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  • Reed posted an update 10 months, 3 weeks ago

    Microspherophakia is characterized by a small, spherical crystalline lens with increased sagittal diameter. Because of the uncertainty about the outcome, as well as the complexity of the operation and development of complications, the management and timing of surgical intervention for microspherophakia are still debated. Lens extraction is effective for avoiding the risk of pupillary blockage, but the outcome after operation is controversial. The iTrace (Tracey, USA) report shows the influence of low-order aberrations (LOA) and high-order aberrations (HOA), which may be valuable in predicting postoperative outcome. Our report concerns a child with microspherophakia who underwent lens extraction via the analysis of visual quality by iTrace.

    Our report is on the case of a 7-year-old girl whose parents observed she had to bring her papers and books extremely close to her face to read. On examination, the girl was bilaterally diagnosed microspherophakia with a small tremble lens. The objective refraction was race.

    ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.

    ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.

    IgG4-related disease (IgG4-RD) is a systemic disease that can involve various organs and is characterized by the infiltrations of IgG4-positive plasma cells and lymphocytes, fibrosis, and elevated serum IgG4 levels. IgG4-related sclerosing cholangitis (IgG4-RSC) is a subtype of IgG4-RD. No certain relationship between IgG4-RSC and cholangiocarcinoma has been established as yet, and there have been few reports of the simultaneous diagnosis of IgG4-RSC and cholangiocarcinoma.

    A 76-year-old male visited our gastroenterology department due to the recent occurrence of pruritus and jaundice.

    Computed tomography (CT) scan showed ductal wall swelling and enhancement from both intrahepatic duct confluence to the common bile duct, upper biliary dilatation, and accompanying autoimmune pancreatitis (a sub type of IgG4-RD). Biopsy of the distal common bile duct by endoscopic retrograde cholangiopancreatography (ERCP) resulted in a diagnosis of IgG4-RSC. Subsequently, adenocarcinoma was identified by repeated cytology of bile juice. Finally, Klatskin tumor type IIIA and IgG4-RSC were concurrently diagnosed.

    IgG4-RSC was treated with steroid and Klatskin tumors by gemcitabine + cisplatin chemotherapy.

    The jaundice had improved and CT showed substantial improvement of the intrahepatic duct dilatation.

    IgG4-RSC and cholangiocarcinoma are easily confused, but their treatments are quite different, and thus, care must be taken during diagnosis. Furthermore, these 2 diseases may co-exist. Therefore, even if IgG4-RSC is diagnosed first, the possibility of accompanying cholangiocarcinoma should be thoroughly investigated.

    IgG4-RSC and cholangiocarcinoma are easily confused, but their treatments are quite different, and thus, care must be taken during diagnosis. Furthermore, these 2 diseases may co-exist. Therefore, even if IgG4-RSC is diagnosed first, the possibility of accompanying cholangiocarcinoma should be thoroughly investigated.

    Intensive care unit-acquired weakness (ICU-AW) is an acquired neuromuscular lesion and a common occurrence in patients who are critically ill. There are already systematic reviews on ICU-AW. Therefore, we provide a protocol for an overview of systematic reviews to improve the effectiveness of the construction of an evidence-based practice for prevention of ICU-AW.

    We will search the PubMed, CINAHL, EMBASE, and the Cochrane Library for the relevant systematic review or meta-analyses about ICU-AW. Study selection, data extraction, and the quality assessment of the included studies will be performed independently by 2 reviewers. And the methodological quality, report quality and evidence quality will be evaluated by Assessment of Multiple Systematic Reviews-2 tool, Preferred Reporting Items for Systematic Reviews and Meta Analyses Statement checklist and Grading of Recommendations Assessment, Development and Evaluation system, respectively.

    This overview of systematic reviews and meta-analysis will collect the evidence published about the ICU-AW.

    We hope that our research will contribute to clinicians and public decision making about the ICU-AW.

    INPLASY202070067.

    INPLASY202070067.

    Diabetic kidney disease (DKD) is 1 of the common microvascular complications of diabetes, and the therapeutic effect of modern medicine on DKD is limited. At present, patented Chinese medicine Qizhijiangtang (QZJT) capsule has been widely used in the treatment of DKD. We aim to systematically assess the efficacy and safety of QZJT capsule for the treatment of diabetic kidney disease (DKD).

    Randomized controlled trials of QZJT capsule for DKD treatment will be searched until July 1, 2020, in 7 electronic databases PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP, and Chinese Biomedical Literature. Furthermore, additional relevant publications will be manually searched according to reference lists from the resulting publications. The Cochrane risk test from the Cochrane Handbook will be used as a bias tool to evaluate the methodological quality. The clinical efficacy will be the primary outcome, which is based on the changes in symptoms and levels of proteinuria. Review Manager 5.3 will be used to analyze the results.

    Our meta-analysis will provide evidence to the clinical application of QZJT capsule in the treatment of DKD from the 4 aspects including the clinical efficacy, changes in proteinuria, the renal function and level of blood glucose. Meanwhile, the results can also reflect the role of traditional Chinese medicine in the treatment of DKD.

    CRD42020153949.

    CRD42020153949.This retrospective study aimed at identifying the predictors of oxygen desaturation (OD) (i.e., SpO2  16.5 events/h would be at risk of OD under sedation. Fulvestrant manufacturer The predictive accuracy, sensitivity, positive predictive value, and negative predictive value were 84%, 100%, 83%, 100%, respectively.For patients with OSA, average SpO2 and AHI-REM may enable clinicians to predict the occurrence of oxygen desaturation under deep sedation. Future large-scale studies are needed to validate the findings.

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