One-year clinical efficacy evaluation of selective corneal wavefront aberration-guided FS-LASIK correction in patients with high myopia

AIM:To evaluate the effectiveness,safety,predictability,precision and changes of higher-order aberrations(HOAs)on corneal front surface of selective corneal wavefront aberration-guided femtosecond laser-assisted in situ keratomileusis(CW-FS-LASIK)in patients with high myopia 1-year postoperatively.METHODS:Totally 74 eyes of 37 patients with high myopia or myopic astigmatism in both the eyes who underwent the CW-FS-LASIK procedure in Xi’an Gaoxin Hospital from January 2021 to June 2021 were included.The changes of uncorrected distance visual acuity(UDVA),best corrected visual acuity(BCVA),spherical equivalent refraction(SER),astigmatism,HOAs and Strehl ratio(SR)on the anterior surface of the cornea after 1y of the surgery were analyzed.RESULTS:At postoperative 1y,the UDVA(logMAR)of 74 eyes(100%)reached 0 or better,including 0 in 8 eyes(10.81%),-0.1 in 45 eyes(60.81%),and-0.2 in 21 eyes(28.38%).The effectiveness index was 1.29±0.134.There was no decrease in postoperative BCVA compared with preoperative BCVA in all patients.Postoperative BCVA was the same in 44 eyes(59.46%)as preoperative BCVA,increased by 1 line in 23 eyes(31.08%)and increased by 2 lines in 7 eyes(9.46%)compared with preoperative BCVA.The safety index was 1.11±0.159.The estimated corrected SER before surgery was(-7.76±1.21)D,and the actual corrected SER was(-7.83±1.25)D(Y=0.9811X+0.2156,R2=0.9084).There was a high correlation between the estimated corrected SER and the actual corrected SER.The postoperative SER in 74 eyes(100%)was within±0.75 D.The postoperative astigmatism of all was within-0.75 D to 0.Root mean square(RMS)HOAs of spherical aberration and SR within 5 mm of the corneal front surface were all increased compared with those before operation(P<0.01).The total coma,horizontal coma and vertical coma were all decreased compared with those before operation(P<0.01).There was no statistically significant difference in horizontal trefoil and vertical trefoil compared with preoperative ones(P>0.05).CONCLUSION:Selective CW-FS-LASIK for correction of high myopia is effective,safe,predictive,and accurate.For patients with preoperative RMS HOAs over 0.25 defocus equivalent,postoperative coma aberration can be significantly reduced,and SR value can be increased,thus corneal imaging quality can be improved.

Changes in corneal biomechanics and posterior corneal surface elevation after FS-LASIK

AIM:To investigate the changes in corneal biomechanics and posterior corneal surface elevation after femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:Totally 197 eyes of 100 patients who underwent the FS-LASIK from April 2022 to November 2022 were included.They were divided into three groups according to the ratio of residual corneal stroma thickness/corneal thickness(RCST/CT):Group I(50%≤RCST/CT<55%,63 eyes of 32 patients),Group II(55%≤RCST/CT<60%,67 eyes of 34 patients),and Group III(RCST/CT≥60%,67 eyes of 34 patients).The intraocular pressure(IOP),corneal compensated IOP(IOPcc),corneal hysteresis(CH)and corneal resistance factor(CRF)were measured immediately,1,and 3mo postoperatively by ocular response analyzer(ORA)and the posterior elevation difference(PED)was measured by Pentacam.RESULTS:After operation,IOP,CH,CRF,and PED were statistically different among the three groups(F=12.99,31.148,23.998,all P<0.0001).There was no statistically significant difference in IOPcc among the three groups(F=0.603,P>0.05).The IOP,IOPcc,CH,and CRF were statistical changed after surgery(F=699.635,104.125,308.474,640.145,all P<0.0001).The PED of Group I was significantly higher than that of Group II(P<0.05),and Group II was significantly higher than that of Group III(P<0.05).The PED value of 3mo after surgery decreased in each group compared with 1mo after surgery,but there was no statistical difference(Group I:t=0.82,P=0.41;Group II:t=0.17,P=0.87;Group III:t=1.35,P=0.18).The correlation analysis of corneal biomechanical parameter changes with PED at 1mo and 3mo after surgery showed thatΔIOP,ΔIOPcc,ΔCH,andΔCRF were not correlated with PED value in three groups(P>0.05).CONCLUSION:The smaller the RCST/CT,the greater effect on corneal biomechanics and posterior surface elevation.There is no correlation between changes in corneal biomechanics and posterior corneal surface elevation in the range of RCST/CT≥50%.

Using machine learning to identify factors related to nitrous oxide(laughing gas)relapse among adolescents

Introduction Nitrous oxide(N2O/laughing gas)has been used in medical practice as an inhalational anaesthetic and analgesic for more than 150 years.1 In the past decades,N2O exhibited increasing popularity among recreational drug users for its euphoric effects,potentially through its interaction with the endogenous opioid system.2 Recreational use of N2O emerged as the seventh most used drug globally in the past decade.3 The use of N2O can cause myelopathy,myocardial injury,anaemia,severe mood disorders,sensory and motor neuropathy,and psychotic symptoms.45 Prolonged N2O intake results in vitamin B12 deficiency and inhibits methionine synthetase,folate and DNA production,leading to plasma homocysteine(HCY)level elevation and bone marrow haematopoietic dysfunction.6 This study aimed to investigate the neurological symptoms of nitrous oxide use and then explore the relapse trajectory and risk factors for relapse.

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke （59.6%） was the primary stroke type found in the young group, while ischemic stroke （60.0%） was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction （such as friendship） improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage

BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality.Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population.Treatment of acute lower gastrointestinal(GI)bleeding(any site below the ligament of Treitz)using this technique has not reached a consensus,because of the belief that the risk of intestinal infarction in this condition is extremely high.The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.AIM To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding.METHODS A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed.The success rate and complication rate of super-selective embolization were recorded.RESULTS Five out of thirty-one patients(16.1%)could not achieve sufficiently selective catheterization to permit embolization.Initial control of bleeding was achieved in 26 patients(100%),and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation.No clinically apparent bowel infarctions were observed in patients undergoing embolization.CONCLUSION Super-selective embolization is a safe therapeutic method for acute lower GI bleeding,and it is suitable and effective for many patients suffering this disease.Importantly,careful technique and suitable embolic agent are essential to the successful operation.

Role of argon plasma coagulation in treatment of esophageal varices

With the development of endoscopic therapy,argon plasma coagulation(APC)has been widely used by endoscopists.It has many advantages,such as simple to operate,low cost,and minimal invasiveness.Because of its capability of lesion ablation and hemostasis,APC has several indications in the gastrointestinal tract.One of them is esophageal varices.The aim of this review is to summarize the research on APC in this field to provide a reference for clinical practice.

Abdominal bronchogenic cyst:A rare case report

BACKGROUND Bronchogenic cysts are cystic masses caused by congenital abnormal development of the respiratory system,and usually occur in the pulmonary parenchyma or mediastinum.CASE SUMMARY A rare case of a bronchogenic cyst discovered in the abdominal cavity of a 35-year-old man is reported.Physical examination found a space-occupying lesion in the patient’s abdomen for 4 d.Laparoscopic exploration found the cyst tightly adhered to the stomach and its peripheral blood vessels;therefore,intraoperative laparotomy was performed.The cystic mass was resected en bloc with an Endo-GIA stapler.The final postoperative pathological diagnosis confirmed an abdominal bronchogenic cyst.CONCLUSION This is a rare case of a bronchogenic cyst that was discovered within the abdominal cavity of a male patient.The cyst is easily confused with or misdiagnosed as other lesions.Therefore,it is necessary to distinguish abdominal bronchogenic cyst from gastrointestinal stromal tumor,Meckel’s diverticulum,enteric duplication cyst,or lymphangioma.Although computer tomography and magnetic resonance imaging were the primary diagnostic approaches,endoscopic ultrasound-guided fine-needle aspiration could assist with clarification of the cytological or histopathological diagnosis before surgery.

Treatment of Vertically Unstable Sacral Fractures with Pelvic External Fixation and Skeletal Traction

Objective: To determine the efficacy in treatment of vertically unstable sacral fractures with pelvic external fixation and skeletal traction. Patients and Methods: The pelvic external fixation and skeletal traction were applied on 12 cases of vertically unstable sacral fracture (eight males and four females, at age of 19 - 52 years, mean 35.2 years) including two cases of Denis Zone I, nine of Zone II, and one of Zone III. All patients were treated with the pelvic external fixation, and pre- and post-operational longitudinal skeletal traction. Results: The mean operation time, skeletal traction time, skeletal traction removal time and full weight bearing time were 38 min, 4.5 weeks, 8.5 weeks, and 10.3 weeks respectively. All these patients were followed up for 12 - 36 months (average, 22.5 months), which showed no associated complication. The function results were rated as excellent in four cases, good in six and fair in two, with a mean score of 84.4 points, according to Majeed scoring system. Conclusion: The anterior pelvic external fixation with continuous skeletal traction can reliably restore and stabilize the vertically unstable sacrum fracture with excellent functional and radiographic outcomes. It is an ideal method to treat unstably vertical sacral fracture.

A clinical study on the treatment of obese polycystic ovary syndrome by electroacupuncture combined with moving cupping

Objective:Effect analysis of electroacupuncture combined with recircupping in treatment of obese polycystic ovary syndrome.Methods: From October 2016 to September 2018, 68 obese PCOS patients were diagnosed and treated in the department of gynaecology, affiliated hospital of shaanxi university of traditional Chinese medicine.Treatment group given cupping and tired walking tank with metformin therapy, the control group only oral metformin treatment, after continuous treatment of three menstrual cycles, observation comprehensive curative effect of two groups before and after treatment, TCM syndrome score, body weight, body mass index (BMI), waist hip ratio (WHR), sex hormone [luteinizing hormone (LH), testosterone (T)], blood sugar [fasting plasma glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMA IR)] and blood lipid [triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC)] metabolic index, on two groups of curative effect are compared and discussed. Results:The total effective rate (83.33%) of the treatment group was higher than that of the control group (66.67%)(P<0.05).After treatment, TCM syndrome score of the two groups decreased significantly(P<0.01).The treatment group was significantly improved compared with the control group (P<0.01).Body weight, BMI, WHR of the two groups decreased significantly after treatment (P<0.01).The treatment group was better than the control group (P<0.05).After treatment, the LH and T values of the two groups decreased significantly (P<0.01).There was no significant difference in T value between the two groups (P>0.05), but the efficacy of LH in the treatment group was better than that in the control group (P<0.01).The levels of FINS, HOMA-IR and FPG in the two groups were significantly decreased after treatment (P<0.01).There was no significant difference in FPG between the two groups (P > 0.05), but the improvement of FINS and HOMA-IR in the treatment group was better than that in the control group (P< 0.01).After treatment, TG, LDL-C and TC levels in the two groups decreased (P< 0.01), while HDL-C levels in the treatment group increased (P< 0.01).There was no significant difference in HDL-C, LDL-C and TC between the two groups (P>0.05), but the efficacy of TG in the treatment group was better than that in the control group (P< 0.01).Conclusion: The curative effect of electroacupuncture and moving cupping combined with metformin is better than that of metformin alone, should be widely used.

Timing of convalescent plasma therapy-tips from curing a 100-yearold COVID-19 patient using convalescent plasma treatment: A case report

BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.

Effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection

Objective:To study the effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection.Methods: A total of 74 patients who received brain glioma resection in our hospital between May 2014 and December 2016 were selected and randomly divided into Dex group and control group who received dexmedetomidine intervention and saline intervention before induction respectively. Serum brain tissue damage marker, PI3K/AKT/iNOS and oxidation reaction molecule contents as well as cerebral oxygen metabolism index levels were determined before anesthesia (T0), at dura mater incision (T1), immediately after recovery (T2) and 24 h after operation (T3).Results: Serum NSE, S100B, MBP, GFAP, PI3K, AKT, iNOS and MDA contents as well as AVDO2 and CERO2 levels of both groups at T2 and T3 were significantly higher than those at T0 and T1 while serum SOD and CAT contents as well as SjvO2levels were significantly lower than those at T0 and T1, and serum NSE, S100B, MBP, GFAP, PI3K, AKT, iNOS and MDA contents as well as AVDO2 and CERO2 levels of Dex group at T2 and T3 were significantly lower than those of control group while serum SOD and CAT contents as well as SjvO2 levels were significantly higher than those of control group.Conclusions: Dexmedetomidine combined with propofol can reduce the brain tissue damage in brain glioma resection.

Affected cortico-striatal-cerebellar network inschizophrenia with catatonia revealed by magneticresonance imaging:indications for electroconvulsive therapy and repetitive transcranial magnetic stimulation

Catatonia is a psychomotor syndrome that can occur in a broad spectrum of brain disorders,including schizophrenia.Current findings suggest that the neurobiological process underlying catatonia symptoms in schizophrenia is poorly understood.However,emerging neuroimaging studies in catatonia patients have indicated that a disruption in anatomical connectivity of the cortico-striatal-cerebellar system is part of the neurobiology of catatonia,which could serve as a target of neurostimulation such as electroconvulsive therapy and repetitive transcranial magnetic stimulation.

Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies

Aims:Minimal hepatic encephalopathy(MHE)significantly affects the prognosis of patients with cirrhosis.This study was performed to determine whether there is a difference in the prevalence of MHE among patients with cirrhosis of different etiologies and whether the etiology directly influences the occurrence of MHE.Methods:This multicenter,cross-sectional study enrolled 1879 patients with confirmed cirrhosis at 40 hospitals from October 25,2021,to January 10,2023(Trial registration:https://clinicaltrials.gov/[NCT05140837]).The patients'demographics,etiologies of cirrhosis,and laboratory test results were collected.The psychometric hepatic encephalopathy score(PHES)was determined in all patients to screen for MHE.Multivariate logistic analyses were performed to identify the risk factors for MHE.Results:In total,736 patients with cirrhosis were analyzed.The prevalence of MHE was 42.0%(n=309).The primary etiology among all patients was hepatitis B virus(HBV)-related cirrhosis(71.9%[529/736]).The prevalence of MHE was significantly higher in patients with alcoholic cirrhosis(57.1%[40/70])than in those with HBV-related cirrhosis(40.6%[215/529],p=0.009)or hepatitis C virus(HCV)-related cirrhosis(38.2%[26/68],p=0.026).Age(odds ratio[OR],1.042;95%confidence interval[CI],1.024-1.059;p<0.001),duration of education(OR,0.935;95%CI,0.899-0.971;p=0.001),etiology(OR,1.740;95%CI,1.028-2.945;p=0.039),and high MELD-Na scores(OR,1.038;95%CI,1.009-1.067;p=0.009)were independent risk factors for MHE.When patients with cirrhosis of different etiologies were analyzed separately,the results showed that age(OR,1.035;95%CI,1.014-1.057;p=0.001)and duration of education(OR,0.924;95%CI,0.883-0.966;p=0.001)were risk factors for MHE among patients with HBV-related cirrhosis,whereas age(OR,1.138;95%CI,1.033-1.254;p=0.009)and creatinine concentration(OR,16.487;95%CI,1.113-244.160;p=0.042)were risk factors for MHE in patients with HCV-related cirrhosis.No risk factors for MHE were found in patients with autoimmune cirrhosis.For patients with alcoholic cirrhosis,the platelet count(OR,1.014;95%CI,1.000-1.027;p=0.045)was a risk factor for MHE.The PHES subtest results were inconsistent among patients who had MHE with cirrhosis of different etiologies.Patients with HBV-related cirrhosis performed better on Number Connection Test B and the serial dotting test than those with alcoholic cirrhosis(p=0.007 and p<0.001),better on Number Connection Test B than those with HCV-related cirrhosis(p=0.020),and better on the line tracing test than those with autoimmune cirrhosis(p=0.037).Conclusion:The etiology of cirrhosis affected the prevalence of MHE and risk factors for MHE.The domains of major cognitive impairment varied among patients with cirrhosis of different etiologies.Further studies are required to verify these findings.

A Bayesian Stepwise Discriminant Model for Predicting Risk Factors of Preterm Premature Rupture of Membranes： A Case-control Study

Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically different between the case and control subgroups （P 〈 0.05）. All etiological agents were introduced into the Bayesian stepwise discriminant model showed that UU, CT, and GBS infections were the main contributors to PPROM, with coe｜＇ficients of 0.441,3.347, and 4.126, respectively. The accuracy rates of the Bayesian stepwise discriminant analysis between the case and control subgroup were 84.1% and 86.8% in the training and validation groups, respectively. Conclusions： This study established a Bayesian stepwise discriminant model to predict the incidence of PPROM. The UU, CT, and GBS infections were discriminant factors for PPROM according to a Bayesian stepwise discriminant analysis. This model could provide a new method for the early predicting of PPROM in pregnant women.

Overexpressed long noncoding RNA CRNDE with distinct alternatively spliced isoforms in multiple cancers

Alternative splicing is a tightly regulated process that contributes to cancer development.CRNDE is a long noncoding RNA with alternative splicing and is implicated in the pathogenesis of several cancers.However,whether deregulated expression of CRNDE is common and which isoforms are mainly involved in cancers remain unclear.In this study,we report that CRNDE is aberrantly expressed in the majority of solid and hematopoietic malignancies.The investigation of CRNDE expression in normal samples revealed that CRNDE was expressed in a tissue- and cell-specific manner.Further comparison of CRNDE expression in 2938 patient samples from 15 solid and hematopoietic tumors showed that CRNDE was significantly overexpressed in 11 malignancies,including 3 reported and 8 unreported,and also implicated that the overexpressed isoforms differed in various cancer types.Furthermore,anti-cancer drugs could efficiently repress CRNDE overexpression in cancer cell lines and primary samples,and even had different impacts on the expression of CRNDE isoforms.Finally,experimental profiles of 12 alternatively spliced isoforms demonstrated that the spliced variant CRNDE-g was the most highly expressed isoform in multiple cancer types.Collectively,our results emphasize the cancer-associated feature of CRNDE and its spliced isoforms,and may provide promising targets for cancer diagnosis and therapy.