AIM: To observe the clinical outcomes of Phorcides analytic engine-assisted topography-guided personalized laser assisted in situ keratomileusis(LASIK)for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from corneal topography.METHODS: Retrospective clinical study. A total of 32 cases(42 eyes)with myopia and astigmatism that received corneal topography-guided personalized LASIK in the Ophthalmology Refractive Surgery Center of the First Affiliated Hospital of Xi'an Jiaotong University from December 2019 to March 2021 were selected. The uncorrected distance visual acuity(UDVA), best corrected distance visual acuity(CDVA), refractive state and aberrations before and at 6 mo after surgery were recorded.RESULTS: There were 15 males and 17 females, with an age of 23.00(18.00, 29.25)years old; preoperative sphere was -5.75(-6.25, -4.00)D, and cylinder was -0.75(-1.38, -0.25)D. At 6 mo postoperatively, the UDVA exceeded the preoperative CDVA in 19 eyes(45%). The spherical equivalent(SEQ)of all eyes(100%)was -0.50 to +0.50 D at 6 mo postoperatively, and the postoperative SEQ of 23 eyes(55%)was -0.13 to +0.13 D. There were 33 eyes(79%)had a postoperative astigmatism ≤ 0.25 D, the target-induced astigmatism(TIA)was 0.94±0.96 D, and the surgically induced astigmatism(SIA)was 0.94±0.86 D, with no statistical significance between TIA and SIA(P>0.05). The astigmatism axial deviation ranged from -5° to +5° in 33 eyes(79%)at 6 mo postoperatively. Compared to pre-operation, the total higher-order aberrations and spherical aberrations within the central 6 mm diameter of the anterior corneal surface increased at 6 mo postoperatively(Z=-3.778, P<0.001; Z=-4.929, P<0.001); the postoperative coma aberrations had no change(Z=-1.763, P=0.078); the postoperative trefoil aberrations decreased(Z=-2.490, P=0.013). Compared to pre-operation, the Strehl ratio of the anterior corneal surface increased significantly at 6 mo after surgeries(t=-5.401, P=0.013).CONCLUSION: Using the Phorcides analytic engine to assist topography-guided personalized LASIK for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from topography-measured astigmatism can achieve good therapeutic effects. Postoperative UDVA exceeded preoperative CDVA in nearly half of the eyes, and the quality of postoperative corneal imaging was improved.

Objective To investigate the distribution and evolutionary patterns of traditional Chinese medicine(TCM)syndromes and syndrome elements during the malignant transformation from chronic pancreatitis(CP)to pancreatic intraepithelial neoplasia(Pan IN)and pancreatic ductal adenocarcinoma(PDAC).Methods A retrospective analysis was conducted on 710 patients(330 of CP,104 of Pan IN,276 of PDAC)diagnosed pathologically or clinically at Shanxi Institute of Traditional Chinese Medicine from January 2021 to June 2024.Data including demographics,laboratory results,and TCM diagnostic information were recorded using EpiData 3.1.Syndrome and syndrome-element patterns were determined via factor analysis and K-means clustering using SPSS 27.0.Results The study identifies seven TCM syndrome types in CP,Pan IN,and PDAC.Among CP patients,the syndrome distribution was primarily liver-gallbladder damp-heat syndrome(22.42％)and gastrointestinal excess-heat syndrome(20.91％),with excess syndromes accounting for a higher proportion(43.33％);the syndrome elements were mainly heat(51.52％)and dampness(35.15％),with the disease location in the pancreas,related to the liver,spleen,and stomach.In Pan IN patients,the syndrome distribution was mainly spleen deficiency with dampness obstruction(23.08％)and liver-gallbladder damp-heat syndrome(17.31％),with mixed deficiency-excess syndrome accounting for a higher proportion(30.00％);the syndrome elements were mainly heat(41.35％),dampness(40.38％),and qi deficiency(37.50％),with the disease location in the pancreas,related to the spleen and liver.In PDAC patients,the syndrome distribution was mainly spleen deficiency with dampness obstruction(29.71％)and qi-blood deficiency syndrome(20.29％),with deficiency syndromes accounting for a higher proportion(49.82％);the syndrome elements were mainly qi deficiency(50.00％)and dampness(36.23％),with the disease location in the pancreas,related to the spleen,kidney,and liver.Chi-square tests revealed significant differences in syndrome types(TCM syndromes:x2=100.419,P＜0.001;deficiency-excess syndromes:x2=73.722,P＜0.001),syndrome elements(x2=117.384,P＜0.001),and disease locations(x2=127.191,P＜0.001)across different stages of CP malignant transformation.During CP malignant progression,the proportion of excess syndromes gradually decreased(43.33％→12.32％),while deficiency syndromes increased(26.67％→49.82％).Excess syndrome elements(fire,heat,qi stagnation,blood stasis)decreased(53.48％→25.36％),whereas deficiency syndrome elements(qi deficiency,yin deficiency,yang deficiency,blood deficiency)increased(25.15％→49.64％).The disease location shifted from primarily the liver,spleen,and stomach in the inflammatory stage to the spleen and kidney in the cancerous stage.Conclusion The malignant transformation of CP basically involves the pancreas,is correlated early with liver and spleen-stomach and later with kidney,and exhibits a progression from excess to deficiency in the pattern of"deficiency interweaved with excess syndrome,transition from excess to deficiency,and progressive spleen deficiency".

As a type of experiential psychotherapy,Satir communication model can help the individual system and the family system achieve a state from dysfunction to healthy function,which can enrich the intervention connotation of family support and provide a new direction for the realization of full-life circle care.This paper aims to introduce the concept,core elements,common treatment techniques,application and effects,current challenges and relevant suggestions of Satir communication model in the nursing field from the perspective of family support,in order to provide references for the localization development and clinical integration of Satir communication model in the field of nursing in China.

Objective:To establish the myocardial ischemia-reperfusion injury (MIRI) model by ligation of the left ventricular branch of coronary artery in rabbits.Methods:Totally 36 New Zealand white rabbits were randomly divided into 3 groups according to the random number table method, including the sham group ( n=6), the model group ( n=15), and the sustained ischemia group ( n=15). The rabbits were placed under general anesthesia, then endotracheal intubation and common carotid artery intubation were performed. The intercostal muscle between the 3rd and 4th ribs of the left thorax was divided with the aid of a ventilator. The left ventricular branch was located and processed according to the different groups. After successful modeling, the gross morphological change of the heart was observed by naked eye, and the survival rate and modeling success rate of rabbits in each group were calculated respectively. Record the waveform of limb lead Ⅱ electrocardiogram before left ventricular branch ligation (N), 45 minutes of ischemia (I45), 15 minutes of reperfusion (R15), 30 minutes of reperfusion (R30), and 60 minutes of reperfusion (R60). Serum cardiac troponin Ⅰ (cTnⅠ) level was detected by enzyme-linked immunosorbent assay (ELISA), myocardial infarct size ratio was detected by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining, and the change of myocardial tissue changes were detected by hematoxylin-eosin (HE) staining. Results:The survival rate of the rabbits was 93.33% (14/15) in the model group, and the success rate of MIRI modeling was 86.67% (13/15). In the model group, the ST segment (5.00±0.71) mm at I45 was higher than that before the ligation (1.20±0.27) mm, the difference was statistically significant ( P<0.01), and it was stable throughout the whole ischemia period. After ligation removal, the ST segment decreased to (3.00±0.61) mm at R15, (2.20±0.45) mm at R30, and (1.30±0.27) mm at R60. There were statistically significant differences between I45 and N, R15 and I45, and R60 and R15 (all P<0.01). The pathological Q-wave was (1.60±0.55) mm at R15, and decreased to (3.60±0.22 and 5.10±0.22) mm at R30 and R60, respectively. There were statistically significant differences between R30 and R15, R60 and R30, and R60 and R15 (all P<0.01). ST segment (6.10±0.42, 5.80±0.45, 5.60±0.22, and 5.30±0.27) mm at I45, I60, I75 and I105 respectively were higher than the ST segment (1.10±0.22) mm at N in the sustained ischemia group, and the differences were statistically significant (all P<0.01). The serum cTnⅠlevels in the model group at N, I45, R30 and R60 were (62.74±1.60, 97.60±6.36, 159.30±17.64, and 166.40±18.56) ng/L, respectively, and the difference between I45 and N was statistically significant ( P<0.05). There were statistically significant differences between R30 and I45, R60 and I45, and R30 and N (all P<0.01). The serum cTnⅠlevels in the sustained ischemia group were (69.00±4.85, 107.90±7.12, 140.60±10.96, 171.00±15.40) ng/L at N, I45, I75 and I105, respectively. There were statistically significant differences between I45 and N, I75 and I45, and I105 and I75 (all P<0.01). The infarct size ratios of the model group and the sustained ischemia group were 39.93% and (52.16±0.06) %, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The method of establishing a MIRI model by ligating the left ventricular branch of the coronary artery in rabbits is simple to operate, with stable and reliable, and the success rate of modeling is high.

Oral hydroxycamptothecin nanosuspension (HCPT-Nano) with high supersaturated dissolution level, high permeation and well physical stability, was manufactured by microprecipitation-high press homogenization method. Its pharmaceutical properties were investigated, such as size and distribution, zeta potential, particle shape, physical existence condition, supersaturated dissolution level and so on. Particle size was measured by laser diffraction, and the mean diameters before and after lyophilization were 138 +/- 11.72 nm and 175 +/- 12.74 nm, respectively, for HCPT-Nano. Zeta potentials of HCPT-Nano was over -20 mV. The nanoparticles, being observed by transmission electron microscopy (TEM), were claviform or column in shape. DSC and X-ray diffraction revealed that HCPT existed in the form of crystal for HCPT-Nano. And HCPT-Nano could maintain higher supersaturated dissolution level for long time. So it supplied the possibility of improving oral bioavailability of HCPT when combining together admoveatur of P-gp inhibitor, CsA.