The corneal epithelium, an essential refractive interface, plays an integral role in the corneal healing after corneal refractive surgery. All existing corneal refractive surgeries entail a degree of corneal epithelial remodeling; however, excessive epithelial remodeling precipitates adverse outcomes on the refractive correction efficacy of such surgeries. This review summarizes the application of corneal epithelial remodeling in the corneal refractive surgery, and more comprehensively investigates the influencing factors of perioperative epithelial remodeling after corneal refractive surgery, with a view to augmenting the safety, efficacy, predictability, and stability of corneal refractive surgical outcomes.

Within traditional teaching models,students frequently assume a passive role in acquiring knowledge,potentially resulting in diminished motivation and limited engagement,particularly within the realm of Medical Immunology education.The inte-gration of role-playing,informed by constructivist learning theory,situated learning theory,and multiple intelligences theory,has demonstrated encouraging outcomes within clinical medical education settings.However,the extent to which this approach has been explored within the context of Immunology instruction remains insufficiently examined.This study investigates the utilization of role-playing as a pedagogical approach in Medical Immunology education,wherein students are assigned specific scenarios to simulate the functions of various immune components.The primary objective is to augment interactivity and the overall appeal of the learning pro-cess.Efficacy of this instructional method was evaluated through in-class quizzes,surveys,and performance analysis.The findings demonstrate that role-playing substantially enhances student engagement,comprehension,knowledge retention,and examination per-formance.In practical application,the integration of role-playing with ideological and political elements has the potential to enhance learning outcomes and foster students'enthusiasm for engaging in cutting-edge literature and immunological research.This approach also necessitates greater proficiency in teachers'professional competencies and organizational skills,as well as increased allocation of class time and spatial resources.Future research should investigate the applicability of role-playing across various educational levels and examine its potential integration with classroom ideological and political education.

Objective To investigate the comparative effect of different spinal traction therapy on the treat-ment of degenerative lumbar spondylolisthesis based on the change of lumbosacral and pelvic sagittal position parameters.Methods The clinical data of 108 patients with degenerative lumbar spondylolisthesis admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2022 to January 2024 were selected for retrospective analysis,and they were divided into the three-dimensional group(n=55)and the four-dimensional group(n=53)according to the difference in treatment methods.The four dimensional group received four dimen-sional traction combined with basic treatment,and the three dimensional group received three dimensional traction combined with basic treatment.Lumbosacral pelvis sagittal position parameters,vertebral glide reduction degree,lumbar curvature value,coronal Cobb Angle of lumbar spine,lumbar function,pain degree and clinical efficacy were compared between the two groups.Results At the end of treatment and 3 months after treatment,the levels of sacral inclination Angle(SS)and lumbar lordosis Angle(LL)in 3D and 4D groups were lower than before treat-ment,and at 3 months after treatment were lower than at the end of treatment(P＜0.05).At the end of treatment,SS and LL levels in 3D group were lower than those in 4D group(P＜0.05),while there was no difference in SS and LL levels between the two groups at 3 months after treatment(P＞0.05).The lumbar lordotic index and coro-nal Cobb Angle of both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,the lumbar lordotic index and coronal Cobb Angle of both groups were lower than at the end of treatment(P＜0.05).At the end of treatment,the lumbar protrusion index and coronal Cobb Angle in the three-dimensional group were lower than those in the four-dimensional group(P＜0.05).At the end of treatment and 3 months after treatment,the distance of lumbar arch top in both groups was higher than before treatment(P＜0.05),and at 3 months after treatment,the distance of lumbar arch top in both groups was higher than at the end of treatment(P＜0.05).At the end of treatment,the distance of lumbar arch in the three-dimensional group was higher than that in the four-dimensional group(P＜0.05).At 3 months after treatment,there were no significant differences in lumbar lordo-sis index,coronal Cobb Angle of lumbar spine and distance between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,visual analogue pain scale(VAS)scores in both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,VAS scores in both groups were lower than at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,the Japanese Orthopaedic Asso-ciation evaluated treatment score(JOA)in both groups was higher than that before treatment(P＜0.05),and at 3 months after treatment,the JOA score in both groups was higher than that at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,there was no significant difference in JOA score and VAS score between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,there was no difference in the reduction rate of vertebral slippage between the two groups(P＞0.05).There was no difference in total effec-tive rate between the two groups(P＞0.05).Conclusion Four dimensional traction and three dimensional traction combined with basic treatment of degenerative lumbar spondylolisthesis have the same efficacy,both can effectively reduce pain and improve lumbar function,but three dimensional traction is better in improving lumbar function and lumbosacral pelvic sagittal position parameters,and correcting lumbar curvature abnormalities.

Objective To investigate the comparative effect of different spinal traction therapy on the treat-ment of degenerative lumbar spondylolisthesis based on the change of lumbosacral and pelvic sagittal position parameters.Methods The clinical data of 108 patients with degenerative lumbar spondylolisthesis admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2022 to January 2024 were selected for retrospective analysis,and they were divided into the three-dimensional group(n=55)and the four-dimensional group(n=53)according to the difference in treatment methods.The four dimensional group received four dimen-sional traction combined with basic treatment,and the three dimensional group received three dimensional traction combined with basic treatment.Lumbosacral pelvis sagittal position parameters,vertebral glide reduction degree,lumbar curvature value,coronal Cobb Angle of lumbar spine,lumbar function,pain degree and clinical efficacy were compared between the two groups.Results At the end of treatment and 3 months after treatment,the levels of sacral inclination Angle(SS)and lumbar lordosis Angle(LL)in 3D and 4D groups were lower than before treat-ment,and at 3 months after treatment were lower than at the end of treatment(P＜0.05).At the end of treatment,SS and LL levels in 3D group were lower than those in 4D group(P＜0.05),while there was no difference in SS and LL levels between the two groups at 3 months after treatment(P＞0.05).The lumbar lordotic index and coro-nal Cobb Angle of both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,the lumbar lordotic index and coronal Cobb Angle of both groups were lower than at the end of treatment(P＜0.05).At the end of treatment,the lumbar protrusion index and coronal Cobb Angle in the three-dimensional group were lower than those in the four-dimensional group(P＜0.05).At the end of treatment and 3 months after treatment,the distance of lumbar arch top in both groups was higher than before treatment(P＜0.05),and at 3 months after treatment,the distance of lumbar arch top in both groups was higher than at the end of treatment(P＜0.05).At the end of treatment,the distance of lumbar arch in the three-dimensional group was higher than that in the four-dimensional group(P＜0.05).At 3 months after treatment,there were no significant differences in lumbar lordo-sis index,coronal Cobb Angle of lumbar spine and distance between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,visual analogue pain scale(VAS)scores in both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,VAS scores in both groups were lower than at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,the Japanese Orthopaedic Asso-ciation evaluated treatment score(JOA)in both groups was higher than that before treatment(P＜0.05),and at 3 months after treatment,the JOA score in both groups was higher than that at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,there was no significant difference in JOA score and VAS score between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,there was no difference in the reduction rate of vertebral slippage between the two groups(P＞0.05).There was no difference in total effec-tive rate between the two groups(P＞0.05).Conclusion Four dimensional traction and three dimensional traction combined with basic treatment of degenerative lumbar spondylolisthesis have the same efficacy,both can effectively reduce pain and improve lumbar function,but three dimensional traction is better in improving lumbar function and lumbosacral pelvic sagittal position parameters,and correcting lumbar curvature abnormalities.

OBJECTIVES: This study evaluated the prognostic power of serum uric acid (UA) in predicting adverse events in elderly acute coronary syndrome (ACS) patients with diabetes mellitus (DM). METHODS: The analysis involved 718 ACS patients ‍>80 years old whose general clinical data and baseline blood biochemical indicators were collected prospectively from January 2006 to December 2012. These patients were classified into two groups based on DM status, and then followed up after discharge. The Kaplan-Meier method was used for major adverse cardiac event (MACE) rates and all-cause mortality. Multivariate Cox regression was performed to analyze the relationship between UA level and long-term clinical prognosis. Receiver operating characteristic (ROC) curves were analyzed to predict the cutoff value of UA in elderly ACS patients with DM. There were 242 and 476 patients in the DM and non-DM (NDM) groups, respectively, and the follow-up time after discharge was 40‒120 months (median, 63 months; interquartile range, 51‒74 months). RESULTS: The all-cause mortality, cardiac mortality, and MACE rates in both DM and NDM patients were higher than those in the control group ( CONCLUSIONS Serum UA level is a strong independent predictor of long-term all-cause death and MACE in elderly ACS patients with DM.

Objective:To discuss the pathogenesis, clinical manifestations, diagnosis and treatment of cervical endometriosis with adenomyosis.Methods:The clinical data, diagnosis and treatment of the deep cervical endometriosis patient with adenomyosis who was collected in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University in May 2020 were analyzed, and the related literatures were reviewed systematically.Results:The patient had no obvious clinical symptoms. Cervical endometriosis cyst was of deep type. Laparoscopic hysterectomy was performed and the prognosis was good.Conclusion:The pathogenesis of cervical endometriosis is not clear, the lack of specific clinical manifestations, treatment methods have not formed a consensus. Hysterectomy may be considered for patients with deep type if no fertility requirement or other uterine lesions are present.

Objective:To discuss the pathogenesis, clinical manifestations, diagnosis and treatment of cervical endometriosis with adenomyosis.Methods:The clinical data, diagnosis and treatment of the deep cervical endometriosis patient with adenomyosis who was collected in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University in May 2020 were analyzed, and the related literatures were reviewed systematically.Results:The patient had no obvious clinical symptoms. Cervical endometriosis cyst was of deep type. Laparoscopic hysterectomy was performed and the prognosis was good.Conclusion:The pathogenesis of cervical endometriosis is not clear, the lack of specific clinical manifestations, treatment methods have not formed a consensus. Hysterectomy may be considered for patients with deep type if no fertility requirement or other uterine lesions are present.

Objective:To investigate the effect of somatostatin on portal vein diameter and biochemical parameters in decompensated cirrhosis with upper gastrointestinal bleeding.Methods:From January 2018 to January 2019, 90 patients with decompensated cirrhosis complicated with upper gastrointestinal bleeding admitted to the gastroenterology department of the Second People's Hospital of Changzhi were selected, and they were divided into two groups according to the random digital table method.The control group(45 cases)was treated with pantoprazole + thrombin, and the observation group(45 cases)was treated with somatostatin on the basis of the control group.The two groups were compared in terms of efficacy, portal vein diameter before and after treatment, biochemical indicators[interleukin-6(IL-6), hypersensitive C-reactive protein(hs-CRP), and procalcitonin(PCT)].Results:The effective rate of the observation group was higher than that of the control group(82.22% vs.62.22%), the difference was statistically significant(χ 2=4.486, P<0.05). After treatment, the anterior and posterior diameter of portal vein in the observation group[(1.12±0.23)cm] was significantly shorter than that in the control group[(1.22±0.22)cm], the difference was statistically significant( t=2.107, P<0.05). The serum levels of IL-6, hs-CRP and PCT were significantly decreased in both two groups after treatment(all P<0.05). The serum levels of IL-6, hs-CRP and PCT in the observation group were(10.32±3.69)ng/L, (13.35±5.46)mg/L, (5.26±1.47)μg/L, which were significantly lower than those in the control group [(15.32±5.69)ng/L, (19.35±7.51)mg/L, (9.45±3.02)μg/L], the differences were statistically significant( t=6.807, 8.433, 10.566, all P<0.05). Conclusion:Somatostatin is effective in the treatment of decompensated cirrhosis with upper gastrointestinal bleeding, which can reduce portal vein dilatation and serum inflammatory factor levels.Somatostatin is effective in the treatment of decompensated cirrhosis with upper gastrointestinal bleeding, which can reduce portal vein dilatation and serum inflammatory factor levels.

Objective To compare the sensitivity and specificity of dot immunogold method (DIM) and particle agglutination (PA) for the diagnosis of mycoplasma pneumoniae (MP) infection. Methods The 190 serum specimens of 113 children with mycoplasmal pneumonia (infection group) and 50 serum specimens of 50 health children (health group) were tested for MP by PA and DIM- A and B. Results In infection group, the positive rates of DIM- A and B were 82.63% (157/190) and 84.74%(161/190), and there was no statistical difference (χ2 = 0.31, P>0.05); the positive rate of PA (titer ≥1:160) was 70.00%(133/190), the positive rate of PA was significantly lower than that in DIM-A and B, and there were statistical differences (P<0.05). In infection group, with the increase of PA titer, the positive rate of DIM was gradually increased, and there was a correlation between 2 methods (rA=0.972, rB=0.830);the positive rates of DIM- A and B in serum specimens of PA negative were 40.62%(13/32) and 53.12%(17/32), and in the PA titer of 1:5120, there was still a negative result in DIM. In health group, the positive rates of DIM-A and B were 26.00% (13/50) and 28.00% (14/50), and there was no statistical difference (χ2 = 0.66, P>0.05); the positive of PA was 8.00% (4/50), the positive rate of PA was significantly lower than that in DIM- A and B, and there were statistical differences (P<0.05 or<0.01). Conclusions Compared with the PA, DIM has low sensitivity and poor specificity for clinical diagnosis. DIM is not suitable for clinical diagnosis of MP infection.

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .