AIM: To evaluate the safety and efficacy of allogeneic intrastromal lenticule implantation combined with corneal collagen cross-linking(CXL)in patients with moderate to advanced keratoconus.METHODS: A retrospective case series analysis was conducted. A total of 19 patients(20 eyes)with moderate to advanced keratoconus who underwent combined allogeneic intrastromal lenticule implantation and CXL at the Jinan Mingshui Eye Hospital from June 2021 to December 2023 were included. The uncorrected distance visual acuity(UCVA), thinnest corneal thickness, central corneal epithelial thickness, anterior corneal flat keratometry(Kf), steep keratometry(Ks), and mean keratometry(Km), as well as the first applanation time(A1T), the first applanation length(A1L), the velocity during the first applanation moment(VIN), the second applanation time(A2T), the second applanation length(A2L), the velocity during the second applanation moment(VOUT), highest concavity time(HCT), highest concavity radius(HCR), peak distance(PD), deformation amplitude(DA), stiffness parameter at first applanation(SP-A1), integrated radius(IR), central corneal thickness(CCT), intraocular pressure(IOP), corneal thickness-corrected IOP, biomechanically intraocular pressure IOP(bIOP), and corneal thickness variation rate(ARTH)were compared between the two groups before surgery and at 1 wk, 1, 3 and 6 mo after surgery.RESULTS: All patients successfully completed the surgery without any intraoperative complications. No significant differences were observed between pre-operative and post-operative measurements for UCVA or the corneal biomechanical parameters, including A1L, A2L, PD, A1T, A2T, VIN, VOUT, DA, IOP, and bIOP(all P>0.05). Significant differences were found between pre-operative and post-operative values for corneal thinnest point thickness, central corneal epithelial thickness, Kf, Ks, Km, and the corneal biomechanical parameters, including HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.05). The anterior corneal curvature demonstrated an initial increase followed by a decrease post-operatively. Furthermore, significant differences were observed between pre-operative and post-operative values for HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.005).CONCLUSION: Allogenic intrastromal lenticule implantation combined with corneal collagen cross-linking demonstrates favorable safety and stability in treating moderate-to-advanced keratoconus. This combined procedure effectively increases corneal thickness and rigidity, resulting in corneas that are more resistant to deformation postoperatively.

[This corrects the article DOI: 10.1016/j.apsb.2025.02.029.].

Although enteric glial cell (EGC) abnormal activation is reported to be involved in the pathogenesis of Parkinson's disease (PD), and inhibition of EGC gliosis alleviated gut and dopaminergic neuronal dysfunction was verified in our previous study, the potential role of gut microbiota on EGC function in PD still need to be addressed. In the present study, fecal microbiota transplantation revealed that EGC function was regulated by gut microbiota. By employing 16S rRNA and metabolomic analysis, we identified that 3-indolepropionic acid (IPA) was the most affected differential microbial metabolite that regulated EGC gliosis. The protective effects of IPA on PD were validated in rotenone-stimulated EGCs and rotenone (30 mg/kg i.g. for 4 weeks)-induced PD mice, as indicated by decreased inflammation, improved intestinal and brain barrier as well as dopaminergic neuronal function. Mechanistic study showed that IPA targeted pregnane X receptor (PXR) in EGCs, and inhibition of IL-13Rα1 involved cytokine-cytokine receptor interaction pathway, leading to inactivation of downstream JAK1-STAT6 pathway. Our data not only provided evidence that EGC gliosis was critical in spreading intestinal damage to brain, but also highlighted the potential role of microbial metabolite IPA in alleviating PD pathological damages through gut-brain axis.

Objective To assess the effects of temperature and rainfall on the incidence of cardiovascular and cerebrovascular diseases (CVD) in Guiyang. Methods Using daily CVD incidence data and temperature and rainfall data in Guiyang City from September 2021 to August 2022, a distributed lag non-linear model was used to explore the nonlinear relationship between meteorological and environmental factors and CVD incidence. Results The risk of CVD was higher under cold (average, minimum, and maximum temperatures <2.1 ℃, 1.6 ℃, and 4.2 ℃, respectively) and hot (maximum temperature>32.5 ℃) effects, and the cumulative lag effect reached its maximum at 10 and 17 days, respectively. The risk of CVD increased sharply when there was a small diurnal temperature (<6.9 ℃), sudden drop in temperature (over 6.1 ℃), and heating (over 2.4 ℃ in 24 hours). The incidence risk of CVD was high when the daily rainfall exceeded 21.5 mm and the continuous rainy days exceed 5.7 days. The risk in rainstorm was 0.81 higher than that in heavy rain. Continuous absence of rain helped to prevent CVD patients from developing symptoms. Conclusion Meteorological environments such as hot and cold weather, dramatic change in temperature, significant rainfall and continuous rainfall have an impact on the incidence of CVD. It is necessary to consider the changes of the meteorological environment during the prevention and control of CVD.

【Objective】 To analyze nutrition-related factors that affect the prevalence of myopia in adolescents, in order to provide reference for primary prevention of myopia. 【Methods】 A stratified sampling method was used to select 385 adolescents from Zhengding County in October 2021. Adolescents in this study took vision testing, physical examination and completed a questionnaire survey. One-way analysis of variance and lasso regression were used to screen the variables, and Logistic regression was used to determine the possible influencing factors of myopia. Factor analysis was adopted to extract the dietary patterns of adolescents in Zhengding County, then the association between dietary patterns and myopia was analyzed. 【Results】 A total of 385 adolescents were surveyed, with the prevalence rate of myopia of about 68.6%. Multivariate analysis revealed that fried food(OR=8.480, 95%CI:1.058 - 67.971) was a risk factor for myopia, while intake of milk and dairy products(OR=0.994, 95%CI:0.991 - 0.999), soybeans and nuts(OR=0.997, 95%CI:0.994 - 0.999), no myopia in either parent(OR=0.312, 95%CI:0.115 - 0.845), physical education class 4 times per week(OR=0.269, 95%CI:0.074 - 0.984) were statistically associated with a lower risk of myopia(P<0.05). Three dietary patterns was extracted through factor analysis, including diversified dietary pattern, soy-hybrid dietary pattern, and snack and beverage dietary pattern. Logistic analysis results indicated that soy-hybrid dietary pattern(OR=0.85, 95%CI:0.73 - 0.99,P<0.05) was statistically associated with myopia. 【Conclusions】 The problem of myopia among adolescents in Zhengding County is more serious. Increasing the intake of milk and dairy products, soybeans and nuts, reducing the intake of fried foods, and adjusting the overall dietary structure should be recommended in order to prevent the development of myopia in adolescents.

Objective To explore the correlation between serum levels of miR-193a-3p,activated transcription factor 5(ATF5),clinicopathological characteristics and chemotherapy efficacy in patients with triple negative breast cancer(TNBC).Methods A total of 120 patients with TNBC admitted to our hospital were collected as the research group.In the same period,120 cases with benign breast disease in our hospital were selected as the control group.Serum levels of miR-193a-3p and ATF5 were detected,and the relationship between them and clinicopathological characteristics were detected in two groups.According to the therapeutic effect,TNBC patients were divided into the treatment ineffective group(n=50)and the treatment effective group(n=70).The expression levels of miR-193a-3p and ATF5 were compared between the two groups,and factors affecting the chemotherapy efficacy of TNBC patients were analyzed.Results Compared with before chemotherapy,the serum miR-193a-3p level increased and ATF5 level decreased in TNBC patients after chemotherapy(P＜0.05).Compared with the control group,the serum miR-193a-3p level of TNBC patients decreased in the research group before chemotherapy,and ATF5 level increased(P＜0.05).The expression level of miR-193a-3p was lower and the expression level of ATF5 was higher in patients with tumor diameter≥3 cm,lymph node metastasis,low histological grade,clinical stage Ⅲ and Ki-67＞30%(P＜0.05).In TNBC patients,compared with the treatment effective group,patients in the treatment ineffective group showed a decreased serum miR-193a-3p level and an increased ATF5 level(P＜0.05).Lower level of miR-193a-3p,higher level of ATF5,lymph node metastasis,tumor diameter≥3 cm,low histological grade,and TNM stage Ⅲ were risk factors affecting the efficacy of chemotherapy in TNBC patients(P＜0.05).Conclusion Low level of miR-193a-3p and high level of ATF5 in the serum of TNBC patients are risk factors for chemotherapy efficacy.

Objective To investigate the predictive value of Cys C and AT Ⅲ for CIAKI in elderly hypertensive patients with AMI after PCI.Methods A total of 911 elderly hypertensive patients with AMI undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2019 to May 2023 were consecutively enrolled,and then randomly divided into a training group(731 cases)and a validation group(180 cases)in a ratio of 8∶2.According to the diagnostic criteria of CIAKI defined by the European Society of Urogenital Radiology,the patients of the training group were further divided into CIAKI subgroup(n=91)and non-CIAKI sub-group(n=640).The basic clinical data were compared between the CIAKI and non-CIAKI sub-groups and between the training and validation groups.Multivariate logistic regression analysis was used.ROC curve was drawn to analyze the predictive value of Cys C,ATⅢ and their combina-tion for CIAKI.Results Fasting blood glucose,TG,Cys C,and diuretics were independent risk factors(OR=1.116,95％CI:1.009-1.235;OR=1.786,95％CI:1.363-2.339;OR=13.360,95％CI:4.462-39.999;OR=10.606,95％CI:4.110-27.370),while LVEF and AT Ⅲ were protective factors(OR=0.932,95％CI:0.897-0.968;OR=0.949,95％CI:0.929-0.969)for CIAKI in eld-erly hypertensive patients after emergency PCI.The AUC value of Cys C and AT Ⅲ combined to-gether in predicting CIAKI after emergency PCI was 0.818(95％CI:0.773-0.863,P＜0.01),which was better than either of them alone.When Cys C level ≥1.10 mg/L,the risk of CIAKI was increased with the increment of the level;when AT Ⅲ ≥69％,the risk of CIAKI was decreased with the increase of AT Ⅲ level.Conclusion High Cys C level and low AT Ⅲ level are independ-ent risk factors for CIAKI,and their combination can improve the accuracy of predicting CIAKI after emergency PCI in elderly patients with hypertensive AMI.

Objective To investigate the analgesic effect of multi-site multiple paravertebral nerve blocks on patients undergoing radical lung cancer surgery and the impact on their serum indices and prognosis.Methods Ninety-eight cases of patients undergoing thoracoscopic radical lung cancer surgery in our hospital were selected from March 2021 to January 2023 and divided into 2 groups according to the difference in anaesthesia.Among them,42 patients in the study group were treated with preoperative and postoperative multipoint paravertebral nerve block combined with general anaesthesia,while 56 patients in the control group were treated with preoperative multipoint paravertebral nerve block combined with general anaesthesia,and the analgesic effect and other differences between the two groups were compared.Results In the study group,extubation time,recovery time,propofol dosage and postoperative VAS score were(150.2±15.2)min,(19.1±5.1)min,(738.2±36.5)mg and(4.2±0.7)points,respectively.The control group was(151.9±12.6)min,(22.6±7.3)min,(902.1±49.0)mg and(2.3±0.3)min,respectively,and the difference between the two groups was statistically significant(P＜0.05).The differences of heart rate,mean arterial pressure and before and after half an hour after surgery in control group were higher than those in study group,and the differences of norepinephrine,epinephrine and before and after surgery were higher than those in study group,with statistical significance(P＜0.05).The total complication rate of the study group was 7.2％,and that of the control group was 23.2％.The QoR score of the control group was lower than that of the study group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion Preoperative and postoperative multi-point paravertebral nerve block combined with general anaesthesia has a better analgesic effect on patients undergoing radical lung cancer surgery,which can not only reduce the inflammatory reaction of the patients,but also have less impact on their haemodynamic indexes and lower rate of postoperative adverse reactions,and ultimately improve the quality of life of the patients.

Objective:To explore the knowledge, attitude, and practice of insulin injection among nurses in Beijing and analyze its influencing factors.Methods:From July to August 2019, stratified-random-cluster multi-stage sampling was used to select 7 448 nurses from 30 hospitals of different levels in Beijing as the research subject. The survey was conducted using the General Information Questionnaire and the Insulin Injection Knowledge, Attitude, and Practice Questionnaire. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, attitude, and practice on insulin injection.Results:A total of 7 448 questionnaires were distributed and 7 448 valid questionnaires were collected, with an effective response rate of 100.00% (7 448/7 448). Among 7 448 nurses, 6 942 had no positions, and the scores of the belief dimension, behavior dimension, and the total score of questionnaire were calculated; the knowledge dimension score was calculated based on the overall sample. The total score of the Insulin Injection Knowledge, Attitude, and Practice Questionnaire was (115.22±10.75), and the scores for each dimension of the questionnaire were (14.14±2.97), (17.29±2.73), and (83.82±7.72), respectively. The proportion of nurses who scored well in all questionnaire dimensions was 19.01% (1 320/6 942). The excellent score rates of each dimension in the questionnaire, from high to low, were the practice dimension [92.71% (6 436/6 942) ], attitude dimension [76.40% (5 304/6 942) ], and knowledge dimension [22.35% (1 665/7 448) ]. Multiple linear regression analysis showed that the influencing factors of insulin injection knowledge, attitude, and practice among nurses were gender, age, professional title and department ( P<0.05). The influencing factors of knowledge were gender, age, years of work, education level, professional title, and department ( P<0.05). The influencing factors of attitude were gender, professional title, and department ( P<0.05). The influencing factors of practice were gender and age ( P<0.05). The above differences were statistically significant. Conclusions:Nurses at all levels of hospitals in Beijing have great beliefs and behaviors in insulin injection but lack knowledge. The knowledge of insulin injection among clinical nurses can be enhanced by improving the training and education standards on insulin injection, regularly providing insulin injection knowledge training and skill assessment to clinical nurses and other methods.

Objective:To conduct a scoping review on the application of family resilience intervention in adults with chronic disease.Methods:Related studies published from database establishment to October 30, 2023 were systematically searched on PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biomedical Database. The included literature was summarized and analyzed.Results:A total of 9 articles were included. The intervention elements for family resilience included increasing awareness of diseases and family characteristics, solving and responding to family problems, engaging in family interaction and communication, integrating internal and external resources, and providing psychological and technical support. The outcome indicators were the level of family resilience and effectiveness.Conclusions:The intervention of family resilience in adults with chronic disease has certain effectiveness and clinical significance, but research is still in the exploratory stage. Further high-quality research is needed to verify the long-term intervention effect and feasibility, and to construct a diversified family resilience intervention program suitable for China.