BACKGROUND:Traditional treatments for corneal alkali burns are limited,especially in controlling inflammation,preventing neovascularization,and inhibiting corneal scarring.Natural,synthetic,or composite materials provide a wide range of treatment options.However,the mechanism by which biomaterials promote corneal alkali burn repair has not yet been systematically understood. OBJECTIVE:To summarize the current research on biomaterials in promoting corneal alkali burn repair in and outside China,and review the mechanism and application of biomaterials in repairing corneal alkali burn. METHODS:The first author searched"cornea,alkali burn,amniotic membrane,hyaluronic acid,collagen,chitosan,polymer materials"as Chinese keywords and"amniotic membrane,hyaluronic acid,collagen,chitosan,polymer,cornea,alkali burn"as English keywords in PubMed,Web of Science,CNKI,and WanFang databases.According to inclusion and exclusion criteria,76 eligible articles were finally included for review. RESULTS AND CONCLUSION:(1)In the field of corneal alkali burn repair,biomaterials such as amniotic membrane,hyaluronic acid,collagen,chitosan,and degradable polymer materials have been widely studied and applied.Each of these biomaterials has its own characteristics,advantages,and disadvantages,and stands out in different aspects.(2)First and foremost,amniotic membranes are considered one of the most promising biomaterials due to their abundance of bioactive factors.They are biocompatible and can regulate the corneal inflammatory response.However,there are issues with donor shortages and susceptibility to infectious diseases.(3)Hyaluronic acid has good moisturizing properties and biocompatibility,and is able to improve the survival rate of corneal cells and increase corneal transparency.(4)The good biocompatibility and scaffold structure of collagen enable the promotion of corneal cell adhesion and proliferation,as well as the reconstruction of corneal tissue structure.(5)Chitosan is recognized for its good biocompatibility and degradability,making it suitable as a carrier for drug delivery and cell transplantation.(6)Degradable polymer materials have good controllability over degradation and can provide a good support and delivery platform for the repair of corneal alkali burns,but further research is needed on their stability and biocompatibility.(7)Overall,there is currently no single biomaterial that can completely address the repair problem of corneal alkali burns,and each biomaterial has its own specific application scenarios and limitations.(8)Future research directions should focus on further improving the properties and structure of biomaterials,exploring more effective combination applications,and deeply understanding the interaction mechanism between biomaterials and corneal tissue,in order to enhance the therapeutic effect of corneal alkali burns and the quality of life of patients.

ObjectiveTo investigate the clinical features and outcomes of recompensation in patients with autoimmune hepatitis （AIH）-related decompensated cirrhosis， to identify independent predictive factors， and to construct a nomogram prediction model for the probability of recompensation. MethodsA retrospective cohort study was conducted among the adult patients with AIH-related decompensated cirrhosis who were admitted to The Fifth Medical Center of PLA General Hospital from January 2015 to August 2023 （n=211）. The primary endpoint was achievement of recompensation， and the secondary endpoint was liver-related death or liver transplantation. According to the outcome of the patients at the end of the follow-up， the patients were divided into the recompensation group （n=16） and the persistent decompensation group（n=150）.The independent-samples t test was used for comparison of normally distributed continuous data with homogeneity of variance， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data with heterogeneity of variance； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups； the Kaplan-Meier method was used for survival analysis； the Cox proportional-hazards regression model was used to identify independent predictive factors， and a nomogram model was constructed and validated. ResultsA total of 211 patients were enrolled， with a median age of 55.0 years and a median follow-up time of 44.0 months， and female patients accounted for 87.2%. Among the 211 patients， 61 （with a cumulative proportion of 35.5%） achieved recompensation. Compared with the persistent decompensation group， the recompensation group had significantly higher white blood cell count， platelet count （PLT）， total bilirubin （TBil）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， total bile acid， prothrombin time， international normalized ratio （INR）， SMA positive rate， Model for End-Stage Liver Disease （MELD） score， Child-Pugh score， and rate of use of glucocorticoids （all P0.05）， as well as significantly lower age at baseline， number of complications， and death/liver transplantation rate （all P0.05）. At 3 and 12 months after treatment， the recompensation group had continuous improvements in AST， TBil， INR， IgG， MELD score， and Child-Pugh score， which were significantly lower than the values in the persistent decompensation group （all P0.05）， alongside with continuous increases in PLT and albumin， which were significantly higher than the values in the persistent decompensation group （P0.05）. The multivariate Cox regression analysis showed that baseline ALT （hazard ratio ［HR］=1.067， 95% confidence interval ［CI］： 1.010 — 1.127， P=0.021）， IgG （HR=0.463，95%CI：0.258 — 0.833， P=0.010）， SMA positivity （HR=3.122，95%CI：1.768 — 5.515， P0.001）， and glucocorticoid therapy （HR=20.651，95%CI：8.744 — 48.770， P0.001） were independent predictive factors for recompensation， and the nomogram model based on these predictive factors showed excellent predictive performance （C-index=0.87，95%CI：0.84 — 0.90）. ConclusionAchieving recompensation significantly improves clinical outcomes in patients with AIH-related decompensated cirrhosis. Baseline SMA positivity， a high level of ALT， a low level of IgG， and corticosteroid therapy are independent predictive factors for recompensation. The predictive model constructed based on these factors can provide a basis for decision-making in individualized clinical management.

This paper reviews the assessment tools for childbirth readiness of pregnant and puerperal women and their applications, analyzes the advantages and disadvantages of these tools, and puts forward suggestions, in order to provide reference for research on the readiness for childbirth in pregnant and puerperal women.

Objective To analyze the differential value of gastrointestinal stromal tumors and non-gastrointestinal stromal tumor by cytokeratin-19 fragment(CYFRA21-1),protein kinase B(PKB)and carbohydrate antigen 19-9(CA19-9)combined with endoscopic ultrasonography(EUS).Methods 69 patients with gastrointestinal stromal tumors from January 2020 to July 2023 were selected as the study group,and 78 patients with non-gastrointestinal stromal tumor(they were 25 cases of gastrointestinal leiomyoma and 53 cases of gastrointestinal schwannoma)were selected as the control group during the same period prospectively.The EUS indicators and tumor markers in the two groups were compared.Receiver operator characteristic curve(ROC curve)was drawn to analyze the diagnostic value of serum levels of CYFRA21-1,PKB and CA19-9 alone and in combination for gastrointestinal stromal tumors.Results Compared with the control group,the mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 in the study group were higher(P<0.05).There was no significant difference in mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 in patients with gastrointestinal stromal tumors of different genders and ages(P>0.05).Compared with patients with gastrointestinal stromal tumors with tumor diameter≤5 cm and pathological mitotic figure≤5/50 HPF,the mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 were higher in patients with gastrointestinal stromal tumors with tumor diameter>5 cm and pathological mitotic figure>5/50 HPF(P<0.05).Gastrointestinal stromal tumors were included as positive and non-gastrointestinal stromal tumor as negative.ROC curve was drawn to analyze the diagnostic value of gray mean value,gray standard deviation,serum levels of CYFRA21-1,PKB,and CA19-9 alone and in combination for gastrointestinal stromal tumors,and the combined detection was the highest,area under the curve(AUC)was 0.936,the sensitivity was 82.61%,and the specificity was 91.03%.Conclusion With the occurrence and development of gastrointestinal stromal tumors,CYFRA21-1,PKB,CA19-9 levels,gray mean value and gray standard deviation increase,and levels of CYFRA21-1,PKB,CA19-9 combined with EUS are valuable in the diagnosis of gastrointestinal stromal tumors.

Objective:To explore the alterations in resting-state functional connectivity (rs-FC) of hippocampal and insular subregions with other regions of the whole brain in nicotine addicts and their correlations with nicotine addiction.Methods:A total of 56 participants, including 27 nicotine addicts and 29 healthy controls, were recruited from community from January 2022 to June 2024. Multidimensional nicotine addiction scales were performed in nicotine addiction group. Resting-state functional magnetic resonance imaging (fMRI) was performed in the 2 groups; general data and rs-FC differences between hippocampal and insular subregions with other regions of the whole brain were compared between the 2 groups. Correlations of rs-FC alterations between hippocampal and insular subregions with other regions of the whole brain with nicotine addiction scale scores in the nicotine addiction group were analyzed.Results:No significant difference in age or years of education was noted between the nicotine addiction group and healthy control group ( P>0.05). Compared with the healthy control group, nicotine addiction group had enhanced rs-FC between the left entorhinal cortex of the hippocampus and left putamen, attenuated rs-FC between the left hippocampal-amygdaloid transitional area and widespread regions including the left angular gyrus, left superior parietal gyrus, left middle occipital gyrus, left precuneus, and left superior occipital gyrus, enhanced rs-FC between the left posterior insular (PI) and bilateral precuneus or pericalcarine cortex, attenuated rs-FC between the left ventral anterior insula and widespread regions including the right supramarginal gyrus, right supratemporal gyrus and right central sulcus, and attenuated rs-FC between the left ventral anterior insula and bilateral medial superior frontal gyrus, with significant differences ( P<0.05). Correlation analysis showed that rs-FC between the left PI and left precuneus was positively correlated with Fagerstr?m test for nicotine dependence (FTND) scores and heaviness of smoking index (HSI, r=0.462, P=0.015; r=0.492, P=0.009); rs-FC between the left PI and right precuneus was positively correlated with FTND scores and HSI ( r=0.417, P=0.031; r=0.472, P=0.013); rs-FC between the left PI and right pericalcarine cortex were positively correlated with FTND scores and HSI ( r=0.485, P=0.010; r=0.496, P=0.009). Conclusion:Abnormal rs-FC patterns have been observed between hippocampal and insular subregions and other regions of the whole brain in nicotine addicts; these alterations are associated with addictive severity and dependency of nicotine addiction.

The management of surplus drugs is an important part of drug administration. At present, China′s medical institutions are in the initial exploration stage in managing surplus drugs.This study analyzed the causes, safety hazards, management policies, and management problems of surplus drugs in medical institutions, and proposed targeted countermeasures and suggestions, including establishing unified and standardized management methods, consensus or guidelines, optimizing internal management of medical institutions, improving the management awareness of medical staff, and clarifying the benefits of surplus drugs, so as to provide references for medical institutions to manage surplus drugs reasonably.

To standardize the management of surplus drugs, improve the efficiency of medical resource utilization, promote the rational use of medical insurance funds, and reduce the financial burden on patients, a large tertiary hospital implemented a practice for managing surplus drugs starting in May 2023. This practice encompassed multiple aspects, including the establishment of organizational structure, clarification of responsibilities, formulation of billing for fractional doses and a reasonable surplus drugs list, establishment of standardized management processes, and allocation of special funds for surplus drugs. These efforts had initially achieved effective management of surplus drugs. As of November 2023, the management of surplus drugs had benefited 136 908 patients, with an average savings of 873.61 yuan per patient and a cumulative savings of approximately 34.7 million yuan in medical insurance funds. This practice had effectively reduced the wastage of medical resources, and could provide references for promoting standardized management of surplus drugs in medical institutions of China. In the future, the hospital should further expand the coverage of surplus drugs, ensure patients′ rights to informed consent, and establish a comprehensive performance incentive mechanism to promote the sustainable development of surplus drug management.

Public hospitals bear the responsibility of ensuring people's health and promoting their healthy lives.New media have emerged as a pivotal platform for health science popularization in public hospitals.Under these contexts,the Science Popularization Base for Health and Chronic Disease Prevention of the First Hospital of Lanzhou University established a multidisci-plinary team model for science popularization,mainly relying on the WeChat official account to disseminate health knowledge and dispel rumors.This article explored the experiences and practices of health science popularization under this model,focusing on the"meticulous selection for science popularization"strategy employed on their WeChat official account.

Objective:To explore the efficiency of a modified caries risk assessment tool(MCAT)on caries-risk prediction of children in Nanning.Methods:MCAT was designed based on caries-risk assessment tool(CAT)of American Academy of Pediatric Dentistry(AAPD)and the caries related factors of the primary school children in Guangxi,China.A cohort study was conducted in 332 children aged 3-year-old in kindergarten of Jiangnan District,Nanning,Guangxi.The data were integrated through questionnaires and oral exam-ination.The MCAT data were respectively scored by CAT and Cariogram and the caries-risk of the children was evaluated.The develop-ment of increased average caires incidece over a period of 1.5 years was compared,the predictive capacity of the methods was com-pared.Results:The ranks of caires risk assessed by CAT and Cariogram were significant different(Z=-10.34,P＜0.001),and the consistency of the 2 methods was poor(Kappa=0.234,P＜0.001).After 1.5 years,there was significant statistical difference of the caries prevalence rate between the low-high and moderate-high risk groups,and dmft increments between the moderate-high risk groups e-valuated by CAT(P＜0.05).There was significant difference of the caries prevalence rate between each risk groups and dmft increments between the low-high and moderate-high risk groups evaluated by Cariogram(P＜0.05).The AUC of CAT and Cariogram was 0.571 and 0.722 respectively(P＜0.001).In the prediction models of caries risk,the fitting of CAT was poor(P＜0.001),while that of Cariogram was better(P=1.00).Cariogram analysis showed that the chance of developing new caries lesions of the subjects with moderate and high caries risk was 2.86 and 11.65 times more than those with low caries risk.Conclusion:MCAT com-bined with Cariogram can more efficiently predict new caries de-velopment in 3-year-old children.

Relapsing polychondritis is a rare systemic autoimmune disease, which involves a wide range of sites, has atypical symptoms, and has no specific means of examination, resulting in very difficult early diagnosis, which seriously affects the prognosis of patients. We report a case of an elderly female patient with respiratory symptoms, discomfort symptoms only appeared for more than 1 month, chest CT and laryngoscopy showed no obvious abnormalities. The effect of antibacterial, antiviral and anti-inflammatory treatment is not good. 18F-FDG PET/CT showed that trachea, bronchus, nasal cartilage, thyroid cartilage, cricoid cartilage were involved. After pathological examination, the patient was clinically diagnosed as relapsing polychondritis. After treatment with methylprednisolone and tripterygium glycoside tablets, the patient had no recurrence at present.