Abstract:Maintenance hemodialysis patients need to return to hospital 3 times a week for routine hemodialysis treatment. In the case of coronavirus disease 2019 (COVID-19) and regional lockdown, a set of management systems and standardizations has been established in our hemodialysis center, including forward movement of the critical nodes of treatment, specialists pooling program for hemodialysis technology, and dynamic bubble personnel management, to implement dynamic prevention and control strategies, precise management of inpatient wards and closed-loop management of outbreaks. While improving the management of our own hemodialysis center, it is recommended to strengthen multi-center collaboration to build a municipal grid management system for hemodialysis and explore different dialysis strategies for end-stage renal disease to meet the treatment needs and safety management of maintenance hemodialysis patients in lockdown areas under the epidemic.

Abstract:The coronavirus disease 2019 (COVID-19) has become a global pandemic. It is urgent to find treatments to control the infection and improve symptoms. Homologous modeling and clinical analyses suggest that histamine receptor antagonists have broad prospects in the treatment of COVID-19. This article introduces the research progress of histamine H₁ receptor antagonist combined with azithromycin, histamine H₂ receptor antagonist famotidine alone or combined with aspirin, and histamine H₁ and H₂ receptor antagonists used in combination in the treatment of COVID-19. Finally, the possible mechanism of histamine receptor antagonists in the treatment of COVID-19 was introduced and the application prospect of histamine receptor antagonists in the treatment of COVID-19 was analyzed.

Abstract:Objective To analyze the viral shedding time and its influencing factors in different site samples of patients infected with severe acute respiratory syndrome coronavirus 2 (SARA-CoV-2) omicron BA.2 variant. Methods Real-time fluorescence polymerase chain reaction was used to detect SARS-CoV-2 nucleic acid in nasopharyngeal swab, sputum and anal swab from 217 patients with coronavirus disease 2019 (COVID-19) who were infected with severe acute respiratory syndrome coronavirus 2 omicron BA.2 variant confirmed by gene sequencing in The First Affiliated Hospital of Naval Medical University (Second Military Medical University). The differences of viral shedding time of different site samples were compared. Stratified analysis and multiple linear regression analysis were used to explore the influencing factors of viral shedding time in different site samples. Results The age of the 217 COVID-19 patients was 32.0 (24.0, 50.5) years old, 59.0% of them were males (n=128), and 41.0% were females (n=89). Eight (3.7%) cases were diagnosed with asymptomatic infection, 184 (84.8%) cases were mild type, 21 (9.7%) cases were moderate type, 3 (1.4%) cases were severe type, and 1 (0.5%) case was critical type. A total of 70 (32.3%) patients were treated with molnupiravir. The viral shedding time of SARS-CoV-2 nucleic acid in nasopharyngeal swab, sputum and anal swab was 13.0 (11.0, 17.0) d, 16.5 (13.0, 21.0) d and 10.0 (5.3, 11.0) d, respectively, with the differences being significant between them (all P<0.001). Age ≥ 60 years old, underlying diseases (especially hypertension, coronary artery diseases, or neurological diseases), and clinical classification of moderate type were risk factors for prolonged viral shedding time in nasopharyngeal swab; male sex and underlying diseases were risk factors for prolonged viral shedding time in sputum; and male sex was a risk factor for prolonged viral shedding time in anal swab. Multiple linear regression analysis showed that critical type was an independent risk factor for prolonged viral shedding time in nasopharyngeal swab (P<0.05), and male sex and underlying diseases were independent risk factors for prolonged viral shedding time in sputum (both P<0.05). Conclusion Among patients infected with omicron BA.2 variant, the viral shedding time in sputum is the longest and that in anal swab is the shortest. Male patients and/or patients with underlying diseases have longer viral shedding time in sputum.

Abstract:Objective To analyze the characteristics of traditional Chinese medicine (TCM) syndromes of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in a shelter hospital in Shanghai. Methods A total of 621 patients infected with SARS-CoV-2 omicron variant from Apr. 4 to May 24, 2022 in a shelter hospital in Shanghai were enrolled. The data of the patients, including the general information and common clinical syndromes (such as fever, headache, stuffy nose, runny nose, cough, and sputum), were collected on admission by TCM syndrome electronic scale, and core syndrome characteristics were analyzed base on the proportion of each symptom. The syndromes were divided according to the symptom score of patients, and the differences of disease course among the syndromes were compared. Results The proportion of patients aged 30 to 49 years old was the highest among 621 patients infected with omicron variant (49.76%, 309/621). The most prominent symptoms were cough and expectoration, accounting for 62.32% (387/621) and 68.12% (423/621), respectively. The more common symptoms included sore throat, stuffy nose, runny nose, fatigue, muscle pain, and headache. White sputum was mostly seen in the expectoration and clear mucus was mostly seen in runny nose. According to the clinical symptoms, the core syndrome characteristic of patients infected with omicron variant was cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome was plague invading the defensive exterior, accounting for 40.10% (249/621). The second and third ones were heat toxin attacking the lung syndrome (29.95%, 186/621) and dampness obstructing (17.55%, 109/621), while the least common syndrome was deficiency of qi and yin (7.73%, 48/621). The course of qi and yin deficiency was longer than the other 3 syndromes (P<0.05). Conclusion The core TCM syndrome characteristic of patients infected with SARS-CoV-2 omicron variant is cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome is plague invading the defensive exterior. The pattern tends to convert into qi and yin deficiency along the long course.

Abstract:Objective To investigate the expression of angiotensin-converting enzyme 2 (ACE2) (a receptor of severe acute respiratory syndrome coronavirus 2[SARS-CoV-2]) in human lung and its significance in SARS-CoV-2 infection. Methods Genotype-Tissue Expression (GTEx) database was used to analyze the gene transcription levels of ACE2 in human normal tissues and organs. Immunohistochemistry was used to detect the protein expression levels of ACE2 in different anatomical sites of primary human lung tissues. Results The expression levels of ACE2 gene and protein in human lung were low, which were mainly expressed in a small number of type Ⅱ alveolar epithelial cells in alveolar tissue, but not in vascular endothelial tissue, bronchial, bronchiole, terminal bronchiole, respiratory bronchiole, or other bronchial tissues. Conclusion The expression of ACE2 in human lung is quite low, and is mainly located in a small number of type Ⅱ alveolar epithelial cells, indicating that human lung possesses the molecular basis for ACE2 to cause SARS-CoV-2 infection, and SARS-CoV-2 may have other mechanisms of infection in human lung.

Abstract:Objective To explore the sociodemographic and psychological factors influencing the continuity of treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019 (COVID-19). Methods A total of 277 patients with chronic kidney disease who were admitted to Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. 2020 to Mar. 2021 were enrolled and divided into 3 groups:non-dialysis group (n=102), hemodialysis (HD) group (n=108), and peritoneal dialysis (PD) group (n=67). All patients were investigated by online and offline questionnaires, including self-designed basic situation questionnaire, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). The general sociodemographic data, anxiety and depression of the 3 groups were compared, and the influence of sociodemographic and psychological factors on the interruption or delay of treatment was analyzed by binary logistic regression model. Results There were significant differences in age distribution, marital status, occupation, medical insurance type, caregiver type, whether there was an urgent need for hospitalization and whether treatment was delayed or interrupted among the 3 groups (all P<0.05). The average SAS score of 65 PD patients was 38.15±15.83, including 53 (81.5%) patients without anxiety, 7 (10.8%) patients with mild anxiety, and 5 (7.7%) patients with moderate to severe anxiety. The average SAS score of 104 patients in the HD group was 36.86±14.03, including 81 (77.9%) patients without anxiety, 18 (17.3%) patients with mild anxiety, and 5 (4.8%) patients with moderate to severe anxiety. There were no significant differences in the mean score of SAS or anxiety severity grading between the 2 groups (both P>0.05). The mean SDS scores of 65 PD patients were 53.42±13.30, including 22 (33.8%) patients without depression, 21 (32.3%) patients with mild depression, and 22 (33.8%) patients with moderate to severe depression. The mean SDS scores of 104 patients in the HD group were 50.79±10.76, including 36 (34.6%) patients without depression, 56 (53.8%) patients with mild depression, and 12 (11.6%) patients with moderate to severe depression. There were no significant differences in mean SDS scores or depression severity grading between the 2 groups (both P>0.05). The results of intra-group comparison showed that the incidence and severity of depression were higher than those of anxiety in both groups. Multivariate binary logistic regression analysis showed that high school education level (odds ratio[OR]=5.618, 95% confidence interval[CI]) 2.136-14.776, P<0.01), and unmarried (OR=6.916, 95% CI 1.441-33.185, P=0.016), divorced (OR=5.588, 95% CI 1.442-21.664, P=0.013), urgent need for hospitalization (OR=8.655, 95% CI 3.847-19.476, P<0.01) could positively promote the continuity of treatment in maintenance dialysis patients under the regular epidemic prevention and control of COVID-19. In the non-dialysis group, no sociodemographic and psychological factors were found to be associated with the interruption or delay of treatment (P>0.05). Conclusion Education, marital status, and urgent need for hospitalization are correlated with the continuity of treatment in patients with chronic kidney disease on maintenance dialysis.

Abstract:Objective To explore the effect of WeChat group management on blood pressure control rate and drug compliance of hypertension patients during the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 428 consecutive patients with essential hypertension in our outpatient department from Jan. 2020 to Dec. 2020 were enrolled and randomly divided into experimental group and control group with a ratio of 1:1. There were 214 patients in the experimental group, 110 males and 104 females, with an average age of (55.48±6.11) years. There were 214 cases in the control group, 108 males and 106 females, with an average age of (56.52±5.19) years. WeChat groups were established for the 2 groups separately. Information on education, supervised medication and lifestyle of hypertension was provided to the patients in the experimental group through WeChat, while no active intervention was given to the control group. The blood pressure control rate and medication possession ratio (MPR) were calculated at 1, 3, 6 and 12 months of intervention, and the differences between the 2 groups were compared. Results There were no significant differences in the blood pressure control rate (91.12%[195/214] vs 90.65%[194/214], 86.67%[182/210]vs 89.62%[190/212]) or MPR (0.90±0.03 vs 0.90±0.05, 0.85±0.04 vs 0.88±0.03) between the 2 groups at 1 or 3 months of intervention (all P>0.05). At 6 and 12 months, the blood pressure control rate (81.73%[170/208]vs 88.57%[186/210],75.12%[154/205]vs 85.99%[178/207]) and MPR (0.74±0.04 vs 0.87±0.05, 0.58±0.05 vs 0.85±0.03) of patients in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion During the COVID-19 epidemic, WeChat group management of hypertension patients by doctors could improve patients' blood pressure control rate and drug compliance and strengthen patients' self-management ability.

Abstract:Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80±8.35) kg and (68.60±7.37) kg, while those of nurses were (55.36±8.27) kg and (53.80±7.38) kg, both showing a decreasing trend but without significant difference (all P>0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.

Abstract:Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05); age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05); and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.

Abstract:The epidemic of coronavirus disease 2019 (COVID-19) has seriously affected people's normal work, life, and medical treatment. Since Mar. 2022, there has been a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in Shanghai. In order to meet the needs of hospitalization for patients, and at the same time for better control of epidemic and nosocomial infections, a large hospital in Shanghai innovatively set up a centralized transition ward in the hospital, and established scientific rules of medical work, regulations for prevention of nosocomial infections and efficient norms for patient admission. During the operation of the ward, a total of 211 patients were treated and one of the patients was confirmed of COVID-19 recurrence. All work was carried out methodically, and neither hospitalized patients nor medical staff had nosocomial infection of COVID-19. The preparation, operation and management of the central transition ward in our hospital are summarized here to provide guidance and reference for general hospitals to carry out similar work under the epidemic.

Abstract:The epidemic caused by the infection of severe acute respiratory syndrome coronavirus 2 omicron variant broke out in Shanghai in Mar. 2022. Omicron variant has characteristics such as strong concealment and rapid transmission, resulting in significant differences between the current round of epidemic and that in Wuhan. The number of infected patients (mainly asymptomatic infected patients) increased rapidly in a short term. Based on dynamic zero policy, shelter hospitals were set up in time in Shanghai to treat the patients. It is suggested that medical resources and patient characteristics should be taken into account in the independent cabin of a shelter hospital with more than 10 000 beds, and the clinical medical practice should be divided to 5 modes (universal education and management, community outpatient clinic, ward duty, emergency rescue, and temporary observation and transport) to optimize the allocation of medical resources, so as to further enhance the treatment capacity and efficiency of shelter hospitals.

Abstract:Objective To predict the target and explore the mechanism of Gancao Fuzi decoction for the treatment of rheumatoid arthritis (RA) by using network pharmacology and molecular docking. Methods The active ingredients and target genes of 4 kinds of traditional Chinese medicines contained in Gancao Fuzi decoction were searched through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Data on RA were downloaded from Gene Expression Omnibus (GEO) database, and differentially expressed genes in synovium between patients with RA and healthy people were screened and intersected with target genes of active ingredients of Gancao Fuzi decoction to obtain potential targets of Gancao Fuzi decoction for the treatment of RA. The Chinese medicine-active ingredient-disease target network was constructed and the network node degree value was analyzed to screen important key activity scores by Cytoscape 3.7.1 software. Key protein targets of Gancao Fuzi decoction in treatment of RA were obtained by protein-protein interaction (PPI) network analysis. Gene Ontology (GO) analysis and Kyoto Gene and Genome Encyclopedia (KEGG) pathway enrichment analysis of the core targets were performed by Metascape database to predict its mechanism of action. Finally, AutoDockTools-1.5.6 and PyMOL software were used for molecular docking to verify its binding ability. Results Forty-four potential target genes for Gancao Fuzi decoction in treating RA were obtained. The traditional Chinese medicine-active ingredient-disease target network contained 4 nodes of traditional Chinese medicines, 95 nodes of active ingredients and 44 nodes of potential target genes. Network topology analysis showed that the degree of quercetin was the highest and might be the possible key active ingredients of Gancao Fuzi decoction in the treatment of RA. The mechanism of Gancao Fuzi decoction in treating RA involves biological process including response to inorganic sunstance, cellular component including membrane raft, and molecular function including CXCR chemokine receptor binding. KEGG analysis showed that the active ingredients of Gancao Fuzi decoction mainly acted on RA through interleukin-17 signaling pathway, tumor necrosis factor signaling pathway, osteoclast differentiation, and other signaling pathways. PPI network analysis showed that matrix metalloproteinase 9 (MMP9), C-X-C motif chemotactic ligand 8 (CXCL8), peroxisome proliferator activated receptor γ (PPARγ) and epidermal growth factor receptor (EGFR) were the key target molecules of Gancao Fuzi decoction in the treatment of RA. And it was confirmed by molecular docking that quereetin had high affinity with key target molecules MMP9, CXCL8, PPARγ and EGFR. Conclusion The active ingredients in Gancao Fuzi decoction can regulate multiple signaling pathways through MMP9, CXCL8, PPARγ and EGFR to treat RA.

Abstract:Objective To investigate the role of peroxisome proliferators-activated receptors γ (PPARγ) in hight-fat induced insulin resistance by regulating microRNA (miRNA)-223. Methods The rat model of type 2 diabetes mellitus was established by feeding high-fat diet and treated with pioglitazone. Serum miRNA-223, blood glucose and 4 inflammatory factors (interleukin[IL]-1β, IL-6, IL-8, and tumor necrosis factor α[TNF-α]) in type 2 diabetes mellitus rats before and after treatment were detected by quantitative polymerase chain reaction (qPCR), glucose oxidase peroxidase and enzyme-linked immunosorbent assay. In a model of insulin resistance in HepG2 cells induced by palmitic acid, the levels of PPARγ or miRNA-223 were upregulated or inhibited, and the level of cellular glucose absorbtion, expression of cell glucose transporters (glucose transporters 1, 2, 4; insulin receptor substrates 1, 2) and miRNA-223 level were detected by Cell glucose absorption experiment, Western blotting and qPCR, respectively. Results Compared with that before pioglitazone treatment, the fasting blood glucose level of rats and the expression of serum inflammatory factors (IL-1β, IL-6, IL-8, and TNF-α) were significantly decreased and the level of serum miRNA-223 was significantly increased after 7 d of pioglitazone treatment (all P<0.001). After 24-h treatment with palmitic acid, the expression of PPARγ protein, miRNA-223 level and glucose absorption level of HepG2 cells were significantly decreased (all P<0.05). Upregulation of PPARγ protein could ameliorate the decrease of cellular glucose absorption induced by palmitic acid and increase the levels of miRNA-223 and inflammatory factors (all P<0.05). Inhibition of PPARγ expression resulted in decreased glucose absorption (P<0.05) and decreased miRNA-223 level (P<0.05), but there was no regulatory effect on the level of inflammatory factors in normal cells. Overexpression of miRNA-223 could improve the palmitic acid-induced decrease of glucose absorption and the increase of inflammatory factors (both P<0.05), as well as up-regulate the expression of glucose transporters (glucose transporters 1, 4) and insulin receptor substrate 1 (all P<0.05). Inhibition of miRNA-223 had an opposite effect of overexpression of miRNA-223 on the level of PA-induced cellular glucose uptake and expression of glucose transporter protein 1, glucose transporter protein 4, and insulin receptor substrate 1 (all P<0.05). However, overexpression or inhibition of miRNA-223 did not affect the expression of PPARγ. Conclusion PPARγ can improve glucose absorption of insulin resistance cells induced by high fat by regulating miRNA-223.

Abstract:With the improvement of people's living standards, obesity has increasingly become a major health problem for adults and children. Drugs are still the main treatment for obesity, but the number of existing drugs is limited and the effect can hardly meet the needs of all patients. While new anti-obesity drugs are in a difficult development situation, the use of drug repositioning (DR) strategy to explore new indications of existing drugs can provide ideas and directions for the discovery of new anti-obesity drugs. In recent years, the steady increase of biomedical data and the continuous development of high-throughput screening technology have shown great potential anti-obesity DR, which is achieved in a more systematic and rational way by computer-based computational approaches and experimental approaches based on high-throughput screening. The computational approaches are driven by data, combining the application of databases, network pharmacology and artificial intelligence. The experimental approaches have transited from low-throughput animal model-based techniques to high-throughput screening, providing opportunities to discover potential therapeutic drugs for obesity. Here, we review the research methods of DR and its application in the discovery of potential anti-obesity drugs.

Abstract:Large bone defects caused by trauma, tumor, fracture complications, etc. are common problems in the field of orthopaedics. Due to limited material source, long treatment period and various complications, the application and clinical effect of autologous or allogeneic bone transplantation are limited by the traditional bone grafting method for the treatment of large bone defects. In recent years, the application of adipose derived stem cells (ADSCs) in bone tissue engineering provides a new idea and perspective for the treatment of large bone defects, and to a large extent overcomes the shortcomings and deficiencies of traditional bone transplantation. Many factors play important roles in the osteogenic differentiation of ADSCs. The influencing factors and research progress of osteogenic differentiation of ADSCs in bone tissue engineering are reviewed in this paper.

Abstract:Cesarean scar pregnancy (CSP) is an ectopic pregnancy of special site, which is one of the long-term complications of cesarean section. If the diagnosis is delayed or misdiagnosed, it may lead to complications such as placental implantation, uterine rupture, massive bleeding, and in serious cases, hysterectomy, or even life-threatening events. In recent years, with the increase of cesarean section rate and the implementation of 3-child policy in China, more and more women face the risk of CSP when they get pregnant again. This paper reviews the pathogenesis of CSP based on relevant literatures.

Abstract:Clear aligner therapy is a new orthodontic treatment. Its indications have been extended with the development of biomaterials and biomechanics. Compared with the traditional fixed orthodontic appliances, clear aligner therapy has attracted great attention in recent years because of the superior asthetics and comfort, the accuracy and predictability of digital planning, and long interval between each revisit. Clear aligner is mainly used for tooth movement, usually combined with conventional appliances for the treatment of early malocclusions in chilare involving many complexities such as the unpredictability of growth, dentition replacement monitoring, muscle functional adjustment, orthopedic treatment, etc. This article reviews the clinical application of clear aligners for early malocclusion in children, hoping to provide a new, simple, efficient and safe method for early orthodontic treatment.

Abstract:Military training injury is the most common type of injuries in the army. It is one of the main reasons for non-combat attrition and reduction of combat effectiveness and a major medical problem faced by the armies of all countries in the world. The rehabilitation for military training injuries in our army is at its initial stage, and there are not enough basic theory and clinical research on the application of brace. This article mainly reviews the function of brace and the role of it to the prevention, treatment and rehabilitation of military training injuries, so as to promote the application of brace in the prevention and treatment of military training injuries, so as to provide a powerful guarantee for the combat effectiveness of troops.

Abstract:Objective To evaluate the angle changes in patients with primary angle closure glaucoma (PACG) after prophylactic laser peripheral iridotomy (LPI) using ultrasound biomicroscopy (UBM), and analyze the treatment effect on patients with different angle closure mechanisms. Methods Basic standard examination and UBM were performed before and 1 week after LPI on 23 patients (35 eyes) who were diagnosed with PACG in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Mar. 2018 to Oct. 2021. Based on the UBM results, the angle closure mechanisms were divided into pupillary block type, plateau iris type, and mixed type. Results Among the 35 eyes, 30 (85.7%) eyes showed pupillary block type and 5 (14.3%) showed plateau iris type before LPI. After LPI, 18 of the 30 eyes showing pupillary block before LPI showed pupillary block type and 12 showed mixed type, and the degree of angle opening was increased (20.2°±4.2° vs 6.6°±1.8° in reclassified pupillary block type and 12.4°±3.9° vs 6.3°±1.7° in reclassified mixed type, both P<0.05); the 5 eyes showing plateau iris type before LPI had no change in classification or the degree of angle opening (8.3°±1.7° vs 6.7°±2.1°, P>0.05). Conclusion The effect of opening angle after LPI is better in PACG patients with pupillary block type, but not in patients with plateau iris type, suggesting that plateau iris plays an important role in angle closure mechanisms in PACG patients and affects the effect of LPI.

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