AIM: To evaluate the postoperative clinical efficacy of non-diffractive extended depth of focus intraocular lens(EDOF IOL)in patients with highly myopic cataract(HMC).METHODS:A retrospective analysis was conducted on the clinical data of patients diagnosed with HMC at the hospital from January 2022 to December 2024. Patients were divided into an observation group [undergoing femtosecond laser-assisted cataract surgery(FLACS)combined with non-diffractive EDOF IOL implantation] and a control group(undergoing FLACS combined with aspheric monofocal IOL implantation)according to the type of implanted IOL. Postoperative visual acuity(LogMAR), visual quality, and patient satisfaction were compared between the two groups.RESULTS: A total of 33 patients(47 eyes)were finally included in this study, including 10 patients(17 eyes)in the observation group and 23 patients(30 eyes)in the control group. The observation group had a median age of 59.0(52.8, 63.8)y, with 8 males(13 eyes)and 2 females(4 eyes). The control group had a median age of 56.0(53.5, 60.0)y, with 13 males(17 eyes)and 10 females(13 eyes). At 3 mo postoperatively, the best-corrected distance visual acuity(BCDVA)was 0.10(0.08, 0.12)in the observation group and 0.20(0.10, 0.40)in the control group(P=0.586). However, the best-corrected intermediate visual acuity(BCIVA)[0.10(0.10, 0.10)vs 0.50(0.40, 0.90), P=0.032] and best-corrected near visual acuity(BCNVA)[0.20(0.18, 0.20)vs 0.60(0.45, 1.45), P=0.044] in the observation group were significantly better than those in the control group. The defocus curve showed that the uncorrected visual acuity(UCVA)in the observation group was relatively stable within the range of -2.00 to +1.00 D, which was superior to that in the control group. Postoperative questionnaires showed that the spectacle independence rate(76%)and overall satisfaction(88%)in the observation group were significantly higher than those in the control group(10% and 60%, respectively).CONCLUSION: Non-diffractive EDOF IOL significantly improves intermediate and near visual acuity, reduces spectacle dependence, and maintains distance visual acuity by extending the depth of focus, providing better postoperative visual quality and life satisfaction for HMC patients.

Objective: To analyze the independent and interaction effects of daytime outdoor light exposure and moderate to vigorous physical activity (MVPA) duration on sleep quality of primary school students, so as to provide scientific evidence for interventions on children s sleep health. Methods: From April to June 2024, a total of 444 students from grades 3 and 4 in 2 primary schools in Jiading District, Shanghai were selected using stratified random cluster sampling method for continuous 7 day monitoring. Wearable devices "Clouclip" were used to monitor daytime outdoor activity time (represented by time with light intensity ≥ 1 000 lx ), and accelerometers were used to monitor MVPA time and sleep quality related indicators. Multiple linear regression was used to analyze the associations of daytime outdoor activity and MVPA with sleep quality. Results: Both daytime outdoor light exposure and MVPA duration(longer actual sleep duration per night,longer time in bed,fewer awakening and shorter post sleep awakening shic) were independently associated with multiple sleep indicators( β =0.52, 0.46, -0.83, -2.19, all P <0.05), with no significant interaction between the associations ( P >0.05). After controlling for MVPA, more daytime outdoor light exposure was significantly and independently associated with longer actual sleep time ( β =0.50, 95% CI =0.21-0.79, P <0.05). After controlling for light exposure, longer MVPA duration was independently associated with shorter post-sleep awakening duration ( β=-4.15, 95% CI = -6.33 to -1.96, P <0.05). Conclusion Increased daytime outdoor activity and MVPA are both associated with better sleep quality in primary school students.

Objective: To investigate the current status of benefit finding among young and middle-aged patients with type 2 diabetes mellitus (T2DM) and analyze its influencing factors, so as to provide a reference for improving the level of benefit finding in this population. Methods: From November 2022 to May 2023, young and middle-aged patients with T2DM aged 18-59 years hospitalized in the endocrinology departments of 2 tertiary hospitals in Hengyang City, Hunan Province were selected as survey subjects by a convenience sampling method. Basic demographic information was collected using a general questionnaire survey. Benefit finding, resourcefulness, and stigma were evaluated using the Benefit Finding Scale, the Chinese Version of the Resourcefulness Scale, and the Type 2 Diabetes Stigma Assessment Scale, respectively. A multiple linear regression model was used to analyze the influencing factors of benefit finding among young and middle-aged patients with T2DM. Results: A total of 305 young and middle-aged patients with T2DM were investigated, including 222 males (72.79%) and 83 females (27.21%). There were 231 cases aged 45-59 years, accounting for 75.74%. The scores for benefit finding, resourcefulness, and stigma were (42.86±6.06), (75.12±11.30), and (41.20±10.10), respectively. Multiple linear regression analysis showed that young and middle-aged patients with T2DM who were male (β′=0.088), aged 18-<45 years (β′=0.083), absence of diabetes complications (β′=0.124), and had higher resourcefulness scores (β′=0.679) had higher levels of benefit finding, while patients with higher stigma scores (β′=-0.097) had lower levels of benefit finding. Conclusion The level of benefit finding among young and middle-aged patients with T2DM was moderate, and was related to gender, age, diabetes complications, resourcefulness, and stigma.

Objective To explore the supportive care needs of heart transplant patients at different stages.Methods Purposive sampling method was used to select 15 heart transplant patients who were hospitalized in a tertiary A hospital in Guangdong Province from July 2023 to February 2024 as research subjects.According to the"Timing It Right"theory,5 semi-structured interviews were conducted with patients.Interpretive phenomenology was used to sort out and analyze the data.Results A total of 5 themes and 18 subthemes were extracted,including urgent desire for transplant information and psychological support during diagnosis,strong physiological and emotional needs during hospitalization,significant demand for health education in the preparation period for discharge,expectation of family support during the adjustment period,increasing demand for social support during the adaptation period.Conclusion The supportive care needs of heart transplant patients at different stages are dynamic.Medical staff should adopt the concept of dynamic and continuous care,and provide personalized care in stages,plans and continuance,in order to improve the quality of life of heart transplant patients.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Objective To explore the supportive care needs of heart transplant patients at different stages.Methods Purposive sampling method was used to select 15 heart transplant patients who were hospitalized in a tertiary A hospital in Guangdong Province from July 2023 to February 2024 as research subjects.According to the"Timing It Right"theory,5 semi-structured interviews were conducted with patients.Interpretive phenomenology was used to sort out and analyze the data.Results A total of 5 themes and 18 subthemes were extracted,including urgent desire for transplant information and psychological support during diagnosis,strong physiological and emotional needs during hospitalization,significant demand for health education in the preparation period for discharge,expectation of family support during the adjustment period,increasing demand for social support during the adaptation period.Conclusion The supportive care needs of heart transplant patients at different stages are dynamic.Medical staff should adopt the concept of dynamic and continuous care,and provide personalized care in stages,plans and continuance,in order to improve the quality of life of heart transplant patients.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Objective To compare the efficacy of tegoprazan and esomeprazole in treatment of reflux esophagitis(RE)and analyze the influencing factors for treatment failure.Methods A total of 120 RE patients were selected as study subjects and divided into control group(treated with esome-prazole)and observation group(treated with tegoprazan)using random number table method,with 60 cases in each group.The clinical efficacy and gastroscopic efficacy of the two groups were com-pared.Based on the gastroscopic assessment results,the patients were divided into failure group(26 cases)and success group(94 cases).The clinical data of the failure group and the success group were collected and compared.Multivariate Logistic regression analysis was used to screen the influen-cing factors for treatment failure in RE patients.Results The total clinical effective rate in the ob-servation group was 93.33％(56/60),which was higher than 76.67％(46/60)in the control group(P＜0.05).The total effective rate under gastroscopy in the observation group was 88.33％(53/60),which was higher than 68.33％(41/60)in the control group,and the difference was statistically significant(P＜0.05).The proportions of patients with body mass index(BMI)＞28 kg/m2,diabe-tes,a family history,Helicobacter pylori(Hp)infection,Los Angeles classification(LA classifica-tion)of gastroesophageal reflux disease(GERD)grade C to D,and treated with esomeprazole in the failure group were all higher than those in the success group,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that BMI＞28 kg/m2,con-comitant diabetes,LA classification grade C to D,and treatment with esomeprazole were all inde-pendent risk factors for treatment failure in RE patients(P＜0.05).Conclusion Tegoprazan has a significant clinical effect in treatment of RE,and its efficacy is superior to that of esomeprazole.BMI＞28 kg/m2,concomitant diabetes,LA classification grade C to D,and treatment with esome-prazole are all risk factors for treatment failure in RE patients.

Objective:To investigate the temporal expression of Growth Differentiation Factor-15 (GDF15) in the serum of patients with Acute Coronary Syndrome (ACS) and explore the clinical significance of GDF15 in protecting cardiomyocytes in ACS.Methods:A retrospective study was conducted on 289 ACS patients admitted to the emergency departments from February to October 2023. Data on gender, age, troponin T (TnT), creatine kinase isoenzyme (CK-MB), GDF15, and B-type natriuretic peptide (BNP) within 30 minutes of admission were recorded. Differences in these indicators among different groups were compared. Receiver Operating Characteristic (ROC) curves were plotted to evaluate the diagnostic value of GDF15, TnT, and BNP for ACS. Among the patients, 15 exhibited a temporal expression pattern of GDF15, and their blood samples were re-measured using a GDF15 fluorescent quantitative immunochromatographic assay kit. Fifteen patients without temporal expression were randomly selected as controls, and their samples were also re-measured to exclude detection errors. Fifteen patients with temporal expression were included in the temporal expression group, and 15 without temporal expression were included in the non-temporal expression group. Laboratory indicators such as fasting blood glucose, glycated hemoglobin, triglycerides, creatinine, and uric acid were compared between the groups. Additionally, patient age, gender, body mass index (BMI), coronary angiography results, echocardiography, Gensini score, left ventricular ejection fraction (LVEF), and GRACE risk score were recorded to assess their correlation with GDF15 temporal expression. Statistical analysis was performed using SPSS 27 software, with continuous data expressed as mean ± standard deviation (Mean ± SD) and compared using t-tests and χ2 tests. Results:The overall trend in ACS patients showed a higher proportion of males than females (73.36% vs. 26.64%). The oldest group was the Unstable Angina (UA) group, with a mean age of (63.98 ± 15.19) years, while the youngest group was the non-ACS chest pain group, with a mean age of (54.29 ± 16.39) years. A higher proportion of patients in the UA, ST-segment elevation myocardial infarction (STEMI), and non-ST-segment elevation myocardial infarction (NSTEMI) groups had a history of smoking. The combination of GDF15 and TnT showed high diagnostic value for ACS, with an area under the ROC curve (AUC) of 0.843, consistent with previous studies. Among all ACS patients, 15 exhibited a temporal expression pattern of GDF15, where GDF15 levels peaked at 4 hours, gradually decreased, and peaked again at 24 hours. Patients in the temporal expression group had higher LVEF and left ventricular end-systolic diameter compared to the non-temporal expression group. The Gensini score was lower in the temporal expression group, and the GRACE risk score was significantly lower in the temporal expression group (00.7±14.72) compared to the non-temporal expression group (116.1±23.46), with a statistically significant difference ( P = 0.0115). There were no significant differences in general characteristics (age, gender, BMI) or clinical biochemical indicators (fasting blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, creatinine, uric acid) between the temporal and non-temporal expression groups ( P > 0.05). Conclusions:GDF15 demonstrates significant diagnostic and prognostic predictive value in ACS. Patients with temporally dynamic expression of serum GDF15 exhibit milder myocardial injury and a lower probability of mortality. These findings provide novel therapeutic targets and research directions for further exploring the role of GDF15 in ACS management.