Stroma is the major part of cornea.The factors maintain corneal stroma transparency include the ultrastructural anatomy and physiology of the cornea and its cellular and extracellular components.During corneal development,neural crest cells and keratoblasts differentiate into keratocytes,which synthesize high levels of collagen and proteoglycans.The production and assembly of collagen fibers need a series of intracellular and extracellular components.The assembled collagen fibers deposite in ECM,assemble into high-order structures to synthesize small fiber bundles,and then form a larger structure in a particular tissue.Corneal wound healing is completed in highly coordinate by various cells and cytokines in time and space.The keratocytes phenotype changes and the remodeling of corneal stroma ECM are two important factors in this process.Corneal refractive surgery are carried out in the worldwide,although most corneal refractive surgery are successful,But the stromal opacity formed during the remodeling of corneal stroma is the most important cause of visual impairment and visual quality decline after refractive surgery.Well understanding the course of stroma remodeling after corneal injury,is meaningful for the exploration of decreasing corneal opacity formation.In this paper,the corneal stroma structure and its synthesis and assembly,the pathophysiological process of stroma remodeling in corneal wound healing and after corneal refractive surgery were reviewed.

Objective:To explore the effect of childhood trauma on non-suicidal self-injury and the chain mediating effect of rejection sensitivity and experiential avoidance.Methods:From June 2021 to April 2022, totally 1 130 college students were investigated with childhood trauma questionnaire-short form(CTQ-SF), the tendency to expect rejection scale, acceptance and action questionnaire-2nd edition(AAQ-Ⅱ) and Ottwa self-injury inventory(OSI). SPSS 25.0 and Mplus 8.0 software were used for descriptive analysis, Spearman correlation analysis, structural equation model construction and Bootstrap mediation effect test.Results:Correlation analysis showed that childhood trauma (34.64±8.25), rejection sensitivity (58.02±9.54), experiential avoidance (23.90±7.96) and non-suicidal self-injury (0(0, 1)) were all significantly positively correlated with each other( r=0.163-0.532, all P<0.01). Structural equation model showed that empirical avoidance played a partial mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.045(95% CI=0.013-0.084). Rejection sensitivity and experiential avoidance played a chain mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.017(95% CI=0.005-0.035). Conclusion:Childhood trauma can directly predict non-suicidal self-injury in college students, and it can also indirectly predict non-suicidal self-injury through the partial mediation effect of experiential avoidance and the chain mediation effect of rejection sensitivity and experiential avoidance.

Heat shock protein 70(HSP70)is a highly conserved polypeptide protein,which plays an im-portant role in protein homeostasis,apoptosis,invasion and cell signaling transduction. Many studies have shown that the expression level of HSP70 is closely related to the development and progression of tumor,which is a low expression in normal tissues and the overexpression in tumor tissue. Hepatocellular carcinoma ( HCC ) is con-cealed,and the related study reported that the expression of HSP70 can be used as a sensitive biological index for the diagnosis and differential diagnosis for early HCC,and also affects the treatment and prognosis of patients with HCC. This article will summary the relationship between the expression of HSP70 and HCC.

Objective:To explore the effects of neural precursor cell-expressed developmentally down regulated 8(NEDD8) covalent modification on ovarian cancer cell proliferation and apoptosis,and the possible underlying mechanisms.Methods:Use different concentrations of MLN4924 (0,0.125,0.25,0.5 mol/L) and human ovarian cancer cell line SKOV3,the expression levels of PAR3, HER2,Neddylated-cullins,P-IκBα were detected by Western blot and the secretion of IL-6 was measured by ELISA after 4 h treatment.The cell proliferation was determined by CCK-8 staining and the cell cycle and apoptosis were analyzed by flow cytometry after 72 h treatment.Results:MLN4924 inhibits the proliferation of SKOV3 cells in a dose-dependent manner,which is associated with reduced IL-6 secretion.Western blot revealed that MLN4924 dose-dependently inhibits the neddylation of cullins(reduced neddylated-cullins) and induced the accumulation of P-IκBα,whereas the expression levels of PARs and HER2 remained largely unchanged.At the same time MLN4924 dose-dependently induced cell cycle prove at S phase and the formation of a large number of tetraploids.Furthermore,apoptosis increased with the dose of MLN4924.Conclusion:NEDD8 covalent modification specific inhibitor MLN4924 can significantly inhibit the proliferation of SKOV3 cells and induce cell cycle arrest and apoptosis.The above inhibitory effects may partially result from impaired P-IκBα degradation and IL-6 secretion.

Objective: To develop a child simple constraint mattress with good permeability,soft,comfort,safe and easily cleanable so as to effectively avoid accidents,such as falling from bed,bump injury,scratch and hurting others.Methods: 70 hospitalized children who need restrictive measures were randomly selected in this research and were divided into observation group(35 cases)and control group(35 cases)according to the time sequence of hospitalization.The constraint mattresses was used for children of observation group,and traditional constraint bands of wrist were used for children of control group.And the effectiveness,safety,comfort,convenience and parental satisfaction of the two constraint tools were observed.Results: The effectiveness,safety,comfort,convenience and satisfaction of constraint measure of observation group were significantly higher than those of control group(x2=10.27,x2=15.97,x2=19.09,x2=3.97,x2=15.88,P＜0.05).Conclusion: The constraint effect of simple constraint mattress is better than that of traditional constraint band of wrist.

Objective To comprehend the trends and fundamental characteristics of medical damage disputes in Guan-gxi,and to offer insightful advice on how to improve patient-physician communication and lower the likelihood of medical dis-putes.Methods The China Judgements Online was searched for a total of 549 civil judgments on medical damage disputes in Guangxi from 2017 to 2021,and the sample sizes were subsequently analyzed by descriptive statistics in four dimensions:distri-bution of precedents,identification,division of liability,and amount of compensation.Results In terms of distribution charac-teristics,the types of medical institutions where disputes occurred were mainly general hospitals above the second level,with ob-stetrics and gynaecology,emergency medicine and orthopaedics being the departments with a high incidence of disputes;in terms of identification,medical fault judicial appraisal was mostly used for identification,and the court's acceptance of the identifica-tion results reached 93.3%,with the average length of the case hearing being about 11.8 months;in terms of the division of re-sponsibility,medical institutions took secondary responsibility From the analysis of liability,medical institutions were mostly re-sponsible for secondary liability,accounting for 37.5%;from the analysis of the amount of compensation,the average amount of compensation has been increasing year by year.Conclusion Medical institutions need to lessen the frequency of litigation cases and lessen litigation compensation since the connection between doctors and patients remains strained.To reduce medical disputes and litigation,they should improve medical risk identification,improve medical safety management,direct people's mediation,investigate medical risk sharing mechanisms,enhance the independence and professionalism of judicial appraisal,standardize the notification of autopsies,and employ expert support personnel.

Objective To develop and assess the reliability and validity of an outpatient satisfaction questionnaire tailor-ed for enterprise-run hospitals.Methods The initial questionnaire was formulated using interviewing and literature review,fol-lowed by a satisfaction survey administered to 380 outpatients at an enterprise-run hospital in Guangxi.Item analysis,exploratory factor analysis,and confirmatory factor analysis were conducted to finalize the evaluation questionnaire and evaluate its reliability and validity.Results The final questionnaire comprised 18 items with the item reliability of 0.438-0.856,composite reliabili-ty of 0.846-0.956,and convergence validity of 0.668-0.782.The correlation coefficients among the common factors were less than the square root of the convergent validity values.Conclusion The outpatient satisfaction evaluation questionnaire developed is characterized by robust reliability and validity.

[摘 要] 在乳腺癌的诊疗过程中，常规药物存在靶向性较差和严重的不良反应等缺陷。近年来，具有高选择性及优异成像性能的超顺磁性氧化铁纳米粒子（SPION）已成为影像学领域的研究热点。SPION是一种具有磁性的纳米材料，其以氧化铁为核心，置于较弱的外磁场中就可产生较强的磁性。新型SPION具有尺寸小、生物相容性好、制备流程简单和生产成本低等优点，且具有较好的磁响应能力，有望作为医学成像探针和药物靶向递送系统的载体，在提高肿瘤影像学特异性诊断和实现更精确给药等方面都具有良好的医学应用前景。在乳腺癌影像学诊断和治疗中，SPION可作为分子靶向造影剂用于磁粒子成像观察，还可应用于化疗药物递送、基因传递、免疫治疗和光动力治疗等。随着以SPION为核心的临床试验进一步开展，SPION在乳腺癌诊疗中的应用将进一步拓展。

[摘 要] 外泌体和EMT在宫颈癌发生发展中均发挥了重要作用。外泌体可通过改变肿瘤微环境、促进肿瘤血管生成而影响宫颈癌疾病进展。EMT可影响肿瘤侵袭迁移能力，宫颈癌细胞的EMT可被miRNA、lncRNA、蛋白质等活性物质调控。而各种细胞、组织来源的外泌体包含丰富的蛋白质、脂质、核酸等多种活性物质，可直接或通过Wnt/β-catenin、PTEN/PI3K/Akt等信号通路调控肿瘤EMT，然而对外泌体在宫颈癌EMT中作用的了解仍有限，还需要大量研究数据支持。对宫颈癌EMT及外泌体对其的作用展开讨论，拟为研究外泌体在宫颈癌EMT中的作用提供方向，为宫颈癌诊断、治疗等研究提供新的思路。

[摘 要] 宫颈癌是我国女性常见的恶性肿瘤，其传统治疗方式仍存在较多的毒副作用，在寻求突破治疗宫颈癌的新途径中， 程 序性死亡受体（programmed cell death-1，PD-1）和程序性死亡配体（programmed cell death-ligand 1，PD-L1）是近年来研究较多的抑 制性免疫检查点，其与多种恶性肿瘤的发生、发展和转移有不可分割的联系。PD-1/PD-L1抑制剂在治疗宫颈癌方面，其总体缓解 率为14%～27%，当其联合传统化疗可以更多地提高总体缓解率，目前已有多项相关研究正在进行中。本文对PD-1/PD-L1的生 物学特性及其抗体在宫颈癌治疗中的应用进展作一综述。