AIM: To investigate the effect of the relationship between scotopic pupil and optical zone diameters on short-term subjective and objective visual quality after small incision lenticule extraction(SMILE).METHODS:In this prospective cohort study, 98 patients(196 eyes)who underwent SMILE from September 2021 to June 2023 were included. Participants were divided into two groups based on the ratio of scotopic pupil diameter to optical zone diameter: group A(ratio >1, 70 eyes)and group B(ratio ≤1, 126 eyes). The preoperative and postoperative uncorrected visual acuity(UCVA), spherical equivalent(SE), total corneal high-order aberrations at 4, 6, and 8 mm of pupil diameters, objective scatter index(OSI), pre- and post-operative QoV subjective visual quality questionnaire were observed and recorded. The refractive status of different groups of patients at different time points before and after surgery, and differences in subjective and objective visual quality indices were analyzed. Furthermore, the changes in subjective and objective visual quality(postoperative-preoperative)at different postoperative time points were analyzed between the two groups.RESULTS:No significant differences in visual acuity or refractive state were observed between the two groups at 3 mo postoperatively. In both the group A and the group B, there was a difference in the changes of corneal total higher-order aberration centered on 8 mm cornea at 1 mo postoperatively(P<0.05), and there was a difference in the changes of total higher-order aberration and corneal spherical aberration centered on 8 mm cornea at 3 mo postoperatively(all P<0.05). At 3 mo after surgery, the most commonly reported symptoms in the group A were glare, starburst, hazy vision, and halo. In the group B, the most common symptoms were hazy vision, halo, starburst, and glare. Statistically significant differences were observed in the severity of glare and visual fluctuation between groups before surgery and at 3 mo postoperatively(all P<0.05). However, no significant differences were found in the severity of halo, starburst, blurred vision, double vision, or focusing difficulty at 3 mo postoperatively(all P>0.05).CONCLUSION:When the scotopic pupil diameter exceeds the optical zone, SMILE may increase postoperative corneal aberrations, as evidenced by an increase in high-order corneal aberrations within an 8-mm central corneal range, a higher incidence of postoperative glare, and more severe glare and visual fluctuation symptoms. Nevertheless, these symptoms are mild and remain within a safe range.

Objective To investigate the clinical value of sarcopenia in predicting the efficacy of bronchial artery chemoembolization(BACE)in patients with lung cancer.Methods The clinical data of 160 patients with lung cancer,who received BACE treatment at the Lishui Municipal Central Hospital of China from December 2012 to August 2021,were retrospectively analyzed.Using CT images to measure and calculate the skeletal muscle index(SMI)at the 4th thoracic vertebra(T4)level,patients with T4-SMI below the gender specific quartile were classified in sarcopenia group(n=40),and patients with T4-SMI above the threshold were classified in non-sarcopenia group(n=120).Kaplan-Meier method was used to compare the differences in progression-free survival(PFS)and overall survival(OS)between the two groups after BACE treatment,and Cox regression analysis was used to determine the risk factors affecting prognosis.Results In the non-sarcopenia group and the sarcopenia group,the median PFS was 5.6 months and 3.0 months respectively(x2=5.141,P=0.023),and the postoperative 14-month PFS rates were 16.7％and 5.0％respectively.There was no statistically significant difference in OS between the two groups(P＞0.05).Cox multivariate analysis showed that sarcopenia(HR=1.557,95％CI=1.083-2.238,P=0.017)was an independent risk factor for postoperative PFS after BACE.Conclusion Sarcopenia is an independent risk factor affecting the efficacy of BACE in patients with lung cancer,and sarcopenia can be used as a predictive indicator for the postoperative efficacy of BACE.

ObjectiveTo investigate the bactericidal effect of loaded multifunctional povidoneiodine-nanometer selenium （PVP-I@Se） disinfectant on Staphylococcus aureus （SA） and methicillin-resistant Staphylococcus aureus （MRSA）， and to provide an experimental basis for the reduction of surgical site infection （SSI）. MethodsThe control group was the povidone iodine （PVP-I） group with different concentrations of iodine （50， 75， 100， 200 and 400 μg/mL）. The PVP-I@Se group （experimental group） was the PVP-I group further supplemented with 2 μg/mL Selenium nanoparticles （SeNPs）. Then we compared the bactericidal effect of the two groups of disinfectant solutions on SA and MRSA by examining the minimum inhibitory concentration （MIC）， minimum bactericidal concentration （MBC）， the shortest sterilization time at a concentration of 50 μg/mL iodine and the inhibition zone diameters at concentrations of 200 μg/mL and 400 μg/mL iodine. ResultsMIC values of PVP-I against SA and MRSA were both 79.17 μg/mL， and those of PVP-I@Se were 54.17 and 70.83 μg/mL， respectively. MBC values of PVP-I against SA and MRSA were 129.17 and 150.00 μg/mL， respectively， and those of PVP-I@Se were 70.83 and 87.50 μg/mL， respectively. At a concentration of 50 μg/mL iodine， the shortest sterilization time of PVP-I for SA and MRSA was 130 s and 140 s， respectively， and that of PVP-I@Se was 65 s and 75 s， respectively. At a concentration of 200 μg/ml iodine， the inhibition zone diameters of PVP-I for SA and MRSA were 7.67 mm and 8.33 mm， and those of PVP-I@Se were both 9.50 mm. At a concentration of 400 μg/mL iodine， the inhibition zone diameters of PVP-I for SA and MRSA were 9.00 mm and 9.33 mm， and those of PVP-I@Se were 11.67 mm and 12.00 mm， respectively. ConclusionsPVP-I with different concentrations of 50， 75， 100， 200 and 400 μg/mL iodine supplemented with 2 μg/mL SeNPs have better and faster bactericidal effect on SA and MRSA. When combined with SeNPs， PVP-I can enhance the bactericidal activity against SA and MRSA， but with better sensitizing effect on SA than MRSA and higher demand of iodine concentration （400 μg/mL） for sensitizing effect on MRSA. This study provides a theoretical basis for selecting optimal concentration and action time of the disinfectant， thus reducing SSI.

Objective:With the in-depth study of complement dysregulation,glomerulonephritis with dominant C3 has received increasing attention,with a variety of pathologic types and large differences in symptoms and prognosis between pathologic types.This study analyzes the clinical,pathological,and prognostic characteristics of different pathological types of glomerulonephritis with dominant C3,aiming to avoid misdiagnosis and missed diagnoses. Methods:The clinical,pathological,and follow-up data of 52 patients diagnosed as glomerulonephritis with dominant C3 by renal biopsy from June 2013 to October 2022 were retrospectively analyzed.According to the clinical feature and results of pathology,15 patients with post-infectious glomerulonephritis(PIGN)and 37 patients with of non-infectious glomerulonephritis(N-PIGN)were classified.N-PIGN subgroup analysis was performed,and 16 patients were assigned into a C3-alone-deposition group and 21 in a C3-dominant-deposition group,or 27 in a C3 glomerulopathy(C3G)group and 10 in a non-C3 nephropathy(N-C3G)group. Results:The PIGN group had lower creatinine values(84.60 μmol/L vs 179.62 μmol/L,P= 0.001),lower complement C3 values(0.36 g/L vs 0.74 g/L,P<0.001)at biopsy,and less severe pathological chronic lesions compared with the N-PIGN group.In the N-PIGN subgroup analysis,the C3-dominant-deposition group had higher creatinine values(235.30 μmol/L vs 106.70 μmol/L,P=0.004)and higher 24-hour urine protein values(4 025.62 mg vs 1 981.11 mg,P=0.037)than the C3-alone-deposition group.The prognosis of kidney in the PIGN group(P=0.049),the C3-alone-deposition group(P=0.017),and the C3G group(P=0.018)was better than that in the N-PIGN group,the C3-dominant-deposition group,and the N-C3G group,respectively. Conclusion:Glomerulonephritis with dominant C3 covers a variety of pathological types,and PIGN needs to be excluded before diagnosing C3G because of considerable overlap with atypical PIGN and C3G;in addition,the deposition of C1q complement under fluorescence microscope may indicate poor renal prognosis,and relevant diagnosis,treatment,and follow-up should be strengthened.

Objective To study the regulation effects of Bazhen Decoction combined with Baizhu Fuzi Decoction on glucose metabolism and estrogen level in rats with polycystic ovary syndrome.Methods The rat model of polycystic ovary syndrome was established by subcutaneous injection of human chorionic gonadotropin(HCG)combined with insulin.Rats were randomly divided into the polycystic ovary syndrome group,the Baizhu Fuzi Tang group(6.4 g/kg),the Bazhen Tang group(9.2 g/kg),the Bazhen Tang combined with Baizhu Fuzi Tang group(11.55 g/kg)and the diethylstilbestrol group(0.5 mg/kg).A blank control group(unmodulated rats)was set up with 10 rats in each group.The uterine index of rats was determined and calculated.Fasting blood glucose(FBG),2 h postprandish blood glucose(2 h PBG)and fasting insulin(FINS)were determined and insulin sensitivity index(ISI)and insulin resistance index(IR)were calculated.Serum estradiol(E2),testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),anti-Mullerian tube hormone(AMH)and insulin-like growth factor 1(IGF-1),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,total peroxidase activity(T-AOC),superoxide dismutase(SOD)and malondialdehyde(MDA)levels in ovarian tissue were detected by enzyme-linked immunosorbent assay(ELISA).The pathological changes of ovarian tissue were detected by hematoxylin-eosin(HE)staining.Real-time quantitative polymerase chain reaction(qPCR)was used to determine mRNA levels of ARA70,CBP,SCR1 and HOXA10 in endometrium and mRNA expressions of AMPK,GLUT4 and PPARγ in ovarian tissue.Western blot assay was used to determine expression levels of AMPK,GLUT4 and PPARγ in ovarian tissue.Results Compared with the polycystic ovary syndrome group,uterine index,FINS,FBG,2 h PBG,IR levels,serum T,LH,FSH,PRL,AMH,IGF-1 levels,ovarian tissue CRP,IL-6,TNF-α,T-AOC and MDA level,endometrial ARA70,CBP,SCR1 mRNA level of rats decreased significantly in the Baizhu Fuzi decoction group,the Bazhen decoction group and the Bazhen decoction combined with Baizhu Fuzi decoction group(P＜0.05).ISI level,serum E2 level,ovarian tissue SOD level,endometrial HOXA10 mRNA level,ovarian tissue AMPK,GLUT4 and PPARγ mRNA and protein levels were significantly increased(P＜0.05).The above indexes were significantly changed in the Bazhen decoction and Bazhu Fuzi decoction group than those of the Bazhu Fuzi decoction group and the Bazhen decoction group(P＜0.05).Conclusion Bazhen Decoction combined with Baizhu Fuzi Decoction can regulate glucose metabolism,inhibit ovarian tissue oxidation and inflammatory damage,improve endometrium tolerance,regulate estrogen level,and improve the progression of polycystic ovary syndrome in rats.The mechanism may be related to the regulation of AMPK/GLUT4/PPARγ pathway.

Objective: To investigate the factors affecting spontaneous preterm birth in singleton pregnancy, so as to provide insights into reducing the risk of preterm birth. Methods: A total of 230 lying-in women with spontaneous preterm birth in singleton pregnancies admitted to the Hangzhou Obstetrics and Gynecology Hospital were selected as the case group, and lying-in women with full-term birth in singleton pregnancies in the hospital during the study period were selected as controls. Basic information and pregnancy status were collected through the hospital information system, and factors affecting spontaneous preterm birth in singleton pregnancies were analyzed using a multivariable logistic regression model. Results: The lying-in women in the case group had a mean age of (33.40±3.16) years and a mean gestational weeks at delivery of (34.72±2.15) weeks. The lying-in women in the control group had a mean age of (28.30±3.92) years and a mean gestational weeks at delivery of (39.84±2.09) weeks. Multivariable logistic regression analysis identified age of 35 years and older (OR=1.280, 95%CI: 1.022-1.603), induced abortion three times and above (OR=3.122, 95%CI: 1.368-7.121), history of preterm birth (OR=3.769, 95%CI: 1.725-8.240), premature rupture of membranes (OR=12.708, 95%CI: 4.836-33.391), gestational hypertension (OR=2.934, 95%CI: 1.313-6.550), gestational diabetes (OR=2.510, 95%CI: 1.249-5.038) and cervical canal length ≤25 mm (OR=5.832, 95%CI: 2.380-14.279) as factors affecting spontaneous preterm birth in singleton pregnancies. Conclusion Spontaneous preterm birth in singleton pregnancy may be associated with age, number of induced abortions, premature rupture of membranes, complications in pregnancy and cervical canal length.

Objective:To explore the effect of ear point embedding beans combined with acupoint pressing in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in patients with hematologic malignancies.Methods:A prospective case series study was conducted. Two hundred patients with hematological tumors who underwent chemotherapy at Fujian Medical University Affiliated Union Hospital from October 2022 to August 2023 were divided into experimental group and control group using the random number table method, with 100 patients in each group. Both groups of patients received chemotherapy with high emetic risk drugs and received routine antiemetic treatment and nursing care with tropisetron hydrochloride. The experimental group added ear point embedding beans and acupoint pressing. The Multinational Association of Supportive Care in Cancer (MASCC) antiemesis tool (MAT) scale was used to evaluate the acute (within 24 hours after the start of chemotherapy, for 3 d) and delayed (24 hours after the end of chemotherapy, for 4 d) CINV status of patients, and the two groups were compared.Results:The final experimental group included 99 cases, while the control group included 90 cases. The age of 189 patients was (38±12) years old; there were 116 males (61.38%) and 73 females (38.62%). There were no statistically significant differences in sociodemographic characteristics (age, gender, etc.), disease type, and gastrointestinal disease history distributions between the two groups (all P>0.05). The incidence of acute nausea [81.81% (81/99) vs. 94.44% (85/90)] and delayed nausea [45.45% (45/99) vs. 78.89% (71/90)] in the experimental group were lower than those in the control group, the delayed MASCC-MAT scale nausea score [ M ( Q1, Q3)] was lower than that in the control group [0 point (0 point, 4 points) vs. 3 points (1 point, 4 points)], and the differences were statistically significant (all P<0.01); there was no statistically significant difference in the acute nausea score between the experimental group and the control group [5 points (2 points, 5 points) vs. 5 points (3 points, 5 points)] ( P = 0.080). The incidence of delayed vomiting in the experimental group [25.25% (25/99) vs. 45.56% (41/90)] and the frequency of vomiting [0 time (0 time, 1 time) vs. 0 time (0 time, 2 times)] were lower than those in the control group, and the differences were statistically significant (both P<0.01); there was no statistically significant difference in the incidence of acute vomiting between the experimental group and the control group [48.48% (48/99) vs. 61.11% (55/90)] and the frequency of vomiting [0 time (0 time, 3 times) vs. 1 time (0 time, 3 times)] (both P>0.05). Conclusions:Ear point embedding beans combined with acupoint pressing can effectively alleviate delayed CINV in patients with hematologic malignancies, and to some extent reduce the incidence of acute nausea.

Objective:To explore the effect of chronic intermittent hypoxia(CIH)on learning and memory dysfunc-tion in rats,as well as the expression of high mobility group box-1(HMGB1)and nuclear transcription factor-KB(NF-κB)in the hippocampus region.Methods:The CIH rat model was established,and forty SD rats were randomly divid-ed into four groups:normoxia group,hypoxia for 4 weeks group(CIH4 group),hypoxia for 8 weeks group(CIH8 group),and hypoxia for 12 weeks group(CIH12 group).Morris water maze was used to assess the learning memory ability of rats,and immunohistochemistry and ELISA were used to detect the expression of HMGB1 and NF-κB in the hippocampus of rats.Results:Compared with the normoxia group,the CIH12 and CIH8 groups had longer escape la-tency,the number of crossing the platform and the residence time in the quadrant of the platform were significantly shortened,but there was no significant difference in the CIH4 group.Additionally,there was no significant expression of HMGB1 and NF-κB in the hippocampal region of the normoxia group,but little expression was observed in CIH4 group,and significantly expressed in CIH8 group and CIH12 group,and the expression of CIH12 group was significantly higher than that of CIH8 group.Conclusion:CIH can lead to a decline in learning and memory function in rats,and the longer time of intermittent hypoxia led to the more significant effect on their learning and memory function.In addi-tion,CIH also leads to increased expression levels of HMGB1 and NF-κB in the hippocampus region,and the expres-sion increased more significantly after hypoxia for 12 weeks,comparing to hypoxia for 8 weeks.

Promoting the modernization of TCM can facilitates the modernization of nation,the development of national social economy,and the construction of a"healthy"China;industrially,it improves of the quality and efficiency,achieving qualitative innovation and development;for the general public,it ameliorates the lifestyle and the perception of the people on being healthy.This article focuses on TCM industry,whilst executing the policies of the State Council.Based on the current stage of development,the modernization of TCM and its essential philosophy,strategic background and pathway,basic principles,this article strives to explore the most appropriate methods to modernize TCM in terms of healthcare,technology,education,industry,culture and management system.

AIM:To clarify the effect of macrophage PKM2 deficiency on mucosal repair in ulcerative colitis(UC).METHODS:The gene expression and metabolic profiles in UC patients were first analyzed based on the following databases:PXD001608,GSE193677,and GSE214695.Using the macrophage-specific PKM2 elimination mice(PKM2ΔMAC),the functions of PKM2 in dextran sulfate sodium(DSS)-induced UC were clarified in vivo by analyzing the body weight,disease activity index(DAI)scores,HE staining,immunohistochemical staining,and expression of muco-sal barrier markers.The impact of PKM2 on macrophage polarization was also investigated by flow cytometry,RNA se-quencing and RT-qPCR in mouse bone marrow-derived macrophages(BMDMs)and THP-1 cells in vitro.RESULTS:Bioinformatic analysis suggested that the intestinal tissues of UC patients preferred glycolysis.The expression of PKM was parallel to the severity of UC in patients,and the expression of PKM2,but not PKM1,was elevated in macrophages of UC mice.In the DSS-induced UC mice,macrophage-specific PKM2 elimination significantly alleviates the body weight loss,diarrhea,rectal bleeding,colonic shorten,as well as decreased DAI scores and mucosal tissue damage.The BMDMs de-rived from the PKM2ΔMAC mice preferred the M2 polarization upon LPS or IL-4 stimulation to that derived from the wild-type mice,as indicated by the F4/80+CD45+CD86+and F4/80+CD45+CD206+population,as well as the expression of Ocln,F11r and Tjp-1.The RNA sequencing results indicated significant gene differential expression in PKM2 knockout mouse macrophages,which was enriched in biological processes such as leukocyte migration,tissue remodeling,and cytokine in-teractions.Macrophage PKM2 deficiency promoted the expression of mucosal repair factors(Il8,Cxcl1,Ptgs2 and Wnt6),which was further validated in PKM2 knockout THP-1 cells.CONCLUSION:The PKM2 deficiency in macro-phages benifits the mucosal repair in UC status via facilitating the wound-healing macrophage polarization.