ObjectiveTo improve the quality and service performance of community visual health services in Shanghai, and to establish a set of reasonable and effective evaluation index system for community visual health services. MethodsCentered on the national and Shanghai-based visual health policies and based on the current status and development trends of community visual health service program in Shanghai, the candidate indicators were formed through literature review and expert interviews, firstly. The framework of an evaluation index system was formulated through qualitative research successively, which was further revised and perfected using the Delphi method. Coefficient weights were calculated using the analytic hierarchy process (AHP), culminating in the establishment of the community visual health evaluation index system, lastly. ResultsA total of 22 visual health experts from district-level center for disease control, hospital ophthalmology and leaders in charging of visual health service in community health centers participated in the Delphi questionnaire survey, with a questionnaire recovery rate of 100% and an expert authority coefficient of 0.86, indicating high credibility. After a round of correspondence to experts’ importance ratings and discussions, a comprehensive evaluation index system comprising 3 primary indicators, 12 secondary indicators, and 47 tertiary indicators, along with 5 additional indicators, was finalized. ConclusionAn index system tailored to effective evaluation for community visual health initiatives was drawn up in this study, which can promote the capacity building in community eye health services, facilitating the high-quality development of visual health courses, and enhancing residents’ eye health.

Objective:Based on the process theory of stress effect, the mediating effect of health literacy and perceived social support between perceived control and fatigue symptom of asthmatic patients was analyzed, which provide the evidence for the formulation of intervention programs to relieve fatigue in patients.Methods:Adopting a cross-sectional survey design, from January 2019 to November 2023, asthmatic patients at The First Affiliated Hospital of Anhui Medical University (Feidong County People′s Hospital) were selected by convenience sampling method and investigated by the General Information Questionnaire, Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale. Pearson correlation analysis was used to investigate the correlation between fatigue symptom, perceived control, health literacy, and perceived social support in asthma patients. A structural equation model was constructed using AMOS24.0 software and conduct mediation analysis.Results:A total of 260 questionnaires were distributed, and 241 valid questionnaires were collected. There were 110 males and 131 females aged (55.48 ± 15.03) years old. The scores of Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale were (4.27 ± 1.68), (31.72 ± 8.51), (85.71 ± 19.36), (46.97 ± 11.79) points, respectively. Pearson correlation analysis showed that fatigue symptom was negatively correlated with perceived control, health literacy, and perceived social support ( r=-0.719, -0.716, -0.767, all P<0.01). The mediating model showed that perceived control had a significant direct effect on fatigue symptom ( β=-0.204, 95% CI-0.252--0.169). Moreover, perceived control also indirectly affected fatigue symptom through the independent mediating effect of health literacy ( β=-0.378, 95% CI-0.405--0.202), the independent mediating effect of perceived social support ( β=-0.227, 95% CI-0.381--0.203), and the chain mediating effect of health literacy and perceived social support ( β=-0.089, 95% CI-0.142--0.025), which accounting for 77.3% of the total effect. Conclusions:Health literacy and perceived social support play a mediating role in the correlation between perceived control and fatigue symptom, which can promote health literacy and perceived social support and thus alleviate fatigue symptom in asthmatic patients.

Objective:Based on the process theory of stress effect, the mediating effect of health literacy and perceived social support between perceived control and fatigue symptom of asthmatic patients was analyzed, which provide the evidence for the formulation of intervention programs to relieve fatigue in patients.Methods:Adopting a cross-sectional survey design, from January 2019 to November 2023, asthmatic patients at The First Affiliated Hospital of Anhui Medical University (Feidong County People′s Hospital) were selected by convenience sampling method and investigated by the General Information Questionnaire, Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale. Pearson correlation analysis was used to investigate the correlation between fatigue symptom, perceived control, health literacy, and perceived social support in asthma patients. A structural equation model was constructed using AMOS24.0 software and conduct mediation analysis.Results:A total of 260 questionnaires were distributed, and 241 valid questionnaires were collected. There were 110 males and 131 females aged (55.48 ± 15.03) years old. The scores of Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale were (4.27 ± 1.68), (31.72 ± 8.51), (85.71 ± 19.36), (46.97 ± 11.79) points, respectively. Pearson correlation analysis showed that fatigue symptom was negatively correlated with perceived control, health literacy, and perceived social support ( r=-0.719, -0.716, -0.767, all P<0.01). The mediating model showed that perceived control had a significant direct effect on fatigue symptom ( β=-0.204, 95% CI-0.252--0.169). Moreover, perceived control also indirectly affected fatigue symptom through the independent mediating effect of health literacy ( β=-0.378, 95% CI-0.405--0.202), the independent mediating effect of perceived social support ( β=-0.227, 95% CI-0.381--0.203), and the chain mediating effect of health literacy and perceived social support ( β=-0.089, 95% CI-0.142--0.025), which accounting for 77.3% of the total effect. Conclusions:Health literacy and perceived social support play a mediating role in the correlation between perceived control and fatigue symptom, which can promote health literacy and perceived social support and thus alleviate fatigue symptom in asthmatic patients.

Objective:To compare the therapeutic effects of 0.05% cyclosporine and 0.1% fluorometholone eye drops in patients with moderate and severe dry eye.Methods:A randomized controlled study was conducted.Fifty-two patients (52 eyes) with moderate to severe dry eye in Tianjin Medical University Eye Hospital from August 2021 to December 2022 were enrolled and randomly divided into 0.05% cyclosporine group and 0.1% fluorometholone group by random number table method, with 26 cases (26 eyes) in each group.Patients received 0.05% cyclosporine eye drops (2 times/day) and 0.1% fluorometholone eye drops (2 times/day) combined with calf blood deproteinized extract eye drops (4 times/day) according to the grouping.Before and 1, 3 and 6 months after treatment, clinical symptoms and signs were observed and Ocular Surface Disease Index (OSDI) score, corneal fluorescein staining (CFS) score, Schirmer Ⅰ test (SⅠT), non-invasive first tear film break-up time (NIBUTf), and conjunctival goblet cell (CGC) density were recorded.Before treatment and after 6 months of treatment, changes in corneal nerves and dendritic cells (DC) were observed by in vivo confocal microscopy (IVCM).This study adhered to the Declaration of Helsinki and was approved by the Medical Ethics Committee of Eye Hospital of Tianjin Medical University (No.2021KY-17).Written informed consent was obtained from each subject. Results:Compared with the 0.1% fluorometholone group, CFS score decreased after 1 month of treatment, but SⅠT, NIBUTf and CFS score increased after 3 months of treatment, and OSDI score, SⅠT and CFS score decreased after 6 months of treatment in the 0.05% cyclosporine group, showing statistically significant differences (all at P<0.05).Compared with baseline, in the 0.05% cyclosporine group, NIBUTf increased and CFS score decreased after 1 month of treatment, OSDI score and CFS score decreased, SⅠT and NIBUTf increased after 3 and 6 months of treatment, showing statistically significant differences (all at P<0.05).In the 0.1% fluorometholone group, CFS score decreased after 3 months of treatment, OSDI score and CFS score decreased, SⅠT increased after 6 months of treatment compared to baseline, showing statistically significant differences (all at P<0.05).OSDI score and CFS score decreased, SⅠT increased after 6 months of treatment compared to 3 months of treatment in the 0.05% cyclosporine group, and the differences were statistically significant (all at P<0.05).Baseline and CGC densities after 1, 3 and 6 months of treatment were (147.66±17.29), (195.44±15.46), (210.36±19.15) and (282.09±22.63)cells/mm 2 in the 0.05% cyclosporine group and (138.09±17.29), (95.67±15.46), (117.77±19.15) and (109.13±22.63)cells/mm 2 in the 0.1% fluorometholone group, respectively, with a statistically significant overall difference ( Fgroup=11.724, P<0.001; Ftime=4.837, P=0.005).Compared with the 0.1% fluorometholone group, CGC density in the 0.05% cyclosporine group increased after 1, 3 and 6 months of treatment, with statistically significant differences (all at P<0.05).Compared with baseline, the CGC density increased in the 0.05% cyclosporine group after 1, 3 and 6 months of treatment, and the differences were statistically significant (all at P<0.05).Compared with the 0.1% fluorometholone group, the corneal nerve fiber density in the 0.05% cyclosporine group increased after 6 months of treatment, and corneal DC density, area and dendrite number decreased, showing statistically significant differences (all at P<0.05). Conclusions:Cyclosporine 0.05% eye drops combined with calf blood deproteinized extract eye drops can improve symptoms and signs in patients with moderate to severe dry eye, and the long-term effect is better than that of 0.1% fluorometholone plus calf blood deproteinized extract eye drops.

Objective:To integrate the best evidence of sexual health management for colorectal cancer patients both domestically and internationally, so as to provide guidance for clinical practice.Methods:Evidence on sexual health management of colorectal cancer patients in domestic and foreign databases and websites was systematically searched, and evidence from literature that met quality evaluation standards was extracted and summarized. The search period was from July 2003 to July 2023.Results:A total of 16 articles were included, including five clinical decisions, six clinical practice guidelines, three expert consensus/group standards, and two systematic reviews. Thirty-four recommended opinions were formed, including eight aspects of evaluation and screening, assessment tools, manifestations of sexual dysfunction, coping strategies for sexual problems, psychological intervention, measures for fertility protection, health education, and follow-up management.Conclusions:This study summarizes the best evidence for sexual health management in colorectal cancer patients. It is necessary to selectively apply evidence based on the evaluation of patient conditions by medical and nursing staff and clinical situations to ensure effective and scientific sexual health management strategies for patients, and promote the translation of best evidence into clinical practice.

Background::The effect of bariatric surgery on type 2 diabetes mellitus (T2DM) control can be assessed based on predictive models of T2DM remission. Various models have been externally verified internationally. However, long-term validated results after laparoscopic sleeve gastrectomy (LSG) surgery are lacking. The best model for the Chinese population is also unknown.Methods::We retrospectively analyzed Chinese population data 5 years after LSG at Beijing Shijitan Hospital in China between March 2009 and December 2016. The independent t-test, Mann–Whitney U test, and chi-squared test were used to compare characteristics between T2DM remission and non-remission groups. We evaluated the predictive efficacy of each model for longterm T2DM remission after LSG by calculating the area under the curve (AUC), sensitivity, specificity, Youden index, positive predictive value (PPV), negative predictive value (NPV), and predicted-to-observed ratio, and performed calibration using Hosmer–Lemeshow test for 11 prediction models. Results::We enrolled 108 patients, including 44 (40.7%) men, with a mean age of 35.5 years. The mean body mass index was 40.3 ± 9.1 kg/m 2, the percentage of excess weight loss (%EWL) was (75.9 ± 30.4)%, and the percentage of total weight loss (% TWL) was (29.1 ± 10.6)%. The mean glycated hemoglobin A1c (HbA1c) level was (7.3 ± 1.8)% preoperatively and decreased to (5.9 ± 1.0)% 5 years after LSG. The 5-year postoperative complete and partial remission rates of T2DM were 50.9% [55/108] and 27.8% [30/108], respectively. Six models, i.e., "ABCD", individualized metabolic surgery (IMS), advanced-DiaRem, DiaBetter, Dixon et al’s regression model, and Panunzi et al’s regression model, showed a good discrimination ability (all AUC >0.8). The "ABCD" (sensitivity, 74%; specificity, 80%; AUC, 0.82 [95% confidence interval [CI]: 0.74–0.89]), IMS (sensitivity, 78%; specificity, 84%; AUC, 0.82 [95% CI: 0.73–0.89]), and Panunzi et al’s regression models (sensitivity, 78%; specificity, 91%; AUC, 0.86 [95% CI: 0.78–0.92]) showed good discernibility. In the Hosmer–Lemeshow goodness-of-fit test, except for DiaRem ( P <0.01), DiaBetter ( P <0.01), Hayes et al ( P = 0.03), Park et al ( P = 0.02), and Ramos-Levi et al’s ( P <0.01) models, all models had a satifactory fit results ( P >0.05). The P values of calibration results of the "ABCD" and IMS were 0.07 and 0.14, respectively. The predicted-to-observed ratios of the "ABCD" and IMS were 0.87 and 0.89, respectively. Conclusion::The prediction model IMS was recommended for clinical use because of excellent predictive performance, good statistical test results, and simple and practical design features.

Glioblastoma (GBM) is an exceptionally aggressive tumor that originates in the brain,characterized by a notably high mortality rate and a limited responsiveness to pharmacological interven-tions.In recent years,antibody-drug conjugates (ADCs) have emerged as a focal point in the advance-ment of anti-cancer therapeutic research,merging the precise targeting capabilities of antibodies with the powerful killing power of cytotoxins.In recent years,the outcomes of numerous clinical trials investi-gating ADCs targeted against GBM have been notably encouraging.This article endeavors to provide a comprehensive overview of the prevalent ADCs targets for GBM therapy,which include the epidermal growth factor receptor,the cluster of differentiation,the mannose receptor family,the integrin family,and the galectin family.Furthermore,it will delve into the contemporary landscape of ADCs drug research and the significant challenges encountered in the application of ADCs for GBM treatment.

Glioblastoma (GBM) is an exceptionally aggressive tumor that originates in the brain,characterized by a notably high mortality rate and a limited responsiveness to pharmacological interven-tions.In recent years,antibody-drug conjugates (ADCs) have emerged as a focal point in the advance-ment of anti-cancer therapeutic research,merging the precise targeting capabilities of antibodies with the powerful killing power of cytotoxins.In recent years,the outcomes of numerous clinical trials investi-gating ADCs targeted against GBM have been notably encouraging.This article endeavors to provide a comprehensive overview of the prevalent ADCs targets for GBM therapy,which include the epidermal growth factor receptor,the cluster of differentiation,the mannose receptor family,the integrin family,and the galectin family.Furthermore,it will delve into the contemporary landscape of ADCs drug research and the significant challenges encountered in the application of ADCs for GBM treatment.

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.
Humans ; White Matter/diagnostic imaging* ; Diffusion Tensor Imaging/methods* ; Alzheimer Disease/complications* ; Reproducibility of Results ; Cognition ; Cognitive Dysfunction/complications* ; Brain/diagnostic imaging*