Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

Early embryonic failure caused by a novel mutation in the TUBB8 gene:A case report

BACKGROUND This study aimed to explore the relationship between gene mutations and early embryonic development arrest and to provide more possibilities for the diagnosis and treatment of repeated implantation failure.CASE SUMMARY Here,we collected and described the clinical data of a patient with early embryonic development stagnation after repeated in vitro fertilization attempts for primary infertility at the Department Reproductive Center of Zaozhuang Maternal and Child Healthcare Hospital.We also detected the whole-exon gene of the patient's spouse and parents,and conducted bioinformatics analysis to determine the pathogenesis of the gene.CONCLUSION A novel mutant of the TUBB8 gene[c.602G>T(p.C201F)]was identified,and this mutant provided new data on the genotype-phenotype relationships of related diseases.

Factors associated with failure of enhanced recovery after surgery program in patients undergoing pancreaticoduodenectomy

Background: The enhanced recovery after surgery (ERAS) protocol is an evidence-based perioperative care program aimed at reducing surgical stress response and accelerating recovery. However, a small propor- tion of patients fail to bene t from the ERAS program following pancreaticoduodenectomy. This study aimed to identify the risk factors associated with failure of ERAS program in pancreaticoduodenectomy. Methods: Between May 2014 and December 2017, 176 patients were managed with ERAS program fol-lowing pancreaticoduodenectomy. ERAS failure was indicated by prolonged hospital stay, unplanned read- mission or unplanned reoperation. Demographics, postoperative recovery and compliance were compared of those ERAS failure groups to the ERAS success group. Results: ERAS failure occurred in 59 patients, 33 of whom had prolonged hospital stay, 18 were readmitted to hospital within 30 days after discharge, and 8 accepted reoperation. Preoperative American Society of Anesthesiologists (ASA) score of ≥III (OR = 2.736;95% CI: 1.276 6.939;P=0.028) and albumin (ALB) level of <35g/L (OR=3.589;95% CI: 1.403 9.181;P=0.008) were independent risk factors associated with prolonged hospital stay. Elderly patients (>70 years) were on a high risk of unplanned reoperation (62.5% vs. 23.1%, P=0.026). Patients with prolonged hospital stay and unplanned reoperation had delayed intake and increased intolerance of oral foods. Prolonged stay patients got off bed later than ERAS success patients did (65h vs. 46h, P =0.012). Unplanned reoperation patients tended to experience severer pain than ERAS success patients did (3 score vs. 2 score, P =0.035). Conclusions: Patients with high ASA score, low ALB level or age >70 years were at high risk of ERAS failure in pancreaticoduodenectomy. These preoperative demographic and clinical characteristics are important determinants to obtain successful postoperative recovery in ERAS program.

Correlation between self-efficacy,parental parenting patterns,and severe depression in adolescents

BACKGROUND Adolescence is a critical period marked by significant psychological changes.This study explores how self-efficacy and parental parenting styles may influence the risk of severe depression among teens.The hypothesis is that higher self-efficacy and authoritative parenting patterns will be negatively correlated with severe depression in adolescents.AIM To investigate the correlation between self-efficacy,parenting patterns and major depression in adolescents,and to provide guidance for mental intervention.METHODS Using a cross-sectional survey design,the data were collected through a questionnaire survey.Patients with major depression and healthy adolescents in the hospital control group were selected as the study objects.The General Self-Efficacy Scale,the Parenting Style Evaluation Scale,and the Beck Depression Inventory were used as research instruments.Data input and statistical analysis were performed,including descriptive statistics,correlation analysis,through SPSS software.RESULTS The study found that depressed patients had significantly lower self-efficacy than healthy controls,and parenting style was significantly associated with depressive symptoms in terms of emotional warmth and understanding,punishment severity,and denial.Specifically,parental emotional warmth and understanding were significantly negatively associated with depressive symptoms,while parental punishment severity and denial were significantly positively associated with depressive symptoms.Self-efficacy showed a significant negative correlation with depressive symptoms,indicating that higher self-efficacy had lower depressive symptoms.CONCLUSION Adolescent major depressive disorder patient was significantly associated with their parenting style and selfefficacy.Higher self-efficacy is associated with decreased depressive symptoms,so improving adolescent selfefficacy and improving parenting style are important.

Periampullary duodenal neuroendocrine tumor in a patient with neurofibromatosis-1:A case report

BACKGROUND Patients with neurofibromatosis type 1(NF1)are exposed to a higher risk of developing neuroendocrine tumors(NETs).Periampullary neuroendocrine neoplasms(NENs)in NF1 patients primarily affect the duodenum and periampullary region.CASE SUMMARY A 50-year-old male patient was admitted to our hospital due to progressive skin and scleral yellowing for over 6 months.An abdominal contrast-enhanced computed tomography scan revealed a tumor in the periampullary region,which measured 1.2 cm×1.4 cm in size and showed a progressive enhancement.Magnetic resonance cholangiopancreatography indicated the dilation of intrahepatic and extrahepatic bile ducts.The patient was diagnosed with an ampullary tumor with the possibility of malignancy.A Whipple procedure was performed.Microscopically,the duodenum tumor was found to invade the mucosa,sphincter,and muscular layer of the duodenal papilla.Histologic hematoxylin and eosin staining confirmed the presence of duodenal G1 NET.Subsequently,a bibliometric analysis was performed to evaluate the state of NEN research.Publications about periampullary NENs showed an annual increase,with most of them focusing on the treatment and diagnosis of NENs.CONCLUSION This article reported a case of periampullary duodenal NET in a patient with NF1,and a bibliometric analysis was conducted.

Downregulation of the nucleosome-binding protein 1 （NSBP1） gene can inhibit the in vitro and in vivo proliferation of prostate cancer cells

This studay is to construct a lentiviral vector harbouring an RNA interference （RNAi） sequence that targets the gene encoding the human high-mobility group nucleosomal binding protein 1 （NSBP1）; to study its role in inducing G2/M phase arrest and apoptosis in prostate cancer （PCa） DU145 cells; and to assess the effect of its knockdown on cell proliferation in vitro and in vivo. RNAi was applied to knock down NSBP1 expression in the PCa cell line DU145 by lentiviral plasmids producing an NSBP1 small hairpin RNA. After NSBP1 knockdown in DU145 cells, the growth rate of cells was analyzed by MTT, and G2/M cell cycle arrest and apoptosis were assessed using a FAC- Scalibur flow cytometer. Tumour growth was assessed in nude mice. The mRNA and protein expression levels of NSBP1, cyclin B1 and Bcl-2 were analysed in vitro and in vivo by reverse-transcriptase polymerase chain reaction and Western blotting. Knockdown of NSBP1 resulted in a 22.6% decrease in the growth rate of cells compared with the PscNC lentivirus control cells at 96 h, decreased tumour growth in nude mice, and the induction of Gz/M cell cycle arrest （8.78%） and apoptosis （2.19-fold）. Consistent with the cell cycle arrest and apoptosis, the mRNA and protein expression levels of cyclin B 1 and Bcl-2 were decreased. In conclusion, knockdown of NSBP 1 causes a statistically significant inhibition of the in vitro and in vivo growth of the PCa cell line DU145. Growth suppression is at least partially due to NSBP1 knockdown-induced Gz/M cell cycle arrest and apoptosis. The present data provide the evidence that the NSBP1 knockdown-induced G2/M phase arrest and apoptosis may result from negative regulation of cyclin B 1 and Bcl-2 by NSBP1, with the resulting reduced expression of these proteins.

角膜缘梯形结膜瓣切口与改良Parks切口对斜视患者泪膜功能及术后并发症的影响

目的:探讨角膜缘梯形结膜瓣切口与改良Parks切口对斜视患者泪膜功能及术后并发症的影响。方法:前瞻性研究,选择2017-01/2019-10于南阳医专一附院手术治疗的斜视患者作为研究对象,分为结膜瓣切口组(60例82眼,行角膜缘梯形结膜瓣切口斜视手术)及改良Parks组(62例83眼,行改良Parks切口斜视手术),评价斜视治疗效果,于手术前后进行干眼症状评分,泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)评分,采用眼表综合分析仪测定泪河高度(TMH)、非侵入性泪膜破裂时间(NIKBUT),手术满意度及不良反应。结果:两组患者均完成手术,角膜缘梯形结膜瓣切口组、改良Parks组分别有80、79眼达到眼位基本正位(±10PD以内),两组治愈率比较无差异(P>0.05)。改良Parks组术后7d SⅠt、BUT、FL评分、NIKBUT与角膜缘梯形结膜瓣切口组比较有差异(P<0.05)。术后14d改良Parks组SⅠt、BUT、TMH、NIKBUT较角膜缘梯形结膜瓣切口组有差异(P<0.05)。角膜缘梯形结膜瓣切口组及改良Parks组手术总体并发症发生率无差异(7.3%vs 2.4%,P>0.05),总体满意度有差异(83.3%vs 95.2%,P<0.05)。结论:角膜缘梯形结膜瓣切口与改良Parks切口手术术式对斜视均有较好的矫正效果,但改良Parks切口手术对泪膜稳定性影响较小,手术满意度较高。

Recent advances in lymphatic targeted drug delivery system for tumor metastasis

The lymphatic system has an important defensive role in the human body. The metastasis of most tumors initially spreads through the surrounding lymphatic tissue and eventually forms lymphatic metastatic tumors; the tumor cells may even transfer to other organs to form other types of tumors. Clinically, lymphatic metastatic tumors develop rapidly. Given the limitations of surgical resection and the low effectiveness of radiotherapy and chemotherapy, the treatment of lymphatic metastatic tumors remains a great challenge. Lymph node metastasis may lead to the further spread of tumors and may be predictive of the endpoint event. Under these circumstances, novel and effective lymphatic targeted drug delivery systems have been explored to improve the specificity of anticancer drugs to tumor cells in lymph nodes. In this review, we summarize the principles of lymphatic targeted drug delivery and discuss recent advances in the development of lymphatic targeted carriers.

Hepatocellular carcinoma with tumor thrombus in bile duct:A proposal of new classification according to resectability of primary lesion

BACKGROUND Hepatocellular carcinoma(HCC)with tumor thrombus in the bile duct(BDTT)is easily misdiagnosed or mistreated due to the clinicopathological diversity of the thrombus and its relationship with primary lesions.AIM To propose a new classification for HCC with BDTT in order to guide its diagnosis and treatment.METHODS A retrospective review of the diagnosis and treatment experience regarding seven typical HCC patients with BDTT between January 2010 and December 2019 was conducted.RESULTS BDTT was preoperatively confirmed by computed tomography/magnetic resonance imaging in only four patients.Three patients with recurrent HCC and one patient with first-occurring HCC had no visible intrahepatic tumors;of these,misdiagnosis occurred in two patients,and three patients died.One patient was mistreated as having common bile duct stones,and another patient with a history of multiple recurrent HCC was misdiagnosed until obvious biliary dilation could be detected.Only one patient who received hepatectomy accompanied by BDTT extraction exhibited disease-free survival during the follow-up period.A new classification was proposed for HCC with BDTT as follows:HCC with microscopic BDTT(Type Ⅰ);resectable primary or recurrent HCC mass in the liver with BDTT(Type Ⅱ);BDTT without an obvious HCC mass in the liver(Type Ⅲ)and BDTT accompanied with unresectable intra-or extrahepatic HCC lesions(Type Ⅳ).CONCLUSION We herein propose a new classification system for HCC with BDTT to reflect its pathological characteristics and emphasize the significance of primary tumor resectability in its treatment.

Small interfering RNA targeting HMGN5 induces apoptosis via modulation of a mitochondrial pathway and Bcl-2 family proteins in prostate cancer cells

We investigated the importance of HMGN5, a nuclear protein that binds to nucleosomes, unfolds chromatin, and affects transcription, in the LNCaP prostate cancer cell line. We also examined the molecular mechanisms that promote apoptosis of LNCaP cells after infection with small interfering RNA （siRNA） targeting HMGN5 （siRNA-HMGN5）. The androgen-dependent LNCaP human prostate cancer cells were infected with siRNA-HMGN5. Apoptosis was detected using the Annexin V-PE/7-AAD double staining and the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling （TUNEL） assays. Mitochondrial membrane potential was measured by JC-1 staining. HMGN5and GAPDHmRNA expression were determined using real-time PCR. Bcl-2 and other apoptosis-related protein levels were determined by Western blot analysis. Caspase activity was measured by cleavage of the caspase substrate. Infection with siRNA targeting HMGN5 efficiently and specifically reduced the HMGN5 expression in LNCaP cells. The downregulation of HMGN5 induced remarkable apoptosis of LNCaP cells and resulted in the reduction of mitochondrial membrane potential. The induction of cell apoptosis was accompanied by the upregulation of Bax, the Bax/Bcl-2 ratio and the activation of caspase3. The HMGN5-targeted siRNA was effective in downregulating the expression of HMGN5 in androgen-dependent prostate cancer cells and inducing cell apoptosis via the regulation of a caspase-related mitochondrial pathway and Bcl-2 family proteins. This study suggests that HMGN5 may be a potential molecular target with therapeutic relevance for the treatment of prostate cancer.

Analysis of B-ultrasound and contrast-enhanced ultrasound characteristics of different hepatic neuroendocrine neoplasm

BACKGROUND Hepatic neuroendocrine neoplasm(hNEN) is a highly heterogeneous tumor. The exact identification of the source and malignant degree of hNEN is important.However, there is a lack of information regarding diagnosis of hNEN with imaging. In addition, no studies have compared the imaging between hNEN and hepatocellular carcinoma(HCC) and among different sources and malignant degrees of hNEN.AIM To compare the ultrasound characteristics between hNEN and HCC and among different sources and malignant degrees of hNEN.METHODS A total of 55 patients with hNEN were recruited and defined as the hNEN group.Among them, 35 cases of hNET were defined as the hNET group. Twenty cases of hepatic neuroendocrine carcinoma(hNEC) were defined as the hNEC group.Among the 55 lesions, 29 were transferred from the pancreas, 20 were from the gastrointestinal tract, and six were from other sites. In total, 55 patients with HCC were recruited and defined as the HCC group. The characteristic differences of Bmode ultrasound and contrast-enhanced ultrasound(CEUS) between hNEN and HCC and among different sources and malignant degrees of hNEN were compared.RESULTS In the hNEN group, the proportions of multiple liver lesions, unclear borders,and high echo lesions were higher than those in the HCC group. The proportions of non-uniform echo and peripheral acoustic halo were lower than those in the HCC group(P < 0.05). The washout to iso-enhancement time and washout to hypo-enhancement time were lower than those in the HCC group(P < 0.05). The characteristics of B-ultrasound and CEUS among different sources of hNEN were similar, and the differences were not statistically significant(P > 0.05). B-mode ultrasound characteristics of hNET and hNEC were similar. The proportions of low enhancement at portal venous phase, non-uniform enhancement forms, and combined tumor vasculature in the hNEC group were larger than those in the hNEN group(P < 0.05).CONCLUSION Compared with HCC, hNEN showed multiple intrahepatic lesions, uniform high echo, uniform high enhancement at arterial phase, and rapid washout. Low enhancement at portal venous phase, overall non-uniform enhancement form,and the proportion of combined tumor vasculature in hNEC were larger than those in hNET.

Analysis of factors potentially predicting prognosis of colorectal cancer

BACKGROUND Accurate assessment of the prognosis after colorectal cancer surgery is of great significance in patients with colorectal cancer.However,there is no systematic analysis of factors affecting the prognosis of colorectal cancer currently.AIM To systematically analyze the influence of clinical data and serological and histological indicators on the prognosis of patients with colorectal cancer,and to explore the indicators that can accurately assess the prognosis of patients with colorectal cancer.METHODS A total of 374 patients with colorectal cancer were enrolled.The clinical data,tumor-node-metastasis(TNM)stage,and Dukes stage were recorded.All patients received examinations including carcinoembryonic antigen(CEA),carbohydrate antigen 199,C-reactive protein,albumin,D-dimer,and fibrinogen as well as routine blood tests one week before surgery.The tumor location,size,depth of invasion,lymph node metastasis,and distant metastasis were recorded during surgery.The pathological tissue typing and expression of proliferating cell nuclear antigen(PCNA)and p53 were observed.All patients were followed for 3 years,and patients with endpoint events were defined as a poor prognosis group,and the remaining patients were defined as a good prognosis group.The differences in clinical data,serology,and histology were analyzed between the two groups.Multivariate COX regression was used to analyze the independent influencing factors for the prognosis of colorectal cancer.The receiver operating characteristic curve was used to evaluate the predictive value of each of the independent influencing factors and their combination for the prognosis of colorectal cancer.RESULTS The follow-up outcomes showed that 81 patients were in the good prognosis group and 274 patients in the poor prognosis group.The TNM stage,PCNA,Glasgow prognostic score(GPS),neutrophil-lymphocyte ratio(NLR),C-reactive protein/albumin ratio(CAR),D-dimer,and CEA were independent influencing factors for the prognosis of colorectal cancer(P=0.000).NLR had the highest predictive power for colorectal cancer prognosis[area under the receiver operating characteristic curve(AUC)=0.925],followed by D-dimer(AUC=0.879)and GPS(AUC=0.872).The accuracy of the combination of all indicators in predicting the prognosis of colorectal cancer was the highest(AUC=0.973),which was significantly higher than that of any of the indicators alone(P<0.05).The sensitivity and specificity of the combination were 92.59%and 90.51%,respectively.CONCLUSION The independent influence factors for the prognosis of colorectal cancer include TNM stage,PCNA,GPS,NLR,CAR,D-dimer,and CEA.The combined assessment of the independent factors is the most accurate predictor of the prognosis after colorectal cancer surgery.

HIF-2α regulates CD44 to promote cancer stem cell activation in triple-negative breast cancer via PI3K/AKT/mTOR signaling

BACKGROUND Breast cancer is a common malignant tumor that seriously threatens women’s health.Breast cancer stem cell(CSC)-like cell population may be the main factor for breast cancer metastasis.Therefore,targeted therapy for CSCs has great potential significance.Hypoxia-inducible factor is a transcription factor widely expressed in tumors.Studies have shown that down-regulation of the hypoxia signaling pathway inhibits tumor stem cell self-renewal and increases the sensitivity of stem cells to radiotherapy and chemotherapy mediated by hypoxiainducible factor-2α(HIF-2α).However,the specific mechanism remains unclear and further research is necessary.AIM To investigate the effect of HIF-2αdown-regulation on stem cell markers,microsphere formation,and apoptosis in breast cancer cell line MDA-MB-231 under hypoxia and its possible mechanism.METHODS Immunohistochemistry was used to detect the expression of HIF-2αand CD44 in triple-negative breast cancer(TNBC)and non-TNBC tissues.Double-labeling immunofluorescence was applied to detect the co-expression of HIF-2αand CD44 in MDA-MB-231 cells and MCF-7 cells.HIF-2αwas silenced by RNA interference,and the expression of CD44 and transfection efficiency were detected by real-time fluorescent quantitative PCR.Further,flow cytometry,TdT-mediated X-dUTP nick end labeling,and mammosphere formation assays were used to evaluate the effect of HIF-2αon CSCs and apoptosis.The possible mechanisms were analyzed by Western blot.RESULTS The results of immunohistochemistry showed that HIF-2αwas highly expressed in both TNBC and non-TNBC,while the expression of CD44 in different molecular types of breast cancer cells was different.In in vitro experiments,it was found that HIF-2αand CD44 were expressed almost in the same cell.Compared with hypoxia+negative-sequence control,HIF-2αsmall interfering ribonucleic acid transfection can lower the expression of HIF-2αand CD44 mRNA(P<0.05),increase the percentage of apoptotic cells(P<0.05),and resulted in a reduction of CD44+/CD24−population(P<0.05)and mammosphere formation(P<0.05)in hypoxic MDA-MB-231 cells.Western blot analysis revealed that phosphorylated protein-serine-threonine kinase(p-AKT)and phosphorylated mammalian target of rapamycin(p-mTOR)levels in MDA-MB-231 decreased significantly after HIF-2αsilencing(P<0.05).CONCLUSION Down-regulation of HIF-2αexpression can inhibit the stemness of human breast cancer MDA-MB-231 cells and promote apoptosis,and its mechanism may be related to the CD44/phosphoinosmde-3-kinase/AKT/mTOR signaling pathway.

光学相干断层扫描在圆锥角膜中的应用进展

圆锥角膜是一种慢性非炎症性的角膜疾病,以角膜基质变薄、局部扩张呈锥形突出为特征,伴不规则散光和近视,严重威胁视力。角膜地形图可明确诊断,光学相干断层扫描技术因其可以显示角膜亚层结构且具有优越的可重复性、分辨率和采集速度,在圆锥角膜的诊疗中发挥着日益重要的作用。本文对圆锥角膜的临床特点、光学相干断层技术的分类和特点及其在圆锥角膜的早期诊断、角膜接触镜验配、交联治疗及角膜移植等中应用的新进展予以讨论和回顾,同时也归纳了光学相干断层扫描的衍生技术包括光学相干弹性成像、光学相干断层扫描血管造影和偏振敏感光学相干断层扫描在圆锥角膜方面的研究进展,有助于进一步发挥光学相干技术在圆锥角膜中的应用价值。

Biomarker identification of thyroid associated ophthalmopathy using microarray data

AIM： To uncover the underlying pathogenesis of thyroid associated ophthalmopathy（TAO） and explore potential biomarkers of this disease.METHODS： The expression profile GSE9340, which was downloaded from Gene Expression Omnibus database, included 18 specimens from 10 TAO patients and 8 hyperthyroidism patients without ophthalmopathy. The platform was HumanRef-8 v2 Expression BeadChip. Raw data were normalized using preprocess. Core package and the differentially expressed genes（DEGs） were identified based on t-test with limma package of R. Functional enrichment analyses were performed recruiting the DAVID tool. Based on STRING database, a protein-protein interaction（PPI） network was constructed, from which a module was extracted. The functional enrichment for genes in the module was performed by the BinGO plugin.RESULTS： In total, 861 DEGs（433 up-regulated and 428 down-regulated） between TAO patients and hyperthyroidism patients without ophthalmopathy were identified. Crucial nodes in the PPI network included TPX2, CDCA5, PRC1, KIF23 and MKI67, which were also remarkable in the module and all enriched in cell cycle process. Additionally, MKI67 was highly correlated with TAO. Besides, the DEGs of GTF2 F1, SMC3, USF1 and ZNF263 were predicted as transcription factors（TFs）. CONCLUSION： Several crucial genes are identified such as TPX2, CDCA5, PRC1 and KIF23, which all might play significant roles in TAO via the regulation of cell cycle process. Regulatory relationships between TPX2 and CDCA5 as well as between PRC1 and KIF23 may exist.Additionally, MKI67 may be a potent biomarker of TAO, and SMC3 and ZNF263 may exert their roles as TFs in TAO progression.

A new multi-wavelength solar telescope: Optical and Near-infrared Solar Eruption Tracer (ONSET)

A new multi-wavelength solar telescope, the Optical and Near-infrared Solar Eruption Tracer （ONSET） of Nanjing University, has been constructed. It was fabricated at the Nanjing Institute of Astronomical Optics ＆ Technology, and the oper- ation is jointly administered with Yunnan Astronomical Observatory. ONSET is able to observe the Sun in three wavelength windows： He I 10830 A, Ha and white-light at 3600 A and 4250 A, which are selected in order to simultaneously record the dynam- ics of the corona, chromosphere and photosphere respectively. Full-disk or partial-disk solar images with a field of 10~ at three wavelengths can be obtained nearly simultane- ously. It is designed to trace solar eruptions with high spatial and temporal resolutions. This telescope was installed at a new solar observing site near Fuxian Lake in Yunnan Province, southwest China. The site is located at E102N24, with an altitude of 1722 m. The seeing is stable and has high quality. We give a brief description of the scientific objectives and the basic structure of ONSET. Some preliminary results are also pre- sented.

Comparison of bevacizumab and ranibizumab in agerelated macular degeneration: a systematic review and meta-analysis

AIMTo compare the effectiveness and safety between bevacizumab and ranibizumab in the treatment of age-related macular degeneration (AMD) through a systematic review and meta-analysis.

Awareness of initiative practice for health in the Chinese population:A questionnaire survey based on a network platform

BACKGROUND In 2016,the Chinese government issued the Healthy China 2030 plan,which also produced the initiative practice for health(IPFH)concept.However,people’s knowledge and awareness of the IPFH are unclear.AIM To investigate awareness of IPFH in the Chinese population and explore the relevant influential factors.METHODS An internet-based self-designed questionnaire survey was used to collect respondents’demographic characteristics and awareness of health and the IPFH from March 26 to April 18,2020.IPFH consciousness was assessed by the scores for different related questions.The Student’s t test,the Chi-square test,and multiple logistic regression analysis were performed to analyze the differences and influencing factors.RESULTS A total of 2678 valid questionnaires were collected.Of the respondents,973(36.3%)had heard of the IPFH concept.In addition,89.5% of participants agreed with the view that the IPFH is beneficial to improving quality of life,and over half thought that a regular schedule,a reasonable diet,tobacco and alcohol control,a cheerful mood,specific life goals and plans,taking the initiative to accept health-related education and implement health knowledge,good interpersonal relationships,and regular physical examinations were closely related to the IPFH.The majority of respondents paid attention to their health and usually obtained health-related knowledge via social media and were also willing to promote the IPFH.Most of the participants underestimated the role of hospitals,family doctors,and health managers in promoting the IPFH.Age,monthly income,and medical-related work experience were the influencing factors for IPFH awareness.CONCLUSION The Chinese population has limited knowledge of the IPFH.People with strong IPFH awareness are older,earn more,and have medical-related work experience.

Clinical application of a shape-preserving rapid corneal donor dehydrater

AIM:To describe the design and clinical application of a corneal donor dehydrator which can quickly dehydrate corneas and keep its original shape.METHODS:The corneal donor material is placed on stainless steel beads with different diameters in the dehydrating box to make the cornea the same shape as the steel ball.Then,the cornea is placed inside the dehydrater for rapid dehydrating using the internal cleaning and ventilation system.Totally 83 eyes underwent deep anterior lamellar keratoplasty(DALK)using corneal donor tissue preserved with corneal dehydrater,and 60 patients(60 eyes)received DALK by the same surgeon using corneal donor tissue preserved with glycerol were included in the control group.The best corrected visual acuity(BCVA),the thickness and transparency of the corneal buttons were recorded.RESULTS:After the completion of dehydrating,all the donor corneas maintained a normal shape without any shrinkage or distortion,and the average intraoperative rehydration time was 43.3±12.1 s during operation.The mean BCVA of the dehydrater group was 0.30±0.18 at 1 wk and 0.32±0.16 at 1 mo,which were statistically better than that of the control group(P<0.001).The score of corneal buttons transparency were lower than that of the control group with statistical difference(P<0.001).The thickness of corneal buttons at 1 wk and at 1 mo in the dehydrater group was significantly better than that of the control group respectively(P<0.001).One week after operation,no corneal button turbidity or edema was observed in both groups.CONCLUSION:The dehydrater can quickly dehydrate the corneal material in a clean and airtight environment and maintain the original shape of the corneal donor during the dehydrating process.This dehydrater is recommended for long-term high-quality preservation in areas where corneal materials cannot be used within a reasonable time period.

带锥齿蜗轮蜗杆传动式消防水炮结构设计及流场仿真（英文）

A fire water monitor driven by worm gear with bevel gear was designed based on the theoretical calcula-tions. The classification and features of fire water monitor were elaborated, and the design of whole structure andkey components of fire water monitor were discussed. Moreover, the jet characteristics and the influence factors onthe jet performances were also investigated in details. The simulation results approximately agree with the expecta-tion effect, which reflects the rationality of the design. The relevant analysis can provide some guidance for thedesign and optimization of fire water monitor.