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Objective:To investigate the influencing factors of secondary retinal detachment (RD) in patients with acute retinal necrosis syndrome (ARN).Methods:A case control study was conducted.A total of 57 patients (64 eyes) with initial diagnosis of ARN not accompanied by RD were enrolled in Qingdao Eye Hospital of Shandong First Medical University from March 2013 to April 2021.Among them, 36 cases (40 eyes) were male and 21 cases (24 eyes) were female, with an average age of (51.72±9.73) years.All patients received topical ophthalmic, systemic intravenous and oral antiviral and anti-inflammatory medications, as well as intravitreal injection of ganciclovir according to the patient's condition and willingness.The RD group was divided into RD group and RD-free group according to whether RD occurred during the 1-year follow-up, of which 23 cases and 23 eyes (35.94%) in the RD group occurred from 27 to 160 days after the onset of the disease, with a mean of 45(30, 83) days.The degree of anterior chamber inflammation was evaluated and graded.The scope of retinal necrosis was evaluated by nine-directional fundus color photographs or ultra-wide angle laser scanning ophthalmoscopy without pupil dilation combined with fundus fluorescein angiography.Retinal hemorrhage was divided into three types, no or little scattered patchy hemorrhage, patchy retinal hemorrhage with >1 papillary diameter (PD) and frost-branch retinal hemorrhage.Baseline systemic parameters included sex, age, course of disease, etc.Ocular parameters included best corrected visual acuity, intraocular pressure, anterior segment inflammatory response, retinal hemorrhage, as well as invasion degree and scope of retinal necrosis.Therapy parameters included duration of systemic antiviral drug treatment, with or without intravitreal injection of ganciclovir and the injection frequency as independent variables, and RD occurred whether or not as dependent variables for multivariate logistic regression analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Qingdao Eye Hospital (No.2020-15).Results:Four eyes with severe vitreous opacity were excluded.In the fundus image analysis of the other 60 eyes, the necrotic lesion involved retina reaching 1 to 4 quadrants were in 14, 9, 17 and 20 eyes, respectively.Necrotic lesion affected 13, 23 and 24 eyes in zone 3, zone 2 and zone 1, respectively.Before treatment, frost-like retinal hemorrhage occurred in 26 eyes (43.33%), retinal hemorrhage with >1 PD in 25 eyes (41.67%). Compared with RD-free group, the RD group had a longer course of disease, worse baseline visual acuity, larger necrotic lesions, more eyes with more invasion areas close to the macular area, and more eyes with frost-branch retinal hemorrhage, with statistically significant differences (all at P <0.05). There were no significant differences in age, intraocular pressure, anterior segment inflammatory response, duration of intravenous antiviral drug injection, with or without intrvitreal injection of antiviral drug and injection frequency between the two groups (all at P>0.05). Multivariate logistic regression analysis showed that the occurrence of frost branch-retinal hemorrhage was a high risk factor for RD (odds ratio=9.14, 95% confidence interval: 1.10-82.44, P=0.049). There were no significant differences between the two groups in age, intraocular pressure, anterior inflammatory response, time of intravenous antiviral drug injection, whether or not antiviral drug was injected into vitreous cavity and frequency at the time of initial diagnosis (all at P>0.05). Conclusions:Frost-branch retinal hemorrhage is a risk factor for retinal detachment in ARN.

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Objective:To investigate the present situation of lymphedema clinics in 60 hospitals and provide reference for the management and development of lymphedema nursing clinic.Methods:Convenience sampling method was used to select 60 hospitals that had set up lymphedema nursing outpatient service. A self-designed questionnaire was conducted for the heads of lymphedema nursing clinics from June 10th 2021 to August 15th, 2021 using electronic questionnaires.Results:Lymphedema clinics had been opened since 2015 and developed rapidly in recent years. The outpatient service mainly took the form of specialized outpatient service for lymphedema, accounted for 61.67%(37/60), and also existed in the form of combined breast rehabilitation, ostomy, catheter maintenance, etc. There was a great difference in the frequency of outpatient service in hospitals, 46.67%(28/60) had outpatient service every day, 36.67% (22/60) had outpatient service only half a day every week. The number of outpatient patients was relatively low, 61.67%(37/60) of the hospitals had no more than 10 patients per week, and only 8.33% (5/60) had more than 50 patients per week. There were only 26 full-time nurses accounted for 14.94%(26/174), and the international lymphedema therapist certification rate was 36.21% (63/174). Training institutions included foreign introduced training programs, domestic and foreign cooperation programs, overseas training and local training, etc. 100.00% (60/60) of the hospitals participating in the survey adopted comprehensive detumescence therapy, combined with auxiliary motor muscle energy binding technology 51.67% (31/60), air wave pressure therapy 48.33% (29/60), traditional Chinese medicine therapy 16.67% (10/60), etc. According to the survey of charging situation, only 14 hospitals accounted for 23.33%(14/60) had special charging, among which 12 hospitals accounted for 20.00%(12/60) had official charging approval.Conclusions:Lymphedema clinics have been developed and the ranks of lymphedema therapists are growing. The relevant departments should strengthen the standard management of lymphedema clinic, clarify the qualifications of visiting personnel, establish the standard of outpatient fees, promote the sustainable development of lymphedema clinic, and finally improve the quality of life of patients with lymphedema.

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BACKGROUND: Transitional cell carcinoma (TCC) of the bladder, the major histologic subtype of bladder cancer, is increasing in incidence and mortality, which requires the identification of effective biomarkers. Actin-regulating proteins have recently been proposed as important antitumor druggable targets. As a gelsolin-family actin-modulating protein, CAPG (gelsolin-like actin-capping protein) generated great interest due to its crucial effects in various biological and physiological processes; however, the role and mechanism of CAPG in TCCs remain unknown. MATERIALS AND METHODS: Bioinformatic analysis and immunohistochemistry of clinical specimens were performed to detect the expression level of CAPG. Both in vitro and in vivo assays were used to determine the oncogenic effect of CAPG in TCCs. Male 4-5-week-old BALB/c nude mice were used for in vivo tumorigenesis assays, while SCID mice were used for in vivo metastatic assays. Affymetrix microarray was used to identify the underlying molecular mechanism. Western blot and immunofluorescence were used to validate the expression and localization of proteins. RESULTS: CAPG was frequently upregulated in TCCs and associated with clinical aggressiveness and worse prognosis. Functional assays demonstrated that CAPG could contribute to the tumorigenesis, metastasis and epithelial-mesenchymal transition (EMT) of TCCs both in vitro and in vivo. A novel mechanism that CAPG promoted TCC development via inactivating the Hippo pathway, leading to a nucleus translocation of Yes-associated protein was suggested. CONCLUSIONS: The current study identified CAPG as a novel and critical oncogene in TCCs, supporting the pursuit of CAPG as a potential target for TCC intervention.

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PURPOSE: Elevation in serum alanine aminotransferase (ALT) levels is a biomarker for metabolic syndrome (MS); however, the relationship has not been fully investigated within the reference interval of ALT levels. Our objective was to explore the relationship between serum ALT levels within the reference interval and MS in Chinese adults. MATERIALS AND METHODS: This cross-sectional study included 16028 adults, who attended routine health check-ups at Shengli Oilfield Central Hospital from January 2006 to March 2012. The reference interval of serum ALT level was defined as less than 40 U/L. Logistic regression models and restricted cubic spline were used to evaluate the association of ALT with MS. RESULTS: The prevalence of MS in the total population was 13.7% (6.4% for females and 18.4% for males). Multiple logistic regression showed that ALT levels were positively associated with MS after adjustment for potential confounding factors. The odds ratio of MS in the top quartile was 4.830 [95% confidence interval (CI): 2.980–7.829] in females and 3.168 (95% CI: 2.649–3.790) in males, compared with the ALT levels in the bottom quartile. The restricted cubic spline models revealed a positive non-linear dose-response relationship between ALT levels and the risk of MS in women (p for nonlinearity was 0.0327), but a positive linear dose-response relationship in men (p for nonlinearity was 0.0659). CONCLUSION: Serum ALT levels within the reference interval are positively associated with MS in a dose-response manner. Elevated ALT levels, even within the reference interval, may reflect early dysmetabolic changes.

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Objective To develop a curriculum of a training course for oncology nurses in regard to patient education in sexuality for breast cancer patients. Methods Delphi Method was used in the study. Two rounds of questionnaire investigation were conducted among 21 specialists in breast nursing care, sexology, and psychology. The curriculum was developed after revised based on the comments and suggestions brought up in the experts. Results The training curriculum in sexual health of the breast cancer patients for oncology nurse consisted of 5 sections, professional education, sexology, medicine, psychology and practice, which were divided into 45 teaching topics included in 13 courses. The comments of the specialists on the training curriculum were consistent. The coefficients of variation ranged from 0.07 to 0.20. The coordination coefficient was 0.344. Conclusions The current study developed an integral curriculum for oncology nurses in regard to patient education in sexuality for breast cancer patients, which will benefit oncology nurses for their nursing practice.

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Objective To prepare imperatorin sustained-release tablets and study their pharmacokinetics and bioavailability in rabbits.Methods Hydroxy-propyl methyl cellulose(HPMC) and carbomer were used to constitute the binary polymer matrix.Orthogonal design was used to optimize the formulation of imperatorin sustained-release tablets.The preliminary pharmacokinetic study in the rabbits was carried out by single-dose crossover design using imperatorin plain tablets as control.An appropriate GC-MS method was developed for measuring the concentration of imperatorin in the blood.Results Optimized formulation contained 1∶20 HPMC K100M and 2∶25 carbomer.Single dose test with 300mg showed that the relative bioavailability of imperatorin sustained-release tablets was(115.37?45.46)%;AUC of the studied tablets and control tablets was(391.08?47.22) and(368.25?136.15)?g/(h?L),tmax(2.26?0.25) and(0.33?0.05)h,Cmax(59.66?6.28) and(295.91?127.00)?g/L,T1/2ke(2.27?0.09) and(0.60?0.10)h,respectively.Conclusion The release behavior of the imperatorin sustained-release tablets prepared with binary polymer system shows evident sustained-release characteristics.