Oseltamivir (Tamiflu)-induced bilateral acute angle closure glaucoma and transient myopia

A 27-year-old woman developed bilateral acute angle closure glaucoma (AACG) and transient myopia after taking oseltamivir for four days. On the fourth day, she received systemic and topical intraocular pressure (IOP)-lowering agents, and IOP decreased in both eyes. However, her visual acuity was unchanged. A myopic shift of -5.25 D OD and -5.0 D OS was estimated to have occurred in the acute phase. A-scan ultrasonography and Pentacam showed markedly shallow anterior chambers and increased lens thickness. Ultrasound biomicroscopy revealed an annular ciliochoroidal effusion with forward displacement of the lens-iris diaphragm. Ciliochoroidal effusion and transient myopia were resolved after discontinuation of oseltamivir.     

Management of Neurogenic Orthostatic Hypotension

The burden of orthostatic hypotension (OH) on public health is a universally recognized enigmatic clinical condition that is associated with significant increases on morbidity and mortality rates, and can take a major toll on one's quality of life. Orthostatic hypotension is predictive of vascular deaths from acute myocardial infarction, strokes in the middle aged population, and increases mortality rates when associated with diabetes, hypertension, Parkinson's disease, and patients receiving renal dialysis. The consensus definition for OH is a fall in systolic blood pressure of at least 20 mm Hg and/or diastolic blood pressure of at least 10 mm Hg within 3 minutes of quiet standing. Because neurogenic OH is often accompanied by supine hypertension, the treatment program should aim toward minimizing OH and the potential fall injuries related to cerebral hypoperfusion without exacerbating nocturnal hypertension that may lead to excessive cardiovascular complications.     

The Secret Life of Exosomes: What Bees Can Teach Us About Next-Generation Therapeutics

Mechanistic exploration has pinpointed nanosized extracellular vesicles, known as exosomes, as key mediators of the benefits of cell therapy. Exosomes appear to recapitulate the benefits of cells and more. As durable azoic entities, exosomes have numerous practical and conceptual advantages over cells. Will cells end up just being used to manufacture exosomes, or will they find lasting value as primary therapeutic agents? Here, a venerable natural process—the generation of honey—serves as an instructive parable. Flowers make nectar, which bees collect and process into honey. Cells make conditioned medium, which laboratory workers collect and process into exosomes. Unlike flowers, honey is durable, compact, and nutritious, but these facts do not negate the value of flowers themselves. The parallels suggest new ways of thinking about next-generation therapeutics.     

Homozygote C/C at rs12543318 was risk factor for non‐syndromic cleft lip only from Western Han Chinese population

Non‐syndromic cleft lip with or without cleft palate (NSCL/P) is a complex disorder, and it results from both of the genetic modifiers and environmental factors, with genetic modifiers contributes to it more than environmental factors. GWASs made great progress in identifying the candidate genes for NSCL/P, but the findings need to be replicated in other populations. In this study, we selected eleven SNPs from recent GWASs and GWAS meta‐analysis to investigate their associations among 308 NSCL/P trios (134 non‐syndromic cleft lip only (NSCLO) trios and 174 non‐syndromic cleft lip with cleft palate (NSCLP) trios) from Han Chinese population. All SNPs were genotyped using SNPscan method and analyzed the data with FBAT, PLINK, and R package. Allelic TDT analysis showed that allele A at rs12543318 was associated with NSCLO trios (P = .0032, OR = 0.57, 95% CI: 0.39‐0.83), and parent‐of‐origin effect analysis indicated that allele A at rs12543318 was significantly maternally undertransmitted among NSCLO (P = .0046), which implied the potential influence of genomic imprinting; global TDT further confirmed this association. Individual genotypic TDT showed homozygote C/C at rs12543318 was overtransmitted among NSCLO (Z = 3.79, P = .00015) and NSCL/P groups (Z = 3.83, P = .00013), which indicated that it could increase the risk to have cleft babies. Our findings indicated that rs12543318 was associated with NSCLO from Western Han Chinese population, which will give new scientific evidence for later researches in the etiology of NSOCs.     

Extensive severe fever with thrombocytopenia syndrome virus contamination in surrounding environment in patient rooms

ObjectivesSevere fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease in Korea and China. Although there is previous evidence of person-to-person transmission via direct contact with body fluids, the role of environmental contamination by SFTS virus (SFTSV) in healthcare settings has not been established. We therefore investigated the contamination of the healthcare environment by SFTSV.MethodsWe investigated the possible contamination of hospital air and surfaces with SFTSV transmission by collecting air and swabbing environmental surface samples in two hospitals treating six SFTS patients between March and September 2017. The samples were tested using real-time RT-PCR for SFTS M and S segments.ResultsOf the six SFTS patients, four received mechanical ventilation and three died. Five rooms were occupied by those using mechanical ventilation or total plasma exchange therapy in isolation rooms without negative pressure and one room was occupied by a patient bedridden due to SFTS. SFTSV was detected in 14 (21%) of 67 swab samples. Five of 24 swab samples were obtained from fomites including stethoscopes, and 9 of 43 were obtained from fixed structures including doorknobs and bed guardrails. Some samples from fixed structures such as television monitors and sink tables were obtained in areas remote from the patients. SFTSV RNA was not detected in five air samples from three patients' rooms.ConclusionsOur data suggest that SFTSV contamination was extensive in surrounding environments in SFTS patients' rooms. Therefore, more strict isolation methods and disinfecting procedures should be considered when managing SFTS patients.     

�ؽ���ê�����������������Խ���������������˫������ؽ���ǰ��λ����Ԣ�������ϻ����ٴ�Ч������

??Objective??To evaluate the effect of articular disc repositioning combined with orthodontic functional appliance in the treatment of juvenile bilateral temporomandibular joint ??TMJ??anterior disc displacement??ADD?? and  skeletal class ??malocclusion. Methods??Fourteen juvenile patients with bilateral TMJ ADD and skeletal class ?? malocclusion were selected from March 2016 to March 2018 in the Department of Oral Surgery??Ninth People’s Hospital??Shanghai Jiao Tong University School of Medicine. Magnetic resonance imaging ??MRI?? and cephalometric radiographs before surgery and  follow-ups were performed for all patients. Condylar height and relevant cephalometric radiographs were measured and compared by statistical analysis. Results??Compared with pre-surgery??MRI showed the condylar height increased ??1.74±0.98??mm during follow-ups after surgery ??P??0.001??. New generated bone was observed on all condyles. About 84.61% of the new bone formed at superior and posterior-anterior surface. Cephalometric radiographs showed that SNB increased ??1.83±1.56??°??P??0.001????pogonion position ??pog-G?? moved ??2.18±3.13??mm ??P = 0.028?? forward and incisor overjet decreased ??3.55 ± 1.86??mm ??P??0.001????whereas no significant changes were found in SNA??Sn - G Vert??Y-Axis??U1 - SN??IMPA ??L1-MP?? or U1-L1 ??P > 0.05??. Conclusion??Articular disc repositioning combined with postoperative orthodontic functional appliances can effectively promote condylar growth and reduce oral-maxillofacial deformities in juvenile patients with bilateral  TMJ ADD and skeletal class??malocclusion.     

“全合一”肠外营养液在结直肠癌患者术后应用分析

目的 分析克林维“全合一”标准肠外营养液在结直肠癌术后患者恢复期的应用效果。方法 选取我科 2017 年 1 月至2017年10月收治的60例开腹结直肠癌患者随机分为观察组（n=30）和对照组（n=30），观察组采用克林维“全合一” 营养组方，对照组采用普通营养组方分别于术前、术后第5天监测患者体重、血清白蛋白、前白蛋白、转铁蛋白、甘油三酯、 血清总胆固醇、 高密度脂蛋白、低密度脂蛋白的变化，比较两组患者术后肠道功能恢复时间、营养治疗费用、住院天数等指标。 结果 术前两组患者营养相关指标、免疫、应激指标无显著差异（P＞0.05）。术后第 5天，观察组血清白蛋白、前白蛋白、 转铁蛋白计数水平显著高于对照组（P＜0.05）；观察组血脂甘油三酯、低密度脂蛋白水平显著低于对照组（P＜0.05）。 观察组术后胃肠道功能恢复时间、住院时间短于对照组（P ＜ 0.05），营养费用低于对照组（P ＜ 0.05）。结论 在直肠癌 术后患者恢复期应用克林维“全合一”标准肠外营养液进行营养治疗效果较好，可改善其营养状况、促进肠道功能恢复、 降低应激反应程度，减少住院时间及费用等，同时患者及医护人员满意度较好。