PRK术后角膜上皮下雾状混浊的相关因素分析

为探讨准分子激光角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）后角膜上皮下雾状混浊（ｈａｚｅ）的原因及影响因素，对ＰＲＫ后６个月时屈光度在－１．００～－１８．５０Ｄ的３１６例（６１５只眼）近视眼的ｈａｚｅ相关因素进行观察和比较。结果：ＰＲＫ后６个月时ｈａｚｅ发生率为４４．７％，１级或以上ｈａｚｅ为１３．３％。ｈａｚｅ的发生率及密度随屈光度增高而增加（Ｐ＜０．０００１），也随切削深度的增加而增加（Ｐ＜０．０００１），术前非接触眼压超过１８ｍｍＨｇ者，ｈａｚｅ的发生率和密度增加（Ｐ＜０．００５），男性较易发生ｈａｚｅ（Ｐ＝０．０００１），与年龄呈负相关（Ｐ＜０．０５）。而角膜厚度、术前戴用接触镜及散光对ｈａｚｅ的影响不显著。结论：高度近视（＞－６．０Ｄ）和过深的切削（＞８０μｍ）是引起ｈａｚｅ的主要原因。术前眼压偏高、年龄偏低对ｈａｚｅ也有明显影响。对ＰＲＫ治疗高度近视应持审     

Light Emitting Diodes Irradiation Regulates miRNA-877-3p to Promote Cardiomyocyte Proliferation

Mammalian cardiomyocytes (CMs) maintain a low capacity for self-renewal in adulthood, therefore the induction of CMs cycle re-entry is an important approach to promote myocardial repair after injury. Recently, photobiomodulation (PBM) has been used to manipulate physiological activities of various tissues and organs by non-invasive means. Here, we demonstrate that conditioned PBM using light-emitting diodes with a wavelength of 630 nm (LED-Red) was capable of promoting the proliferation of neonatal CMs. Further studies showed that low-power LED-Red affected the expression of miR-877-3p and promoted the proliferation of CMs. In contrast, silencing of miR-877-3p partially abolished the pro-proliferative actions of LED-Red irradiation on CMs. Mechanistically, GADD45g was identified as a downstream target gene of miR-877-3p. Conditioned LED-Red irradiation also inhibited the expression of GADD45g in neonatal CMs. Moreover, GADD45g siRNA reversed the positive effect of LED-Red on the proliferation of neonatal CMs. Taken together, conditioned LED-Red irradiation increased miR-877-3p expression and promoted the proliferation of neonatal CMs by targeting GADD45g. This finding provides a new insight into the role of LED-Red irradiation in neonatal CMs biology and suggests its potential application in myocardial injury repair.     

限制性输液复苏法对失血性休克孕兔血流动力学变化的影响

目的 探讨限制性输液复苏法对失血性休克孕兔血流动力学变化及血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)含量变化的影响.方法 将20只妊娠中晚期新西兰大白兔分为2组,分别采用生理盐水传统输液复苏法(PNL组)及限制性输液复苏法(PLH组),每组10只.建立非控制性失血性休克模型,实验设计分为休克期(0～30 min),院前复苏期(30～90 min)及院内复苏期(90～180 min).休克期:两组孕兔均接受颈动脉放血至平均动脉压(MAP)为40～45 mm Hg(1 mm Hg=0.133 kPa).院前复苏期:剪开两组孕兔孕囊血管放血,复制活动性出血模型,然后PNL组和PLH组孕兔分别接受生理盐水及自身血复苏至MAP为80、60 mm Hg.院内复苏期:两组孕兔均接受手术止血及输血、输液治疗.比较两组孕兔各时间点血流动力学、TNF-α及IL-6含量的变化,记录输血、输液量及生存率.结果 (1)120 min时,PLH组孕兔呼吸、心率分别为(66±16)、(235±41)次,PNL组分别为(78±16)、(291±37)次,两组分别比较,差异有统计学意义(P＜0.01);PLH组孕兔MAP和中心静脉压(CVP)分别为(80.4±7.2)mm Hg、(8.0±4.4)cm H2O,PNL组孕兔分别为(72.5±8.2)mm Hg、(5.8±3.1)cm H2O,两组分别比较,差异也有统计学意义(P＜0.01);(2)两组孕兔血清TNF-α、IL-6含量休克后均升高,且在240 min时达高峰,PLH组孕兔血清TNF-α、IL-6含量分别为(105±67)、(118±51)ng/L,PNL组分别为(280±160)、(311±240)ng/L,两组比较,差异有统计学意义(P＜0.01),且PLH组孕兔血清TNF-α、IL-6含量在480 min时已降至正常;(3)PLH组输血、输液量在院前复苏期分别为(16.0±2.2)、(39.0±5.5)ml,在院内复苏期分别为(28.0±6.7)、(90.0±7.1)ml,PNL组在院前复苏期分别为(31.0±8.2)、(85.0±7.9)ml,在院内复苏期分别为(37.5±9.4)、(140.0±24.8)ml,两组比较,差异也有统计学意义(P＜0.05);(4)PLH组孕兔24、72 h的生存率分别为100%、90%;PNL组为80%、60%,两组比较,差异有统计学意义(P＜0.01).结论 限制性输液有利于失血性休克孕兔血流动力学指标的恢复,缓解血清TNF-α、IL-6含量升高的程度,从而提高了动物生存率.     

联络小组工作模式在糖尿病社区干预中的效果评价

目的探讨社区糖尿病联络小组在社区糖尿病患者管理中的作用与护理效果。方法以糖尿病专科医生及护士为主导,成立4个糖尿病联络小组,每个小组包括1名医生和2名护士,以医院附近的居民小区内的120名糖尿病患者为对象进行干预。干预前后进行对比。结果经过糖尿病联络小组干预3个月后,本社区糖尿病患者对糖尿病相关知识及操作技能的掌握程度显著提高(P<0.01),对胰岛素注射管理及低血糖处理的正确率明显提高(P<0.05)。结论社区糖尿病联络小组提高了糖尿病患者对糖尿病知识的掌握,减少了患者不正确的护理方式,自我管理技能显著提高。     

经圆窗径路导入正庚醇建立老年性聋模型的实验研究

目的 研究经耳后圆窗径路向C57BL/6Cnc小鼠内耳导入正庚醇对其听性脑干诱发电位(ABR)的影响,并建立老年性耳聋模型.方法 选取30只健康4周龄C57BL/6Cnc小鼠,随机分成实验组和对照组,每组15只.实验组经耳后圆窗径路缓慢导入正庚醇5μL,对照组经耳后圆窗径路缓慢导入0.9％氯化钠注射液5μL.各组小鼠分...     

Modified Chevron Osteotomy with Distal Soft Tissue Release for Treating Moderate to Severe Hallux Valgus Deformity: A Minimal Clinical Important Difference Values Study

ObjectiveTo explore whether modified Chevron osteotomy together with distal soft tissue release would correct moderate to severe HV deformity and what is the minimal clinical important difference (MCID) for objective and subjective evaluating parameters.MethodsFrom March 2018 to January 2019, 40 hallux valgus patients (including moderate to severe) were enrolled in this retrospective study. The cohort included four males and 36 females. The average age at surgery was 50.95 (range 22–75) years. All patients underwent modified Chevron osteotomy together with distal soft tissue release and completed at least one follow‐up at clinic. The American Orthopaedic Foot and Ankle forefoot score (AOFAS, forefoot), Visual Analog Scale (VAS), and Foot Function Index (FFI) were all collected before and after surgery. Besides, the hallux valgus angle (HVA), 1st–2nd intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were measured both before surgery and at last follow‐up. All MCID values were calculated by employing distribution‐based method.ResultsThirty‐seven patients (92.5%) showed satisfied result at a mean 14.3‐month follow‐up (range 13–22 month). Two patients complained about residual pain at the bunion, and overcorrection (hallux varus) occurred in one patient. Meanwhile, no patient observed nonunion. Being female, age more than 60, residual HVA deformity (>15°), and post IMA more than 9° showed no statistical relationship with the post‐operation residual pain (P > 0.05). However, high VAS score before surgery (more than 7) showed strong correlation with residual pain (P < 0.01). The subjective MCID value was 9.50 for AOFAS, 18.92 for FFI, and 1.27 for VAS, respectively.ConclusionThe modified Chevron osteotomy together with distal soft tissue release could achieve a satisfied result for moderate to severe HV deformity at early follow‐up. The residual pain was associated with severe pain before surgery (VAS more than 7).

This study aimed to explore:

1. The clinical result of Chevron osteotomy combined with distal soft tissue release for moderate to severe HV patients;
2. The actual subjective MCID values (derived from Patient Reported Outcomes) of AOFAS, VAS, and FFI of HV patients who underwent such a procedure;
3. The objective (detected from measurements) MCID values of hallux valgus angle (HVA), 1st–2nd intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA).

The retrospective study aimed to provide more options for surgeons when selecting proper procedure for treating moderate to severe HA patients.     

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

BackgroundThere have been a few studies regarding the pre-attack symptoms (PAS) and pre-episode symptoms (PES) of cluster headache (CH), but none have been conducted in the Chinese population. The purpose of this study was to identify the prevalence and features of PAS and PES in Chinese patients, as well as to investigate their relationships with pertinent factors.MethodsThe study included patients who visited a tertiary headache center and nine other headache clinics between January 2019 and September 2021. A questionnaire was used to collect general data and information about PAS and PES.ResultsAmong the 327 patients who met the CH criteria (International Classification of Headache Disorders, 3rd edition), 269 (82.3%) patients experienced at least one PAS. The most common PAS were head and facial discomfort (74.4%). Multivariable logistic regression analysis depicted that the number of triggers (OR = 1.798, p = 0.001), and smoking history (OR = 2.067, p = 0.026) were correlated with increased odds of PAS. In total, 68 (20.8%) patients had PES. The most common symptoms were head and facial discomfort (23, 33.8%). Multivariable logistic regression analysis showed that the number of triggers were associated with increased odds of PES (OR = 1.372, p = 0.005).ConclusionsPAS are quite common in CH patients, demonstrating that CH attacks are not comprised of a pain phase alone; investigations of PAS and PES could help researchers better understand the pathophysiology of CH.     

Status and influencing factors of patients with kinesiophobia after insertion of peripherally inserted central catheter: A cross-sectional study

This study aimed to investigate the current status and influencing factors of kinesiophobia in patients after insertion of peripherally inserted central catheter (PICC).A total of 240 patients with PICC were included. Their postinsertion status and influencing factors were investigated using the general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Medical Coping Modes Questionnaire, Numerical Rating Scale, and Self-rating Anxiety Scale.The mean TSK score was 36.49 ± 4.19 points, and 89 patients (37.08%) had kinesiophobia. Multiple linear regression analysis showed that factors such as education level, age, monthly income level, catheterization history, face, pain level, anxiety, and number of needle insertions influenced postoperative kinesiophobia in patients with PICC (P < .05). The total variation in the TSK score was 71.8%.The incidence of kinesiophobia was relatively high after PICC insertion. The medical staff needs to undertake targeted intervention measures to help minimize kinesiophobia after PICC insertion, allowing patients to perform scientifically correct functional exercises and attain physical recovery.     

Excellent Photonic and Mechanical Properties of Macromorphic Fibers Formed by Eu3+-Complex-Anchored,Unzipped, Multiwalled Carbon Nanotubes

The macromorphic properties of carbon nanotubes perform poorly because of their size limitations: nanosize in diameters and microsize in length. In this work, to realize these dual purposes, we first used an electrochemical method to tear the surface of multiwalled carbon nanotubes (MWCNTs) to anchor photonic Eu³⁺-complexes there. Through the polar reactive groups endowed by the tearing, the Eu³⁺-complexes coordinate at the defected structures, obtaining the Eu³⁺-complex-anchored, unzipped, multiwalled carbon nanotubes (E-uMWCNTs). The controllable surface-breaking retains the MWCNTs’ original, excellent mechanical properties. Then, to obtain the macromorphic structure with infinitely long fibers, a wet-spinning process was applied via the binding of a small quantity of polyvinyl alcohol (PVA). Thus, the wet-spun fibers with high contents of E-uMWCNTs (E-uMWCNT-Fs) were produced, in which the E-uMWCNTs took 33.3 wt%, a high ratio in E-uMWCNT-Fs. On the other hand, due to the reinforcing effect of E-uMWCNTs, the highest tensile strength can reach 228.2 MPa for E-uMWCNT-Fs. Meanwhile, the E-uMWCNT-Fs show high-efficiency photoluminescence and excellent media resistance performance due to the embedding effect of PVA on the E-uMWCNTs. Therefore, E-uMWCNT-Fs can exhibit excellent luminescence properties in aqueous solutions at pH 4~12 and in some high-concentration metal-ion solutions. Those distinguished performances promise outstanding innovations of this work.