Rhegmatogenous retinal detachment(RRD)is a common blinding ophthalmic disease that has always received significant attention in clinical treatment. The foldable capsular buckle(FCB), as a new method for extraocular treatment of RRD, offers“Five Noes” advantages over traditional treatments such as scleral buckling(SB), pars plana vitrectomy(PPV), and pneumatic retinopexy(PR), including no retrobulbar anesthesia, no muscle traction, no scleral fluid release, no intraoperative positioning, and no cryotherapy. This effectively reduces postoperative complications in RRD patients and shortens the operation time. This review aims to investigate the development process and treatment principle of FCB, and focus on its therapeutic advantages, indication selection, efficacy and safety for RRD. It is expected to play a more important role in the treatment of a variety of retinal diseases through technological innovation and application field expansion.

With the emergence of high-throughput technology and massive toxicology data,toxicology research has entered the era of big data.How to efficiently integrate existingtoxicological data,clarify the toxic effects of chemicals,and use these patterns to providenew information,in order to achieve effi-cient prediction of the toxicity of new chemicalsubstances,is one of the cutting-edge issues in toxicology.In view of the high cost,low throughput and difficulty in revealing the mechanism information of tradi-tional chemical toxicity testing methods,high throughput prediction models are urgently needed.Machine learning methods have been applied to toxicity testing,such as supervised learning models,unsupervised learning models,deep learning models,reinforcement learning models,and transfer learning models.Chemical characteristic data commonly used in machine learning models include chemical structure data,text data,toxicological genome data and image data.There is huge potential for applying machine learning to toxicity testing and machine learning methods have made some prog-ress.However,current research focuses on the processing of data and development of models,which has failed to produce a widely used and accepted method.In addition,the prediction accuracy of machine learning models is not only dependent on algorithms,but also affected by data quality,and the mutual promotion and development of algorithms and data quality remains a big challenge.In short,data processing and model construction in the field of toxicology require interdisciplinary cooperation and technological innovation.With the increasing perfection of toxicology databases and the continuous optimization of various model algorithms,the toxicity prediction of new chemicals based on machine learning models will become increasingly efficient and accurate,playing an important role in ensuring human health and environmental safety.

BACKGROUND: Intensive systolic blood pressure (SBP) control improved outcomes in the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Whether baseline serum lipid parameters influence the benefits of intensive SBP control is unclear. METHODS: The STEP trial was a randomized controlled trial that compared the effects of intensive (SBP target of 110 to <130 mmHg) and standard (SBP target of 130 to <150 mmHg) SBP control in Chinese patients aged 60 to 80 years with hypertension. The primary outcome was a composite of cardiovascular disease events. A total of 8283 participants from the STEP study were included in this post hoc analysis to examine whether the effects of the SBP intervention differed by baseline low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) concentrations. RESULTS: Regardless of the randomized SBP intervention, baseline LDL-C and non-HDL-C concentrations had a J-shaped association with the hazard of the primary outcome. However, the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline LDL-C level ( P for interaction = 0.80) and non-HDL-C level ( P for interaction = 0.95). Adjusted subgroup analysis using tertiles in LDL-C1 (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.52-1.13; P = 0.18), LDL-C2 (HR, 0.81; 95% CI, 0.55-1.20; P = 0.29), and LDL-C3 (HR, 0.68; 95% CI, 0.47-0.98; P = 0.04) was provided, with an interaction P value of 0.49. Similar results were showed in non-HDL-C1 (HR, 0.87; 95% CI, 0.59-1.29; P = 0.49), non-HDL-C2 (HR, 0.70; 95% CI, 0.48-1.04; P = 0.08), and non-HDL-C3 (HR, 0.67; 95% CI, 0.47-0.95; P = 0.03), with an interaction P -value of 0.47. CONCLUSION: High baseline serum LDL-C and non-HDL-C concentrations were associated with increased risk of primary cardiovascular disease outcome, but there was no evidence that the benefit of the intensive SBP control differed by baseline LDL-C and non-HDL-C concentrations. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03015311.
Aged ; Humans ; Cardiovascular Diseases ; Blood Pressure/physiology* ; Cholesterol, LDL ; Hypertension ; Cholesterol ; Risk Factors

SIRT6 belongs to the conserved NAD⁺-dependent deacetylase superfamily and mediates multiple biological and pathological processes. Targeting SIRT6 by allosteric modulators represents a novel direction for therapeutics, which can overcome the selectivity problem caused by the structural similarity of orthosteric sites among deacetylases. Here, developing a reversed allosteric strategy AlloReverse, we identified a cryptic allosteric site, Pocket Z, which was only induced by the bi-directional allosteric signal triggered upon orthosteric binding of NAD⁺. Based on Pocket Z, we discovered an SIRT6 allosteric inhibitor named JYQ-42. JYQ-42 selectively targets SIRT6 among other histone deacetylases and effectively inhibits SIRT6 deacetylation, with an IC₅₀ of 2.33 μmol/L. JYQ-42 significantly suppresses SIRT6-mediated cancer cell migration and pro-inflammatory cytokine production. JYQ-42, to our knowledge, is the most potent and selective allosteric SIRT6 inhibitor. This study provides a novel strategy for allosteric drug design and will help in the challenging development of therapeutic agents that can selectively bind SIRT6.

Objective:To explore the effect of Internet + technical liaison service mode on the postoperative continuing nursing of elderly patients with osteoporotic hip fractures.Methods:A total of 92 elderly patients with osteoporotic hip fractures who were admitted into in Orthopaedics Department of the First Affiliated Hospital of Soochow University from July 2018 to December 2019 were selected, and randomly divided into intervention group and control group by random number table method, with 46 cases in each group. The control group was given routine follow-up outside hospital, while the intervention group was given the continuing nursing led by the orthopedic specialist nurses based on the Internet + Technology home orthopedic care platform. All patients were followed up to 6 months after operation, and the differences of Harris Hip Score (Harris), Numeric Rating Scales (NRS), Barthel Index, Short Form 36-item Health Survey (SF-36) between the two groups were compared.Results:The Harris scores were 49.74 ± 4.28, 76.59 ± 4.33 and 90.78 ± 2.61 in the intervention group, and 46.17 ± 3.85, 74.26 ± 4.24 and 88.65 ± 2.17 in the control group in 1, 3 and 6 months after operation, respectively. The differences were statistically significant ( t=-4.20, -2.60, -4.26, all P<0.05). The NRS scores in the intervention group were 1.33 ± 0.47, 0.83 ± 0.38 and 0.76±0.43 in 1, 3 and 6 months after operation respectively, while the NRS scores in the control group were 1.61 ± 0.54, 0.96 ± 0.42 and 0.84 ± 0.38, respectively. The difference in pain scores between the two groups was statistically significant only at 1 month after operation ( t=2.68, P<0.05). The Barthel Index in the intervention group were 61.74 ± 8.90, 93.80 ± 5.29 and 98.26 ± 2.83 in 1, 3 and 6 months after operation respectively, while those of the control group were 60.33 ± 5.81, 91.09 ± 7.52 and 97.83 ± 3.10, respectively. The difference in Barthel Index between the two groups was statistically significant only in 3 months after operation ( t=-2.00, P<0.05). The scores of SF-36 in the intervention group were 93.73 ± 3.89, 100.26 ± 3.77 and 107.50 ± 3.56 at 1, 3 and 6 months after operation respectively, while those of the control group were 92.67±3.42, 97.71±2.67 and 103.68±2.83, respectively. The difference in SF-36 scores between the two groups was statistically significant only at 3 and 6 months after operation ( t=-3.74, -5.71, P<0.05). Conclusions:The continuing nursing based on multi-disciplinary team cooperation in hospital + Internet + Technology home orthopaedic nursing platform led by orthopaedic specialist nurses can improve joint function, relieve pain and improve quality of life of elderly patients with osteoporotic hip fractures after operation.

Objective To evaluate the effect of of home-care orthopedic nursing platform in rehabilitation exercise of patients after knee replacement.Methods A total of 60 patients with knee joint replacement were randomly divided into experimental group (n =30) and control group (n =30).The control group adopted conventional nursing,while the experimental group was added home care platform for orthopedics.Joint function recovery (HSS score),quality of life score (SF-36) and daily living ability (Barthel index) between the two groups were compared on admission,and at 6 months after discharge.Results No statistical differences in culture and knowledge absorption and understanding ability were found between the two groups before intervention (P ＞ 0.05).After intervention,the score of knee function,quality of life and ability of daily living of the patients in the experimental group were significantly higher than that in the control group (P ＜ 0.01).Conclusion Home care platform of orthopedics provides a new extension nursing mode for patients after total knee arthroplasty.It is a scientific and reliable rehabilitation consultation platform,which significantly improves postoperative rehabilitation and quality of life.

Objective To evaluate the effect of of home-care orthopedic nursing platform in rehabilitation exercise of patients after knee replacement.Methods A total of 60 patients with knee joint replacement were randomly divided into experimental group (n =30) and control group (n =30).The control group adopted conventional nursing,while the experimental group was added home care platform for orthopedics.Joint function recovery (HSS score),quality of life score (SF-36) and daily living ability (Barthel index) between the two groups were compared on admission,and at 6 months after discharge.Results No statistical differences in culture and knowledge absorption and understanding ability were found between the two groups before intervention (P ＞ 0.05).After intervention,the score of knee function,quality of life and ability of daily living of the patients in the experimental group were significantly higher than that in the control group (P ＜ 0.01).Conclusion Home care platform of orthopedics provides a new extension nursing mode for patients after total knee arthroplasty.It is a scientific and reliable rehabilitation consultation platform,which significantly improves postoperative rehabilitation and quality of life.

Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method:McGrath-5 video-laryngoscope group (group A, n = 30) and McCoy laryngoscope group (group B, n = 30). All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 < 90% within intubation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction (T0), glottic exposure upon laryngoscope insertion (T1), immediately after intubation (T2), 3 min (T3) after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B (P < 0.05), whereas the intubation time in group A was significantly higher than that in group B (P < 0.05). The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at T0 in both groups (P < 0.05). The systolic pressure and heart rate at T1 and T2 in group A were considerably lower in group A than those in group B (P < 0.05). Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient's oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.