Objective To evaluate the efficacy of myopia progression control over a one-year period for defocus in-corporated multiple segments lenses(DIMS),peripheral defocus modifying(PDM)lenes and single vision spectacle lenses(SVL)in a real-world cohort.Methods A total of 188 cases in the DIMS group,116 cases in the PDM group,and 373 ca-ses in the SVL group,all diagnosed with refractive errors and aged 6-16 years,were enrolled in Department of Ophthal-mology,Fujian Provincial Hospital from July 2019 to June 2022.A 1∶1 propensity score matching(PSM)of covariates was used to balance factors between the groups.The changes in spherical equivalent(SE)and axial length(AL)in each patient before and 1 year after wearing glasses were compared without other interventions.The myopia control effects of different groups were compared through the changes in SE and AL.Results After PSM,92 cases were matched between DIMS group and PDM group,163 cases were matched between DIMS group and SVL group,and 99 cases were matched between PDM group and SVL group.The changes in SE and AL in the DIMS group were less than those in the PDM and SVL groups,with statistically significant differences(all P＜0.05).However,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).In the age subgroup analysis,in the younger age group(6～＜13)and the older age group(13～16)the changes in SE and AL in the DIMS group were less than those in the PDM group and SVL group,with statistically significant differences(all P＜0.05).In the younger age group,the changes in SE and AL in the PDM group were less than those in the SVL group,with statistically significant differences(all P＜0.05);while in older age group,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).Conclusion The myopia control efficacy of DIMS is superior to that of PDM and SVL.In younger children,the myopia control efficacy of PDM is superior to that of SVL.

Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

Objective:To analyze the patterns of change of brain function among civil pilots in prospective memory tasks by using task-state functional magnetic resonance imaging (fMRI) and a cue-based repetitive search task.Methods:A total of 85 subjects were enrolled, including 47 civil pilots (pilot group) and 38 ordinary workers (control group). The task-state fMRI data during the execution of the prospective memory task was analyzed using a general linear model to find out about the activation patterns of brain functions in the 2 groups in the 3 phases of encoding, maintenance, and retrieval of the prospective memory task. The differences in activation patterns between the 2 groups and correlations between regions of interest and the rate of accuracy, reaction time and flying hours were analyzed.Results:The repeated measurement analysis of variance showed that there were no interactions of reaction time or of the rate of accuracy between the task and grouping ( P>0.05), and that the difference in the main effect of grouping was significant ( F=5.67, 15.46, P=0.020, <0.001). The difference in the main effect of grouping on the rate of accuracy was significant ( F=5.42, P=0.022), and the rate of accuracy in the pilot group was higher than in the control group ( P=0.048). In the phase of encoding, the activation in the bilateral cerebellum, bilateral superior frontal gyrus, bilateral fusiform gyrus, and temporal lobe regions decreased in the pilot group compared with the control group ( t=2.68-4.13, all P<0.05), while the activation in the fusiform gyrus and the right parietal superior gyrus increased, and the differences were statistically significant ( t=3.28, 3.35, 3.02, P=0.038, 0.024, 0.042). During the phase of maintenance, the pilot group showed significantly reduced activation in the bilateral cerebellum, bilateral medial superior frontal gyrus, bilateral middle occipital gyri, and the right middle temporal gyrus compared with the control group ( t=2.24-3.36, P<0.05 or 0.01). In the retrieval phase, activation in the right peri-calcarine cortex, bilateral caudate nuclei, and bilateral precentral and postcentral gyri was enhanced in the pilot group compared with the control group ( t=2.57-3.35, all P<0.05), especially in the right middle frontal gyrus ( t=3.12, P=0.007). In the encoding phase, activation was increased in the left fusiform gyrus and right parietal superior gyrus of the pilot group, which was positively correlated with flying hours in the last 3 months ( r=0.347, 0.418, P=0.020, 0.005). Conclusions:Due to long-term flights, the way in which such regions as the frontal lobe, cerebellum, and default mode network are activated in civil pilots is likely to undergo some changes during prospective memory activities, which is why they have higher processing efficiency when performing prospective memory tasks.

Objective:To establish and validate a nomogram for postoperative disease progression (including recurrence, metastasis, and death) in patients with primary liver cancer (PLC) based on quantitative CT measurements of relevant indicators.Methods:Clinical data of 290 patients with PLC admitted to Zhongshan Hospital Affiliated to Fudan University and Kunshan Hospital Affiliated to Jiangsu University from January 2016 to December 2021 were retrospectively collected, including 177 males and 113 females, aged (60.3±11.9) years. Two hundred and three patients admitted to Zhongshan Hospital Affiliated to Fudan University were used as the training set, and 87 patients admitted to Kunshan Hospital Affiliated to Jiangsu University were used as the validation set. The patient's condition of ascites , tumor length, number of lesions, tumor differentiation degree, relevant indicators of quantitative CT detection (including decreased muscle mass and increased intra-abdominal fat area), prognosis and other clinical data were recorded. The influencing factors of postoperative disease progression was analyzed through multiple logistic regression in the training set, and the nomogram model was constructed based on the results of multiple factor analysis. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curves and calibration curves. The clinical applicability of predictive models was evaluated using the decision curve analysis.Results:The results of multiple logistic regression analysis showed that the increase in maximum tumor diameter ( OR=1.519, 95% CI: 1.251-1.843), multiple lesions ( OR=3.193, 95% CI: 1.493-6.830), low tumor differentiation ( OR=5.604, 95% CI: 2.442-12.863), ascites ( OR=3.321, 95% CI: 1.166-9.463), portal vein tumor thrombus ( OR=3.990, 95% CI: 1.681-9.474), decreased muscle mass ( OR=2.173, 95% CI: 1.051-4.492) and increased intra-abdominal fat area ( OR=2.634, 95% CI: 1.276-5.438) were independent risk factors for postoperative disease progression in patients with PLC (all P<0.05). A nomogram was constructed based on the above variables, and the area under the ROC curve for predicting postoperative disease progression in patients with PLC in the training set and validation set was 0.862 (95% CI: 0.810-0.914) and 0.879 (95% CI: 0.806-0.953), respectively. The calibration curve and ideal curve fit well, indicating that the predicted situation was basically consistent with the actual situation. Decision curve analysis showed that the column chart model had a high clinical net benefit and good clinical prediction effectiveness. Conclusion:The nomogram constructed based on the maximum diameter of the tumor, the number of lesions, the degree of tumor differentiation, ascites, portal vein tumor thrombus, decreased muscle mass, and increased intra-abdominal fat area has good predictive power for postoperative disease progression in patients with PLC.

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Schizophrenia is a prevalent mental-behavioral disorder characterized by perceptual disturbances,affective dysregulation,and behavioral abnormalities.In traditional Chinese medicine,it is classified under"manic depressive psychosis"according to its symptomatology.The concepts of"spirit,soul,and inferior spirit"originate from Lingshu·Benshen.Drawing on the concept of"spirit governs the soul and inferior spirit"from Lei Jing,this study explored schizophrenia pathogenesis and treatment from the perspective of the three-level regulation of spirit,soul,and inferior spirit.The core pathogenesis involves failure of spirit to govern as the root cause,disruption of soul homing as the pathodynamic process,and the loss of inferior spirit's somatic functional expression as the manifestation.The pathological locations are the heart,liver,and lungs.Therapeutic strategies are developed according to the pathological transmission pattern"spirit derangement,soul floating,inferior spirit dissipation,"forming a treatment system that emphasizes"calming the heart and tranquillization,restoring its control to solidify the root;suppressing the liver soul and regulating the central mechanism to pacify excess to stop mania;purifying the lungs and calming the inferior spirit to restore its clarity and regulate sensory perception and restore cognition."The treatment emphasizes the synergistic use of"calming the spirit,stabilizing the soul,and soothing the inferior spirit,"and combines acupuncture and repetitive transcranial magnetic stimulation and other treatments to treat both the manifestation and root cause of schizophrenia.Exploring the syndrome differentiation and treatment of schizophrenia from the perspective of spirit,soul,and inferior spirit,aiming to provide a theoretical basis for the treatment of schizophrenia with traditional Chinese medicine.

Objective: To establish a mouse model of lung injury induced by self-antigens and explore its pathological mechanisms to provide a reliable animal model for studying the pathogenesis of rheumatoid arthritis-associated interstitial lung disease(RA-ILD). Methods: The mice were injected intradermal with antigenemulsion made of complete freund′s adjuvant(CFA) and lung tissue protein, and the emulsion prepared with incomplete Freund′s adjuvant(IFA) was used to enhance immunity. HE staining was used to observe the histopathological changes in the mice. Masson staining was used to detect pulmonary fibrosis. The mRNA levels of rheumatoid factor(RF), krebs von den lungen-6(KL-6) and surfactant protein D(SP-D) were detected by qPCR. The levels of ACPA, IgG1, IgG2a and IgG3 antibodies were detected by ELISA. The changes of inflammatory cells and α-smooth muscle actin(α-SMA)expression in lung tissue were detected by immunofluorescence staining. The protein expression levels of Collagen I and α-SMA were detected by Western blot. The changes of immune cells were detected by flow cytometry. Results: HE staining showed that inflammatory cell infiltration increased and tissue structure changed significantly in lung tissue after the model was established by self-lung tissue antigen. Masson staining showed increased collagen deposition in lung tissue of model mice. qPCR tests revealed elevated mRNA levels of RF, KL-6 and SP-D. ELISA tests revealed elevated levels of ACPA, IgG1 and IgG3 antibodies. Immunofluorescence results showed that monocytes and T cells increased, and α-SMA expression increased in the model group. Western blot results showed increased protein expressions of Collagen Ⅰ and α-SMA. The flow cytometry results showed an increase in T cells and monocytes in the lung tissue. Conclusion The mouse model of lung injury induced by self-antigens is successfully established, and T cells and monocytes may be involved in the occurrence and progression of the disease.

Objective:To develop a scientific and practical questionnaire for general practice residents, and to conduct multidimensional and comprehensive evaluation of the quality of general practice teaching clinics.Methods:A preliminary draft of the questionnaire items was formulated based on a literature review and in-depth interviews. The Delphi method was employed to conduct two rounds of consultation with 14 experts. Following revisions, a convenience sampling method was used to invite general practice residents from three standardized residency training bases to test the reliability and validity of the questionnaire.Results:The questionnaire consisted of 23 items, covering the three dimensions of preparation, implementation process, and comprehensive evaluation of the teaching clinics. The response rates for the two rounds of the expert consultation were both 100.00%, with expert authority coefficients of 0.89 and 0.90, respectively. The overall Cronbach's α coefficient of the questionnaire was 0.93, and the correlation coefficients between each item score and the total score were all >0.30. Structural validity analysis revealed that three common factors were extracted from the questionnaire, with a cumulative variance contribution rate of 77.89%. Conclusions:The General Practice Teaching Clinic Quality Evaluation Questionnaire for Residents developed in this study demonstrates high reliability and validity. The questionnaire provides a scientific basis for the standardized assessment of teaching quality in general practice clinics. By incorporating resident feedback on the teaching process, the questionnaire promotes the development of a teaching clinic quality improvement mechanism focused on residents and plays a significant role in enhancing the teaching capabilities of supervising physicians in clinics.