Population-based survey of prevalence,causes,and risk factors for blindness and visual impairment in an aging Chinese metropolitan population

AIM： To assess the prevalence, causes, and risk factors for blindness and visual impairment among elderly （〉60 years of age） Chinese people in a metropolitan area of Shanghai, China. METHODS： Random cluster sampling was conducted to identify participants among residents ≥60 years of age living in the Xietu Block, Xuhui District, Shanghai, China. Presenting visual acuity （PVA） and best-corrected visual acuity （BCVA） were checked by the Early Treatment Diabetic Retinopathy Study （ETDRS） visual chart. All eligible participants underwent a comprehensive eye examination. Blindness and visual impairment were defined according to World Health Organization （WHO） criteria. RESULTS： A total of 4190 persons （1688 men and 2502 women） participated in the study, and the response rate was 91.1%. Based on PVA, the prevalence of blindness was 1.1% and that of visual impairment was 7.6%. Based on BCVA, the prevalence of blindness and visual impairment decreased to 0.9% and 3.9%, respectively. Older （〉80 years of age） women, with low educational levels and smoking habits, exhibited a significantly greater chance for blindness and visual impairment than did those with high educational levels and no smoking habits （P〈0.05）. Based on PVA and BCVA, the main causes of blindness were cataract, myopic maculopathy, and age-related macular degeneration （AMD）. CONCLUSION： Our findings help to identify the population in need of intervention, to highlight the need for additional eye healthcare services in urban China.

Resistance of grid steel-tube-confined concrete targets against projectile impact: Experimental investigation and analytical engineering model

Steel-tube-confined concrete(STCC) targets are provided with excellent anti-penetration performance over semi-infinite concrete(SIC) targets since the steel tube imposes passive restraint on the in-filled concrete during the penetration process. Grid STCC system with square steel tubes is a potential solution to protective structures. In this paper, experiments of 9-cell grid STCC targets penetrated by 12.7 mm Armor Piercing Projectile(APP) were performed. The influence of side length and thickness of steel tube,steel ratio and impact velocity on anti-penetration performance were taken into account. Additionally,single-cell square STCC targets were also designed and tested for comparison with the 9-cell grid STCC targets. Damage modes and parameters of the tested targets were measured and discussed. Moreover,the stiffness of radial confinement of grid STCC targets is achieved according to the elastic solution of infinite cylindrical shell in Winkler medium. Furthermore, the penetration resistance and depth of penetration(DOP) for grid STCC targets are obtained on the basis of the dynamic finite spherical cavityexpansion(FSCE) models including radial confinement effect. It is shown that the 9-cell grid STCC targets with optimal dimension match of thickness and side length of steel tube can reduce the DOP by about17 % and 23 % in comparison with the SIC targets and single-cell square STCC targets, respectively, due to both the confinement of square steel tube to concrete in the impacted cell and the additional confinement of the surrounding cells to the impacted cell;the penetration resistance and DOP of the grid and cellular STCC targets with similar steel ratio is close, and thus the grid STCC targets with simpler manufacturing process and excellent in-plane expandability are preferred in engineering practice;moreover, the predicted results of DOP model based on the FSCE models agree well with the tested results with the maximum disparity less than 12 % and the proposed model is more applicable to the grid and cellular STCC targets with high radial confinement.

Changes in rheumatoid arthritis under ultrasound before and after sinomenine injection

BACKGROUND Rheumatoid arthritis(RA)is a prevalent clinical autoimmune disease that is commonly treated with diclofenac and methotrexate.In recent years,the application of traditional Chinese medicine in RA has received widespread attention;it promotes blood circulation,strengthens the immune system,and eliminates evil.The sinomenine preparation of Zhingqeng Fengtongning is studied as a possible treatment for patients with RA.AIM To explore the value of sinomenine injection into the articular cavity for the treatment of RA.METHODS A total of 94 patients with RA treated from January 2019 to January 2021 were selected and divided into the study and control groups with 47 patients each using a simple random number table method.Both groups received conventional treatment with diclofenac sodium and methotrexate tablets.The control group received diproxone and lidocaine by intra-articular administration while the study group received an intra-articular administration of the sinomenine preparation of Zhengqing Fengning and lidocaine.χ^(2) test was used to evaluate the therapeutic effect and synovial thickness,degree of pain through the visual analog scale(VAS),blood flow grade,arthroinflammatory indexes[rheumatoid factor(RF),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)]before and after treatment in the two groups.RESULTS The total effective rate of the study group(93.62%)was higher than that of the control group(78.72%)(P<0.05).Before treatment,there were no significant differences between the two groups in terms of synovial thickness,VAS score,blood flow grading,levels of RF,and ESR(P>0.05).After treatment,the synovial thickness and VAS score were significantly lower(P<0.05)in the study group than in the control group(2.05±0.59 mm vs 2.87±0.64 mm and 2.11±0.62 vs 2.90±0.79 scores,respectively).The rate of blood flow at grade 0 in the study group(76.60%)was higher than that in the control group(57.45%),and the rate of blood flow at grade I(10.64%)was lower than that in the control group(31.91%)(P<0.05).Furthermore,the levels of RF(55.61±6.13 U/mL),CRP(11.43±3.59 mg/L),and ESR(29.60±5.56 mm/h)in the study group were lower than those in the control group(73.04±9.23 U/mL,15.07±4.06 mg/L,36.64±6.10 mm/h,respectively)(P<0.05).CONCLUSION Sinomenine administration of Zhengqing Fengtongning in the articular cavity with conventional treatment of RA can improve ultrasonographic blood flow and synovial thickness,reduce pain,regulate inflammation,and enhance therapeutic effect.

Surgical Technique and Efficacy Analysis of Extra-pseudocapsular Transnasal Transsphenoidal Surgery for Pituitary Microprolactinoma

Objective To elucidate the role of transsphenoidal surgery in the treatment of pituitary microprolactinoma.Methods The clinical data of 107 prolactinoma cases treated by extra-pseudocapsular transnasal transsphenoidal surgery(ETTS)for different indications in our department since 2011 was retrospectively analyzed.Results The most common indication was the ineffectiveness of oral medication(41.1%),followed by the personal willingness of the patient(35.5%),and 20.6%of the patients were young women with clear tumor boundaries.The pseudocapsule was not observed in 63 cases(58.9%),incomplete pseudocapsule was observed in 26 cases(24.3%),and complete pseudocapsule in 18 cases(16.8%).A total of 97 patients(90.7%)obtained 1-year post-operation remission.According to the relative location of the adenoma and pituitary gland on the MRI scan,46 patients were classified into a central type,59 a lateral type,and 2 a supra-pituitary type.Two patients developed hypogonadism,one patient developed hypocortisolism,and one patient developed post-operative hypothyroidism.Two patients were administrated with hormone replacement treatment,and the treatment was stopped within one week.There was no permanent hypopituitarism.Further investigation demonstrated that the adenoma types could affect the remission rates of hyperprolactinemia and gross total resection rate in microprolactinoma.Conclusion ETTS was an effective treatment for pituitary microprolactinomas.This could be the first choice for patients who presented enclosed adenoma on the MRI and were potentially curable in a preoperative evaluation.Maximal safe removal of the adenoma by ETTS with the aim to increase the sensitivity of the drugs was also recommended for patients with invasive dopamine agonist resistant prolactinomas and patients with difficulty in childbirth.