Objective To observe the effect of Jian Pi Hua Shi Ke Li(JPHSKL) on IBS‐D ,gastrointestinal peptide hormones of rats 5‐HT ,and explore the therapeutic mechanism .Methods 60 clean‐level Wistar rats were used in the experiment .The rats were randomly divided into normal group ,model group ,JPHS low ,middle ,high and Deshute group(10 rats in each group) .Used gavage senna and restraint stress to establish D‐IBS rat model .The drug contrations of JPHSKL low ,midle ,high group were 1 .5 ,2 .5 ,4 .0 g/mL ,3 mg/mol in Deshute group .Once each day ,for 2 weeks ,the other groups were nomol group without any treatment and mod‐el group which building successful .Immunohistochemical SABC method to observe 5‐HT level of colonic specimens .Results The 5‐HT level in colonic tissue of the rats in IBS‐D model were obviously higher than the nomal group(P<0 .01) ,and the 5‐HT level in colonic tissue in JPHSKL treated group were obviously lower than the mold group (P<0 .05) .Among them ,the JPHSKL high group had significant effect and there was no obviously difference with Deshute group (P>0 .05) .Conclusion JPHSKL can im‐prove gastrointestinal function of IBS‐D model rats ,effect mechanism is relating to decrease the level of 5‐HT in colonic mucosa .

The Bowman membrane separates the corneal epithelium from the anterior stroma.It may be closely associated with retaining corneal transparency and stabilizing corneal morphology and biomechanics.Keratoconus presents with histopathological manifestations such as disruption of the Bowman membrane and stromal collagen filling.Bowman layer transplantation is a new type of keratoplasty for patients with progressive severe keratoconus who show no good efficacy after corneal contact lenses treatment and are not suitable for ultraviolet corneal cross-linking and corneal ring implantation therapy.The procedure uses an intact eye or anterior lamellar corneal implant as the donor and the implant is implanted into the corneal stroma of the affected eye using the stromal bed or stromal pocket method.Complications include intraoperative corneal perforation and acute postoperative corneal edema.The postoperative 5-year overall surgical success rate is 84%, with significant improvement in visual quality and corneal morphology, as well as prevention of disease progression and delay or avoidance of penetrating keratoplasty and deep lamellar keratoplasty.Bowman layer transplantation has the advantages of minimal trauma and few intraoperative and postoperative complications, but this surgical technique requires a high degree of precision and is difficult.The theoretical basis of Bowman layer transplantation, the latest surgical techniques and the prognosis and regression were reviewed in this article.

Objective To investigate the hepatic hemodynamic characteristics of cirrhotic patients with splenectomy using iodine map of dual-source computed tomography(DSCT).Methods Twenty-four cirrhotic patients with splenectomy were selected as a study group,41 cirrhotic patients without splenectomy as a cirrhosis group and other 32 patients with normal liver as a control group.The iodine concentration(IC)in hepatic arterial and venous phases was measured on the iodine map,and the arterial iodine fraction(AIF)and portal venous iodine concentration(PVIC)were calculated.Receiver operating characteristic(ROC)curves were plotted and the area under the curve(AUC)was recorded to evaluate the diagnostic efficacy of each parameter using the DeLong test.Results IC in arterial phase and AIF were significantly higher,and IC in venous phase and PVIC were significantly lower in study group(P<0.05).The AUC values of the four parameters between study group and cirrhosis group were 0.735,0.992,0.943,and 0.994,respectively.Conclusion DSCT iodine map is helpful for clinical quantitative assessment of hepatic hemodynamic characteristics in cirrhotic patients with splenectomy,and the PVIC has optimal independent diagnostic performance.

Objective:To explore whether the degree of skeletal muscle atrophy in obese individuals under the influence of colorectal cancer is more severe than that in non-obese individuals.Methods:The clinical data of patients who underwent radical resection of colorectal cancer in our department from Jul 2020 to Dec 2021 was collected. Sixty-four obese patients were included and 64 non-obese patients were matched according to propensity score. At the same time, 51 obese patients were collected from non-tumor patients and matched with 51 non-obese patients. The psoas muscle index (PMI) of included patients was analyzed and compared.Results:The PMI of patients with colorectal cancer was significantly lower than that of corresponding non-tumor patients, regardless of gender and body weight (both P<0.05). The PMI of obese patients with colorectal cancer was significantly lower than that of non-obese patients ( P<0.05). Conclusions:The impact of colorectal cancer on skeletal muscle atrophy in obese individuals is greater than that in normal weight individuals. Therefore, the skeletal muscle status of obese patients with colorectal cancer should be evaluated more comprehensively.

Objective:To compare ocular surface dry eye-related indexes and tear cytokine level changes in chronic ocular graft-versus-host disease (oGVHD) patients after receiving topical treatment of 0.05% cyclosporine or 0.1% tacrolimus eye drops.Methods:A randomized controlled study was conducted.A total of 60 chronic oGVHD patients (60 eyes) were recruited at Beijing University Third Hospital from April 2020 to April 2021.The patients were divided into tacrolimus group and cyclosporine group by a random number table, with 30 patients (30 eyes) in each group.Patients in tacrolimus group used 0.1% tacrolimus eye drops (twice a day) and patients in cyclosporine group used 0.05% cyclosporine eye drops (4 times a day).Additionally, 0.1% flumetholon (twice a day), deproteinized calf blood extract (3 times a day), and 0.1% sodium hyaluronate eye drops (8 times a day) were applied for anti-inflammation and lubrication in both groups.Patients were screened according to exclusion criteria after 1-month treatment.Eventually, 21 patients (21 eyes) in tacrolimus group and 12 patients (12 eyes) in cyclosporine group were included for further study.Patients were examined before and 1 month after treatment.The primary evaluation indexes included Ocular Surface Disease Index (OSDI), corneal fluorescein staining scores and tear film break-up time (BUT).Expressions of interleukin (IL)-6, IL-8, IL-17, epidermal growth factor (EGF), and tumor necrosis factor-α (TNF-α) in tears were detected before and after treatment using Luminex chip.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University Third Hospital (No.M2020489).Written informed consent was obtained from each subject before any medical examination.Results:The OSDI differences between before and after treatment were 0.4(-5.6, 2.5) in tacrolimus group and 27.2(4.6, 45.0) in cyclosporine group, and the OSDI improvement was significantly greater in cyclosporine group than in tacrolimus group ( Z=-2.547, P=0.009).The differences of corneal fluorescein staining scores and BUT between before and after treatment were 5.0(2.5, 10.0) scores and 3.5(-0.5, 13.8) seconds in tacrolimus group, 0.0(-3.0, 0.0) scores and -1.5(-3.0, 0.0) seconds in cyclosporine group, respectively, with no significantly difference between both groups ( Z=-0.526, -0.804; both at P>0.05).The differences of IL-6, IL-8, IL-17, EGF and TNF-α expressions between before and after treatment in tacrolimus group and cyclosporine group were not significantly different ( Z=-0.487, -0.112, -0.412, -1.085, -1.198; all at P>0.05). Conclusions:Altered levels of all tested cytokines in oGVHD tears are of no significant differences between tacrolimus and cyclos porine treatment.In addition, 0.05% cyclosporine eye drops may be more comfortable than 1% tacrolimus for chronic oGVHD patients.