Systematic review and network meta-analysis of different nonsteroidal anti-inflammatory drugs for juvenile idiopathic arthritis

BACKGROUND Various non-steroidal anti-inflammatory drugs(NSAIDs)have been used for juvenile idiopathic arthritis(JIA).However,the optimal method for JIA has not yet been developed.AIM To perform a systematic review and network meta-analysis to determine the optimal instructions.METHODS We searched for randomized controlled trials(RCTs)from PubMed,EMBASE,Google Scholar,CNKI,and Wanfang without restriction for publication date or language at August,2023.Any RCTs that comparing the effectiveness of NSAIDs with each other or placebo for JIA were included in this network meta-analysis.The surface under the cumulative ranking curve(SUCRA)analysis was used to rank the treatments.P value less than 0.05 was identified as statistically significant.RESULTS We included 8 RCTs(1127 patients)comparing 8 different instructions including meloxicam(0.125 qd and 0.250 qd),Celecoxib(3 mg/kg bid and 6 mg/kg bid),piroxicam,Naproxen(5.0 mg/kg/d,7.5 mg/kg/d and 12.5 mg/kg/d),inuprofen(30-40 mg/kg/d),Aspirin(60-80 mg/kg/d,75 mg/kg/d,and 55 mg/kg/d),Tolmetin(15 mg/kg/d),Rofecoxib,and placebo.There were no significant differences between any two NSAIDs regarding ACR Pedi 30 response.The SUCRA shows that celecoxib(6 mg/kg bid)ranked first(SUCRA,88.9%),rofecoxib ranked second(SUCRA,68.1%),Celecoxib(3 mg/kg bid)ranked third(SUCRA,51.0%).There were no significant differences between any two NSAIDs regarding adverse events.The SUCRA shows that placebo ranked first(SUCRA,88.2%),piroxicam ranked second(SUCRA,60.5%),rofecoxib(0.6 mg/kg qd)ranked third(SUCRA,56.1%),meloxicam(0.125 mg/kg qd)ranked fourth(SUCRA,56.1%),and rofecoxib(0.3 mg/kg qd)ranked fifth(SUCRA,56.1%).CONCLUSION In summary,celecoxib(6 mg/kg bid)was found to be the most effective NSAID for treating JIA.Rofecoxib,piroxicam,and meloxicam may be safer options,but further research is needed to confirm these findings in larger trials with higher quality studies.

Systemic juvenile idiopathic arthritis–associated lung disease: A retrospective cohort study

BACKGROUND Lung damage in systemic juvenile arthritis(sJIA)is one of the contemporary topics in pediatric rheumatology.Several previous studies showed the severe course and fatal outcomes in some patients.The information about interstitial lung disease(ILD)in the sJIA is scarce and limited to a total of 100 cases.AIM To describe the features of sJIA patients with ILD in detail.METHODS In the present retrospective cohort study,information about 5 patients less than 18-years-old with sJIA and ILD were included.The diagnosis of sJIA was made according to the current 2004 and new provisional International League of Associations for Rheumatology criteria 2019.ILD was diagnosed with chest computed tomography with the exclusion of other possible reasons for concurrent lung involvement.Macrophage activation syndrome(MAS)was diagnosed with HLH-2004 and 2016 EULAR/ACR/PRINTO Classification Criteria and hScores were calculated during the lung involvement.RESULTS The onset age of sJIA ranged from 1 year to 10 years.The time interval before ILD ranged from 1 mo to 3 years.The disease course was characterized by the prevalence of the systemic features above articular involvement,intensive rash(100%),persistent and very active MAS(hScore range:194-220)with transaminitis(100%),and respiratory symptoms(100%).Only 3 patients(60%)developed a clubbing phenomenon.All patients(100%)had pleural effusion and 4 patients(80%)had pericardial effusion at the disease onset.Two patients(40%)developed pulmonary arterial hypertension.Infusion-related reactions to tocilizumab were observed in 3(60%)of the patients.One patient with trisomy 21 had a fatal disease course.Half of the remaining patients had sJIA remission and 2 patients had improvement.Lung disease improved in 3 patients(75%),but 1 of them had initial deterioration of lung involvement.One patient who has not achieved the sJIA remission had the progressed course of ILD.No cases of hyper-eosinophilia were noted.Four patients(80%)received canakinumab and one(20%)tocilizumab at the last follow-up visit.CONCLUSION ILD is a severe life-threatening complication of sJIA that may affect children of different ages with different time intervals since the disease onset.Extensive rash,serositis(especially pleuritis),full-blown MAS with transaminitis,lymphopenia,trisomy 21,eosinophilia,and biologic infusion reaction are the main predictors of ILD.The following studies are needed to find the predictors,pathogenesis,and treatment options,for preventing and treating the ILD in sJIA patients.

Fruit Powder of Tetrapleura tetraptera in Local Feed on Some Zootechnical Performances of Juveniles of Clarias gariepinus in Concrete Tank

This study focused on the supplementation of four-sided spice fruit powder (Tetrapleura tetraptera) on some zootechnical performances of juveniles of Clarias gariepinus and was carried out from February 14 to July 20 at the Massoma Fish Farm of Bojongo Mbeidi located in the Littoral Region, Department of Wouri, Douala IV district. The farm benefits from a climate favorable to aquaculture activity. For this purpose, five (5) treatments were tested including T0+ (imported feed), T0-, T0.3, T0.4, and T0.5 respectively for the treatments with 0% supplemented food;0.3%;0.4% and 0.5% of Tetrapleura tetraptera powder. A total of 450 Clarias gariepinus fry with an initial average weight of 7 ± 1.5 g, were distributed in happas of 0.49 m2 each placed in Triplicate in a completely randomized device. Four isoprotein foods with 38% crude protein were formulated to feed these fry at 7% of their biomass per day for 15 days then to their fullness until the end of the experiment. Intermediate fishing was carried out every fortnight. 75 days later, the results recorded show that the highest average survival rate (96.44% ± 3.5%) was recorded with the subjects fed feed supplemented with 0.4% T. tetraptera powder. The average weight (120.93 ± 67.20), weight gain (113.93 ± 67.20), specific growth rate (3.64 ± 0.79% g/d) and total lengths and standard (26.43 ± 1.9 and 23.66 ± 1.76) the highest were recorded with the T0+ treatment (imported feed). The highest conditioning factor K (2.14 ± 0.15) was recorded with the treatment supplemented with 0.4% T. tetraptera. The lowest conversion ratio (1.28) was recorded with the treatment fed with imported blue crown food (T0+). Furthermore, the lowest production cost was recorded with the treatment supplemented with 0.4% T. tetraptera. It appears from this study that the juveniles of C. gariepinus better value the feed substituted with 0.4% of the powder of four sides (Tetrapleura tetraptera).

Juvenile Xanthogranuloma: A Case Report with Literature Review

Juvenile xanthogranuloma (XGJ) is the most common form of non-Langerhansian histiocytosis. We report a pediatric case of multiple XGJ without visceral involvement in a 6-month-old female infant who was hospitalized with disseminated congenital skin nodules, of firm consistency, of variable diameter ranging from a few millimetres to 1 cm, involving the face, scalp, trunk and limbs. There was no mucosal localization. The remainder of the somatic examination was unremarkable. The diagnosis of disseminated XGJ was confirmed by skin biopsy without visceral or systemic involvement. Therapeutic abstention was recommended. This observation underlines the fact that XGJ is a rare clinical entity that should not be overlooked when faced with congenital skin nodules.

Serum Zinc and Copper Level in Juvenile Idiopathic Arthritis (JIA) Patients and Its Correlation with Disease Duration-A Tertiary Hospital Study

Background: Juvenile Idiopathic Arthritis (JIA) is the most prevalent rheumatic disease in children. It is associated with abnormal levels of serum zinc (Zn) and copper (Cu) as during inflammation serum copper concentration increases and zinc decreases. Objective: To assess the serum Zn and Cu levels in different sub-types of JIA patients and their correlation with the disease duration. Methods: This cross-sectional study was conducted over twelve months at the Pediatric Rheumatology Division, Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University. Sixty-nine JIA cases that fulfilled the International League of Association for Rheumatology (ILAR) criteria were taken as cases and age and sex-matched healthy children were considered as controls. The serum Zn and Cu tests were done using the spectrophotometric method with INDIKO PLUS Drug Analyzer. Data were recorded in a pre-designed questionnaire. Data were checked, verified and analyzed manually where continuous variables were analyzed using unpaired t-test and categorical variables using the ANOVA test. Pearson’s correlation coefficient test was used to see the correlation of serum zinc and copper levels with disease duration. Results: Boys were predominant in both case and control groups, with the majority within the 10 to 16-year-age group. Enthesitis-related arthritis (ERA) was the most common subtype followed by sJIA, Oligo JIA, Poly JIA (RF-) and unclassified subtypes. Disease duration was found less than 12 months in 30.4% of JIA patients. Serum analysis revealed a statistically significant reduction in mean zinc levels and increased copper levels in JIA patients compared to controls. This study observed a negative correlation between serum zinc levels and disease duration, whereas serum copper levels exhibited a positive correlation with disease duration. Conclusion: In conclusion, this study revealed that JIA patients exhibit alterations in serum zinc and copper levels. Serum copper levels showed a positive correlation and serum zinc levels showed a negative correlation with the duration of the disease.

Giant juvenile fibroadenoma in a 14-year old Chinese female:A case report

BACKGROUND A giant juvenile fibroadenoma(GJF)is a rare,benign breast tumor that affects females<18 years of age.GJFs are generally suspected based on a palpable mass.GJFs influence breast shape and mammary gland development via the pressure effect from their enormous size.CASE SUMMARY Herein we report a case involving a 14-year-old Chinese female with a GJF in the left breast.GJF is a rare,benign breast tumor that usually occurs between 9 and 18 years of age and accounts for 0.5%-4.0%of all fibroadenomas.In severe cases,breast deformation may occur.This disease is rarely reported in Chinese people and has a high clinical misdiagnosis rate due to the absence of specific imaging features.On July 25,2022,a patient with a GJF was admitted to the First Affiliated Hospital of Dali University.The preoperative clinical examination and conventional ultrasound diagnosis needed further clarification.The mass was shown to be an atypical lobulated mass during the operation and confirmed to be a GJF based on pathologic examination.CONCLUSION GJF is also a rare,benign breast tumor in Chinese women.Evaluation of such masses consists of a physical examination,radiography,ultrasonography,computer tomography,and magnetic resonance imaging.GJFs are confirmed by histopathologic examination.Mastectomy is not selected when the patient benefits from a complete resection of the mass with breast reconstruction and an uneventful recovery.

Polyposis found on index colonoscopy in a 56-year-old female-BMPR1A variant in juvenile polyposis syndrome:A case report

BACKGROUND Juvenile polyposis syndrome(JPS)is a rare hereditary polyposis disease frequently associated with an autosomal-dominant variant of the SMAD4 or BMPR1A gene.It often manifests with symptoms in children and adolescents and is infrequently diagnosed in asymptomatic adults.Establishing the diagnosis is important as patients with JPS have a high risk of developing gastrointestinal cancer and require genetic counselling and close routine follow-up.CASE SUMMARY We report on the case of a 56-year-old female diagnosed with JPS after genetic testing revealed a rare variant of the BMPR1A gene BMPR1A c.1409T>C(p.Met470Thr).She was initially referred for colonoscopy by her general practitioner after testing positive on a screening faecal immunochemical test and subsequently found to have polyposis throughout the entire colorectum on her index screening colonoscopy.The patient was asymptomatic with a normal physical examination and no related medical or family history.Blood tests revealed only mild iron deficiency without anemia.To date,there has only been one other reported case of JPS with the same genetic variant.Subsequent colonoscopies were organised for complete polyp clearance and the patient was returned for surveillance follow-up.CONCLUSION JPS patients can present with no prior symptoms or family history.Genetic testing plays an important diagnostic role guiding management.

Familial Lateral Sclerosis with Juvenile Onset: About 3 Cases and Review of the Literature

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease deadly. In Africa, little data exists on this condition and the form familial is the most common with a younger age of onset. Our observations relate to three brothers, born from a consanguineous marriage. The diagnosis of amyotrophic lateral sclerosis was certain placed in all patients according to the criteria of Awaji. The average age of patients was 16.66 years, and the average age of onset of symptoms was 10.33 years old. The female gender was the most represented with a sex ratio of 0.5. Our patients benefited from rilusole, vitamin D and physiotherapy. A only patient presented with dysphagia. However, no cases have been observed at this day.

Thalidomide Is an Adjunct Therapy for the Refractory Systemic Juvenile Idiopathic Arthritis Patients in a Tertiary Hospital Study

Background: Systemic JIA (sJIA) is one of the subtypes of JIA, which is most difficult to treat among all JIA cases. About 50% of sJIA cases did not respond to traditional disease modifying anti-rheumatic drugs (DMARDs)—metho-trexate (MTX). Thalidomide is an immunomodulating and anti-inflammatory drug that induces sustained improvement of refractory sJIA cases. Objectives: To evaluate the efficacy of thalidomide in refractory sJIA patients. Methods: This was a prospective interventional study carried out in the Paediatric Rheumatology and Immunology follow-up clinic run by the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2019 to July 2020. Twenty-five sJIA patients who were refractory to conventional DMARDs were included in this study. These patients were prescribed thalidomide at a dose of 3 - 5 mg/kg/day for six months and efficacy was assessed by using juvenile arthritis disease activity score (JADAS 27) at 12th and 24th weeks of treatment. Result: Active joint counts and ESR improvement were observed in 90.69%, 97.67% and 69.84%, 100% of sJIA patients respectively at 12th and 24th weeks of treatment. Improvement of physicians and parent global assessment of VAS were 77.56%, 97.43% and 70.62% and 96.04% respectively at 12th and 24th weeks of treatment. Improvement of the total score of JADAS-27 was 77.51% at 12th week and 97.52% at 24th of week follow-up which was statistically significant. Somnolence, constipation and paresthesia were found as common adverse effect in this study. Conclusion: Efficacy of thalidomide was assessed by JADAS 27 criteria showed significant improvement in refractory sJIA patients in this study. It may be concluded that Thalidomide is safe and effective as an adjunct therapy of refractory sJIA patients.

Prolapsed Juvenile Polyp of the Anus in 2 Cases

Introduction :Rectal polyps are well-circumscribed, sessile or pedunculated formations that develop on the digestive mucosa. Juvenile polyps are seen in 4% - 12% of cases during pediatric colonoscopies. In children, rectal bleeding is a frequent warning sign, often a recurrent bleed with no impact on general condition. Diagnosis is based on clinical, imaging and digestive investigations, but anatomopathological examination remains the only means of confirmation. There are a number of treatment options, ranging from abstention to surgical excision. We report two (2) cases of isolated hemorrhagic juvenile polyp prolapsed to the anus in order to analyze the diagnostic and therapeutic features of this pathology. Patients and observations: A 7-year-old female patient presented to the pediatric emergency department of the Donka National Hospital with a hemorrhagic anal mass. On clinical examination, the patient was found to be in satisfactory general condition, with a hemorrhagic pedicle mass prolapsed to the anus. The mass was removed under general anesthesia. Postoperative management was straightforward. Conclusion: Juvenile polyps are the most common proctological condition in this age group. Clinical examination must be meticulous, as certain signs may point to a particular pathology. Colonoscopy is the diagnostic test of choice, and can also be used as a therapeutic tool.

Vaccination coverage in children with juvenile idiopathic arthritis,inflammatory bowel diseases,and healthy peers:Cross-sectional electronic survey data

BACKGROUND Patients with immune-mediated diseases,such as juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)are at increased risk of developing infections,due to disease-related immune dysfunction and applying of immunosuppressive drugs.AIM To evaluate vaccine coverage in patients with IBD and JIA,and compare it with healthy children.METHODS In the cross-sectional study we included the data from a questionnaire survey of 190 Legal representatives of children with JIA(n=81),IBD(n=51),and healthy children(HC,n=58).An electronic online questionnaire was created for the survey.RESULTS There were female predominance in JIA patients and younger onset age.Parents of JIA had higher education levels.Employment level and family status were similar in the three studied groups.Patients with JIA and IBD had lower vaccine coverage,without parental rejection of vaccinations in IBD,compare to JIA and healthy controls.The main reason for incomplete vaccination was medical conditions in IBD and JIA.IBD patients had a lower rate of normal vaccine-associated reactions compared to JIA and HC.The encouraging role of physicians for vaccinations was the lowest in JIA patients.IBD patients had more possibilities to check antibodies before immune-suppressive therapy and had more supplementary vaccinations compared to JIA and HC.CONCLUSION JIA and IBD patients had lower vaccine coverage compared to HC.Physicians'encouragement of vaccination and the impossibility of discus about future vaccinations and their outcomes seemed the main factors for patients with immune-mediated diseases,influencing vaccine coverage.Further investigations are required to understand the reasons for incomplete vaccinations and improve vaccine coverage in both groups,especially in rheumatic disease patients.The approaches that stimulate vaccination in healthy children are not always optimal in children with immunemediated diseases.It is necessary to provide personalized vaccine-encouraging strategies for parents of chronically ill children with the following validation of these technics.

Application of integrated traditional Chinese and Western medicine in the treatment of juvenile localized scleroderma with skin ulcer: a case report

Background:Juvenile Localized Scleroderma(JLS)is a rare pediatric rheumatic disease characterized by inflammation and skin sclerosis.The side effect of consensus-recommended medications and the risk of disability posed challenges to the JLS treatment.We intend to demonstrate the potential of traditional Chinese medicine in treating JLS with skin ulcers and reducing the dose of glucocorticoid.Method:Here we report a case of a 13-year-old male with JLS who took oral methotrexate tablets of 10 mg/week and methylprednisolone of 6 mg/day for over six months without significant effect and suffered from skin ulcers on the dorsal feet one month after drug cessation.Subsequently,the patient was treated with integrated traditional Chinese and Western medicine of low-dose glucocorticosteroid,adjusted Shenqi Huoxue formula and Jinshe Xiaoyan formula,etc.Results:After integrated treatment,the patient’s dorsal feet ulcers healed and the skin sclerosis and hyperpigmentation improved significantly.Conclusions:This case report suggests that integrated traditional Chinese and Western medicine can be used as an effective treatment for JLS.

Current Review of Systemic Juvenile Idiopathic Arthritis: What Do Paediatricians Need to Know?

Systemic juvenile idiopathic arthritis is classified as an autoimmune entity and a subtype of juvenile idiopathic arthritis, although it has many features of autoinflammatory-type of diseases. This review article will elaborate on the disease’s pathogenesis and its proposed relation to autoinflammatory diseases including defective innate immunity and phagocytosis response leading excessive cytokine release. It also explains the disease’s epidemiology, clinical phenotype, diagnostic challenges, complications and current advancements in the treatment of systemic juvenile idiopathic arthritis, such as IL-1 and IL-6 antagonists and their impact on the disease trajectory. Care of patients with systemic juvenile idiopathic arthritis requires a comprehensive multidisciplinary team to optimize the care and avoid complications of the disease itself such as growth impairment, macrophage activation syndrome or the complications of immunosuppressant and immunomodulatory treatments.

Assessing the anti-estrogenic activity of sodium pentachlorophenol in primary cultures of juvenile goldfish (Carassius auratus) hepatocytes using vitellogenin as a biomarker

Both pentachlorophenol and 2,3,7,8-tetrachlorodibenzo-p-dioxin （TCDD） had been studied widely because of their probable anti-estrogenic activity. Sodium pentachlorophenol （PCP-Na）, as a industrial product used in many fields, usually contains a trace of TCDD. The aim of this study was to assess the anti-estrogenic effect of PCP-Na in juvenile goldfish （Gurassius auratus） hepatocyte cultures using vitellogenin （VTG） as the biomarker. The ID50 of PCP-Na was investigated and then a series of concentrations （0.001 0.5 μg/ml） of PCP-Na were evaluated to estimate the anti-estrogenic activity. Results showed that PCP-Na was cytotoxic for hepatocytes even at very low concentration 〈1.21 μg/ml, and it could not induce VTG at any concentrations tested. Since it failed to stimulate VTG production, the possibility of its anti-estrogenic effect was tested, and a well-known anti-estrogenic compound-tamoxifen was used as positive control. PCP-Na caused a reduction in VTG synthesis in juvenile goldfish （Carassius auratus） hepatocytes at concentrations 〉0.1μg/ml when co-exposure with 1μg/ml 17β-estradiol （E2）, making its anti-estrogenic activity approximately as potent as tamoxifen. Our results indicate that PCP-Na can act as negative modulators of estrogenic function in juvenile goldfish （Carassius auratus） hepatocytes.

Sub-Lethal Effects of Fenvalerate on the Development, Fecundity, and Juvenile Hormone Esterase Activity of Diamondback Moth, Plutella xylostella (L.)

The toxicities of fenvalerate （20% EC） to the 3rd instar larvae of diamondback moth （DBM）, Plutella xylostella （L.）, reared on three host plants viz., radish, oilseed rape, and cabbage were tested. The LC50 values of fenvalerate to the 3rd instar larvae of DBM varied with host plants, however, there wasn＇t any significant difference among them （P〉 0.05）. Similarly, DBM fed on three host plants had same pupal weight, pupal period, pupation rate, adult emergence rate, female ratio, and fecundity. The activity of juvenile hormone esterase （JHE, EC 3.1.1.1） in the 3rd instar larvae of DMB did not significantly vary with host plants, either. These suggested that DBM had similar fitness on the three host plant species. When fed on the host plants pretreated with fenvalerate at the concentrations equivalent to LC20, LC50 and LC50, the pupation rate, pupal weight, adult emergence rate, female ratio, fecundity, and JHE activity of the tested insects were declined as compared with insects in control treatments fed on the same host plant species. Furthermore, the pupal period of the tested insects was extended after fenvalerate treatment. The decrease in JHE activity after fenvalerate treatment in the tested insects could partly explain the changes in the mentioned growth parameters. Whether the role of fenvalerate in the inhibition of JHE activity could serve as a new way to control DBM needs further investigation.

Effectiveness of Huai Qi Huang Granules on Juvenile Collagen-induced Arthritis and Its Influence on Pyroptosis Pathway in Synovial Tissue

Summary:Huai Qi Huang(HQH)exerts great effects in clinic,such as anti-inflammation,immune-regulation,anti-cancer,and so on.However,the mechanism by which HQH protects juvenile idiopathic arthritis(JIA)is obscure.Thus,we explored deeply the protective mechanisms in juvenile collagen-induced arthritis(CIA)rat model.Pyroptosis is Gasdermin D(GSDMD)-dependent programmed cell death,involved in many diseases,such as sepsis.We investigated whether GSDMD-induced pyroptosis take part in mechanisms of juvenile CIA arthritis.Juvenile Wistar rats(3-4 weeks)were injected intradermally with fully emulsified bovine typeⅡcollagen and complete Freund's adjuvant to establish CIA rat models.Later,the CIA rats received oral administration of HQH(4.16 g/kg)once a day from the day 21 of modeling,with the treatment lasting for 28 days.Varieties of indicators were measured for evaluation of anti-inflammation effect of HQH,including hind paw swelling,arthritis scores,micro CT,and histopathological changes and the level of pro-inflammatory cytokines in the serum,including tumor necrosis factor alpha(TNF-α)and interleukin-18(IL-18).The expression of GSDMD and caspasein the joint synovial tissues was detected.The results demonstrated that the expression of the pyroptotic protein GSDMD and its upstream caspase-1 was significantly increased in the synovial tissues of CIA rats.The treatment of HQH ameliorated the symptoms in CIA rats,reduced levels of pro-inflammatory cytokines and hind paw swelling,down-regulated the expression of GDSMD and caspase-1.GSDMDinduced pyroptosis participated in the pathogenesis of CIA rats.The study supported that HQH can effectively improve joints inflammation of juvenile collagen-induced arthritis rats by inhibiting pyroptosis pathway in the joint synovial tissues.

Effects of Salinity and Temperature on Growth and Survival of Juvenile Iwagaki Oyster Crassostrea nippona

Iwagaki oyster Crassostrea nippona occurs naturally along the coasts of Japan and Korea. Because of its unique flavor, delicious taste, edibility during the summer and high commercial value, it has been identified as a potential aquaculture species. To determine the optimum aquaculture conditions and provide necessary information for mass production of the juvenile, the effects of six salinities(15, 20, 25, 30, 35 and 40) and five temperatures(16, 20, 24, 28 and 32℃) on growth and survival of juvenile C. nippona were examined in this study. In the salinity experiment, the largest values of mean shell height and growth rate were observed at salinity 25(20.96 ± 0.36 mm and 172.0 μm d^(-1), respectively), which were significantly different(P < 0.05) with those of other treatments, except at salinity 30(20.56 ± 1.05 mm and 160.3 μm d^(-1), respectively)(P > 0.05). The maximum survival rate 84.44% was always observed at salinity 20, and there was no significant difference(P > 0.05) in survival rate among salinities varying between 15 and 35. In the temperature-related experiments, the highest growth and survival rates of juvenile were observed at 24℃(180.8 μm d^(-1) and 84.4%) and 28℃(190.7 μm d^(-1) and 83.3%), respectively, on day 20, and showed significantly(P < 0.05) larger size and higher survival rate than any other groups. Both juvenile survival and growth were significantly depressed at extreme salinities(15, 40) and temperatures(16℃, 32℃). Based on the results of the present study, a salinity range from 25 to 30 and a temperature range from 24℃ to 28℃ are considered optimal conditions for survival and growth of juvenile C. nippona.

Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles

AIM： To evaluate the positive effects of blue-violet light filtering lenses in delaying myopia and relieving asthenopia in juveniles. METHODS： Sixty ametropia juveniles （aged range, 11-15y） were randomized into two groups： the test group （30 children, 60 eyes）, wearing blue-violet light filtering lenses; and the control group （30 children, 60 eyes）, wearing ordinary aspherical lenses. Baseline refractive power of the affected eyes and axial length of the two groups was recorded. After 1-year, the patients underwent contrast sensitivity （glare and non-glare under bright and dark conditions）, accommodation-related testing, asthenopia questionnaire assessment, and adverse reaction questionnaire assessment. RESULTS： After ly of wearing the filtering lenses, changes in refractive power and axial length were not significantly different between the two groups （P〉0.05）. Under bright conditions, the contrast sensitivities at low and medium- frequency grating （vision angles of 6.3, 4.0, and 2.5） with glare in the test group were significantly higher than in the control group （P〈0.05）, while the contrast sensitivity at low-frequency grating （vision angles of 6.3 and 4.0） in the absence of glare in the test group was higher than in the control group （P〈0.05）. Under glare and non-glare dark conditions, the contrast sensitivities of various frequencies in the test group did not show significant differences compared with those in the control group （P〉0.05）. In the test group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity of patients wearing glasses for 6 and 12mo were significantly elevated （P〈0.05）, while the asthenopia gratings were significantly decreased （P〈0.05）. Nevertheless, in the control group,the amplitude of accommodation, accommodative lag, and accommodative sensitivity after 12mo were not significantly altered compared with baseline （P〉0.05）, and the asthenopia grating was not significantly decreased （P〉0.05）. In addition, after wearing glasses for 6 to 12mo, the asthenopia grating of patients in the test group decreased significantly compared with the control group （P〈0.05）. At 12mo, the constituent ratio of adverse reactions did not show significant difference between the two groups （P〉0.05）. CONCLUSION： A l-year follow-up reveal that compare with ordinary glasses, short-wavelength filtering lenses （blue/ violet-light filters） increase the low- and medium-frequency contrast sensitivity under bright conditions and improved accommodation. They effectively relieved asthenopia without severe adverse reactions, suggesting potential for clinical application. However, no significant advantages in terms of refractive power or axial length progression were found compared with ordinary aspheric lenses.

Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis:A case report

BACKGROUND Juvenile polyps are the most common type of polyps in children but are rare in adults.Inflammatory bowel disease(IBD)patients have a similar spectrum of symptoms as patients with juvenile polyps.Both patients with juvenile polyps and those with active IBD have high fecal calprotectin levels.Four cases of children with ulcerative colitis(UC)with solitary juvenile polyps and one case of an adult with UC with juvenile polyposis syndrome have been reported upon diagnosis of UC,while there have been no cases of adults with UC with solitary juvenile polyp reported in the literature.CASE SUMMARY A 37-year-old man with a 12-year history of UC was admitted to our clinic because of increased stool frequency.UC was diagnosed at the age of 25.As the lesion was confined to the rectum,sulfasalazine suppositories or mesalazine suppositories were used.The patient was followed in an outpatient clinic,and colonoscopy was performed every one or two years.The latest examination was undertaken three years prior in the presence of proctitis.Recently,the patient complained of three to five bowel movements a day.There was mucus in the stool but no visible blood.Colonoscopy revealed a solitary polyp,about 1.5 cm in diameter,with a short and broad peduncle in the transverse colon surrounded by congestive and edematous mucosa.The patient had no family history of colorectal polyps or cancer.The polyp was successfully removed by endoscopic mucosal resection.Histopathological examination revealed that the polyp was a juvenile polyp without any malignant signs.Immunohistochemical staining for p53 showed wild-type expression and p53 overexpression was not detected.Ki67 labeling index was 3%.CONCLUSION This is the first case of an adult UC patient with a solitary juvenile polyp at the 12-year follow-up.The correlation between juvenile polyps and the activity of IBD needs further study.

A New Juvenile Specimen of Lufengosaurus Huenei Young, 1941 (Dinosauria: Prosauropoda) from the Lower Jurassic Lower Lufeng Formation of Yunnan, Southwest China

A skull and a series of associated cervical vertebrae （ZLJ0112） discovered from the Lower Lufeng Formation （Lower Jurassic） are determined as a juvenile specimen of Lufengosaurus huenei Young 1941 based on amended autapomorphies. Differences between ZLJ0112 and the holotype （subadult specimen） are considered as ontogenetic characteristic changes of L. huenei. Since some of these differences are present in other prosauropod dinosaurs （i.e., forms of the maxillary vascular foramen are irregular; the frontal contribution to the dorsal margin of the orbit is substantial; the frontal contribution to the supratemporal fossa is absent; the supratemporal fenestra is visible in lateral view; the supraoccipital inclined at 75 degrees; the parasphenoid rostrum lies level with the occipital condyle; the retroarticular process is short; the axial postzygapophysis project caudally beyond the end of the centrum） they may be common ontogenetic changes in prosauropod dinosaurs.