Retinitis pigmentosa (RP) is a genetic disorder of photoreceptor cell apoptosis and retinal pigment epithelium (RPE) cell atrophy caused by gene mutation. The clinical manifestations are night blindness, peripheral visual field loss and progressive vision loss. RPE cell apoptosis plays an important role in the progression of RP, and exogenous implantation of RPE cells as an alternative therapy has shown certain efficacy in animal experiments and clinical trials. With the diversification of cell sources, the update of surgical techniques and the continuous emergence of biological materials, more possibilities and hopes are provided for cell therapy. To further promote the development of this field in the future, it is still necessary to strengthen the cooperation between medicine, bioengineering and other disciplines in the future to jointly promote the innovation and development of therapeutic methods. It is believed that RPE cell transplantation therapy will show a brighter prospect in the future

Objective To analyze the characteristics of sports lottery purchase addiction behavior and provide evidence for health-re-lated services and public health intervention strategies for lottery buyers at different risk levels. Methods Based on International Classification of Diseases,11th Revision,and International Classification of Function-ing,Disability,and Health,the psychological and behavioral characteristics of lottery addiction and its functional impairments were analyzed.A questionnaire survey was conducted on 1 920 sports lottery buyers from Zhejiang,Hainan,Hunan,Gansu,Yunnan and Heilongjiang provinces from June to August,2024,using the Risk Level Questionnaire for Sports Lottery Addiction Behavior,the Characteristics Measurement Questionnaire for Sports Lottery Purchase Behavior,and the Functional Impairments Measurement Questionnaire for Sports Lottery Ad-diction Behavior.The health service system and public health intervention measures for sports lottery addiction were comprehensively discussed based on WHO policies and international research findings on gambling addic-tion. Results A total of 1 817 valid questionnaires were collected.There were significant differences in the prevalence of ad-dictive behavior at different risk levels across gender(χ2=12.804,P<0.005),age(χ2=40.825,P<0.001),in-come(χ2=41.522,P<0.001),economic zone(χ2=37.658,P<0.001)and years of lottery purchase history(χ2=66.520,P<0.001).The lottery participation(Z=-5.068,P<0.001),frequency of purchase(Z=-2.561,P=0.01)and expenditure-to-income ratio(Z=-4.062,P<0.001)increased in those with addictive behavior risk.Risk levels of addiction behavior significantly predicted physical harm,negative emotions,influences on work and academic performance,deterioration in interpersonal relationships,and financial problems,and prediction ef-fects increased with risk levels. Conclusion Lottery purchase addiction is predominant in young males with low incomes and short purchase histories,in central and western economic regions,which may be associated with purchase time,frequency and economic expenditure.Addiction behavior may impair individuals'physical,psychological and social functioning.A health-related service system encompassing prevention,intervention,rehabilitation and health promotion is needed to address lottery purchase addiction.Public health intervention strategies should focus on setting health goals,pri-oritizing health needs,mobilizing resources and implementing guidance plans,to provide support and services for groups at different risk levels of addiction to mitigate its harms.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To evaluate the efficacy of total laparoscopic surgery vs. open surgery for hilar cholangiocarcinoma. Methods:The clinical data of 45 patients undergoing laparoscopic radical resection of hilar cholangiocarcinoma and 42 patients by open surgery from Mar 2017 to Mar 2021 were retrospectively analyzed.Results:There was no significant difference in demographics, Bismuth classification and excision extension between the two groups (all P>0.05). The laparoscopic surgery used longer time ( t=-1.366, P<0.05). The intraoperative blood loss, number of lymph node dissection and postoperative hospital stay favored laparoscopic method( t=0.043, t=0.026, t=-1.852, P<0.05). R 0 radical resection rate，postoperative complications were also in favor of laparoscopic surgery ( χ2=3.216, χ2=2.566, all P<0.05). There was no significant difference in postoperative pathology and in hospital expenses (all P>0.05). The 1- and 3-year survival rate of the laparoscopic group was superior (all P<0.05). Conclusions:In spite of longer operational time，patients in laparoscopic hilar cholangiocarcinoma radical resection group have shorter postoperative in hospital stay and longer postoperative survival time.

Objective To systematically retrieve and integrate the clinical randomized controlled trials(RCTs)and systematic reviews/Meta-analyses of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN)in recent 10 years,aiming to summarize the overall evidence distribution of traditional Chinese medicine in the treatment of DPN.Methods CNKI,WANFANG,VIP,CBM,PubMed,Web of Science,Embase and the Cochrane Library were used as retrieval database.The retrieval time was from January 1,2012 to October 23,2022.RCTs and systematic reviews/Meta-analyses were included.The distribution of evidence was displayed in the form of charts.AMSTAR-1 was used for the methodological quality evaluation of systematic reviews/Meta-analyses.Results A total of 1648 RCTs and 59 systematic reviews/Meta-analyses were included.The overall number of RCTs were on the rise,but most of the scale of the RCTs were relatively small,with 68％of the samples size of a single study concentrated between 50-100;The Duration of intervention was 4-8 weeks;Multi-therapy was the most commonly used intervention,among which the most involved intervention was the combination of TCM decoction;Traditional Chinese medicine monotherapy was mainly oral traditional Chinese medicine decoction.The evaluation indexes of clinical efficacy paid much attention to the total effective rate,nerve conduction velocity,TCM diseases and syndromes;economic index,quality of life,long-term efficacy and other indicators had attracted less attention of researchers.The overall methodological quality of systematic reviews/Meta-analyses was not high,most of which show good clinical efficacy,but lack sufficient evidence support.Conclusion The research results show that the treatment of diabetes peripheral neuropathy with TCM have good characteristics and advantages,the shortcomings are mainly reflected in the low quality of the overall methodology of systematic reviews/Meta-analyses.Suggesting that more high-quality clinical RCTs with breadth and depth are still needed in the future to verify the characteristics and advantages of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy and provide data information support for evidence-based medicine.

Objective:To summarize and discuss the surgical effect in otoplasty of prominent ear using cartilage folding with unilateral cartilage incision.Methods:Data of patients with prominent ear who were treated in the Department of Vascular and Plastic Surgery of Guangdong Provincial People’s Hospital and the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital from May 2018 to April 2022 were retrospectively analyzed. All patients underwent otoplasty using cartilage folding with unilateral cartilage incision. During the operation, a unilateral cartilage incision was made along the lateral bottom of intended antihelix, cartilage dissection and scoring were made, and the cartilage was folded and sutured to form the antihelix. The patients were followed up postoperatively for auricular shape, wound healing and other complications.Results:A total of 18 patients with prominent ear (22 ears) were included, consisting of 12 males (15 ears) and 6 females (7 ears), aged from 18 to 51 years(average of 25.8 years). There were 9 cases on the left, 5 cases on the right and 4 cases on both sides. Four patients had pain in the operation area within 2 days postoperatively which could be relieved by analgesics. The patients were followed up for 1-24 months, with an average follow-up of 13.6 months. Twenty-two prominent ears were corrected. Scaphoconchal angle and cranioauricular angle of the prominent ears were significantly reduced, and the shape of the antihelix was smooth after the operation. All patients were satisfied with the results. There were no other complications after the operation, such as deformity relapse, infection, unhealing, auricular cartilage deformation and hypertrophic scar.Conclusions:Otoplasty of prominent ear using cartilage folding with unilateral cartilage incision is a simple, stable and satisfactory surgical method for the treatment of prominent ear.

Objective:To summarize and discuss the surgical effect in otoplasty of prominent ear using cartilage folding with unilateral cartilage incision.Methods:Data of patients with prominent ear who were treated in the Department of Vascular and Plastic Surgery of Guangdong Provincial People’s Hospital and the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital from May 2018 to April 2022 were retrospectively analyzed. All patients underwent otoplasty using cartilage folding with unilateral cartilage incision. During the operation, a unilateral cartilage incision was made along the lateral bottom of intended antihelix, cartilage dissection and scoring were made, and the cartilage was folded and sutured to form the antihelix. The patients were followed up postoperatively for auricular shape, wound healing and other complications.Results:A total of 18 patients with prominent ear (22 ears) were included, consisting of 12 males (15 ears) and 6 females (7 ears), aged from 18 to 51 years(average of 25.8 years). There were 9 cases on the left, 5 cases on the right and 4 cases on both sides. Four patients had pain in the operation area within 2 days postoperatively which could be relieved by analgesics. The patients were followed up for 1-24 months, with an average follow-up of 13.6 months. Twenty-two prominent ears were corrected. Scaphoconchal angle and cranioauricular angle of the prominent ears were significantly reduced, and the shape of the antihelix was smooth after the operation. All patients were satisfied with the results. There were no other complications after the operation, such as deformity relapse, infection, unhealing, auricular cartilage deformation and hypertrophic scar.Conclusions:Otoplasty of prominent ear using cartilage folding with unilateral cartilage incision is a simple, stable and satisfactory surgical method for the treatment of prominent ear.

Objective:To compare the embedding anastomosis with the intermittent eversion anastomosis on the pancreatic fistula rates after laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 116 patients who underwent LPD at the Center Hospital of Xianyang City affiliated to Xi' an Jiaotong University Health Science Center from March 2016 to March 2020 were retrospectively studied. According to the method of pancreaticojejunostomy used, these patients were divided into the following two groups: the embedding anastomosis group ( n=55) and the intermittent eversion anastomosis group ( n=61). The duration of pancreaticojejunostomy, bilioenterostomy and gastrointestinal anastomoses, and the amounts of intraoperative blood loss and postoperative complication rates were compared between the two groups. Results:Of 116 patients in this study, there were 67 males and 49 females, with a median age of 61.5 years. No perioperative death occurred in the 2 groups. The operation time, digestive tract reconstruction time and pancreaticojejunostomy time in the embedded anastomosis group were (260±20), (65±15) and (35±15) min, respectively, which were significantly lower than those in the intermittent eversion anastomosis group (305±25), (81±25) and (45±12) min, (all P<0.05). The grade A and B pancreatic fistula rates in the embedded anastomosis group were 27.3%(15/55) and 21.8%(12/55), respectively, which were significantly higher than those in the intermittent eversion anastomosis group [8.2%(5/61) and 6.6%(4/61)], (all P<0.05). The postoperative hospital stay in the intermittent eversion anastomosis group (10.3±1.1) d was significantly lower than that in the embedding anastomosis group [(15.2±3.2) d, P<0.05]. Conclusion:In LPD, when compared with embedded pancreaticojejunostomy, intermittent eversion pancreaticojejunostomy reduced the postoperative pancreatic fistula rate and shortened the postoperative hospital stay.

Objective:To investigate the normal range of exhaled nitric oxide (FeNO) in 6-18-year-old children in China, so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods:A multi-center study was conducted on 5 949 children aged 6-18 (3 101 males and 2 848 females) in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association, FeNO was measured, and the relationship of FeNO with the sex, age, height, weight, body mass index and region was discussed.Results:The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb, and its 95% confidence interval (skewness distribution) was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb, respectively, and their 95% confidence intervals (skewness distribution) were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old, FeNO decreased with age, with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11, and FeNO of children aged 12-18 was significantly correlated with the gender, height, and region(all P<0.01). Conclusions:FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18, 16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old, the influence of age on FeNO should be considered, and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.

Objective:To study the impact of traditional versus artery first approach in laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 58 patients who underwent laparoscopic pancreaticoduodenectomy using the two different approaches from February 2016 to August 2018 at the Xianyang Central Hospital affiliated to Xi'an Jiaotong University Medical Department were retrospectively analyzed.Results:All 58 patients successfully underwent the complete laparoscopic Whipple operation using the Child digestive tract reconstruction and anastomosis. There was no conversion to laparotomy. The average operation times for the conventional approach group (35 cases) was (302.0±20.0) min and the digestive tract reconstruction time was (36.0±15.0) min. The intraoperative blood loss was (365.0±150.0) ml. Negative pathological resection margins on intraoperative frozen section examination were achieved in 33 patients. Early postoperative complications happened in 6 patients which included grade A pancreatic fistula in 3 patients (1 patient complicated with biliary fistula and 1 patient complicated with gastric emptying disorder), and grade B pancreatic fistula in 2 patients who were complicated with abdominal hemorrhage, successfully treated by conservative treatment. Postoperative pathological examination showed that 32 patients (91.4%) had R 0 resection and 3 patients (8.6%) had R 1 resection. The number of lymph node dissection was (7.5±5.5). On the other hand, the average operation time of the artery first access group (23 cases) was (355.0±25.0) min, and the reconstruction time of digestive tract was (41.0±12.0) min. The amount of bleeding was (410.0±200.0) ml. During the operation, 22 patients had negative resection margins shown on pathological frozen sections. Early postoperative complications occurred in 3 patients, including 1 patient with grade A pancreatic fistula which was complicated with gastric emptying disorder, and 2 patients with grade B pancreatic fistulas which were complicated with abdominal hemorrhage. The patients were successfully managed by conservative treatment. Postoperative pathological examination showed that 22 patients (95.7%) had R 0 resection and 1 patient (4.3%) R 1 resection. The number of lymph node dissection was (6.8±4.2). Conclusion:The LPD surgical approach was selected according to the general conditions of patients, locations of tumors, relationship of tumors with blood vessels, and technical skills of surgeons with the aims to achieve adequate lesion clearance, organ protection, damage control, and safety and efficiency of minimally invasive surgery.