showed that the occurrence of sarcopenia in elderly COPD patients was correlated with forced expiratory volume in the first second (FEV1) (OR=0.97, 95% CI: 0.94-1.0, p=0.035), body mass index (BMI) (OR=0.80, 95% CI: 0.71-0.89, p=0.035) and hemoglobin (OR=0.98, 95% CI: 0.96-1.0, p=0.023). Furthermore, the COX regression indicated the association of sarcopenia with acute exacerbations of COPD within the follow-up period (HR=2.4, 95% CI: 1.01-5.72, p=0.048). CONCLUSIONS: Sarcopenia increases the risk of acute exacerbations of chronic obstructive pulmonary disease in the elderly. Sarcopenia incidence in elderly COPD is associated with FEV1, BMI, and hemoglobin and closely monitoring indicators is useful for early diagnosis of sarcopenia.

Fe3O4nanoparticles anchored on carbon nanotubes as high-performance anodes for asymmetric supercapacitors.

Fe3O4/CNT composites are synthesized with ethylene glycol as solvent by a one-step solvothermal method and used as anode materials for asymmetric supercapacitors (ASC). An appropriate amount of water in ethylene glycol can accelerate the formation of Fe3O4and reduce the average size of Fe3O4to around 20 nm. However, spherical Fe3O4particles larger than 100 nm will form in pure ethylene glycol for long reaction time. The Fe3O4/CNT composite with small Fe3O4nanoparticles exhibits a high specific surface area, promoted electron transfer ability, as well as a high utilization rate of active materials. The optimized electrode shows a high specific capacity of 689 C g-1at 1 A g-1, and remains 443 C g-1at 10 A g-1. The inferior long-term cycling stability is due to the phase transition of Fe3O4and a reductive effect to form metallic Fe. An ASC using Fe3O4/CNT and NiCoO2/C composites as anode and cathode, respectively, delivers a high energy density of 58.1 Wh kg-1at a power density of 1007 W kg-1in a voltage window of 1.67 V and has a capacity retention of 63% after 5000 cycles. The self-discharge behavior of the ASC is also investigated.

Controllable reduction of NiCoO2@NiCo core-shell nanospheres on CNTs for high-performance electrochemical energy storage.

The performances of energy storage devices are strongly dependent on the electrode materials. Owing to the high theoretical capacity, NiCoO2 is a promising transition metal oxide for supercapacitors. Despite many efforts have been devoted, it still lacks of effective methods to overcome its shortcomings such as low conductivity and poor stability, in order to achieve its theoretical capacity. Herein, utilizing the thermal reducibility of trisodium citrate and its hydrolyzate, a series of NiCoO2@NiCo/CNT ternary composites in which NiCoO2@NiCo core-shell nanospheres deposited on CNT surface with adjustable metal contents are synthesized. Benefiting from the enhanced synergistic effect of both metallic core and CNTs, the optimized composite exhibits an extremely high specific capacitance (2660 F g-1 at 1 A g-1, the effective specific capacitance of the loaded metal oxide is 4199 F g-1, close to the theoretical value), an excellent rate performance and stability, when the metal content is about 37%. After depolarized calculation, the energy storage mechanism of the composite is reasonably analyzed. By controlling the contents of hexamethylenetetramine, trisodium citrate and CNTs in the reactant, the roles of them are distinguished. This study reveals an efficient novel strategy for transition metal oxides to maximize the electrochemical performances.

[Myocardial biopsy of Liwen procedure: representability and etiological diagnostic value of cardiac samples obtained by a novel technique in patients with hypertrophic cardiomyopathy].

Objective: To investigate the representability and etiological diagnostic value of myocardium samples obtained from patients with hypertrophic cardiomyopathy (HCM) by transthoracic echocardiography-guided percutaneous intramyocardial septal biopsy (myocardial biopsy of Liwen procedure). Methods: This study was a retrospective case-series analysis. Patients with HCM, who underwent myocardial biopsy of Liwen procedure and radiofrequency ablation in Xijing Hospital, Air Force Military Medical University from July to December 2019, were included. Demographic data (age, sex), echocardiographic data and complications were collected through electronic medical record system. The histological and echocardiographic features, pathological characteristics of the biopsied myocardium of the patients were analyzed. Results: A total of 21 patients (aged (51.2±14.5) years and 13 males (61.9%)) were enrolled. The thickness of ventricular septum was (23.3±4.5)mm and the left ventricular outflow tract gradient was (78.8±42.6)mmHg (1 mmHg=0.133 kPa). Eight patients (38.1%) were complicated with hypertension, 1 patient (4.8%) had diabetes, and 2 patients (9.5%) had atrial fibrillation. Hematoxylin-eosin staining of myocardial samples of HCM patients before radiofrequency ablation evidenced myocytes hypertrophy, myocytes disarray, nuclear hyperchromatism, hypertrophy, atypia, coronary microvessel abnormalities, adipocyte infiltration, inflammatory cell infiltration, cytoplasmic vacuoles, lipofuscin deposition. Interstitial fibrosis and replacement fibrosis were detected in Masson stained biopsy samples. Hematoxylin-eosin staining of myocardial samples of HCM patients after radiofrequency ablation showed significantly reduced myocytes, cracked nuclear in myocytes, coagulative necrosis, border disappearance and nuclear fragmentation. Quantitative analysis of myocardial specimens of HCM patients before radiofrequency ablation showed that there were 9 cases (42.9%) with mild myocardial hypertrophy and 12 cases (57.1%) with severe myocardial hypertrophy. Mild, moderate and severe fibrosis were 5 (23.8%), 9 (42.9%) and 7 (33.3%), respectively. Six cases (28.6%) had myocytes disarray. There were 11 cases (52.4%) of coronary microvessel abnormalities, 4 cases (19.0%) of adipocyte infiltration, 2 cases (9.5%) of inflammatory cell infiltration,6 cases (28.5%) of cytoplasmic vacuole, 16 cases (76.2%) of lipofuscin deposition. The diameter of cardiac myocytes was (25.2±2.8)µm, and the percentage of collagen fiber area was 5.2%(3.0%, 14.6%). One patient had severe replacement fibrosis in the myocardium, with a fibrotic area of 67.0%. The rest of the patients had interstitial fibrosis. The myocardial specimens of 13 patients were examined by transmission electron microscopy. All showed increased myofibrils, and 9 cases had disorder of myofibrils. All patients had irregular shape of myocardial nucleus, partial depression, mild mitochondrial swelling, fracture and reduction of mitochondrial crest, and local aggregation of myofibrillary interfascicles. One patient had hypertrophy of cardiomyocytes, but the arrangement of muscle fibers was roughly normal. There were vacuoles in the cytoplasm, and Periodic acid-Schiff staining was positive. Transmission electron microscopy showed large range of glycogen deposition in the cytoplasm, with occasional double membrane surround, which was highly indicative of glycogen storage disease. No deposition of glycolipid substance in lysozyme was observed under transmission electron microscope in all myocardial specimens, which could basically eliminate Fabry disease. No apple green substance was found under polarized light after Congo red staining, which could basically exclude cardiac amyloidosis. Conclusion: Myocardium biopsied samples obtained by Liwen procedure of HCM patients are representative and helpful for the etiological diagnosis of HCM.

[Implantation of a monofocal intraocular lens after femtosecond laser intrastromal keratotomy and contralateral implantation of a trifocal IOL: a case report].

An age-related cataract patient who underwent femtosecond laser intrastromal keratotomy in the right eye for presbyopia correction 8 years ago was subjected to femtosecond laser-assisted phacoemulsification, with implantation of a monofocal intraocular lens (IOL) and a trifocal IOL in the right and left eyes, respectively. The corneal stromal ring was complementary to the monofocal IOL, which recovered the distance and near visual acuity, in the right eye postoperatively. The trifocal IOL provided good intermediate visual acuity for the left eye. The vision of the patient reached an ideal level for all visual distances. The binocular fusion was within the normal range, and the stereoscopic vision was restored. We hope that this case report can act as a reference for the treatment of cataract after presbyopia corrective surgery.

[Clinical analysis of 10 cases with extramedullary plasmacytoma of the head and neck].

Objective: To explore the clinical characteristics, treatment methods and outcomes of extramedullary plasmacytoma of the head and neck. Methods: A retrospective analysis was conducted on 10 cases with extramedullary plasmacytoma of the head and neck who were admitted to Henan Tumor Hospital from January 2005 to January 2020. Among the 10 patients, 6 were male and 4 were female. The average age at diagnosis was 56.3 years old (34-74 years old). Among them, 3 cases were located in the nasal cavity, 2 cases in the nasopharynx, 1 case in the sinuses, 2 cases in the larynx, 1 case in the oropharynx, and 1 case in the cervical lymph nodes. Treatments were administered according to tumor size and resection extent. Complete surgical excision (negative margins) was preferred, followed by adjuvant radiotherapy or radiotherapy alone. The clinical characteristics, diagnosis, treatment and prognosis of EMP were analyzed. Results: The patients' symptoms were not specific, frequently with local obstruction symptom and localized masses. All patients were confirmed pathologically as suffering from monoclonal plasmacytoma, with negative bone marrow biopsy and negative skeletal survey. Five patients received surgery, 3 received radiotherapy, and 2 received surgery with additional radiation. The follow-up time was 16-125 months, with a median of 92 months. Two patients developed into multiple myeloma. One patient who received radiotherapy after surgery relapsed after 7 years of follow-up and again received surgical treatment, with no evidence of second recurrence. The remaining patients had no recurrence or progression. Conclusion: Extramedullary plasmacytoma of the head and neck has a good prognosis. Surgical treatment can be considered for completely resectable lesions.

[The controversy and value of the combination of hydrocortisone, ascorbic acid and thiamine in treating sepsis].

Sepsis is a common cause of death in intensive care unit. Some retrospective studies had shown the combination of hydrocortisone, ascorbic acid and thiamine (HAT therapy) could lower mortality rate of patients with sepsis or septic shock. Recently, multiple randomized controlled trials(RCTs) related to the efficacy of combination therapy don't reach a consensus. Though one meta-analysis indicated beneficial effect of HAT regimen on decreasing mortality rate of patients with sepsis or septic shock, improving SOFA score and reducing use of vasopressor. However, controversy still exist in the target population, timing, dose and duration of HAT regimen. Thus, the optimized RCTs are needed to provide more definitive evidence.

[Effects of N-trimethyl chitosan-recombinant tissue factor pathway inhibitor complex on avulsion flap with roll compaction in rat].

Objective: To investigate the effect of N-trimethyl chitosan-recombinant tissue factor pathway inhibitor (rTFPI) complex on avulsion flap with roll compaction in rat. Methods: The experimental methods were adopted. The N-trimethyl chitosan-rTFPI complex solution was prepared by ion cross-linking method. The morphology of the complex was observed by scanning electron microscope, and its diameter was measured. The encapsulation rate of rTFPI in the complex and drug loading rate of the complex was determined and calculated by enzyme-linked immunosorbent assay (ELISA) method (n=3). The concentration of rTFPI in the solution at 0, 10, 30, 45, 60, 90, 120, 240 minutes of storage was measured by ELISA method to observe the release of rTFPI, and its half-life was calculated (n=3). Twenty-four 6-week-old male Sprague-Dawley rats were divided into phosphate buffered saline (PBS) group, N-trimethyl chitosan alone group, rTFPI alone group, and N-trimethyl chitosan-rTFPI group according to the random number table, with 6 rats in each group. The avulsion flaps with roll compaction were prepared on the backs of rats with pedicles located on the line of the bilateral iliac spine and lifted from the surface of the muscle membrane. One injection of corresponding reagents was carried out immediately after in-situ suture and on post operation day (POD) 1, 2, and 3. General changes of the flap were observed on POD 1, 3, and 7. On POD 7, the survival area of the flap was measured and the survival rate of the flap was calculated; the flaps were divided into pedicle, proximal, middle, and distal segments, and the blood perfusion in the proximal, middle, and distal segment tissue of the flap was detected by the laser speckle blood flow imager; tissue samples in the middle of the flap were cut and stained with hematoxylin and eosin to observe the changes in tissue structure and the infiltration of inflammatory cells, and the numbers of embolized blood vessels and new blood vessels per 100 times visual field were counted. Data were statistically analyzed with one-way analysis of variance and least significant difference test. Results: The N-trimethyl chitosan-rTFPI complex had an irregular spherical structure with a diameter of 150-200 nm. The encapsulation rate of rTFPI in the complex and drug loading rate of the complex were (88.7±2.1)% and (2.83±0.09)%, respectively. The concentration of rTFPI in the solution of the N-trimethyl chitosan-rTFPI complex gradually increased with prolonged storage time, and the release was basically stable at 90 min, with half-life of (651±36) min. On POD 1, the distal parts of flaps of rats in N-trimethyl chitosan alone group darkened significantly. On POD 3, scabs and necrosis were relatively mild on the distal segment of the flaps of rats in rTFPI alone group and N-trimethyl chitosan-rTFPI group as compared with those of the other two groups. On POD 7, the necrosis boundaries of the flaps of rats in each group were clear. On POD 7, the flap survival rates of rats in rTFPI alone group and N-trimethyl chitosan-rTFPI group were (63±7)% and (73±5)%, respectively, which were significantly higher than (41±3)% in PBS group and (52±7)% in N-trimethyl chitosan alone group. Moreover, the flap survival rate of rats in N-trimethyl chitosan-rTFPI group was significantly higher than that in rTFPI alone group (P<0.05). On POD 7, the flaps of rats in each group had blood perfusion; the blood perfusion values in the proximal segment tissue of the rat flaps in N-trimethyl chitosan alone group and the blood perfusion values in the proximal, middle, and distal segment tissue of the rat flaps in rTFPI alone group and N-trimethyl chitosan-rTFPI group were significantly higher than those in PBS group (P<0.05 or P<0.01); the blood perfusion values in the distal segment tissue of the rat flaps in rTFPI alone group and the blood perfusion values in the middle and distal segment tissue of the rat flaps in N-trimethyl chitosan-rTFPI group were significantly higher than those in N-trimethyl chitosan alone group (P<0.05 or P<0.01); the blood perfusion value in the middle segment tissue of the rat flaps in N-trimethyl chitosan-rTFPI group was significantly higher than that in rTFPI alone group (P<0.01). On POD 7, inflammatory cells infiltrated more and cell edema was obvious in the middle segment tissue of the rat flaps in PBS group and N-trimethyl chitosan alone group. Compared with those of the previous two groups, the inflammation degrees in the middle segment tissue of the rat flaps in rTFPI alone group and N-trimethyl chitosan-rTFPI group were significantly milder, the number of embolized blood vessels was significantly decreased (P<0.05 or P<0.01), and the number of new blood vessels was significantly increased (P<0.05 or P<0.01). Compared with that of rTFPI alone group, the number of new blood vessels in the middle segment tissue of the rat flaps in N-trimethyl chitosan-rTFPI group increased significantly (P<0.05). Conclusions: The effect of sustained release of rTFPI can be achieved by loading rTFPI with N-trimethyl chitosan. Compared with rTFPI alone, the N-trimethyl chitosan-rTFPI complex can further improve the blood perfusion of the avulsion flaps with roll compaction in rat and improve the survival rate of the flap.

[Clinical characteristics and risk factors of deaths in patients with Wiskott-Aldrich syndrome].

Objective: To explore the clinical characteristics and risk factors of pediatric patients with Wiskott-Aldrich syndrome (WAS). Methods: This was a case-control study. Clinical data of 165 cases of pediatric patients with WAS, who visited the Department of Rheumatology, Children's Hospital of Chongqing Medical University between January 2007 and August 2020 were retrospectively analyzed and divided into death group and survival group (control group) according to the prognosis in the follow-up. Two independent samples t-test, Welch approximate t-test, Mann-Whitney U test, Pearson χ² test, Yates corrected χ² test, or Fisher exact probability test were used for comparison between groups. Risk factors were analyzed by multivariate Logistic regression analysis. Results: A total of 165 patients with Wiskott-Aldrich syndrome were enrolled in this study, including 40 cases in the death group and 125 cases in the survival group. The WAS score was (4.1±0.8) score in the death group and (3.1±1.2) score in the survival group. The age was 19 (9, 28) months in the death group and 60 (36,86) in the survival group. The episode rates of recurrent infection and (or) severe infection, intracranial hemorrhage and eczema in the death group were significantly higher than those in the survival group (95.0% (38/40) vs.32.0% (40/125),25.0% (10/40) vs. 2.4% (3/125), 90.0% (36/40) vs. 72.0% (90/125), χ²=48.253, 18.325, 5.440, all P<0.05). Infection (22 cases, 55.0%) and intracerebral hemorrhage (15 cases, 37.5%) were the main causes of death, 3 cases (7.5%) died of severe graft-versus-host disease after transplantation. The Logistic regression model indicated that repeated infection and (or) severe infection and non-use of intravenous immunoglobulin (IVIG) replacement therapy were risk factors for death in Chinese WAS patients (OR values were 8.999 and 2.860, 95% CI were (2.041-39.667) and (1.375-5.950), respectively, all P<0.05). Conclusions: Recurrent and (or) severe infection is the main risk factor of death for WAS patietns. Regular IVIG treatment can improve the survival rate of patients with WAS.

[The prognostic value of myoglobin difference in sepsis related chronic critical illness].

Objective: To investigate the predictive value of myoglobin (Mb) for the prognosis of sepsis related chronic critical illness (CCI). Methods: Retrospective study was conducted on septic patients with the length of ICU stay equal or greater than 14 days, and sepsis-related organ failure assessment (SOFA) score equal or greater than 2 on the 14th day in ICU in the First Department of Critical Care Medicine at the First Affiliated Hospital of Sun Yat-sen University from January 2017 to March 2020. Patients' clinical and laboratory data were collected on the 1st and 14th day in ICU. The survival on day 28 in ICU was recorded. According to the myoglobin levels on day 1 and day 14, all subjects were divided into myoglobin elevation group and decline group. Kaplan-Meier survival curve was used to compare the cumulative survival rate at day 28. Cox regression analysis was used to analyze the independent risk factors of mortality. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of myoglobin. Results: A total of 131 patients with sepsis related CCI were recruited, including 58 patients in the elevation group and 73 in the decline group. The Mb level in elevation group on day 1 was significantly lower than that in decline group [172.40(59.99, 430.53) µg/L vs. 413.60(184.40, 1 328.50) µg/L, Z=3.749, P=0.000], and the Mb level on day 14 was the opposite change in two groups [483.65(230.38, 1 471.75)µg/L in elevation group vs. 132.20(76.86, 274.35)µg/L in decline group, Z=5.595, P=0.000]. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate of the elevation group was significantly lower than that of decline group (χ²=7.051, P=0.008). Cox ratio regression analysis suggested that elevated myoglobin was an independent risk factor for 28-day mortality in septic patients with CCI (OR=2.534, 95%CI 1.212-5.295, P=0.013). ROC curve analysis suggested that the sensitivity of myoglobin elevation in predicting mortality related to CCI within 28 days was 64.5%, and the specificity was 32.0% with area under the curve(AUC) 0.661(95%CI 0.550-0.773,P=0.007) and Jorden Index was 0.325. Conclusion: Elevated myoglobin, an independent risk factor for mortality within 28 days in ICU, can predict the prognosis of sepsis related chronic critical illness.

[DNA double-strand breaks repair capacity and risk of differentiated thyroid cancer: a case-control study].

Objective: To study the influencing factors of DNA double-strand breaks (DSB) repair capacity and relationship with differentiated thyroid cancer (DTC). Methods: A total of 140 patients with thyroid diseases admitted to the Henan Cancer Hospital from January 2020 to March 2020 were retrospectively analyzed, including 26 males and 114 females, aged from 18 to 78 years old. According to the pathological results, the patients were divided into DTC group (90 cases) and control group or benign thyroid nodules (BTN) group (50 cases). The DSB repair ability of peripheral blood T lymphocytes was measured by flow cytometry. The data of two groups were compared by Wilcoxon rank sum test to evaluate the relationship between DSB repair ability and the risk of DTC. According to the median repair ability of DSB in BTN group, the repair ability of DSB was divided into high and low categories, and the factors influencing the repair ability of DSB were analyzed by Logistic regression method. SPSS 22.0 software was used to analyze the data. Results: The DSB repair capacity was 27.87% in DTC group and 36.75% in BTN group, with significant difference (Z=-3.999,P<0.05). Logistic regression analysis suggested that patients with thyroid cancer had lower DSB repair capacity than patients without cancer (OR=2.245; 95%CI: 1.067-4.725; P=0.033), and patients with a history of radiation exposure had a reduced DSB repair capacity (OR=2.698; 95%CI: 1.271-5.725, P=0.010). Conclusion: The risk of DTC increases in patients with low DSB repair capacity. Radiation exposure is a risk factor for the reduction of DSB repair capacity.

[The predictive value of ultrasonic measurement of the diaphragmatic thickening fraction combined with the maximal inspiratory pressure in mechanical ventilation patients].

Objective: To evaluate the value of the diaphragmatic thickening fraction (DTF) combined with the maximum inspiratory pressure (MIP) for the prediction of weaning success in mechanically ventilated patients. Methods: Patients admitted to the intensive care unit (ICU) of Yijishan Hospital of Wannan Medical College and on mechanical ventilation for 24 hours from June 2018 to April 2019 were selected as the study subjects. A low-level pressure support ventilation (PSV) method was applied to conduct a spontaneous breathing test (SBT) for 30 minutes after the patients met the screening conditions for clinical weaning; and the patients were weaned when they met the clinical weaning criteria. Before weaning, the patient's MIP was measured. The right hemidiaphragmatic excursion (DE) and the thickness of the diaphragm at the end of inspiration and at the end of exhalation were measured by ultrasound, and the DTF was calculated. The statistical relationship between the DTF, DE and MIP was analyzed. The predictive value for the success of weaning was calculated with the DTF, DE and MIP and was evaluated by the area under the receiver operating characteristic curve (AUC). Results: A total of 73 patients were included in this study, including 57 patients who were successfully weaned, and 16 patients who experienced failure. The DTF of the successful weaning group (35%, 8%) was significantly higher than that of the failed weaning group (25%±5%), and the difference was statistically significant (t=6.401, P<0.01). The MIP (34±9 cmH(2)O) in the successful weaning group was significantly higher than that in the failed weaning group (23±3 cmH(2)O), and the difference was statistically significant (t=7.186, P<0.01). The ROCs for the DTF, MIP, and diaphragmatic displacement were 0.907, 0.896, and 0.749, respectively. A DTF ≥ 27.78%, with a sensitivity of 92.98%, a specificity of 81.25%, and an AUC of 0.907 (95% CI: 0.816-0.963), was used as the standard to predict the success of weaning. An MIP>26.5 cmH(2)O, with a sensitivity of 80.7%, a specificity of 93.75%, and an AUC of 0.896 (95% CI: 0.803-0.955), was used as the standard to predict the success of weaning. The AUC of DTF ≥ 27.78% and MIP ≥ 26.5 cmH(2)O was 0.920 (95% CI:0.832-0.971), and the specificity increased to 87.7%, but the sensitivity was slightly reduced to 87.5%. Conclusions: The DTF and MIP play a crucial role in determining the appropriate time and predicting the outcome of weaning of mechanical ventilation patients. Compared with the DTF and MIP alone, the DTF combined with MIP greatly improved the accuracy of predicting successful weaning.

[Analysis of clinical diagnosis and treatment of 12 cases of intraparotid facial nerve schwannoma].

Objective: To investigate the clinical manifestation and management strategy of intraparotid facial nerve schwannoma. Methods: The clinical data of 12 patients with parotid schwannoma treated in Henan Cancer Hospital from January 2009 to January 2019 were analyzed retrospectively, including 5 males and 7 females, aged from 23 to 72 years. All the 12 patients complained of a mass in the parotid region, of whom 4 patients had local discomfort and pain, and 6 patients had varying degrees of pain during palpation. Ultrasound examination showed solid mass in parotid region in 8 cases and mixed mass in 4 cases. The treatment methods, the relationship between tumor and facial nerve, the modes of treatments and the nerve functions before and after operation were analyzed and summarized with House-Brackmann grade. Results: All 12 patients received surgical treatment: 8 patients underwent tumor resection plus partial or total superficial parotidectomy, 1 patient underwent tumor resection and total parotidectomy, and 3 patients underwent tumor resection, with 1 patient in whom tumor could not be removed completely due to tumor extention to the skull base. In 9 cases, the tumor occurred in the trunk or main branch of the facial nerve, and there was no facial nerve injury occurred after surgery; in 1 case, the tumor occurred in the terminal branch of the facial nerve, and part of the severe small branches of adhesion were cut off during the operation; in 1 case, the total trunk of the facial nerve was not found and the broken end of the nerve could not be found during the operation, so the nerve transplantation was not performed. In 1 case, nerve grafting was performed after nerve transection because it was impossible to separate the trunk of the facial nerve from the tumor during the operation. Preoperatively, House-Brackmann grade (H-B)Ⅰfacial nerve function was shown in 10 patients, H-BⅡ in 1 patient and H-B Ⅴin 1 patient. Postoperatively, the facial nerve function recovered to H-B Ⅰfor 7 patients, H-B Ⅱfor 2 patients, H-B Ⅲ for 1 patient, grade Ⅳ for 1 patient with nerve transplantation, and H-B Ⅴfor 1 patient with a revised surgery due to tumor recurrence. Conclusions: The intraparotid facial nerve schwannoma is rare, and it is easy to be misdiagnosed before operation. Surgery is a main treatment for intraparotid facial nerve schwannoma. Attention should be paid to the protection of facial nerve during operation.

[Effect of inhibiting the activity of double-stranded RNA-dependent protein kinase in sepsis mice].

Objective: To observe the effects of 2-aminopurine (2-AP), a double-stranded RNA-dependent protein kinase (PKR) inhibitor, on organ function, plasma inflammatory factor expression and 7 days mortality in sepsis mice induced by cecal ligation puncture (CLP). Methods: Forty specific specific pathogen free C57BL/6 mice were randomly divided into sham group (n=10), CLP group (n=10), CLP+2-AP group (n=10) and 2-AP group (n=10). CLP was used to establish sepsis mice models.Peripheral blood serum was collected 24 hours after operation, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Cr), blood urea nitrogen (BUN) and inflammatory factors (IL-1ß, IL-10 and TNF-α) were detected; peripheral blood and peritoneal lavage fluid were taken for bacterial clearance detection. Another 60 C57BL/6 mice were selected to observe the 7-day survival rate according to the above groups (n=15). Independent sample t test was used to compare the measurement data between groups. Results: The levels of ALT, AST, Cr and BUN in CLP Group and CLP+2-AP group were significantly higher than those in sham group (all P<0.001). The levels of ALT and AST in CLP+2-AP group were significantly lower than those in CLP Group (t=27.88, 11.33, both P<0.001); the levels of Cr and BUN in CLP+2-AP group were significantly lower than those in CLP Group (t=11.02, 7.15, bothP<0.001). Compared with sham group, the levels of pro-inflammatory (IL-1ß and TNF-α) and anti-inflammatory (IL-10) cytokines in CLP group were significantly higher (all P<0.001); the levels of IL-1ß and IL-10 in CLP+2-AP group were significantly lower (all P<0.001), but the levels of TNF-α in CLP+2-AP group were not significantly lower (P=0.33). The 7-day survival rate was 100% in sham group, 13.3% in CLP+2-AP group, 86.7% in 2-AP group and 20.0% in CLP+2-AP group. Inhibition of PKR activation slightly improved the trend of 7-days survival rate of CLP model mice (analysis by mantel Cox test, χ(2)=0.0012, P=0.97). Conclusion: In sepsis mice model, inhibition of PKR activity can reduce the expression of inflammatory factors in plasma, decrease bacterial load in blood and abdominal cavity, and protect organ function, which could suggest that inhibition of PKR activity has potential application in sepsis treatment.