Myopic traction maculopathy(MTM)is a common vision-threatening complication in patients with high myopia. With the global increase in high myopia, the prevalence of MTM has been rising worldwide, leading to a growing burden of disease, economic costs,and social impact. The emergence and development of optical coherence tomography(OCT)have provided robust technical support for the staging of MTM. Based on the evolving understanding of its pathological mechanisms and natural course, various staging systems have been proposed and applied in clinical practice, offering crucial guidance for the personalized management of MTM patients. Additionally, innovations and refinements in surgical techniques and materials, such as pars plana vitrectomy(PPV), posterior scleral reinforcement, and macular buckling(MB), have expanded the therapeutic options for MTM. This article systematically reviews the staging systems and treatment strategies for MTM, focusing on the role of OCT-based staging in guiding individualized treatment plans. It also summarizes the current evidence on the efficacy and safety of existing and emerging surgical approaches, including PPV, MB, and their combined procedures. The review further proposes that future research should focus on developing predictive models integrating multimodal data to clarify surgical timing and indications, as well as conducting large-scale, multicenter randomized controlled trials to explore the selection of PPV, MB, or combined surgeries. The review aims to discuss personalized treatment for MTM, providing theoretical foundations and practical directions for optimizing clinical management and improving patient prognosis for MTM patients.

Objective:To observe the clinical effect of tracheal tube with an attached laryngeal pillow cushion(LPC)in the patients under general anesthesia,and to provide new methods for the preventing arytenoid dislocation during tracheal intubation.Methods:Forty-eight patients scheduled for elective oral tracheal intubation under general anesthesia and meeting the inclusion criteria were selected.Based on the head and neck positions,the patients were divided into supine without pillow(SWOP)group,supine with pillow(SWP)group,trendelenburg position(TP)group,and head side position(HSP)group,each group consisted of 12 patients.The patient in the following groups underwent two sequential treatments after tracheal intubation:intervention group(LPC-inflated)and control group(LPC uninflated,representing the current method of tracheal tube use).One patient in TP group and two patients in HSP group rminated the experiment,so a total of 45 patients were successfully included in this study.Electronic fiber laryngoscopy was used to observe and record the positional relationship between the endotracheal tube LPC and the posterior commissure arytenoid joint area under different head and neck positions after two treatments.The evaluation indicators were whether the tracheal tube was lifted from the posterior commissure arytenoid joint area and the degree of compression of the tracheal tube on the arytenoid joint.The incidence of tracheal tube lift-off and the percentage of compression degree on cricoarytenoid joint of the patients in various groups were calculated.Results:Within the same head and neck position group,compared with control group,the incidence of endotracheal tube lift-off of the patients in intervention group was significantly increased(P<0.05),and the percentage of compression degree of endotracheal tube on the arytenoid joint was significantly decreased(P<0.05).In control and intervention groups,there were no statistically significant differences in the incidence of endotracheal tube lift-off and the percentage of compression degree on arytenoid joint of the patients in various head and neck positions groups(P>0.05).Conclusion:Under the four head and neck positions,inflating the LPC of the tracheal tube can lift the tracheal tube from the posterior commissure arytenoid joint area,effectively relieving or reducing the compression and mechanical friction injuries to the arytenoid joint.

Objective:To investigate the differences in clinical characteristics and antibiotic resistance of neonatal sepsis（NS）caused by different Gram-staining pathogens.Methods:A retrospective study was conducted on confirmed NS cases admitted to the Neonatal Ward of the Pediatric Department at The First Affiliated Hospital of Dali University，from June 1，2014，to May 31，2024.Patients were divided into Gram-positive and Gram-negative groups based on blood or cerebrospinal fluid（CSF）culture results.Clinical characteristics，pathogen distribution，and antibiotic resistance were compared between the two groups.Results:A total of 98 cases were included，with 81 in the Gram-positive group and 17 in the Gram-negative group.Multivariate logistic regression analysis revealed that NS cases with a high neutrophil percentage（ OR=0.933，95% CI：0.899-0.969）or hemorrhagic symptoms/signs（ OR=0.059，95% CI：0.008-0.458）were less likely to have Gram-positive pathogens detected in blood or CSF cultures（ P<0.05）.Common Gram-positive pathogens included Staphylococcus epidermidis with 35 strains（33.65%）and Staphylococcus hominis with 22 strains（21.15%）.The predominant Gram-negative pathogen was Escherichia coli with 14 strains（13.46%）.Gram-positive pathogens exhibited high resistance to oxacillin（91.30%），erythromycin（90.91%），and penicillin G（90.00%），but low resistance to tigecycline（0），linezolid（0），and vancomycin（0）.Gram-negative pathogens showed high resistance to ampicillin（92.31%），cefazolin（90.00%），and ampicillin/sulbactam（75.00%），but low resistance to amikacin（6.25%），latamoxef（0），and ertapenem（0）.The incidence of concurrent purulent meningitis was lower in the Gram-positive group than in the Gram-negative group（9.88% vs.47.06%， χ2=11.628， P<0.05），and there was significant difference. Conclusion:NS cases with high neutrophil percentages or hemorrhagic symptoms/signs are less likely to be caused by Gram-positive pathogens.Staphylococcus epidermidis and Staphylococcus hominis are common Gram-positive pathogens，while Escherichia coli is the predominant Gram-negative pathogen in NS.Both Gram-positive and Gram-negative pathogens exhibit resistance to specific antibiotics.NS caused by Gram-positive pathogens is less likely to be complicated by purulent meningitis compared to those caused by Gram-negative pathogens.

BACKGROUND:D1-3-n-butylphthalide has antioxidant and anti-inflammatory effects and has been explored to have protective role in Parkinson's disease,but the underlying mechanisms are unknown.OBJECTIVE:To investigate the protective effect of D1-3-n-butylphthalide by the approach of network pharmacology,molecular docking,and cellular experimental validation.METHODS:(1)Network pharmacology and molecular docking:The database was used to screen the targets of D1-3-n-butylphthalide and Parkinson's disease.The intersection was taken from the construction of the target protein interaction network,and then screen the core targets.The GO and KEGG pathway enrichment was used to further analyze the core targets.The interaction between the target proteins and D1-3-n-butylphthalide was verified by molecular docking.(2)Cell validation:The passage 6 PC12 cells were divided into six groups for culture.The control group was cultured with conventional culture medium.The model group was cultured with N-methyl-4-phenylpyridinium iodide to induce Parkinson's disease model.The ML385 inhibitor group was added with nuclear factor E2-related factor 2 inhibitor ML385 on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide treatment group was added with butylphthalide on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide combined with ML385 treatment group was added with D1-3-n-butylphthalide and ML385 on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide group was cultured with conventional culture medium containing butylphthalide alone.Cell proliferation,intracellular reduced glutathione and malondialdehyde levels,and protein expression of protein kinase B/glycogen synthase kinase 3β/nuclear factor E2-related factor 2(AKT/GSK-3β/Nrf2)signaling pathway were detected.RESULTS AND CONCLUSION:(1)A total of 52 targets were screened for the intersection of drugs and disease targets,and the core targets including the matrix metalloproteinase 9 and GSK-3β were involved the phosphatidylinositol 3-kinase(PI3K)/AKT and oxidative stress-related signaling pathways.The molecular docking binding energy of D1-3-n-butylphthalide and GSK-3β was-18.27 kJ/mol,which indicated that D1-3-n-butylphthalide had a good binding ability with GSK-3β.(2)Compared with the model group,the PC12 cell activity and reduced glutathione level in the D1-3-n-butylphthalide treatment group were increased(P＜0.05),the malondialdehyde level was decreased(P＜0.05),and the expression of p-AKT,p-GSK-3β,Nu-Nrf2,and T-Nrf2 proteins was increased(P＜0.05).Compared with the D1-3-n-butylphthalide group,the PC12 cell activity and reduced glutathione level in the D1-3-n-butylphthalide combined with ML385 treatment group were decreased(P＜0.05),the malondialdehyde level was increased(P＜0.05),and the expression of Nu-Nrf2 and T-Nrf2 proteins was decreased(P＜0.05).(3)These results demonstrate that D1-3-n-butylphthalide can inhibit oxidative stress and improve cell activity through the AKT/GSK-3β/Nrf2 signaling pathway,and has a protective effect on the Parkinson's cell model induced by N-methyl-4-phenylpyridinium iodide.

BACKGROUND:D1-3-n-butylphthalide has antioxidant and anti-inflammatory effects and has been explored to have protective role in Parkinson's disease,but the underlying mechanisms are unknown.OBJECTIVE:To investigate the protective effect of D1-3-n-butylphthalide by the approach of network pharmacology,molecular docking,and cellular experimental validation.METHODS:(1)Network pharmacology and molecular docking:The database was used to screen the targets of D1-3-n-butylphthalide and Parkinson's disease.The intersection was taken from the construction of the target protein interaction network,and then screen the core targets.The GO and KEGG pathway enrichment was used to further analyze the core targets.The interaction between the target proteins and D1-3-n-butylphthalide was verified by molecular docking.(2)Cell validation:The passage 6 PC12 cells were divided into six groups for culture.The control group was cultured with conventional culture medium.The model group was cultured with N-methyl-4-phenylpyridinium iodide to induce Parkinson's disease model.The ML385 inhibitor group was added with nuclear factor E2-related factor 2 inhibitor ML385 on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide treatment group was added with butylphthalide on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide combined with ML385 treatment group was added with D1-3-n-butylphthalide and ML385 on the basis of inducing Parkinson's disease model.The D1-3-n-butylphthalide group was cultured with conventional culture medium containing butylphthalide alone.Cell proliferation,intracellular reduced glutathione and malondialdehyde levels,and protein expression of protein kinase B/glycogen synthase kinase 3β/nuclear factor E2-related factor 2(AKT/GSK-3β/Nrf2)signaling pathway were detected.RESULTS AND CONCLUSION:(1)A total of 52 targets were screened for the intersection of drugs and disease targets,and the core targets including the matrix metalloproteinase 9 and GSK-3β were involved the phosphatidylinositol 3-kinase(PI3K)/AKT and oxidative stress-related signaling pathways.The molecular docking binding energy of D1-3-n-butylphthalide and GSK-3β was-18.27 kJ/mol,which indicated that D1-3-n-butylphthalide had a good binding ability with GSK-3β.(2)Compared with the model group,the PC12 cell activity and reduced glutathione level in the D1-3-n-butylphthalide treatment group were increased(P＜0.05),the malondialdehyde level was decreased(P＜0.05),and the expression of p-AKT,p-GSK-3β,Nu-Nrf2,and T-Nrf2 proteins was increased(P＜0.05).Compared with the D1-3-n-butylphthalide group,the PC12 cell activity and reduced glutathione level in the D1-3-n-butylphthalide combined with ML385 treatment group were decreased(P＜0.05),the malondialdehyde level was increased(P＜0.05),and the expression of Nu-Nrf2 and T-Nrf2 proteins was decreased(P＜0.05).(3)These results demonstrate that D1-3-n-butylphthalide can inhibit oxidative stress and improve cell activity through the AKT/GSK-3β/Nrf2 signaling pathway,and has a protective effect on the Parkinson's cell model induced by N-methyl-4-phenylpyridinium iodide.

BACKGROUND: There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS: Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS: A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
Female ; Humans ; China/epidemiology* ; Cities ; Cold Temperature ; Hot Temperature ; Mortality ; Temperature ; Time Factors ; Middle Aged ; Male

Objective: The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying. Methods: A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ 2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender. Results: The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour ( r =0.16, 0.27, P <0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls ( β boy =0.17, t =11.13; β girl =0.07, t =4.11, P <0.01). Conclusions ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.

Objective:To observe the application of the controlled respiratory persistence monitor designed based on the principle of rhythmic temperature variations in artificial airways among different populations and in various artificial airways,and to discuss the feasibility and efficacy of monitoring controlled respiration persistence,and to provide a new method for the clinical respiratory monitoring.Methods:A total of 60 adult patients scheduled for general anesthesia,and 30 pediatric patients aged from 1 to 3 years old,classified as American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were selected.A total of 60 adult patients were randomly divided into adult tracheal intubation(ATI)group and adult laryngeal mask(ALM)group,and there were 30 cases in each group.Additionally,30 pediatric patients aged from 1 to 3 years old were regarded as pediatric tracheal intubation(CTI)group.After induction of general anesthesia,the patients in CTI and ATI groups were underwent tracheal intubation,while the patients in ALM group were given a laryngeal mask inserted and were connected to the anesthesia machine for mechanical ventilation.Whether or not the device could detect the respiratory rate(RR)of the patients in various groups was observed;the RR detected by the device and the frequency set on the anesthesia machine in various groups were compared.All the patients in three groups were simulated three common clinical scenarios of continuous respiration changes before surgery:disconnection of the breathing circuit,failure to switch from manual to mechanical control on the anesthesia machine,and slow air leakage in the breathing circuit.The ways to report the alert and start time of the atarm by the monitors were compared.Results:The controlled respiratory persistence monitor was able to detect the RR of the patients in three groups,and there was no significantly difference between the RR detected by the device and the frequency set on the anesthesia machine(P＞0.05).In the simulated scenarios of common respiratory persistence changes,all the patients in three groups received an artificial voice alarm signaling"Attention,breathing has stopped.",which was acknowledged.There was no significant difference in the start time of alarm of the controlled respiratory persistence monitor between ATI group and ALM group(P＞0.05).Compared with the start time of alarm of the patients in the same group across different scenarios,compared with slow air leakage in the breathing circuit,the start time to alarm for circuit disconnection and failure to switch from manual to mechanical control was shorter(P＜0.05).Conclusion:The clinical application of the controlled respiratory persistence monitor device designed based on the principle of detecting rhythmic temperature variations within artificial airways is feasible and effective in different populations and artificial airways.This device offers a new method for monitoring the respiratory continuity and ensuring the respiratory safety during surgery.

Objective:To analyze the drug-resistant gene loci of Mycoplasma pneumoniae (MP) using metagenomic next-generation sequencing (mNGS). Methods:From November 2022 to October 2023, 697 clinical samples (including sputum, alveolar lavage fluid and blood) of 686 children with Mycoplasma pneumoniae positive detected by mNGS were retrospectively analyzed. Samples were divided into intensive care unit (ICU) group and non-ICU group, Chi-square test was used to compare groups, and Mann-Kendall trend test was used to analyze the change trend of the detection rate of drug resistance gene loci over time. Results:Of the 697 samples, 164 were from the ICU group and 533 were from the non-ICU group. The detection rate of Mycoplasma pneumoniae resistance gene was 44.3% (309/697), and all detected drug-resistant gene loci of MP were A2063G. The detection rate of Mycoplasma pneumoniae in ICU group was 50.0% (82/164), and the detection rates of Mycoplasma pneumoniae resistance gene loci in sputum, alveolus lavage fluid and blood samples were 75.0% (18/24) and 48.4% (62/128), respectively. The detection rate in sputum was higher than alveolus lavage fluid samples ( χ2=5.72, P=0.017). The detection rate of Mycoplasma pneumoniae in non-ICU group was 42.6% (227/533), the detection rate of Mycoplasma pneumoniae resistance gene loci in sputum and alveolar lavage fluid was 40.0% (16/40), 44.3% (201/454), and no detection rate in blood samples (0/12). There was no significant difference in the detection rate of alveolar lavage fluid and sputum ( χ2=0.27, P=0.602). From November 2022 to October 2023, the detection rate of submitted samples showed an increasing trend month by month (overall: Z=3.99, ICU inspection group: Z=2.93, non-ICU group: Z=3.01, all P<0.01). Among the bacteria commonly detected with Mycoplasma pneumoniae, Streptococcus pneumoniae accounted for the highest proportion, the detection rate was 15.5% (108/697), and Epstein-Barr virus accounted for the highest proportion of 17.6% (123/697). Conclusions:From November 2022 to October 2023, the detection rate of Mycoplasma pneumoniae drug resistance gene loci showed an increasing trend. The detection rate of drug resistance gene loci in sputum samples of ICU group was higher than alveolus lavage fluid. No new drug resistance site were detected.

Objective:To investigate the status of fear of progression (FoP) in patients with esophageal gastric variceal bleeding (EGVB) due to liver cirrhosis and analyze its influencing factors.Methods:A convenience sampling method was used to select 210 patients with liver cirrhosis and EGVB who were hospitalized at Shanxi Bethune Hospital and Shanxi Provincial People's Hospital between May and December 2023. Data were collected using a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Medical Coping Modes Questionnaire (MCMQ), and the Perceived Social Support Scale (PSSS) .Results:A total of 210 questionnaires were distributed and 200 valid questionnaires were recovered, with a valid recovery rate of 95.24%. Among 200 EGVB patients, the FoP-Q-SF score was (31.82±10.02). Multiple linear regression analysis showed that gender, number of bleeding episodes, illness perception, coping strategies, and social support were significant influencing factors of FoP in these patients ( P<0.05) . Conclusions:The incidence of FoP is relatively high in patients with liver cirrhosis and EGVB. Healthcare providers should pay attention to the impact of gender, bleeding episodes, illness perception, coping strategies, and social support on FoP and implement targeted interventions to reduce its levels.