AIM: To observe the variation characteristics of postoperative optical coherence tomography(OCT), optical coherence tomography angiography(OCTA)examination indicators in patients with high myopia and macular hole retinal detachment(MHRD), and analyze their correlation with visual function.METHODS: A total of 78 MHRD patients with high myopia who were treated in the Baoding No.1 Central Hospital from January 2019 to October 2023 were selected as the study objects, all of which underwent vitrectomy combined with internal limiting membrane tamponade. The changes in the best corrected visual acuity(BCVA), OCT and OCTA parameters, including choriocapillary blood flow area(CBFA), diameter of ellipsoid zone absence(DEZA)and blood flow density were observed at 1, 3 and 6 mo after surgery. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation between BCVA and CBFA, DEZA, and blood flow density at different time points after surgery.RESULTS: BCVA of enrolled patients at 1, 3, and 6 mo after surgery were 1.75±0.79, 1.49±0.53, and 1.08±0.44, respectively, and the differences at different points were statistically significant(all P<0.05). At 1, 3, and 6 mo after surgery, the patient's CBFA was 1.67±0.24, 1.82±0.13, and 1.94±0.15 mm2, respectively, the DEZA was 813.27±453.16, 590.89±421.38, and 427.58±385.34 μm, respectively, and the blood flow density was 24.36±7.81, 27.74±8.12, and 31.54±8.59, respectively. The differences in above indicators at different time points were statistically significant(all P<0.05). Pearson correlation analysis found that there was no significant correlation between DEZA, blood flow density and BCVA in patients with high myopia and MHRD at 1 mo after surgery(all P>0.05). However, CBFA was negatively correlated with BCVA(LogMAR; P<0.05); at 3 and 6 mo after surgery, CBFA and blood flow density were negatively correlated with BCVA(LogMAR)in patients with high myopia and MHRD, while DEZA was positively correlated with BCVA(LogMAR; all P<0.05). Multiple linear regression analysis showed that CBFA, blood flow density, and DEZA were important influencing factors of BCVA at 3 and 6 mo after surgery(all P<0.05).CONCLUSION:Visual function of patients with high myopia and MHRD gradually increases after surgery, and is closely related to postoperative CBFA, DEZA and blood flow density. It is recommended to regularly monitor changes in OCT and OCTA indicators after surgery.

AIM: To compare the efficacy of simple autologous blood coverage with ILM flap tamponade combined with autologous blood coverage after pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling in treating macular hole retinal detachment(MHRD)of high myopia patients with moderately long axial length.METHODS: This retrospective study enrolled 45 patients(45 eyes)with high myopia and MHRD, and axial lengths of 26-29 mm treated at our institution between January 1, 2020 and January 1, 2024. Patients were divided into two groups based on surgical technique: group A(24 eyes)underwent PPV with ILM peeling, ILM flap tamponade, autologous blood coverage, and silicone oil injection; group B(21 eyes)received PPV with ILM peeling followed by autologous blood coverage and silicone oil injection. Intraocular pressure, best-corrected visual acuity(BCVA), retinal reattachment and macular hole closure status were compared at 1 wk, 1, 3, and 6 mo postoperatively. Silicone oil removal was performed at 6 mo postoperatively, with additional 2-month follow-up.RESULTS:At 8-month postoperative follow-up, both groups achieved complete retinal reattachment. Macular hole closure rates showed no significant intergroup difference(88% vs 86%, P=0.860). Significant improvement in BCVA was observed in both groups compared to preoperative values, with the group B demonstrating better visual outcomes than the group A(P<0.001). Transient parafoveal subretinal fluid persistence was noted in 2 eyes of the group A(resolved spontaneously at 5 and 8 mo post-PPV, respectively), and 1 eye of the group B(resolved by 4 mo post-PPV). Serial optical coherence tomography(OCT)monitoring revealed no macular hole reopening, with complete subretinal fluid resolution confirmed in all cases at final follow-up.CONCLUSION:For high myopic MHRD patients with moderately long axial length, both surgical approaches effectively promote macular hole closure and retinal reattachment. However, the autologous blood coverage technique demonstrates better BCVA than the combined ILM tamponade.

Objective: To understand the relationship between working hours and occupational stress among front-line employees in manufacturing enterprises, so as to provide a basis for the prevention and control of occupational stress. Methods: Front-line employees from 5 manufacturing enterprises in Hangzhou City were selected from June to November 2024 using random cluster sampling. Demographic information and occupational information such as daily average working hours and weekly working hours, were collected through questionnaires. The effort-reward imbalance questionnaire was used to investigate occupational stress. The association between working hours and occupational stress was analyzed using a multivariable logistic regression model. Results: A total of 926 people were surveyed, among whom 572 were male, accounting for 61.77%, and 354 were female, accounting for 38.23%. The average age was (32.98±8.28) years. There were 515 people (55.62%) who had a monthly personal income of more than 5 000 yuan but less than 9 000 yuan. There were 353 people (38.12%) who had a working seniority of less than 5 years. There were 784 people (84.67%) who had an average daily working hours of >8 hours and 645 people (69.65%) who had a weekly working day of more than 5 days. There were 338 people (36.50%) on the shift work system, and 331 people (35.75%) worked night shifts. A total of 707 people were detected with occupational stress, with a detection rate of 76.35%. Multivariable logistic regression analysis showed that after adjusting for gender, age, educational level, marital status, number of children, only-child status, monthly personal income, working seniority, weekly working hours, assembly-line work, shift work system and night shift, compared with employees with an average daily working hours of ≤8 hours, the risk of occupational stress increased by 118.7% for those with an average daily working hours of >8-<10 hours (OR=2.187, 95%CI: 1.434-3.336) and by 248.4% for those with an average daily working hours of ≥10 hours (OR=3.484, 95%CI: 2.034-5.966). Conclusions The detection rate of occupational stress among front-line employees in manufacturing enterprises in Hangzhou City is high. Long average daily working hours can increase the risk of occupational stress among employees in manufacturing enterprises. It is recommended to reasonably arrange work intensity and working hours.

Objective:To explore the application of game-based teaching combined with Jeffries simulation teaching in training orthopedic trauma nursing interns.Methods:Totally 120 intern nurses who received orthopedic trauma nursing training from 2021 to 2023 were selected. They were divided into two groups according to their start dates, with 60 nurses in each group. The control group (started before December 2022) adopted routine teaching, whereas the observation group received game-based teaching combined with Jeffries simulation teaching. The assessment results, core competence [Competency Inventory for Registered Nurse (CIRN)], and learning enthusiasm [Active Learning Scale (ALS)] were compared both between the groups and within each group before and after the training. The course experience [Course Experience Questionnaire (CEQ)] of the trainees after training was recorded.Results:After the internship, the theoretical exam scores [(89.64±6.73) vs. (83.71±6.20)], practical operation scores [(80.82±5.94) vs. (75.61±5.73)], CIRN scores [(180.69±7.61) vs. (157.33±6.83)], and ALS scores [(89.48±6.83) vs. (73.22±6.25)] of two groups of nursing students increased compared to their scores before the internship, and the observation group showed significantly higher scores than the control group ( P<0.05). After the internship, the CEQ score was higher in the observation group than in the control group [(49.65±2.58) vs. (36.57±1.94)]. Conclusions:In the training of orthopedic trauma nursing interns, game-based teaching combined with Jeffries simulation teaching can not only improve course experience and learning enthusiasm, but also enhance the assessment results, core competence, and critical thinking.

Objective:To establish a medical equipment maintenance model based on the analytic hierarchy process(AHP),and to study its application effect in the management of orthopedic medical equipment in hospitals.Methods:Based on the analytic hierarchy process(AHP),the equipment maintenance model was constructed from the classification of the service life,failure mode,failure consequences and other indicators of orthopedic medical equipment.25 sets of medical equipment in clinical use in the Department of Orthopedics of The Second Affiliated Hospital of the Air Force Medical University from 2019 to 2022 were randomly selected,taking the time as the dividing point,the traditional orthopedic medical equipment management model(referred to as traditional management)was implemented during the equipment use period from 2019 to 2020,and the equipment maintenance model based on AHP was used to manage orthopedic medical equipment(referred to as model management)during the equipment use period from 2021 to 2022.A total of 1,000 equipment usage records were collected,500 for each mode,and the effect of equipment repair and maintenance,the satisfaction score of equipment usage management and the incidence of adverse events were compared under different management modes.Results:The cost-effectiveness of equipment using the model management mode was an average of CNY(34,500.00±4,700.00)per unit per year,which was higher than that of the traditional management mode,the difference was statistically significant(t=8.417,P<0.05),the maintenance costs and operating costs were CNY(15,381.95±13.67)per year and CNY(31,600.00±10,500.00)per year,respectively,which lower than those of the traditional management model,the difference was statistically significant(t=858.675,5.371,P<0.05).The scores of equipment management personnel on equipment performance,timeliness and cleanliness of the equipment using the model management mode,and the patients'satisfaction with convenience,effect and comfort of the equipment(9.65±1.14),(9.74±1.38),(9.53±1.09),(9.58±1.07),(9.62±1.14)and(9.81±1.28),respectively,which were all higher than those of the traditional management mode,the difference was statistically significant(t=5.629,5.687,4.736,8.085,5.330,7.680,P<0.05).The total incidence of adverse events in equipment using model management mode was 4.8%(24/500),which was lower than that of the traditional management mode,the difference was statistically significant(x2=12.515,P<0.05).Conclusion:The application of medical equipment maintenance model based on analytic hierarchy process to the management of orthopedic medical equipment can effectively reduce the equipment maintenance cost,improve the cost-effectiveness of the equipment,and improve the satisfaction of the equipment use management personnel.

AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.

Objective:To investigate the early and middle term clinical efficacies of 3D-printed metal prostheses in the reconstruction of bone defects after osteotomy in malignant bone tumors.Methods:A total of 34 patients with malignant bone tumors of lower extremity femur and tibia who underwent 3D printing individualized metal prosthesis replacement surgery in the Department of Bone and Soft Tissue of Affiliated Cancer Hospital of Zhengzhou University from March 2019 to March 2022 were retrospectively analyzed. There were 23 males and 11 females, with an average age of 19.1±15.2 years (range, 7-80 years). There were 22 children and adolescents younger than 18 years old. There were 3 cases in the proximal femur, 15 cases in the middle and distal femur, 10 cases in the proximal tibia and 6 cases in the distal tibia. According to the final pathological diagnosis, 24 cases of osteosarcoma, 6 cases of Ewing's sarcoma, 2 cases of undifferentiated sarcoma, 1 case of osteosarcoma, and 1 case of malignant giant cell tumor of bone were enrolled in this study. Postoperative complications, wound healing, periprosthetic fracture and aseptic loosening, tumor outcome (evaluated by tumor control evaluation criteria), and length difference of lower limbs were recorded. Response evaluation criteria in solid tumor (RECIST) was used to evaluate tumor outcomes. Prosthetic-bone interface healing was evaluated postoperatively, and the function was evaluated based on Musculoskeletal Oncology Society (MSTS) 93.Results:The length of lesions was 70-240 mm in 34 patients, with an average of 125.5±35.4 mm. The length of osteotomy was 80-275 mm, with an average of 160.2±33.9 mm. No tumor was found on the osteotomy surface. The customized prosthesis was firmly installed and closely matched with the side of the preserved articular surface. There were 2 patients with local incision fat liquefaction and 4 patients with superficial wound infection, which healed after debridement and antibiotic treatment. One distal tibia osteosarcoma case developed severe periprosthetic infection 2 months after surgery, resulting in prosthesis implantation failure, limb movement pain and poor ankle function. After removal of the prosthesis, infection control and osteogenesis with the Ilizarov technique, the infection was completely controlled and local osteogenesis was possible. The remaining 33 patients had a good prosthetic-bone interface union. One case was found to have localized bone resorption on the contact surface of the prosthesis 7 months after operation, but the metal prosthesis and screws were not loose. The incisions healed well in other patients, without infection, prosthesis loosening, fracture or other complications. All patients survived and were followed up for 13.8±5.6 months (range, 7-27 months). During the follow-up, there was no recurrence of tumor at the osteotomy end in all patients, but 5 patients developed lung metastasis. At the end of the last follow-up, all patients survived. Among them, 16 patients had unequal length of lower limbs, including 10 cases within 2 cm, 3 cases between 2-5 cm, and 3 cases over 5 cm. With the exception of one patient whose prosthesis was removed due to infection, the MSTS 93 of the other patients was 24.9±2.2 (range, 19-28), and were rated as excellent in 26 cases and good in 7 cases. According to the RECIST evaluation criteria, 26 of 34 patients had complete response, 5 had disease progression, and 3 had stable disease.Conclusion:3D printed metal prosthesis is one of the effective methods for the treatment of bone defects after resection of malignant bone tumors in lower limbs, which is safe, reliable and has satisfactory early curative effect.

Objective:To assess the changes of peripheral blood NK cells in patients with systemic lupus erythematosus (SLE) following belimumab and classic therapy.Methods:From January 2020 to March 2022, peripheral lymphocyte subsets were detected by flow cytometry in SLE patients treated with Belimumab and classic therapy. The duration of treatment was 24 weeks. A total of 40 treated SLE patients were enrolled. The lymphocyte subsets in healthy donors were used as normal control group. Paired sample t-test, rank-sum test, Spearman correlation and generalized linear mixed model were used for statistical analysis. Results:In contrast to healthy subjects, the numbers of NK cells in SLE patients before treatment were significantly decreased [276.0 (179.8, 384.0) cells/μl vs. 61.4 (43.0, 105.1) cells/μl; Z=-7.32, P<0.001], although that after treatment was higher than that before treatment [61.4 (43.0, 105.1) cells/μl vs. 107.7 (72.5, 186.5) cells/μl; Z= -3.22, P<0.001]. Generalized linear mixed model results showed that the increase in serum levels of C3 ( t= -2.94, P=0.006) and NK cells ( t=-2.25, P=0.031) were associated with a decrease of anti-dsDNA antibody titers. The cutoff value of elevated counts of NK cells after treatment was equal or more than 38.5 cells/μl with a sensitivity of 61.9% and a specificity of 81.2%. Compared with those with elevated counts of NK cells ≤38.5 cells/μl, patients with elevated counts of NK cells >38.5 cells/μl had a bigger difference anti-dsDNA antibody [49.2 (0.2, 207.2) vs. 156.2 (19.8, 260.7); Z=-1.55, P=0.120] and a bigger difference of SLEDAI-2000[4.5 (0.0, 10.0) vs. 13.0 (4.5, 18.0); Z=-2.52, P=0.012]. Conclusion:The change in the numbers of NK cells may serve as biomarkers for evaluating the therapeutic responses of SLE. Combinatory approaches employing belimumab and classic therapy may control SLE disease by increasing the number of NK cells

OBJECTIVE To distinguish Anoectochilus roxburghii and relative species by near infrared(NIR) spectroscopy combined with chemometrics, and to establish a prediction model for rapid determine polysaccharides contents in Anoectochilus roxburghii. METHODS The NIR spectroscopy of Anoectochilus roxburghii, Anoectochilus formosanus Hayata and Ludisia discolor were collected. The prepossessing of original spectrum was optimization through accuracy of classification in the NIR model, and six supervised pattern recognition algorithms such as decision tree, K-nearest neighbor algorithm, random forest, partial least squares regression discriminant analysis, linear discriminant analysis and support vector machine(SVM) were applied to identify effect of the classification effect, optimum algorithm and then establish qualitative model. The content of polysaccharides in 76 batches of Anoectochilus roxburghii samples were examined by ultraviolet visible spectrophotometry combined with phenol sulfuric acid method. In order to select optimization algorithm, six quantitative stoichiometry algorithms consisted of SVM, extreme learning machines, decision trees, random forests, principal component regression and partial least squares regression(PLS) were used to connect polysaccharide content and the NIR spectroscopy in Anoectochilus roxburghii respectively. The best method for determining the content of Anoectochilus roxburghii polysaccharides was further optimized by spectra pretreatment, band selection and number of band variables based on successive projection algorithm(SPA). RESULTS The NIR discriminant analysis model was established by SVM with SNV+SG+2ndD, and the classification accuracy was best. The prediction performance was evaluated based on the radial basis kernel function algorithm combined with confusion matrix and ROC curve, and the model performance was good. In addition, the quantitative analysis model was constructed by continuous projection-partial least squares by the prepossessing of SNV+SG+2ndD and the optimal band of 7 000-4 000 cm-1 with 97 of variables number. The accuracy was 0.992, which was the highest. The root mean square error calibration set, correlation coefficient of calibration set, and the root mean square error in validation set, correlation coefficient of validation set were 0.625, 0.993, 0.767, 0.992, separately. The prediction deviation was 8.467, and relative deviation of prediction set was less than 10%. CONCLUSION The established NIR-SVM qualitative model and SPA-PLS quantitative model are accurate and reliable, which are enable to identify Anoectochilus roxburghii and determine polysaccharide content nondestructively. It is a new and promising method for rapid evaluation of Anoectochilus roxburghii quality.

Objective:To explore the relationship between severe fever with thrombocytopenia syndrome virus (SFTSV) Gc and its N-glycosylation site and viral infectivity, a recombinant pseudovirus containing SFTSV Gc glycosylation site mutant was constructed.Methods:The eukaryotic expression vectors pcDNA3.1(+ )-GC, PCDNA3.1(+ )-GC(N291Q), PCDNA3.1(+ )-GC(N352Q) and PCDNA3.1(+ )-GC (N374Q) were constructed by site-directed mutagenesis and homologous recombination. After their successful expression in 293T cells, we infected VSVΔG-Fluc*G pseudovirus, constructed four recombinant pseudoviruses and tested their effects on the cell force of infection.Results:Double digestion identification and sequence determination confirmed the successful construction of eukaryotic expression vectors pcDNA3.1 (+ )-Gc, pcDNA3.1 (+ )-Gc(N291Q), pcDNA3.1 (+ )-Gc(N352Q) and pcDNA3.1 (+ )-Gc(N374Q). Indirect immunofluorescence and Western Blotting result indicated the successful expression of all the four recombinant plasmids. SFTSV Gc recombinant pseudoviruses are specific for infecting Vero cells. Pseudovirus infection capacity was decreased significantly after the glycosylation site mutation, and the mutant strain with the glycosylation site at position 352 had the lowest level of infectivity ( P<0.001, P=0.001). Conclusions:The glycosylation site of SFTSV Gc may be associated with the infectious effect of the viral infection, and the amino acid mutation at position 352 has the greatest effect on the viral infectivity.