Objective To explore the effect of remote ischemic preconditioning (RIPC) on preoperative heart rate variability in patients with heart valves. Methods Patients scheduled to undergo on-pump cardiac valve surgery in the Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, between January and July 2022 were initially enrolled. Eligible patients were randomly assigned at a 1 : 1 ratio to either the RIPC group or the control group. Relevant indicators of heart rate variability [standard deviation of NN interval (SDNN), standard deviation of mean value of NN interval in every five minutes (SDANN), mean square root of difference between consecutive NN intervals (RMSSD), percentage of adjacent RR interval>50 ms (PNN50), low frequency (LF) component, high frequency (HF) component and LF/HF] at 8 hours in the morning on the surgical day between two groups were compared. Results A total of 118 patients were initially assessed. After screening, 58 patients were excluded, and 60 patients provided written informed consent and were enrolled in the trial, with 30 allocated to the RIPC group and 30 to the control group. Seven patients in the control group and 5 patients in the RIPC group were subsequently excluded due to missing heart rate variability data resulting from cancelled operations. Finally, 23 patients in the control group and 25 patients in the RIPC group were included in the analysis. There was no statistical difference in baseline characteristics between the two groups, and there was no significant difference in heart rate variability 24 hours before intervention (P>0.05). After the intervention measures were taken, the comparison of the results of heart rate variability at 8 hours on the day of operation showed that SDNN and SDANN of patients in the RIPC group were higher than those in the control group, with statistical differences (P<0.05). Conclusion RIPC can stabilize the preoperative heart rate variability of patients undergoing cardiac valve surgery.

AIM: To analyze the reasons and clinical outcomes of intraocular lens(IOL)exchange.METHODS:This retrospective case series study included 47 patients(53 eyes)who underwent IOL exchange surgery at the Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, between April 2020 and May 2024, aged from 5 to 87(44.8±3.6)years old. Patients' demographics, surgical indications, surgical techniques, preoperative and postoperative uncorrected visual acuity(UCVA)and best-corrected visual acuity(BCVA), as well as postoperative complications were recorded.RESULTS:The reasons for IOL exchange included refractive error(18 cases, 23 eyes, 43%), IOL dislocation(12 cases, 13 eyes, 25%), IOL opacification(12 cases, 12 eyes, 23%), neuroadaptation failure(3 cases, 3 eyes, 6%), and patient dissatisfaction with visual quality(2 cases, 2 eyes, 4%). The surgical techniques for IOL exchange included in-the-bag IOL fixation(16 eyes, 30%), ciliary sulcus fixation(27 eyes, 51%), and scleral suture fixation(10 eyes, 19%). There was statistical significant difference between preoperative UCVA(LogMAR)and UCVA(LogMAR)at 1 d postoperatively(1.03±0.64 vs 0.50±0.46, P<0.05), and there was statistical significant difference between preoperative BCVA(LogMAR)and BCVA(LogMAR)at 1 mo postoperatively(0.41±0.37 vs 0.17±0.21, P<0.05). Postoperative complications included posterior capsule opacification in 2 eyes and IOL dislocation in 1 eye.CONCLUSION:Refractive error, IOL dislocation, and IOL opacification were the three most common reasons for IOL exchange. Although less frequent, factors such as neuroadaptation issues associated with multifocal IOLs and patient-reported visual quality dissatisfaction reflect growing expectations for improved visual outcomes. IOL exchange surgery, though technically challenging, demonstrates favorable clinical efficacy and a low complication rate, representing an effective intervention for managing postoperative IOL-related issues following cataract surgery.

Polymorphism refers to the simultaneous and frequent existence of two or more discontinuous variants or genotypes or alleles in a biological population, also known as genetic polymorphisms or genes Polymorphism. This gene polymorphism may have a certain degree of influence on the pharmacokinetics and pharmacodynamics of the drug. The study of genomics plays an important role in realizing personalized, patient-oriented precision medicine treatment. Population model analysis is to use a modeling method to quantitatively describe the correlation and variability between pharmacokinetic and pharmacodynamic parameters and individual characteristics and to quantify the impact of covariates. At present, this method has been widely used. This paper systematically introduces the application examples of using the population model approach to assess the effects of genetic polymorphisms on the drug PK/PD.

Objective: To evaluate efficacy of the BiRd regimen, a combination of clarithromycin, lenalidomide, and dexamethasone, in the treatment of patients with relapsed/refractory multiple myeloma (RRMM) . Methods: Patients with RRMM treated with BiRd between September 11, 2013 and August 1, 2016 at six centers were included to evaluate overall survival rate (ORR) , clinical benefit rate (CBR) , progression-free survival (PFS) , overall survival (OS) , as well as adverse events. Results: Of 30 patients with RRMM, 27 patients were evaluable, and ORR and CBR were 51.9% (14/27) and 66.7% (18/27) respectively, including 1 sCR (3.7%) , 3 CR (11.1%) , 3 VGPR (11.1%) , and 7 PR (25.6%) . In 13 patients with prior Rd, ORR and CBR were 38.5% (5/13) and 61.5% (8/13) respectively, of which 5 patients with ≥MR carried high-risk cytogenetic[ (e.g.17p- or t (4;14) ] together with at least one of other adverse-prognostic cytogenetic (e.g.13q- and/or 1q21+) . In 24 patients with prior bortezomib-based therapy, ORR and CBR were 45.8 and 62.5%, respectively. With a median follow-up time of 14.9 (range 1.0-33.8) months, the median PFS and OS were 12.0 (95%CI 11.6-12.4) and 27.6 (95%CI 15.1-40.1) months, respectively. The BiRd regimen was well tolerated. Conclusion The BiRd regimen is an effective and safety protocol for RRMM, including those carrying high-risk cytogenetic markers.

A 53-year-old male patient was admitted to the hospital on March 26, 2006. Ten years prior to the presentation, a small furuncle developed on the dorsum of his right hand, and subsided after 2-week treatment with erythromycin ointment; one month later, a broadbean-sized cutaneous ulcer developed on the dorsum of the same hand. After anti-infective treatment, the ulcer healed while the lesional skin thickened, and long-term topical treatment with compound dexamethasone acetate cream showed no obvious effect Dermatological examination revealed an irregular verrucous plaque measuring 2.5 cm × 4 cm with little exudation on the dorsum of the right hand. KOH preparation of the skin lesion revealed brown spores. Sabouraud's dextrose agar culture grew restricted, velvety and dark green colony, and microscopy revealed branched, globular conidiophores generated by cladospores. DNA sequencing showed that the isolate was different from Cladosporium sphaerospermum (AB100654) by 2 bases in the sequence of D1/D2 region of 26S rDNA, from Cladosporium sphaerospermum (AY625063) by 5 bases in the sequence of internal transcribed spacer 1 and 2 (ITS 1 and ITS 2), but fully consistent with Cladosporium sphaerospermum (AM 176719) in the sequence of ITS region. The isolate was identified as Cladosporium sphaerospermum. Hematoxylin-eosin stain of the lesional tissue revealed granulomatous changes,and PAS stain demonstrated brown spores. A diagnosis of phaeohyphomycosis was made. Antifungal susceptibility testing indicated that the isolate was highly sensitive to itraconazole. The lesion obviously subsided after treatment with oral itraconazole 0.2 g once daily for 8 weeks, but the patient was lost to follow up 2 months later.

Purpose To build up the Potassium Sodium Dehydroandroan Drographolide Succinate enteric coating sustained-release pellets delivery system by aqueous dispersion coating technique. Methods 1. Adopting MCC as vehicle, SiO_2 as antisticking agent, appropriate amount of 40% ethanol, preparing the core of pellets by extrude-spheronization method and the formulation and manufacturing process were optimized by orthogonal design. 2. Preparing the coating material with Eudragit L 30 D, which is used as pore-forming agent, EC as blocker and PEG6000 as plasticizer. The pellets were coated by fluid-bed coating method. Results 1. The optimal formulation and manufacturing process of pelltes' core were as follows: drug: MCC: SiO_2 = 7:7:5, extruding rate: 1 080 r/min, rounding rate: 960 r/min, rounding time: 5 min. 2. After the addition of EC: Eudragit L = 35:65, the plasticizer is 1.71 % and weight gain is 5% . The release in the gastric model fluid(pH 1.0) < 10% , and complete release ( > 80% ) in the enteric model fluid(pH 6.8) was in two hours. The release behavior accords with the regulations on the release rate of enteric preparation in ChP. Conclusion By adjusting the formulation and the parameters of the process of pellet and coating, we can make enteric coating Potassium Sodium Dehydroandroan Drographolide Succinate sustained-release pellets. All this accords with the regulation of pharmacopedia in vitro release.