Ocular surface in patients with different degrees of myopia

AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June,2023.After completing the Ocular Surface Disease Index(OSDI)score scale,measurements were taken for refraction,biometric parameters and ocular surface parameters.The prevalence,severity and related parameters of the dry eye among different groups based on axial length(AL)were compared.Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.RESULTS:Statistically significant differences were observed in refractive error,corneal thickness,anterior chamber depth,and subfoveal choroidal thickness among the groups(all P<0.05).With the increase in AL,the incidence and severity of dry eye increased significantly(P<0.05).Moreover,the tear film break-up time(BUT)shortened(P<0.05),and the corneal fluorescein staining(CFS)points increased significantly(P<0.05).OSDI scores were positively correlated with AL and spherical equivalent(SE;both P<0.05);BUT was negatively correlated with AL,SE,and corneal astigmatism(AST;all P<0.05);Schirmer I test(SIT)results were negatively correlated with AL and SE(both P<0.05).CONCLUSION:AL elongation is a risk factor for dry eye onset in myopic participants.The longer the AL,the more severe the dry eye is,with the increased CFS spots and tear film instability.Additionally,SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.

1990年与2019年中国病毒性脑炎疾病负担分析

目的分析中国1990年与2019年病毒性脑炎(viral encephalitis,VE)疾病负担的变化状况,并与同期全球数据进行对比,为我国制定有效的VE防治策略提供参考。方法采用2019年全球疾病负担研究(The Global Burden of Diseases 2019,GBD 2019)数据,分析VE的发病率、患病率、死亡率、伤残损失健康寿命年(years lived with disability,YLD)率、死亡损失健康寿命年(years of life lost,YLL)率及其标化率,并对比全球变化情况。结果2019年,中国VE发病率为15.27/10万、患病率为74.34/10万、死亡率为0.24/10万、YLD率为7.29/10万、YLL率为13.40/10万,与1990年相比,分别下降27.18%、33.42%、70.00%、40.29%及78.56%。2019年,中国除标化死亡率、YLL率外,其余标化指标均超全球水平。2019年,中国男性标化发病率、患病率、死亡率、YLD率及YLL率分别为22.81/10万、73.74/10万、0.34/10万、7.46/10万、22.26/10万,均高于同期女性。与1990年相似,2019年中国0~4岁人群VE的发病率、死亡率均较其他年龄组高,50岁以上人群发病率、死亡率呈逐渐升高趋势。结论截至2019年,我国VE的疾病负担整体水平较高,在积极降低感染风险的同时,也应重视疾病初期的实验室检查,早发现早治疗以控制病情发展,重点关注儿童和老年男性群体。

Association of Satellite Sign with Postoperative Rebleeding in Patients Undergoing Stereotactic Minimally Invasive Surgery for Hypertensive Intracerebral Haemorrhage

There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery(MIS)for hypertensive intracerebral haemorrhage(ICH),and little is known about the relationship between satellite sign on computed tomography(CT)scans and postoperative rebleeding after MIS.This study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic MIS.We retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following admission.Postoperative rebleeding occurred in 14 of 65(21.5%)patients with the satellite sign on baseline CT,and in 5 of the 40(12.5%)patients without the satellite sign.This diiTerence was statistically significant.Positive and negative values of the satellite sign for predicting postoperative rebleeding were 21.5%and 87.5%,respectively.Multivariate logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative rebleeding.In conclusion,the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.

Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

BACKGROUND Currently, there is no uniform standard for analgesia during laparoscopic hepatectomy. Most of the analgesia schemes adopt epidural analgesia after laparotomy. Although the analgesia is effective, it has a great impact on the recovery of patients after laparoscopic hepatectomy and is not completely suitable for analgesia after laparoscopic hepatectomy. Although multimodal perioperative analgesia can significantly relieve postoperative pain, there is no relevant study of parecoxib combined with ropivacaine for post-laparoscopic hepatectomy analgesia. AIM To study the analgesic effect of the preoperative intravenous injection of parecoxib combined with long-acting local anesthetic ropivacaine for incision infiltration in patients undergoing laparoscopic hepatectomy. METHODS Forty-eight patients undergoing laparoscopic hepatectomy were randomly divided into a combined group (parecoxib combined with ropivacaine) and a control group. The visual analogue scale (VAS) at rest and during movement was used to compare the analgesic effect of the two groups. Meanwhile, the cumulative sufentanil, the recovery time for enterokinesia, the length of postoperative hospital stay, and the adverse reactions (nausea and vomiting) were recorded and compared between the two groups.The change tendency in VAS scores for both groups was similar after operation. At rest, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, 24 and 36 h, and during movement, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, and 24 h. The recovery time for enterokinesia in the combined group was 2.9 d, which was significantly shorter than that in the control group. The cumulative sufentanil in the combined group decreased significantly at 24, 36, and 48 h after operation. CONCLUSION Preoperative intravenous injection of parecoxib combined with ropivacaine for incision infiltration is a simple and effective method for postoperative analgesia in laparoscopic hepatectomy, which could relieve pain and promote recovery.

Awake fiberoptic intubation and use of bronchial blockers in ankylosing spondylitis patients

BACKGROUND Patients with ankylosing spondylitis(AS)combined with severe cervical fusion deformity have difficult airways.Awake fiberoptic intubation is the standard treatment for such patients.Alleviating anxiety and discomfort during intubation while maintaining airway patency and adequate ventilation is a major challenge for anesthesiologists.Bronchial blockers(BBs)have significant advantages over double-lumen tubes in these patients requiring one-lung ventilation.AIM To evaluate effective drugs and their optimal dosage for awake fiberoptic nasotracheal intubation in patients with AS and to assess the pulmonary isolation effect of one-lung ventilation with a BB.METHODS We studied 12 AS patients(11 men and one woman)with lung or esophageal cancer who underwent thoracotomy with a BB.Preoperative airway evaluation found that all patients had a difficult airway.All patients received an intramuscular injection of penehyclidine hydrochloride(0.01 mg/kg)before anesthesia.In the operating room,dexmedetomidine(0.5μg/kg)was infused intravenously for 10 min,with 2%lidocaine for airway surface anesthesia,and a 3%ephedrine cotton swab was used to contract the nasal mucosa vessels.Before tracheal intubation,fentanyl(1μg/kg)and midazolam(0.02 mg/kg)were administered intravenously.Awake fiberoptic nasotracheal intubation was performed in the semi-reclining position.Intravenous anesthesia was administered immediately after successful intubation,and a BB was inserted laterally.The pre-intubation preparation time,intubation time,facial grimace score,airway responsiveness score during the fiberoptic introduction,time of end tracheal catheter entry into the nostril,and lung collapse and surgical field score were measured.Systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)were recorded while entering the operation room(T1),before intubation(T2),immediately after intubation(T3),2 min after intubation(T4),and 10 min after intubation(T5).After surgery,all patients were followed for adverse reactions such as epistaxis,sore throat,hoarseness,and dysphagia.RESULTS All patients had a history of AS(20.4±9.6 years).They had a Willson's score of 5 or above,grade III or IV Mallampati tests,an inter-incisor distance of 2.9±0.3 cm,and a thyromental(T-M)distance of 4.8±0.7 cm.The average pre-intubation preparation time was 20.4±3.4 min,intubation time was 2.6±0.4 min,facial grimace score was 1.7±0.7,airway responsiveness score was 1.1±0.7,and pulmonary collapse and surgical exposure score was 1.2±0.4.The SBP,DBP,and HR at T5 were significantly lower than those at T1-T4(P<0.05).While the values at T1 were not significantly different from those at T2-T4(P>0.05),they were significantly different from those at T5(P<0.05).Seven patients had minor epistaxis during endotracheal intubation,two were followed 24 h after surgery with a mild sore throat,and two had hoarseness without dysphagia.CONCLUSION Patients with AS combined with severe cervical and thoracic kyphosis should be intubated using fiberoptic bronchoscopy under conscious sedation and topical anesthesia.Proper doses of penehyclidine hydrochloride,dexmedetomidine,fentanyl,and midazolam,combined with 2%lidocaine,administered prior to intubation,can provide satisfactory conditions for tracheal intubation while maintaining the comfort and safety of patients.BBs are safe and effective for onelung ventilation in such patients during thoracotomy.

Role of Mutant TBP in Regulation of Myogenesis on Muscle Satellite Cells

In polyglutamine(PolyQ)diseases,mutant proteins cause not only neurological problems but also peripheral tissue abnormalities.Among all systemic damages,skeletal muscle dystrophy is the severest.Previously by studying knock-in(KI)mouse models of spinal cerebellar ataxia 17(SCA17),it was found that mutant TATA box binding protein(TBP)decreases its interaction with myogenic differentiation antigen,thus reducing the expression of skeletal muscle structural proteins and resulting in muscle degeneration.In this paper,the role of mutant TBP in myogenesis was investigated.Single myofibers were isolated from tibialis anterior muscles of wild type(WT)and SCA17KI mice.The 1TBP18 staining confirmed the expression of mutant TBP in muscle satellite cells in SCA17Ki mice.In the BaCl2-induced TA muscle injury,H&E cross-section staining showed no significant change in myofibril size before and after BaCl2 treatment,and there was no significant difference in centralized nuclei between WT and SCA17KI mice,suggesting that mutant TBP had no significant effect on muscle regeneration.In the cultured primary myoblasts from WT and SCA17KI mice in vitro,representative BrdU immunostaining showed no significant difference in proliferation of muscle satellite cells.The primary myoblasts were then induced to differentiate and immunostained for eMyHC,and the staining showed there was no significant difference in differentiation of primary myoblasts between WT and SCA1KI mice.Our findings confirmed that mutant TBP had no significant effect on myogenesis.

Cerebral venous sinus thrombosis in pregnancy: A case report

BACKGROUND Cerebral venous thrombosis(CVT)is a rare but life-threatening disease in pregnant women.Anticoagulation is the first-line therapy for CVT management.However,some patients have poor outcomes despite anticoagulation.Currently,the endovascular treatment of CVT in pregnant women remains controversial.We report a rare case of CVT in a pregnant woman who was successfully treated with two stent retriever devices.CASE SUMMARY The patient was a 29-year-old pregnant woman.She was first diagnosed with hyperemesis gravidarum due to severe nausea and vomiting for one week.As the disease progressed,she developed acute left hemiplegia.Imaging confirmed the diagnosis of superior sagittal sinus,right transverse sinus and sinus sigmoideus thrombosis.As anticoagulant therapy was ineffective,she underwent thrombectomy.After the mechanical thrombectomy,her headache diminished.Three weeks later,the patient was completely independent.At a 3-mo follow-up,no relapse of symptoms was observed.CONCLUSION Mechanical thrombectomy may be an effective alternative therapy for CVT in pregnant women if anticoagulation therapy fails.

Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consortprospective, randomized, controlled trial

BACKGROUND Postoperative ileus is a frequent postoperative complication,especially after abdominal surgery.Sympathetic excitation is the primary factor for postoperative ileus.Sympathetic activation becomes increased by surgical stress,postoperative pain,and inflammation.Dexmedetomidine(DEX)can inhibit sympathetic nerve activity,inflammation,and pain.AIM To observe whether DEX promotes bowel movements in patients after laparoscopic nephrectomy.METHODS One hundred and twenty patients undergoing laparoscopic nephrectomy were assigned to three groups:C(normal saline infusion),D1(DEX 0.02μg/kg/h),and D2(DEX 0.04μg/kg/h).The primary outcomes were the recorded times to first flatus,defecation,and eating after surgery.The secondary outcomes were postoperative pain,assessed using the numerical rating scale(NRS),adverse effects,and the duration of the postoperative hospital stay.RESULTS The times to first flatus,defecation,and eating in groups D1 and D2 were significantly shorter than those in group C(P<0.01).The NRS scores at 8 h and 24 h after surgery were significantly lower in groups D1 and D2 than in group C(P<0.05).No adverse effects were observed(P>0.05).CONCLUSION Postoperative infusion of DEX at 0.04μg/kg/h facilitates bowel movements in patients undergoing laparoscopic nephrectomy.

PRRT2 Mutation and Serum Cytokines in Paroxysmal Kinesigenic Dyskinesia

Objective Paroxysmal kinesigenic dyskinesia(PKD)is a rare movement disorder PRRT2 gene mutations have been reported to cause PKD.However,the pathophysiological mechanism of PKD remains unclear,and it is unknown whether an inflammatory response is involved in the occurrence of this disease.We aimed to investigate the symptomatology,genotype,and serum cytokines of patients with PKD.Methods We recruited 21 patients with PKD,including 7 with familial PKD and 14 with sporadic PKD.Their clinical features were investigated,and blood samples were collected,and PRRT2 mutations and cytokine levels were detected.Results The mean age at PKD onset was 12.3±2.2 years old.Dystonia was the most common manifestation of dyskinesia,and the limbs were the most commonly affected parts.All attacks were induced by identifiable kinesigenic triggers,and the attack durations were brief(<1 min).Four different mutations from 9 probands were identified in 7 familial cases(71.4%)and 14 sporadic cases(28.6%).Two of these mutations(c.649dupC,c.620_621delAA)had already been reported,while other 2(c.1018_1019delAA,c.1012+1G>A)were previously undocumented.The tumor necrosis factor(TNF)-αlevel in the PKD group was significantly higher than that in the age-and sex-matched control group(P=0.025).There were no significant differences in the interleukin(IL)-1β,IL-2R,IL-6,IL-8,or IL-10 levels between the two groups.Conclusion In this study,we summarized the clinical and genetic characteristics of PKD.We found that the serum TNF-αlevels were elevated in patients clinically diagnosed with PKD,suggesting that an inflammatory response is involved in the pathogenesis of PKD.

Stepwise colloidal lithography toward scalable and various planar chiral metamaterials

Chiral metamaterials(CMs)composed by artificial chiral resonators have attracted great attentions in the recent decades due to their strong chiroptical resonance and identifiable interaction with chiral materials,facilitating practical applications in chiral biosensing,chiral emission,and display technology.However,the complex geometry of CMs improves the fabrication difficulty and hinders their scalable fabrication for practical applications,especially in the visible and ultraviolet wavelengths.One potential strategy is the colloidal lithography that enables parallel fabrication for scalable and various planar structures.Here,we demonstrate a stepwise colloidal lithography technique that uses sequential deposition from multiple CMs and expand their variety and complexity.The geometry and optical chirality of building blocks from single deposition are systematically investigated,and their combination enables a significant extension of the range of chiral patterns by multiple-step depositions.This approach resulted in a myriad of complex designs with different characteristic sizes,compositions,and shapes,which are particularly beneficial for the development of nanophotonic materials.In addition,we designed a flexible chiral device based on PDMS,which exhibits a good CD value and excellent stability even after multiple inward and outward bendings.The excellent compatibility to various substrates makes the planar CMs more flexible in practical applications in microfluidic biosensing.

Engineering high-performance dielectric chiral shells with enhanced chiral fields for sensitive chiral biosensor

Chiral metamaterials have been a topic of significant research interest in recent years due to their potential for various applications in nanophotonic devices and chiral biosensors.However,the intrinsic Ohmic loss in surface plasmonic resonance has limited their practical use,resulting in large light dissipation and weak chiroptical resonance.Here,we report on the development of high-performance dielectric chiral shells(DCS)through a two-step Si deposition process on a self-assembled microsphere monolayer.The form DCS sample completely oyercomes the cancelation effect originated from the disorder property of the micro-sphere monolayer in macroscale,and at a wavelength of approximately 710 nm,the measured optimal chiral signal(g-factor)and transmittance can reach up to 0.7 and 0.3,respectively.The strong chiroptical effect comes from the asymmetric circular displacement currents(i.e.,magnetic modes)enabled by the specific shell geometry.The chiral shell geometry,electromagnetic properties,sensor sensitivity of chiral molecules and figure of merit are systematically investigated.The DCSs demonstrate highly sensitive detection of chiral biomolecules owing to their easily accessible geometry and enhanced uniform chiral field.