Phacoemulsification represents the mainstream, efficient, and safe surgical modality for cataract treatment, and continuous technological advances have further improved the safety profile of this procedure in ordinary patients. However, patients with high myopia feature inherent anatomical abnormalities of the eyeball, leading to a fundamental incompatibility with conventional phacoemulsification protocols. Such patients face a markedly elevated risk of both anterior and posterior segment perioperative complications, posing a persistent clinical challenge in cataract surgery. Focusing on the unique ocular anatomical characteristics associated with high myopia, this review systematically summarizes the distinct traumatic effects and pathological impacts of phacoemulsification on the anterior and posterior ocular segments of affected patients. Moving beyond generalized discussions of routine cataract management, it consolidates clinical evidence specific to this special-population patients, aiming to provide refined references for perioperative risk prevention and control in cataract patients complicated with high myopia.

AIM: To design and construct recombinant epitope nucleotides vaccine of glycoprotein B(gB)and glycoprotein D(gD)of herpes simplex virus type 1(HSV-1), and to investigate its immunoprotective effects and tissue expression in animal models.METHODS: The HSV-1 gB and gD epitope genes were selected and tandem assembled to construct the recombinant protein-coding gene X, which was transducted into the prokaryotic expression vector pET28(a). The recombinant protein was synthesized and utilized to generate monoclonal antibodies, which were subsequently used to immunize New Zealand white rabbits. The immunogenicity of the purified protein and the presence of polyclonal antibodies in the serum were tested through separating serum from cardiac blood, and the serum antibody titers were determined. The pcDNA3.1-X was successfully constructed as a eukaryotic expression vector and immunized the female BALB/c mice aged 4 to 6 wk via intramuscular injection. Serum antibodies and immune-related cytokines were quantified using enzyme-linked immunosorbent assay(ELISA). The expression of the X protein in the ocular, trigeminal ganglion, and brain tissues of the mice was assessed.RESULTS: The target polyclonal antibody was identified with a serum antibody titer of 1:3200 in the rabbit serum after immunized by recombinant protein X. Upon immunizing mice with the eukaryotic recombinant plasmid pcDNA3.1-X, the concentration of HSV-1 serum IgM antibodies of the experimental group was 12.13±0.85 ng/L, which was significantly higher than that of the vector control group(0.49±0.44 ng/L; t=21.07, P<0.001). The concentrations of cytokines interleukin IL-2, IL-4, IL-10, and IFN-γ in the experimental group were 11.63±0.60, 22.65±1.47, 85.75±14.12, and 114.90±6.39 ng/L, respectively, all of which were significantly higher than those in the vector control group and the blank control group(all P<0.05). Immunohistochemical staining revealed the presence of target protein X in the eyeball, trigeminal ganglion, and brain tissue.CONCLUSION: The HSV-1 gB and gD tandem epitope nucleotides vaccine pcDNA3.1-X was successfully constructed, which activates a remarkable immune response and is stably expressed in the eyeball, trigeminal ganglion, and brain tissue. This study provides a foundation for further research of an HSV-1 recombinant antigen epitope tandem vaccine.

BACKGROUND:Diabetes exacerbates intervertebral disc degeneration in a number of ways,and good glycemic control is beneficial in preventing intervertebral disc degeneration.OBJECTIVE:To review the relationship between diabetes and intervertebral disc degeneration to provide a reference for the clinical treatment of disc degeneration in patients with diabetes.METHODS:Literature searches were performed in CNKI and PubMed databases for articles published from 1980 to 2023.The Chinese and English search terms were"diabetes,intervertebral disc degeneration,cartilage endplate degeneration,apoptosis,advanced glycation end products,osmotic stress."Finally,73 articles were included for summary and analysis.RESULTS AND CONCLUSION:(1)The pathophysiological process of diabetes-induced intervertebral disc degeneration is different from that of physiological degeneration.The main mechanisms of diabetes-induced intervertebral disc degeneration include:intracellular hyperglycemia,impaired blood supply to the intervertebral discs due to microvascular pathology,cellular senescence,apoptosis,and autophagy,accumulation of advanced glycation end products,osmotic stress,and destruction of the extracellular matrix components due to other pathways.(2)Drugs such as curcumin,resveratrol,and lupeol have therapeutic effects on intervertebral disc degeneration,but their safety and effectiveness need to be further demonstrated in clinical treatment.

BACKGROUND:Diabetes exacerbates intervertebral disc degeneration in a number of ways,and good glycemic control is beneficial in preventing intervertebral disc degeneration.OBJECTIVE:To review the relationship between diabetes and intervertebral disc degeneration to provide a reference for the clinical treatment of disc degeneration in patients with diabetes.METHODS:Literature searches were performed in CNKI and PubMed databases for articles published from 1980 to 2023.The Chinese and English search terms were"diabetes,intervertebral disc degeneration,cartilage endplate degeneration,apoptosis,advanced glycation end products,osmotic stress."Finally,73 articles were included for summary and analysis.RESULTS AND CONCLUSION:(1)The pathophysiological process of diabetes-induced intervertebral disc degeneration is different from that of physiological degeneration.The main mechanisms of diabetes-induced intervertebral disc degeneration include:intracellular hyperglycemia,impaired blood supply to the intervertebral discs due to microvascular pathology,cellular senescence,apoptosis,and autophagy,accumulation of advanced glycation end products,osmotic stress,and destruction of the extracellular matrix components due to other pathways.(2)Drugs such as curcumin,resveratrol,and lupeol have therapeutic effects on intervertebral disc degeneration,but their safety and effectiveness need to be further demonstrated in clinical treatment.

Objective:To explore the teaching effect of combining diversified teaching modes with individualized teaching methods in musculoskeletal ultrasound training classes compared with traditional teaching modes.Methods:The 109 trainees participated in the muscle and bone ultrasound training classes from June 2020 to June 2022 were included as the research subjects and divided into the observation group ( n=53) and control group ( n=56). The control group received traditional teaching modes, while the observation group received diversified teaching modes in combination with individualized teaching methods. The differences in teaching satisfaction and final exam scores between the two groups were compared after training. Statistical analysis was conducted using the software SPSS 27.0. Categorical data were presented as cases and percentages, while continuous data were presented as mean±standard deviation. The intergroup differences in continuous variables were compared using the t-test, while the intergroup differences in categorical variables were compared using the chi-square test. Results:There were no significant differences in age, sex, education, and professional title between the control group and the observation group ( P>0.05). The comprehensive satisfaction score of ultrasound teaching was (88.08±6.65) in the observation group and (80.71±8.59) in the control group, with a significant difference between the two groups ( χ2=5.02, P<0.01). Before training, the test scores of the control group and the observation group were (62.61±5.39) and (63.87±7.77), respectively, and there was no significant difference between the two groups ( t=0.98, P=0.330). The final scores, theoretical exam, computer operation, and video reading exam scores of the control group were (84.07±1.49), (82.39±1.97), (85.13±2.55), and (86.79±6.06), respectively, while those of the observation group were (90.06±2.17), (88.28±3.19), (88.92±3.23), and (96.23±5.96); there were significant differences between the two groups in these four indicators ( t=16.75, 11.53, 6.79, and 8.20, respectively; P<0.01). The scores were compared for the two groups of trainees classified based on their unit level, professional title, and educational background. Trainees with the same unit level, professional title, and educational background showed no significant differences in test scores between the two groups, though their final scores were significantly different ( P<0.01). Conclusions:The combination of diversified teaching modes and individualized teaching methods can increase the learning enthusiasm of trainees, improve the teaching effect of training classes, and increase the satisfaction of trainees.

Objective: To analyze the trend and characteristics of school tuberculosis epidemic in Shijiazhuang from 2011 to 2020, and to provide reference for school tuberculosis prevention and control. Methods: Descriptive methods were used to analyze the epidemiological characteristics of tuberculosis among students and the epidemic situation of tuberculosis in schools in Shijiazhuang from 2011 to 2020. The χ 2 test and χ 2 trend test were used to analyze the characteristics and trend of school tuberculosis. Results: A total of 4 896 cases of tuberculosis were registered among students in Shijiazhuang from 2011 to 2020. The average annual registered incidence rate of students was 24.69/100 000, and the difference in incidence rate was statistically significant ( χ 2=318.50, P <0.01) the overall registered incidence rate of tuberculosis among students in the past 10 years was on the rise ( χ 2 trend =87.79, P <0.01). Among the student cases, male accounted for 53.89%, female accounted for 46.11%. The age group of students aged >18 and above accounted for the largest proportion(50.35%), followed by the age group aged 16-18( 35.80 %). Most students cases occurred in April and September-November, with September the highest(12.03%). A total of 22 clustered outbreaks (174 cases) and the aggregate epidemic accounted for 3.55% of the total number of students with tuberculosis. Conclusion The prevention and control of tuberculosis epidemic in schools in Shijiazhuang should not be underestimated, and strengthen the supervision, management, publicity and education of students in key age groups to avoid clusters of outbreaks.

Social anxiety disorder is a common anxiety disorder in which a key feature is interpersonal avoidance accompanied by generalized problems with emotion identification and emotion regulation. In response to the gap in these therapeutic priorities in other therapies, emotion-focused therapy has emerged to fill the part of the treatment of emotions with an emphasis on the relational process. The paper reviews the recent studies related with the treatment of social anxiety disorder with emotion-focused therapy. The results suggest that the main points of social anxiety onset in an emotion-focused perspective are traumatic emotional experiences and self-criticism, and that the therapeutic focus of emotion-focused therapy is on dealing with the traumatic emotional scenario behind the anxiety and exposing it to adaptive emotions to be transformed. It also works better in combination with other more mainstream therapies. This suggests that emotion-focused therapy is a promising approach for the clinical treatment of social anxiety disorder and looks forward to the development of a more integrated treatment approach in the clinic.

The programmed cell death receptor 1 (PD-1) antibody has been used in the treatment of a variety of malignant tumors, in which colorectal cancer is considered immune " cold" tumor and is not sensitive to anti-PD-1 therapy. The molecular characteristics of mismatch repair deficient (dMMR)/high microsatellite instability (MSI-H) are important molecular markers for screening patients with immune checkpoint inhibitors therapy (ICIs). However, only some patients can benefit from ICIs treatment, and some patients even have disease progression. This article summarizes the research progress of anti-PD-1 immunotherapy of MSI-CRC in recent years, including the mechanisms of resistance, new efficacy biomarkers and treatment options, so as to provide ideas for expanding the application of immunotherapy in colorectal cancer.

Objective:To analyze the difference of positioning accuracy by cone beam CT(CBCT) between modified head neck shoulder thermoplastic mask and breast bracket in intensity modulated radiotherapy for breast cancer patients after modified radical mastectomy.Methods:A total of 68 cases of breast cancer treated with IMRT after modified radical mastectomy were selected from August 2015 to December 2018. According to the different immobalization methods, the patients were divided into two groups: modified head neck shoulder thermoplastic mask group (body mask group, 42 cases) and breast bracket group (bracket group, 26 cases). After the first, sixth, 11th, 16th and 21st treatment, the patients were scanned by CBCT. The positioning errors in left and right (RL), anterior and posterior (AP) and head and foot (SI) directions were obtained, and the duration of radiotherapy positioning was recorded. The positioning error, distribution ratio and positioning duration were compared between two groups, and the respective MPTV margin were calculated. The influence of various factors on the setup error of patients was analyzed in the mask group. Results:There were 210 scans in the body mask group and 130 in the bracket group. The setup errors of the body mask group and bracket group in RL, AP and SI directions were (2.12±2.01) and (2.38±1.92) mm, (3.29±2.46) and (3.88±2.76) mm, (3.47±2.29) and (4.11±3.15) mm, respectively, and the differences in AP and SI directions were statistically significant ( t=-2.05, -2.16, P<0.05). The proportion of setup errors less than or equal to 3 mm in the direction for body mask group was higher than that of bracket group ( χ2=4.97, P<0.05). The proportion of setup errors more than 5 mm in AP and SI directions for body mask group was lower than that of bracket group ( χ2=5.21, 9.29, P<0.05). The positioning duration of mask group was shorter than of bracket group ( t=-2.16, P<0.05). The MPTV margins of the mask group in RL, AP and SI directions were smaller than those of the bracket group. The modified head, neck and shoulder thermoplastic mask immobalization method led to large setup errors in AP and / or SI directions for the elderly (≥ 60 years old), the patients with body mass index (BMI) ≥ 24 kg/m 2 and the patients who were relatively unfamiliar with the radiotherapy process (treatment time≤ 2 weeks). The setup error for patients aged < 60 years old in SI direction was smaller than that for the elderly (≥ 60 years old) patients ( t=-2.43, P<0.05). The setup error for patients with BMI <24 kg/m 2 in AP and Si directions was smaller than that with BMI ≥24 kg/m 2 ( t=-2.21, -2.04, P<0.05). The setup error for treatment time > 2 weeks in AP direction was smaller than that for treatment time ≤ 2 weeks ( t=2.23, P<0.05). Conclusions:In IMRT radiotherapy for breast cancer patients after modified radical mastectomy, the application of modified head neck shoulder thermoplastic mask can reduce the setup error in the anterior-posterior and superior-inferior directions, and shorten the positioning duration. For the elderly (≥ 60 years old), BMI ≥ 24 kg/m 2 and the patients who are not familiar with the radiotherapy process (treatment time ≤ 2 weeks), attention should be paid to the setup of anterior-posterior and superior-inferior directions to ensure the treatment effect of radiotherapy.

Objective To study the relationship between the severity of Mycoplasma pneumoniae pneumonia(MPP) and interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-α level.Methods From Jan.to Jul.2012,according to clinical pulmonary infection score(CPIS),30 children with severe MPP(severe MPP group) and 32 children with mild MPP(mild MPP group) were enrolled,and 30 healthy children were enrolled as control group).Subjects of all groups were detected for the levels of IL-6,IL-10,TNF-α,IgA,IgM and IgG.Besides,children with MPP were also detected for the levels of IL-6,IL-10 and TNF-α after treatment.Results The levels of IL-6,IL-10 and TNF-α in bronchoalveolar lavage fluid(BALF) and serum in severe MPP group were higher than those in mild MPP group and control group(P<0.05).The levels of IL-6,IL-10 and TNF-α in BALF and serum were significantly higher in mild MPP group than those in control group(P<0.05).In all children,the levels of IL-6,IL-10 and TNF-α in BALF were higher than those in serum.After treatment,the levels of IL-6 and TNF-α in BALF in children with severe MPP were significantly decreased,while that of IL-10 were increased(P<0.05).Compared with control group,the IgM level in children with MPP was increased significantly,and the IgG level was decreased notablely(P<0.05).Conclusion There might be significant correlation between levels of cytokines IL-6,IL-10,TNF-α and the disease severity of MPP in children patients,which could be used as the basis for the clinical diagnosis and treatment.