Botulinum toxin type A in treating early-stage patients with small-angle acute acquired comitant esotropia

AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.

Carotid versus axillary artery cannulation for descending aorta remodeling in type A acute aortic dissection

BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulation.Postoperative descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic remodeling.METHODS A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the study.Of these,209 received right AA cannulation and 234 received bilateral CA cannulation.The primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA group.CONCLUSION The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.

Dermal thickness,rather than drug concentration and injection speed,influences the effective area of botulinum toxin type A in the dermis

Background:Recently,microbotulinum,a new technique that involves injecting botulinum toxin type A(BoNTA)microdroplets into superficial cutaneous tissue,has gained popularity.The precise distribution of BoNTA in the targeted area profoundly affects outcomes.Many factors may influence the effective area of BoNTA in the dermis.This study aimed to determine the dermal distribution properties of BoNTA to guide microbotulinum injection.Methods:Ten healthy males aged 18–65 years without BoNTA treatment in the previous year were recruited to receive intradermal injections in the chest and back.Ultrasound was used to ensure the intradermal delivery of injections and measure the dermal thickness.The minor iodine starch test was performed at baseline and 3 days,7 days,21 days,1 month,and 2 months after treatment.Results:All participants received intradermal injections.The dermis was thinner on the chest(thickness,0.20±0.03 cm)than on the back(thickness,0.39±0.07 cm)(P<0.05).An injection in the thicker dermis had a significantly smaller effective area at every follow-up visit.The drug concentration did not affect the effective area except at 3 days after treatment.Injection speed did not influence the effective area at any follow-up visits.Conclusion:An injection in a thicker dermis leads to a smaller effective area for intradermal injections.When the BoNTA dose is the same,the drug concentration and injection speed do not matter.

Botulinum toxin type A for treating chronic low back pain:A double blinded randomized control study

BACKGROUND Low back pain(LBP)is a prevalent issue that orthopedic surgeons frequently address in the outpatient setting.LBP can arise from various causes,with stiffness in the paraspinal muscles being a notable contributor.The administration of Botulinum toxin type A(BoNT-A)has been found to alleviate back pain by relaxing these stiff muscles.While BoNT-A is approved for use in numerous conditions,a limited number of randomized clinical trials(RCTs)validate its efficacy specifically for treating LBP.AIM To study the safety and the efficacy of BoNT-A in minimizing pain and improving functional outcomes in patients of chronic LBP(CLBP).METHODS In this RCT,adults aged 18-60 years with mechanical LBP persisting for at least six months were enrolled.Participants were allocated to either the Drug group,receiving 200 Ipsen Units(2 mL)of BoNT-A,or the Control group,which received a 2 mL placebo.Over a 2-month follow-up period,both groups were assessed using the Visual Analog Scale(VAS)for pain intensity and the Oswestry Disability Index(ODI)for disability at the start and conclusion of the study.A decrease in pain by 50%was deemed clinically significant.RESULTS The study followed 40 patients for two months,with 20 in each group.A clinically significant reduction in pain was observed in 36 participants.There was a statistically significant decrease in both VAS and ODI scores in the groups at the end of two months.Nonetheless,when comparing the mean score changes,only the reduction in ODI scores(15 in the placebo group vs 16.5 in the drug group,clinically insignificant)was statistically significant(P=0.012),whereas the change in mean VAS scores was not significant(P=0.45).CONCLUSION The study concludes that BoNT-A does not offer a short-term advantage over placebo in reducing pain or improving LBP scores in CLBP patients.

Progress in pathogenesis and treatment of type A hepatic encephalopathy in acute liver failure:a comprehensive review

Hepatic encephalopathy is a serious neuropsychiatric complication caused by liver failure,which is characterized by the development of cognitive and motor disorders into coma.Typically,hepatic encephalopathy can be divided into three types(A,B,and C)according to the etiology.Type A hepatic encephalopathy(AHE)caused by acute liver failure seriously affects the prognosis of patients,ranging from mild neuropsychological changes to coma,brain edema,and even death.So far,the research on the pathogenesis of AHE has focused on the toxic effects of ammonia on the central nervous system,metabolic disorders(glutamine and lactate accumulation),neurotransmission alteration,systemic inflammation,especially neuro-inflammation.All these mechanisms are not independent,but mutually have synergistic effects.In clinic,treatment of AHE based on only one mechanism is often ineffective.To clarify the pathogenesis and the interaction among the mechanisms will be beneficial to the effective treatment of AHE and reduce the mortality.The aim of this review is to provide comprehensive scientific evidence for the clinical treatment of AHE via collecting and analyzing the latest mechanism of AHE,and clarifying the relationship among these mechanisms combing the investigation of the latest research progress of drug treatment of acute liver failure.Consequently,we find that the pathogenesis of AHE is a complex neurocognitive disorder shaped by interactions among hyperammonemia,inflammation,and changes in neurotransmission,the signaling pathways thereby integrating the inflammatory and neurological inputs to impact pathophysiological or neurobehavioral outcomes.

Numerical Simulation on Production Trials by Using Depressurization for Typical Marine Hydrate Reservoirs:Well Type and Formation Dip

Natural gas hydrate has huge reserves and is widely distributed in marine environment.Its commercial development is of great significance for alleviating the contradiction between energy supply and demand.As an efficient research method,numerical simulation can provide valuable insights for the design and optimization of hydrate development.However,most of the current production models simplify the reservoir as a two-dimensional(2D)horizontal layered model,often ignoring the impact of formation dip angle.To improve the accuracy of production prediction and provide theoretical support for the optimization of production well design,two three-dimensional(3D)geological models with different dip angles based on the geological data from two typical sites are constructed.The vertical well,horizontal well and multilateral wells are deployed in these reservoirs with different permeabilities to perform production trial,and the sensitivity analysis of dip angles is also carried out.The short-term production behaviors in high and low permeability reservoirs with different dip angles are exhibited.The simulation results show that 1)the gas and water production behaviors for different well types in the two typical reservoirs show obviously different variation laws when the short-term depressurization is conducted in the inclined formation;2)the inclined formation will reduce the gas production and increase the water extraction,and the phenomena becomes pronounced as the dip angle increases,particularly in the low-permeability reservoirs;3)and the impact of formation dip on hydrate recovery does not change significantly with the variation of well type.

An explorative study on document type assignment of review articles in Web of Science,Scopus and journals’websites

Purpose:Accurately assigning the document type of review articles in citation index databases like Web of Science(WoS)and Scopus is important.This study aims to investigate the document type assignation of review articles in Web of Science,Scopus and Publisher’s websites on a large scale.Design/methodology/approach:27,616 papers from 160 journals from 10 review journal series indexed in SCI are analyzed.The document types of these papers labeled on journals’websites,and assigned by WoS and Scopus are retrieved and compared to determine the assigning accuracy and identify the possible reasons for wrongly assigning.For the document type labeled on the website,we further differentiate them into explicit review and implicit review based on whether the website directly indicates it is a review or not.Findings:Overall,WoS and Scopus performed similarly,with an average precision of about 99% and recall of about 80%.However,there were some differences between WoS and Scopus across different journal series and within the same journal series.The assigning accuracy of WoS and Scopus for implicit reviews dropped significantly,especially for Scopus.Research limitations:The document types we used as the gold standard were based on the journal websites’labeling which were not manually validated one by one.We only studied the labeling performance for review articles published during 2017-2018 in review journals.Whether this conclusion can be extended to review articles published in non-review journals and most current situation is not very clear.Practical implications:This study provides a reference for the accuracy of document type assigning of review articles in WoS and Scopus,and the identified pattern for assigning implicit reviews may be helpful to better labeling on websites,WoS and Scopus.Originality/value:This study investigated the assigning accuracy of document type of reviews and identified the some patterns of wrong assignments.

Basic Research on the Burden of Dropping off and Picking up Children: Differences by Employment Type and Gender in the Tokyo Metropolitan Area

There is a need to reduce the burden of child drop-off and pick-up for child-rearing generations, but most studies on the actual situation in Japan are based on survey results. In this study, we analyzed differences in child drop-off and pick-up by employment type and gender, utilizing the “Metropolitan Area Person Trip Survey,” which is a statistical data set. The study targeted households in which both spouses were between 30 and 49 years old, had children under the age of 6, and included the following three groups. 1) Dual-income Group 1 (both spouses employed/on contract/temporary);2) Dual-income Group 2 (husband employed/on contract/temporary, wife part-time);3) Full-time housewife group (husband employed, wife unemployed). The analysis revealed that a) wives are almost always responsible for dropping off and picking up their children;b) husbands drop off and pick up their children less frequently in dual-income households;and c) households with children raising within 10 to 30 km of Tokyo Station have longer commuting times and need to reduce the burden of dropping off and picking up their children.

Text Type and C-E Translation of Public Signs

This paper contends that the public sign is a kind of text with such vocative functions as indicating,instructing,restricting,prohibiting,persuading,and publicizing,so it falls into the type of vocative texts.The paper suggests that conveying the vocative function of the public sign is the essential task of the translator,so as to achieve the intended effect of the public sign.

Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery

Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.

Postoperative hypoxemia for patients undergoing Stanford type A aortic dissection

Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease characterized with an acute onset,poor prognosis,and high mortality.However,the incidences of postoperative complications are relatively higher due to the complexity of the disease and its intricate procedure.It has been considered that hypoxemia,one of the most common postoperative complications,plays an important role in having a worse clinical prognosis.Therefore,the effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford type A aortic dissection.

The Anzhen Risk Scoring System for Acute Type A Aortic Dissection:A Prospective Observational Study Protocol

Introduction:Acute type A aortic dissection(ATAAD)is a catastrophic disease with fatal outcomes.Malperfusion syndrome(MPS)is a serious complication of ATAAD,with an incidence of 20–40%.Many studies have shown that MPS is the main risk factor for poor ATAAD prognosis.However,a risk scoring system for ATAAD based on MPS is lacking.Here,we designed a risk scoring system for ATAAD to assess mortality through quantitative assessment of relevant organ malperfusion and subsequently develop rational treatment strategies.Methods and analysis:This was a prospective observational study.Patients’perioperative clinical data were col-lected to establish a database of ATAAD(N≥3000)and determine whether these patients had malperfusion complica-tions.The Anzhen risk scoring system was established on the basis of organ malperfusion by using a random forest survival model and a logistics model.The better method was then chosen to establish a revised risk scoring system.Ethics and dissemination:This study received ethical approval from the Ethics Committees of Beijing Anzhen Hospital,Capital Medical University(KS2019034-1).Patient consent was waived because biological samples were not collected,and no patient rights were violated.Findings will be disseminated at scientific conferences and in peer-reviewed publications.

Systematic evaluation of the efficacy and safety of botulinum toxin type A in the treatment of spastic cerebral palsy

Background:Botulinum toxin type A(BTX-A)is a neuromuscular blocking agent.BTX-A inhibits acetylcholine release,causes neuromuscular transmission impairment,and decreases muscle spasms.Objective:To explore the efficacy and safety of BTX-A injection in the treatment of spastic cerebral palsy through systematic evaluation and to provide a reference for the clinical use of BTX-A.Methods:We used“Cerebral palsy”and“BTX-A”as the subject terms and used a combination of subject terms and free words for the search.We searched 7 databases,including CNKI,Wanfang,VIP,Sinomed,PubMed,Embase,and Web of science.Based on the inclusion and exclusion criteria,we screened the articles by reading their titles,abstracts,and full texts and finally included relevant literature for systematic evaluation.Result:A total of 93 papers were systematically evaluated,revealing that BTX-A injection treatment can effectively reduce muscle tone,increase joint mobility,improve gait and motor posture,and enhance gross motor movements in patients with spastic cerebral palsy.The benefits of BTX-A treatment can be sustained for 3–6 months,with motor ability improvement lasting up to 1 year.Combining BTX-A treatment with rehabilitation or external fixation therapy can enhance its efficacy.However,the effectiveness of BTX-A treatment is influenced by several factors,such as the dosage,number of injections,and patient age.Adverse reactions to BTX-A treatment are typically mild and can be relieved within 1–2 weeks.Conclusion:BTX-A injection is relatively safe but reversible.

STUDIES ON THE PROPERTIES OF SCHIFF BASE TYPE ARYLMERCURY COMPOUNDS Ⅲ TRANSMETALLATION REACTION OF SCHIFF BASE TYPE ARYLMERCURY COMPOUNDS WITH METALLIC TIN

The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phenylazo)phenyl]mercury(Ⅱ) to give dichlorobisaryltin(Ⅳ).The ~1H NMR spectra of the products provide evidence for the presence of N→Sn intramolecular coordination.The formation of dichlorobisaryltin(Ⅳ)as a unique product probably arises from the N→Sn intramolecular coordination which results in the increasing of the stability of the molecule.

Division of forest fuel type areas of Heilongjiang Province by using GIS

Eight factors, including forest coverage, fuel load, species composition, elevation, monthly mean temperature, monthly mean relative humidity, monthly mean wind velocity, and monthly mean precipitation of fire season, were considered and the methods of weight, the cumulative probability, ARC/INFO technique, and raster-to-vector conversion were adopted in division of forest fuel type area. Firstly, the electronic maps of forest distribution and administrative divisions were built, then overlaid and transformed to the real-world coordinates. Finally, the forest fuel type areas of Heilongjiang Province including 81 counties were divided into five grades, accounting for 16%, 17%, 17%, 11%, and 38% respectively. The grade Ⅰ fuel type areas with highest fire danger rating mainly distributed on Daxinganling Mountains, Xiaoxinganling Mountains, and Zhangguangcailing Mountains, the grade Ⅴ fuel type areas mainly centralized on Songnen Plain, Sanjiang Plain, and other Plains, and other forest fuel type areas (grades Ⅱ, Ⅲ, and Ⅳ) were situated between plains and mountainous areas.

高集成度TYPE A读写器芯片MF RC500及其应用

介绍了高集成度TYPEA读写器芯片MFRC500的内部电路结构 ,并对其内部寄存器的有关命令及加密算法等功能做了较详细的阐述 。

Mating Genotype Analysis of Ganoderma lucidum Populations

[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ technique was applied to identify standard mating types and determinate mating genotype between groups of monokaryons isolates from 24 G. lucidum stains. Genetic relationships were analyzed by combined group mating genotype determination with esterase isozyme assay. [Result] All strains of G. lucidum could be divided into 7 large groups of the mating genotype. Four alleles of A factor, four alleles of B factor and one mixed alleles of A factor were found in this study. Distorted segregation ratio among monokaryon mycelia of G. lucidum had been observed in four kinds of mat- ing types to some extent. Twenty-eight different types of enzyme bands were determined in esterase isozyme test, Twenty-four strains of G. lucidum could be divided into 9 large groups through the cluster analysis when the genetic similarity coefficient was 0.73214. Comparing the results of mating genotype analysis and esterase isozyme analysis, it showed great similarity. [Conclusion] Mating genotype analysis could be used as an important supplementary method for strain identification and genetic diversity research.

Treatment of Stanford type A aortic dissection with triple prefenestration, reduced diameter, and three-dimensional-printing techniques: A case report

BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.

Origin of C type adakite magmas in the NE Xing＇an block, NE China and tectonic implication

In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatial extent of the influence of the Mongol-Okhostsk ocean tectonic regime and the collision between the Jiamusi Massif and Songliao Terrane. New zircon laser-ablation inductivity coupled plasma mass spectrometry （LA-ICP-MS） U-Pb data indicated that the monzogranites in the studied area were emplaced in the Early Jurassic （～ 180 Ma）. These rocks were characterized by unusally high SiO2 （≥67.49）, and Sr （461-759 ppm）, but strikingly low Y （4.63-8.06 ppm） and HREE （∑HREE = 3.83-6.49 ppm, Yb = 0.5-0.77 ppm） contents, with therefore high Sr/Y （67.2-119） and （La/Yb）N （29.7-41.5） ratios, showing the geochemical characteristics of C type adakitic granite. The data displayed negligible Eu anomalies （Eu/Eu^＊ =0.77-1.08）, LREE-enriched and pronounced negative Nb and Ta anomalies. The C-type adakites in the studied area were most likely derived from the partial melting of a thickened lower continental curst. The magma source is most likely dominated by amphibolites and garnet amphibolites. In combination with previously-reported data from igneous rocks from the Mesozoic in NE China, we conclude that the Xing＇ an block was influenced by the Mongol-Okhotsk subduction tectonic system, and experiences compressive settings from the amalgamation of the Jiamusi block in the east of the CAOB.

THE PROPERTIES AND LONGITUDINAL EXPERIENCE OF CHINESE TYPE A BOTULINUM TOXIN FOR THE TREATMENT OF FOCAL DYSTONIA AND HEMIFACIAL SPASM

Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and recovery of crude and crystalline toxin were tested.Long?term data from305patients with hemifacial spasm(HFS),blepharospasm(BS)and cervical dystonia(CD)were evalu-ated and subgroups of patients received CBTXA injections between1994and2000in at least six sepa-rate treatment sessions,with follow up for2～8years.The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session.Result.CBTXA purity was high[(2.55～2.60)×10 7 LD50/mgPr ,A260/A280≤0.55,high molecular substance accounted for99.2%of total proteins].Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit,and efficacy may improve slightly with repeat treatments.CBTXA is an excellent long-term treatment of HFS,BS and CD.Conclusion.We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long?term clinical applications.The re?injection of CBTXA significantly improves the quality of life of most patients and is a safe,effective and comparatively economical treatment for patients with focal dystonia and HFS.