[Research progress on the impacts of pregnancy and puerperium-related factors on refractive errors in children]

Refractive error is a common ophthalmic disease in children. It refers to the mismatch between the axial length and the refractive power that results in visual blur, which is usually driven by the interaction of genetic and environmental factors. The impacts of pregnancy and puerperium-related factors on refractive error in children have gradually gained attention. According to the different stages of pregnancy, this review summarizes the impacts of four aspects on refractive error in children, including lifestyle during pregnancy, complications and comorbidities during pregnancy, adverse pregnancy outcomes and other factors, which aims to provide perinatal healthcare clues for the prevention and control of refractive error in children, achieve prevention beforehand and reduce the public health burden of refractive error in children.

[Correlation analysis and benchmark dose study on bone metabolic biochemical index of low doses of exposed hydrogen fluoride workers]

Objective: To analyze correlation of occupational hydrogen fluoride exposure to low doses of bone metabolism index through occupational epidemiological investigation and benchmark dose calculation. Methods: In May 2021, using cluster sampling method, 237 workers exposed to hydrogen fluoride in a company were selected as the contact group, and 83 workers not exposed to hydrogen fluoride in an electronics production company were selected as the control group. The external exposure dose and urinary fluoride concentration, blood and urine biochemical indicators of the workers was measured.The relationship between external dose and internal dose of hydrogen fluoride was analyzed. The external dose, urinary fluoride was used as exposure biomarkers, while serum osteocalcin (BGP), serum alkaline phosphatase (AKP) and urinary hydroxyproline (HYP) were used as effect biomarkers for bone metabolism of hydrogen fluoride exposure. The benchmark dose calculation software (BMDS1.3.2) was used to calculate benchmark dose (BMD) . Results: Urine fluoride concentration in the contact group was correlated with creatinine-adjusted urine fluoride concentration (r=0.69, P=0.001). There was no significant correlation between the external dose of hydrogen fluoride and urine fluoride in the contact group (r=0.03, P=0.132). The concentrations of urine fluoride in the contact group and the control group were (0.81±0.61) and (0.45±0.14) mg/L, respectively, and the difference between the two groups was statistically significant (t=5.01, P=0.025). Using BGP, AKP and HYP as effect indexes, the urinary BMDL-05 values were 1.28, 1.47 and 1.08 mg/L, respectively. Conclusion: Urinary fluoride can sensitively reflect the changes in the effect indexes of biochemical indexes of bone metabolism. BGP and HYP can be used as early sensitive effect indexes of occupational hydrogen fluoride exposure.

[Clinical characteristics of anomalous aortic origin of a coronary artery in children]

Objective: To analyze the clinical characteristics, diagnosis and treatment of anomalous aortic origin of a coronary artery (AAOCA) in children. Methods: There were 17 children diagnosed with AAOCA from January 2013 to January 2022 in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine.Their clinical manifestations, laboratory and imaging data, treatment and prognosis were retrospectively analyzed. Results: These 17 children included 14 males and 3 females, with the age of (8.7±3.5) years. There were 4 anomalous left coronary artery (ALCA) and 13 anomalous right coronary artery (ARCA). Seven children presented with chest pain or chest pain after exercise, three patients presented with cardiac syncope, one complained chest tightness and weakness, and the other six patients had no specific symptoms. Cardiac syncope and chest tightness occurred in patients with ALCA. Fourteen children had the dangerous anatomical basis of myocardial ischemia caused by coronary artery compression or stenosis on imaging. Seven children had coronary artery repair, of whom two were ALCA and five were ARCA. One patient had received heart transplantation because of heart failure. The incidence of adverse cardiovascular events and poor prognosis in ALCA group was higher than that in ARCA group (4/4 vs. 0/13, P<0.05). They were followed up in the outpatient department regularly for 6 (6, 12) months; except for the one who lost visit, the rest of the patients had a good prognosis. Conclusions: Cardiogenic syncope or cardiac insufficiency usually occurs in ALCA, and adverse cardiovascular events and poor prognosis are more common in ALCA than in ARCA. Early surgical treatment should be considered for children with ALCA and ARCA accompanied by myocardial ischemia.

Application of fracture body surface localization film combined with CT volume rendering in the minimally invasive rib fractures internal fixation

OBJECTIVE

To investigate the application value of the technique of fracture body surface localization film combined with CT volume rendering in the selection of minimally invasive incision for internal fixation of rib fractures.

PATIENTS AND METHODS

Clinical data of 55 cases of patients who underwent internal fixation for rib fracture in our hospital from June 2019 to April 2020 were selected. The differences in the accuracy of preset incision, incision length, operation time, intraoperative blood loss, postoperative wound drainage, and postoperative pain score between the group with fracture body surface localization film combined with CT volume rendering (n=32) and the group with traditional localization method (n=23).

RESULTS

Compared with traditional localization method, fracture body surface localization film combined with CT volume rendering could improve the accuracy of surgical incision, reduce the operation time, incision length, intraoperative blood loss, postoperative wound drainage, and postoperative pain score (p<0.05).

CONCLUSIONS

The application of fracture body surface localization film combined with CT volume rendering has obvious effects on the accurate selection of incision of rib fracture internal fixation, and it is an effective method that is worthy of promotion.

[Efficacy and safety of implantable cardioverter-defibrillator implantation in pediatric tachycardia cases]

Objective: To analyze the indication, efficacy and complications of implantable cardioverter-defibrillator (ICD) implantation in children with severe tachycardia. Methods: The retrospective study collected the clinical data of 6 patients who accepted ICD implantation in Shanghai Children's Medical Center from January 2009 to January 2020. The etiologies of tachycardia, procedure of the ICD implantation and the operation associated complications were analyzed. Results: The 6 patients aged from 6 years and 5 months to 16 years and 2 months, and their weight were from 15.4 kg to 49.8 kg. Three patients were diagnosed with long QT syndrome, and the remaining three with catecholaminergic polymorphic ventricular tachycardia, hypertrophic cardiomyopathy and lethal cardiac channelopathy, respectively. All the patients suffered from drug-resistant ventricular tachycardia or ventricular vibration before the operation. After the ICD implantation, 3 patients had electric storm, which was alleviated after analgesics-sedatives treatment with chlorpromazine, dexmedetomidine or midazolam combined with fentanyl, as well as reset of the ICD parameters and support from psychological consultation. The other 3 patients did not undergo any complications as the above comprehensive strategies were given after the operation prophylactically. All patients continued anti-arrhythmic medicine after the operation and all survived at the end of the follow-up period lasted from 1 month to 7 years. Two patients had ventricular tachycardia (VT) and ventricular vibration, which were successfully recognized and defibrillated by ICD. Conclusions: ICD implantation is safe and effective in children and adolescent patients. The electric storm may happen after operation, which could be prevented by the comprehensive strategies including appropriate ICD parameter-setting, analgesics-sedatives treatment and psychological support.

miR-145 regulates chemoresistance in hepatocellular carcinoma via epithelial mesenchymal transition

Resistance to chemotherapeutic drugs is a major obstacle in hepatocellular carcinoma (HCC) therapy. MicroRNA&mdash;145 (miR&mdash;145) has been shown to be down&mdash;regulated in several cancers and may be involved in the process of carcinogenesis. The present study aimed to evaluate the effects of miR&mdash;145 in adriamycin (ADM)&mdash;resistant human HCC cells. We found that miR&mdash;145 was significantly reduced in HepG2/ADM and HuH7/ADM cells compared with the chemosensitive parental cells. Up&mdash;regulation of miR&mdash;145 increased the ADM cytotoxicity in chemoresistant tumor cells. In addition, Smad3 was identi&#64257;ed as the target of miR&mdash;145 and miR&mdash;145 overexpression inhibited Smad3 expression both at the mRNA and protein levels. The luciferase reporter assay confirmed that Smad3 was a direct target of miR&mdash;145. Moreover, up&mdash;regulation of miR&mdash;145 suppressed Smad3 related EMT features as shown by increased expression of E&mdash;cadherin and reduced vimentin level in HepG2/ADM and HuH7/ADM cells. Our study demonstrated that miR&mdash;145 modulated both chemoresistance and EMT in HCC cells, and up&mdash;regulation of miR&mdash;145 might be a potential therapeutic strategy for treatment of chemoresistant HCC.

The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review

It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management.

Enantiomer separation of mandelates and their analogs on cyclodextrin derivative chiral stationary phases by capillary GC

Enantiomer separation of mandelates and their analogs, which are important intermediates in asymmetric synthetic and pharmaceutical chemistry, was investigated by capillary gas chromatography using different cyclodextrin derivative chiral stationary phases (CD CSPs). The used cyclodextrin derivatives included permethylated beta-CD (PMBCD), permethylated gamma-CD, heptakis(2,6-di-O-butyl-3-O-butyryl)-beta-CD, heptakis(2,6-di-O-pentyl-3-O-acetyl)-beta-CD and heptakis(2,6-di-O-nonyl-3-O-trifluoroacetyl)-beta-CD (DNTBCD), respectively. Among all the CSPs used, PMBCD and DNTBCD exhibited the broadest and best enantioselectivity for all the racemates investigated. Some thermodynamic parameters were evaluated and an enthalpy-entropy compensation effect was observed in enantiomer separation processes of mandelates and their analogs. Based on thermodynamic data and molecular mechanics calculations, the chiral recognition mechanism of mandelate derivatives on CD CSPs is discussed.

[Preparation and evaluation of wide-bore stainless-steel packed capillary liquid chromatographic columns]

A zero-dead volume column end and a conical shaped slurry reservoir for wide-bore stainless-steel packed capillary liquid chromatographic columns were designed and evaluated. A detailed procedure for the preparation of reversed-phase stainless-steel packed capillary columns with 0.5 mm-1.0 mm i.d. is described. The influences of the column length and the packing material on the column performance have been studied. Columns were evaluated by the reduced plate height vs reduced velocity curve and the peak asymmetric factor. Experimental results showed that the column efficiency and the reproducibility were better than 75% of theoretical value and 6% RSD, respectively. Separations of antiepileptic drugs and chlorinated benzenes are demonstrated.

[Dynamic pre-concentration method of gas sample]

By utilizing the combination of frontal chromatography at ambient temperature, back-flushing and temperature gradient thermal desorption, a prototype of a dynamic pre-concentration system has been designed and evaluated. It realized the enrichment for gas samples of boiling point higher than - 103 degrees C without cryogenic facilities. To reduce the sample volume and enhance enrichment factor, the technique of momentarily non-steady state produced at the beginning of back-flushing, and the negative temperature gradient generated during thermal desorption were utilized, resulting a very sharp desorption band. Standard samples were tested to demonstrate the applicability of the method. At 10 mL sample volume, the enrichment factor was 100.