AIM:To investigate the effect of ranibizumab on blood flow density in different regions of the macula in patients with macular edema(ME)secondary to ischemic and non-ischemic branch retinal vein occlusion(BRVO).METHODS:This retrospective study enrolled patients with BRVO-ME who were treated at the hospital from September 2019 to March 2021. Patients were divided into ischemic and non-ischemic groups based on fundus findings. All patients received intravitreal injections of ranibizumab once monthly for three consecutive months. Best corrected visual acuity(BCVA), central macular thickness(CMT), and macular blood flow density were measured before treatment and at 1 d, 1 wk, 1 and 3 mo after treatment.RESULTS: A total of 46 patients(46 eyes)with BRVO-ME were included, comprising 21 eyes in the ischemic group(7 males, 14 females; mean age 55.81±10.36 y)and 25 eyes in the non-ischemic group(11 males, 14 females; mean age 54.84±9.81 y). At 3 mo after treatment, BCVA(LogMAR)in the non-ischemic group was superior to that in the ischemic group(0.19±0.19 vs 0.38±0.27, P=0.009). Analysis of CMT changes showed that the reduction amplitude in the ischemic group was significantly greater than that in the non-ischemic group at both 1 and 3 mo after treatment(all P<0.05). Blood flow densities in the whole, parafoveal, and perifoveal regions of the superficial capillary plexus(SCP), as well as in the whole and perifoveal regions of the deep capillary plexus(DCP), were significantly lower in ischemic patients than in non-ischemic patients, while blood flow density in the foveal region of DCP was significantly higher in the ischemic group(all P<0.05).CONCLUSION: Ranibizumab is effective for both types of patients. Non-ischemic patients have a better long-term visual prognosis, and the advantage may be related to better blood flow perfusion patterns in specific areas 3 mo after treatment. Monitoring changes in blood flow density in these areas can help provide personalized treatment for patients.

AIM: To investigate the risk factors associated with the recurrence of macular edema secondary to branch retinal vein occlusion(BRVO-ME)after anti-vascular endothelial growth factor(anti-VEGF)therapy.METHODS:A total of 32 patients(32 eyes)with BRVO-ME who were treated at the ophthalmology department of the Affiliated Hospital of Shandong Second Medical University from February 2021 to June 2022 were selected. They were treated with a 3+pro re nata (PRN)anti-VEGF regimen and followed up for 6 mo. Following 3 consecutive anti-VEGF injections, patients were categorized into a non-recurrence group and a recurrence group based on central macular thickness(CMT)measured by optical coherence tomography(OCT)at 6 mo post-treatment. Aqueous humor levels of various cytokines levels were quantified using suspension assay method. Demographic characteristics, CMT, and cytokine levels were compared between the two groups, and their correlations with the recurrence of BRVO-ME after anti-VEGF treatment were analyzed.RESULTS:At 6 months post-treatment, ME resolved in 19 eyes(no recurrence group), while 13 eyes showed persistent or recurrent ME(recurrence group). Compared to baseline, the CMT significantly improved in both groups at 1 d, 1, and 6 mo post-treatment(all P<0.05). However, the recurrence group exhibited significantly higher baseline, 1 d and 6 mo post-treatment CMT values than the non-recurrence group(all P<0.05). The aqueous humor levels of VEGF and monocyte chemoattractant protein-1(MCP-1)at baseline were significantly higher in the recurrence group than the non-recurrence group(all P<0.05). Spearman correlation analysis revealed positive associations between baseline CMT and interlukin IL-1β, IL-5, IL-12, MCP-1 and IP-10 levels(all P<0.05). Multivariable Logistic regression analysis identified baseline CMT and MCP-1 levels as independent risk factors for BRVO-ME recurrence(OR>1, P<0.05).CONCLUSION: Elevated baseline CMT and aqueous humor MCP-1 levels were identified as independent risk factors for BRVO-ME recurrence after anti-VEGF therapy. Patients exhibiting higher baseline CMT and MCP-1 levels demonstrated significantly increased susceptibility to recurrence.

Objective: To investigate the availability and use of child safety seats among children aged 0-3 years, so as to provide the basis for improving riding safety for children. Methods: Parents of children aged 0-3 years in Huangpu District, Shanghai Municipality, were recruited using the stratified multistage random sampling method from May to July 2024. Demographic information, family travel patterns, the use of child safety seat and related health beliefs were collected using questionnaire surveys. Factors affecting the use of child safety seats were identified using a multivariable logistic regression model. Results: Totally 514 valid questionnaires were recovered, with an effective rate of 96.98%. The respondents included 122 fathers (23.74%) and 392 mothers (76.26%), with a median age of 34.00 (interquartile range, 5.00) years. There were 446 families equipping with child safety seats, accounting for 86.77%; and 169 families using child safety seats, accounting for 32.88%. Multivariable logistic regression analysis showed that the parents who had children aged >1-2 years (OR=0.597, 95%CI: 0.366-0.973), travelled 2-4 times per month (OR=0.359, 95%CI: 0.213-0.607) or once per month or less (OR=0.384, 95%CI: 0.202-0.729), and scored high in perceived barrier (OR=0.634, 95%CI: 0.486-0.827) were less likely to use child safety seats; the parents who had children with local household registration (OR=2.506, 95%CI: 1.356-4.633), travelled 5-<10 km (OR=1.887, 95%CI: 1.148-3.101) or ≥10 km (OR=2.319, 95%CI: 1.355-3.967), always wore seat belts (OR=2.342, 95%CI: 1.212-4.524), scored high in perceived susceptibility (OR=1.392, 95%CI: 1.091-1.778) and self-efficacy (OR=1.413, 95%CI: 1.156-1.727) were more likely to use child safety seats. Conclusions Equipping family cars with child safety seats and using them can prevent and reduce traffic injuries among children aged 0-3 years. It is recommended to strengthen publicity to promote the use of child safety seats.

Objective To investigate the proactive coping of schizophrenia patients with auditory hallucinations and to analyze its influencing factors.Methods A total of 240 schizophrenia patients with auditory hallucinations hospitalized in Shandong Mental Health Center from February to October 2023 were selected as subjects.General information questionnaire,simplified coping style questionnaire,perceived social support scale,insight and treatment attitude questionnaire were used to conduct the survey.Results A total of 236 valid questionnaires were collected,and effective questionnaire response rate was 98.33％.The proactive coping score of schizophrenia patients with auditory hallucinations was(18.55±7.74)points,which was at a moderate level.The results of multiple linear regression analysis showed that education level,perceived of social support,and self-awareness were the influencing factors of proactive coping to schizophrenia patients with auditory hallucinations(P＜0.05).Conclusion The proactive coping of schizophrenia patients with auditory hallucinations needs to be further improved,and nursing staff can focus on patients with low education level,low ability to perceive social support and poor self-awareness,and formulate targeted interventions to improve their proactive coping to auditory hallucinations.

Objective:To analyze the clinical characteristics,diagnosis and treatment of pediatric myocardial infarction (MI) patients with coronary artery lesions (CAL) after Kawasaki disease (KD).Methods:Clinical data including baseline characteristics, KD and CAL information, clinical symptoms at MI onset, electrocardiogram (ECG) and imaging findings, MI treatment, and clinical outcomes of 41 MI patients with CAL after KD admitted to the Children′s Hospital of Fudan University from January 2017 to August 2024 were analyzed retrospectively.Results:(1) Demographic characteristics: a total of 41 patients were included (36 males and 5 females). The age at MI was 4.6 (2.3, 5.7) years, and time from KD onset to MI was 397 (50, 1 095) d. (2) Treatment of acute KD: only 15 patients (37%) received standard initial treatment within 10 days of KD onset with intravenous immunoglobulin 2 g/kg. The other 26 cases (63%) received non-standard treatment or no treatment. (3) Treatment of CAL before MI: the time from KD onset to CAL was 14 (10, 116) d, with CAL not identified before MI onset in 15 patients. Among the 26 cases diagnosed with CAL prior to MI, 9 cases received only single or dual antiplatelet drug, of which 7 cases received oral dipyridamole. The remaining 16 cases received antiplatelet drug combined with warfarin, but only 1 case achieved the target international standardized ratio of 1.5-2.5. Out of all 41 cases, only 1 case (2%) received standard antithrombotic treatment before MI onset. (4) Clinical symptoms of MI: at MI onset, 32 patients presented with different clinical symptoms, with typical MI symptoms such as chest tightness, chest pain, precordial discomfort in 18 cases, and cardiopulmonary arrest accompanied by syncope or convulsions in 10 cases. Other non-specific symptoms included abdominal pain, nausea, vomiting and pallor. Nine patients were asymptomatic and were found to have silent MI on follow-up. (5) ECG and imaging findings: ECG showed ST-T changes in 33 cases, and abnormal Q waves, and arrhythmias in the remaining patients; echocardiography indicated coronary artery aneurysm with thrombosis in 27 cases, reduced left ventricular ejection fraction in 18 cases, abnormal wall motion in 15 cases, and ventricular aneurysm in 3 cases. Thirty-seven patients underwent coronary angiography and (or) multi-slice spiral CT angiography, with 39 occluded vessels and 3 severe stenosis (≥75%), all of which were caused by giant aneurism with thrombus formation. (6) Treatment of MI: of the 32 patients with acute MI, 9 patients received successful cardiopulmonary resuscitation, 7 patients received intravenous thrombolysis, and 1 patient underwent percutaneous coronary balloon angioplasty. All of these patients received dual antiplatelet drugs and low-molecular-weight heparin at therapeutic doses following MI treatment. Sixteen patients received coronary artery bypass graft (CABG) treatment, all of which were successful. (7) Outcomes: the follow-up time was 994 (215, 1 832) d. Thirty-one patients showed improvement, 5 patients experienced disease progression or no change, 1 patient died, and 4 patients were lost to follow-up.Conclusions:MI in children with CAL after KD often occurs within 1 year after the onset of KD. MI can present with atypical clinical symptoms in children. CABG is the main treatment option in children severe CAL after KD who developed MI.

Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P＞0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P＜0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beats/min,(92.97±1.46)mmHg](P＜0.05).There were no significant differences in HR and MAP among the three groups at T3(P＞0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B(P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P＞0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

Objective To investigate the proactive coping of schizophrenia patients with auditory hallucinations and to analyze its influencing factors.Methods A total of 240 schizophrenia patients with auditory hallucinations hospitalized in Shandong Mental Health Center from February to October 2023 were selected as subjects.General information questionnaire,simplified coping style questionnaire,perceived social support scale,insight and treatment attitude questionnaire were used to conduct the survey.Results A total of 236 valid questionnaires were collected,and effective questionnaire response rate was 98.33％.The proactive coping score of schizophrenia patients with auditory hallucinations was(18.55±7.74)points,which was at a moderate level.The results of multiple linear regression analysis showed that education level,perceived of social support,and self-awareness were the influencing factors of proactive coping to schizophrenia patients with auditory hallucinations(P＜0.05).Conclusion The proactive coping of schizophrenia patients with auditory hallucinations needs to be further improved,and nursing staff can focus on patients with low education level,low ability to perceive social support and poor self-awareness,and formulate targeted interventions to improve their proactive coping to auditory hallucinations.

Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P＞0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P＜0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beats/min,(92.97±1.46)mmHg](P＜0.05).There were no significant differences in HR and MAP among the three groups at T3(P＞0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B(P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P＞0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

Objective:To analyze the clinical characteristics,diagnosis and treatment of pediatric myocardial infarction (MI) patients with coronary artery lesions (CAL) after Kawasaki disease (KD).Methods:Clinical data including baseline characteristics, KD and CAL information, clinical symptoms at MI onset, electrocardiogram (ECG) and imaging findings, MI treatment, and clinical outcomes of 41 MI patients with CAL after KD admitted to the Children′s Hospital of Fudan University from January 2017 to August 2024 were analyzed retrospectively.Results:(1) Demographic characteristics: a total of 41 patients were included (36 males and 5 females). The age at MI was 4.6 (2.3, 5.7) years, and time from KD onset to MI was 397 (50, 1 095) d. (2) Treatment of acute KD: only 15 patients (37%) received standard initial treatment within 10 days of KD onset with intravenous immunoglobulin 2 g/kg. The other 26 cases (63%) received non-standard treatment or no treatment. (3) Treatment of CAL before MI: the time from KD onset to CAL was 14 (10, 116) d, with CAL not identified before MI onset in 15 patients. Among the 26 cases diagnosed with CAL prior to MI, 9 cases received only single or dual antiplatelet drug, of which 7 cases received oral dipyridamole. The remaining 16 cases received antiplatelet drug combined with warfarin, but only 1 case achieved the target international standardized ratio of 1.5-2.5. Out of all 41 cases, only 1 case (2%) received standard antithrombotic treatment before MI onset. (4) Clinical symptoms of MI: at MI onset, 32 patients presented with different clinical symptoms, with typical MI symptoms such as chest tightness, chest pain, precordial discomfort in 18 cases, and cardiopulmonary arrest accompanied by syncope or convulsions in 10 cases. Other non-specific symptoms included abdominal pain, nausea, vomiting and pallor. Nine patients were asymptomatic and were found to have silent MI on follow-up. (5) ECG and imaging findings: ECG showed ST-T changes in 33 cases, and abnormal Q waves, and arrhythmias in the remaining patients; echocardiography indicated coronary artery aneurysm with thrombosis in 27 cases, reduced left ventricular ejection fraction in 18 cases, abnormal wall motion in 15 cases, and ventricular aneurysm in 3 cases. Thirty-seven patients underwent coronary angiography and (or) multi-slice spiral CT angiography, with 39 occluded vessels and 3 severe stenosis (≥75%), all of which were caused by giant aneurism with thrombus formation. (6) Treatment of MI: of the 32 patients with acute MI, 9 patients received successful cardiopulmonary resuscitation, 7 patients received intravenous thrombolysis, and 1 patient underwent percutaneous coronary balloon angioplasty. All of these patients received dual antiplatelet drugs and low-molecular-weight heparin at therapeutic doses following MI treatment. Sixteen patients received coronary artery bypass graft (CABG) treatment, all of which were successful. (7) Outcomes: the follow-up time was 994 (215, 1 832) d. Thirty-one patients showed improvement, 5 patients experienced disease progression or no change, 1 patient died, and 4 patients were lost to follow-up.Conclusions:MI in children with CAL after KD often occurs within 1 year after the onset of KD. MI can present with atypical clinical symptoms in children. CABG is the main treatment option in children severe CAL after KD who developed MI.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.