AIM: To observe the characteristics of best corrected visual acuity(BCVA), microperimetry(MP), multifocal electroretinogram(mfERG), and optical coherence tomography angiography(OCTA)parameters in patients with idiopathic epiretinal membrane(IERM), and conduct a comparative study and correlation analysis on these parameters.METHODS:This was a cross-sectional study. A total of 56 patients(56 eyes)diagnosed with IERM who visited our hospital between February 2021 and November 2024 were collected as IERM group, and 33 healthy individuals(33 eyes)undergoing physical examinations were included as control group. Parameters were compared between the IERM group and the control group, as well as among IERM subgroups at different stages. Additionally, correlations among visual function parameters and between these visual function parameters and vascular structural OCTA parameters were analyzed.RESULTS: The general data of patients in the control group and IERM group were comparable. In the IERM group, BCVA, retinal sensitivity(RS), P1 wave amplitude in ring 1, superficial capillary plexus parafoveal vessel density(SCPpfvd), deep capillary plexus parafoveal vessel density(DCPpfvd), and the foveal avascular zone(FAZ)area were significantly lower than the control group(all P<0.01). In contrast, central retinal thickness(CRT), superficial capillary plexus foveal vessel density(SCPfvd), and deep capillary plexus foveal vessel density(DCPfvd)were significantly increased(all P<0.001). When comparing different stages of IERM, significant differences were observed in BCVA, CRT, RS, SCPfvd, and FAZ(all P<0.01). In eyes affected by IERM, BCVA(LogMAR)was negatively correlated with RS; P1 wave amplitude in ring 1 positively correlated with P1 wave implicit time in ring 1; SCPfvd positively correlated with BCVA(LogMAR)and negatively correlated with RS; DCPfvd negatively correlated with P1 wave implicit time in ring 1; and DCPpfvd positively correlated with RS(all P<0.05).CONCLUSION: Eyes with IERM exhibit abnormalities in visual function parameters and vascular structure, with varying degrees of alteration in BCVA, CRT, RS, SCPfvd, and FAZ across different stages. Comprehensive evaluation of BCVA, MP, mfERG, and OCTA contributes to a deeper understanding of the nature of IERM and aids in formulating appropriate diagnosis and treatment plans.

Objective:To analyze the existing problems in maternal and child health services in Shanghai′s communities, so as to provide references for the continuous improvement and enhancement of maternal and child health work in community.Methods:Retrieve relevant literature on community maternal and child health services in Shanghai from databases such as CNKI, Wanfang, VIP, Chinese biomedical literature database and PubMed for text analysis, with a search period from 2009 to 2023. From August 2022 to May 2023, a purposive sampling method was used to select community health service centers in Shanghai for participatory observation. Interviews were conducted with maternal and child health service providers in community, management personnel at all levels, and obstetric experts from tertiary hospitals participating in the construction of medical alliances to understand the problems that exist in the process of providing maternal and child health services in community service centers. Based on text analysis, participatory observation, and interview results, a structure-process-outcome theory model was used to sort out a list of problems of maternal and child health services in Shanghai′s community. An electronic questionnaire was created based on the list of questions, and maternal and child health service personnel in each jurisdiction were invited to rate the existing problems from three aspects: importance, severity, and solvability. The key issues was determined based on the total score of each problem.Results:A list of 24 issues related to maternal and child health services in Shanghai′s community has been formed, with the structural dimension including team building and hardware facilities, the process dimension including mechanism construction, implementation process, and institutional coordination, and the result dimension only including system result category. According to the survey results, the three key questions with a total score greater than 7 were identified as the need for improvement in the maternal and child health knowledge and skills of service personnel; Insufficient staffing of service personnel, lack of dedicated personnel and specialized talents; The health information platform was not well-established, and institutions could not fully and timely share diagnosis and treatment data.Conclusions:This study has identified a problem list for maternal and child health care services in Shanghai′s communities, as well as key issues that urgently need to be addressed, which can provide reference for improving the quality of maternal and child health care services in Shanghai′s communities.

Objective:To investigate the value of CHA2DS2-VASc score for predicting percutaneous coronary intervention (PCI) prognosis in patients with coronary chronic total occlusion.Methods:The clinical data of 139 patients with coronary chronic total occlusion who underwent PCI at the Second Hospital of Anhui Medical University from January 2019 to December 2020 were retrospectively analyzed. These patients were divided into good prognosis and poor prognosis groups according to prognosis outcomes. Univariate and multivariate Cox regression analysis was performed to evaluate the influential factors of adverse events after PCI in patients with coronary chronic total occlusion. The receiver operating characteristic curves were plotted to evaluate the value of the CHA2DS2-VASc score for predicting the occurrence of adverse events in patients with coronary chronic total occlusion undergoing PCI.Results:Among the 139 patients with coronary chronic total occlusion, the average follow-up time was (19.88 ± 7.90) months, 19 (13.7%) patients had a poor prognosis, and 120 (86.3%) patients had a good prognosis. The age, uric acid, and CHA2DS2-VASc score in the poor prognosis group were 73 (65.0, 77.0) years, (383.26 ± 120.60) μmol/L, and 4 (3, 5) points, respectively, which were significantly higher than 66 (57.0, 71.8) years, (322.68 ± 91.88) μmol/L, and 3 (2, 4) points in the good prognosis group ( U = -2.74, t = 2.24, U = -3.09, all P < 0.05). However, the proportion of patients with the successful opening of the occluded coronary artery and albumin, hemoglobin, and triacylglycerol levels in the poor prognosis group were 11 (57.9%), 36.7 (34.4, 38.3) g/L, (120.26±19.74) g/L, and 1.03 (0.85, 1.49) mmol/L, respectively, which were significantly lower than 98 (81.7%)( χ2 = 4.16, P = 0.041), 39.3 (36.78, 42.1) g/L ( U = -2.85, P = 0.004), (133.62 ± 16.84) g/L ( t = 1.52, P = 0.002), and 1.52 (1.09, 2.25) mmol/L ( U =-2.13, P = 0.033) in the good prognosis group. Multivariate Cox regression analysis showed that CHA2DS2-VASc score was a risk factor for poor prognosis of patients with coronary chronic total occlusion undergoing PCI (95% CI: 1.137-2.274, P = 0.007). The receiver operating characteristic curve analysis results showed that the area under the receiver operating characteristic curve plotted for CHA2DS2-VASc score predicting poor prognosis in patients with coronary chronic total occlusion undergoing PCI was 0.716 (95% CI: 0.588-0.844, P = 0.003), with the cut-off point of 3.5, the sensitivity of 68.4%, and specificity of 66.7%, respectively. Conclusion:Compared with those with a good prognosis, patients with a poor prognosis have a higher CHA2DS2-VASc score. The CHA2DS2-VASc score has a certain application value for predicting mid- and long-term prognosis in patients with coronary chronic total occlusion who undergo PCI.

The solute carrier family 12(SLC12)of cation-chloride cotransporters(CCCs)comprises potassium chlo-ride cotransporters(KCCs,e.g.KCC1,KCC2,KCC3,and KCC4)-mediated Cl-extrusion,and sodium po-tassium chloride cotransporters(N[K]CCs,NKCC1,NKCC2,and NCC)-mediated Cl-loading.The CCCs play vital roles in cell volume regulation and ion homeostasis.Gain-of-function or loss-of-function of these ion transporters can cause diseases in many tissues.In recent years,there have been considerable ad-vances in our understanding of CCCs'control mechanisms in cell volume regulations,with many tech-niques developed in studying the functions and activities of CCCs.Classic approaches to directly measure CCC activity involve assays that measure the transport of potassium substitutes through the CCCs.These techniques include the ammonium pulse technique,radioactive or nonradioactive rubidium ion uptake-assay,and thallium ion-uptake assay.CCCs'activity can also be indirectly observed by measuring y-aminobutyric acid(GABA)activity with patch-clamp electrophysiology and intracellular chloride con-centration with sensitive microelectrodes,radiotracer 36Cl-,and fluorescent dyes.Other techniques include directly looking at kinase regulatory sites phosphorylation,flame photometry,22Na+uptake assay,structural biology,molecular modeling,and high-throughput drug screening.This review sum-marizes the role of CCCs in genetic disorders and cell volume regulation,current methods applied in studying CCCs biology,and compounds developed that directly or indirectly target the CCCs for disease treatments.

The occurrence of eosinophilic leukemia complicated with cardiogenic embolism and L?ffler endocarditis are relatively rare.Early accurate diagnosis and prompt treatment can improve the its prognosis.When patients have symptoms of neurological impairment accompanied by increased eosinophils,the rare etiological type of cerebral infarction should be actively screened.Further improvements are needed in the examination of bone marrow smears,detection of fusion genes associated with leukemia,screening for L?ffler endocarditis,and identification of intraventricular thrombi.In this case,the main manifestations of eosinophilic leukemia were cardiogenic embolism and L?ffler endocarditis.After active treatment,the symptoms improved,and the eosinophil count returned to normal.This study summarizes the case data of this patient and combines it with a literature review,with the hope of raising clinicians'understanding of this rare disease.

Objective:To understand the symptom clusters of patients with indwelling tracheal cannula after head and neck cancer surgery, and to identify the sentinel symptoms of different symptom clusters.Methods:A total of 197 patients with head and neck cancer who underwent surgical treatment in Department of Head, Neck and Thyroid Surgery in Cancer Hospital Affiliated to Zhengzhou University (Henan Cancer Hospital) from June 2020 to December 2021 were selected as the research objects by the convenient sampling method. On the 7th day after surgery, general information questionnaire and Anderson Symptom Inventory, Head and Neck Module were used, and exploratory factor analysis was used to extract symptom clusters. Apriori association analysis was used to identify sentinel symptoms in the symptom clusters.Results:There were 4 symptom clusters in patients with indwelling tracheal cannula after head and neck cancer surgery, including head and neck cancer-specific symptom cluster, pain-digestive tract symptom cluster, voice/swallowing disorder symptom cluster and fatigue-sleep-emotional symptom cluster. Oral and throat mucus was the sentinel symptom of head and neck cancer-specific symptom cluster, nausea was the sentinel symptom of pain-digestive tract symptom cluster, numbness and needling sensation were the sentinel symptom of voice/swallowing disorder symptom cluster, sadness was the sentinel symptom of fatigue-sleep-emotional symptom cluster.Conclusions:Patients with indwelling tracheal cannula after head and neck cancer surgery have more symptoms, which are combined into symptom clusters, and sentinel symptoms exist in each symptom cluster, suggesting that medical workers should take sentinel symptoms as the entry point for symptom cluster management to achieve effective management of symptoms.

Objective:To explore the effect of early activity based on action research method in severely ill children.Methods:From February 2020 to January 2022, 101 children with severe illness admitted to the Henan Provincial People's Hospital were selected as the study subjects by convenient sampling. The 51 children with severe illness included from February 2020 to January 2021 were set as the control group, and the 50 children with severe illness included from February 2021 to January 2022 were set as the experimental group. The children in the control group were treated with routine rehabilitation in the Pediatric Intensive Care Unit (PICU) , and the experimental group was treated with early activity based on action research method on the basis of the control group. Before and after the intervention, the effect was evaluated by the Medical Research Council Scale (MRC) , the Intensive Care Unit Mobility Scale (IMS) , the length of stay in PICU and hospitalization time, and the incidence of ICU-acquired weakness (ICU-AW) when transferring out of PICU.Results:When transferring out of PICU, the MRC muscle strength score of children in the experimental group was higher than that in the control group, and the incidence of ICU-AW was lower than that in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the IMS score of children in the experimental group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . The length of stay in PICU and hospitalization time of children in the experimental group were shorter than those in the control group with statistical differences ( P<0.05) . Conclusions:Early activity based on action research method can effectively prevent the occurrence of ICU-AW in severely ill children, improve the activity of children, and shorten the hospitalization time, which is worthy of clinical promotion and application.

Objective:To explore the effect of preoperative home-based rehabilitation in patients undergoing lung cancer surgery.Methods:From January 2021 to June 2022, convenience sampling was used to select 118 lung cancer patients who underwent surgical treatment at the Xinxiang First People's Hospital of Henan Province. The patients were randomly divided into an observation group and a control group, with 59 cases each. The control group received routine nursing, while the observation group received preoperative home-based rehabilitation. We compared the lung function, nutritional indicators, incidence of postoperative atelectasis and pulmonary infection, as well as the duration of thoracic closed drainage tube insertion and postoperative hospital stay between the two groups.Results:After intervention, the forced vital capacity (FVC), maximum ventilation volume (MVV), the percentage of forced expiratory volume in one second to the predicted value (FEV 1%), ventilate storage ratio (VSR), hemoglobin and serum albumin in the control group were lower than those before intervention, and the levels of FVC, MVV, FEV 1%, VSR, hemoglobin and serum albumin in the observation group after intervention were higher than those in the control group, with statistical differences ( P<0.05). The incidence of postoperative atelectasis and pulmonary infection in the observation group were lower than that in the control group, and the differences were statistically significant ( P<0.05). The observation group had shorter duration of thoracic closed drainage tube insertion and postoperative hospital stay compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Preoperative home-based rehabilitation can effectively maintain postoperative lung function and nutritional status of patients, reduce postoperative complications, shorten postoperative drainage tube insertion time and hospital stay, and facilitate postoperative recovery.

Objective:To explore the symptom cluster characteristics of early postoperative patients with head and neck cancer and analyze its influencing factors.Methods:From June 2020 to June 2022, convenience sampling was used to select 230 head and neck cancer patients who underwent surgery in the Head and Neck Thyroid Surgery of Henan Cancer Hospital as the research subject. The questionnaire survey was conducted using the Demographic and Disease Characteristics Questionnaire, Chinese version of M.D. Anderson Symptom Inventory-Head & Neck, Self-perceived Burden Scale for Cancer Patient, and Medical Outcome Study Social Support Scale. Exploratory factor analysis and multiple linear regression analysis were used for statistics.Results:A total of 230 questionnaires were distributed, and 215 qualified questionnaires were collected, with an effective rate of 93.48%. Postoperative patients with head and neck cancer had four symptom clusters, including pain-gastrointestinal symptom cluster, fatigue-sleep-emotional symptom cluster, head and neck cancer-specific symptom cluster, and vocal/swallowing disorders symptom cluster. Medical social support, per capita monthly income of families, type of head and neck cancer, self-perceived burden and complications were the influencing factors of pain-gastrointestinal symptom cluster ( P<0.05). Medical social support, disease staging, complications, self-perceived burden, and per capita monthly income of families were the influencing factors of fatigue-sleep-emotional symptom cluster ( P<0.05). Medical social support, complications, treatment methods, and type of head and neck cancer were the influencing factors of head and neck cancer-specific symptom cluster ( P<0.05). Medical social support, complications, treatment methods, course of disease, and per capita monthly income of families were the influencing factors of vocal/swallowing disorders symptom cluster ( P<0.05) . Conclusions:Postoperative patients with head and neck cancer have multiple symptom clusters and are influenced by psychological, social, and disease factors. Medical and nursing staffs should pay attention to the symptom cluster of postoperative head and neck cancer patients with low levels of social support, heavy self-perceived burden, and complications, and scientifically formulate interventions to reduce the burden of patient symptom cluster and promote rehabilitation.