Objective:To investigate the relationship between visual recovery and non-treponemal serologic test titers [tolulized red unheated serum test (TRUST) or rapid plasma reagin (RPR)] in patients with isolated ocular syphilis and those with ocular syphilis combined with neurosyphilis.Methods:A total of 35 ocular syphilis patients treated at the Department of Ophthalmology, the First Affiliated Hospital of Soochow University, and the Department of Dermatology, the Fifth People′s Hospital of Suzhou between 2016 and 2024 were enrolled. Pre-treatment serum TRUST/RPR and treponema pallidum particle agglutination (TPPA) assay results were collected for all 35 patients. Cerebrospinal fluid (CSF) biochemical, routine, TRUST/RPR, and TPPA results were obtained for 29 patients. Visual acuity (logMAR) before and after treatment was recorded for 21 patients (34 eyes). Pearson or Spearman correlation analysis was used to assess the relationship between pre-and post-treatment visual acuity, degree of visual recovery, and serum titers.Results:No significant differences in titer distribution were observed among the 35 ocular syphilis patients based on age or sex ( P>0.05). Among the 29 patients who underwent lumbar puncture, 17(58.62%) were diagnosed with ocular syphilis combined with neurosyphilis, while 12(41.38%) had isolated ocular syphilis. The proportion of patients with high pre-treatment serum titers did not differ significantly between the two groups ( P=0.294). The degree of post-treatment visual recovery showed a positive correlation with pre-treatment serum titers, indicating that higher initial titers were associated with better visual recovery (34 eyes, r=-0.302, P=0.081). Post-treatment visual acuity was positively correlated with pre-treatment visual acuity (34 eyes, r=0.547, P=0.001), suggesting that patients with poor baseline vision had worse post-treatment visual outcomes. The median visual improvement was logMAR 0.560 in the isolated ocular syphilis group and logMAR 0.202 in the neurosyphilis-combined group, with no significant difference between the two ( P=0.322). Conclusions:Ocular syphilis patients with higher pre-treatment titers exhibit better visual recovery, while poor post-treatment visual outcomes are associated with low baseline visual acuity.

Objective:To investigate the relationship between visual recovery and non-treponemal serologic test titers [tolulized red unheated serum test (TRUST) or rapid plasma reagin (RPR)] in patients with isolated ocular syphilis and those with ocular syphilis combined with neurosyphilis.Methods:A total of 35 ocular syphilis patients treated at the Department of Ophthalmology, the First Affiliated Hospital of Soochow University, and the Department of Dermatology, the Fifth People′s Hospital of Suzhou between 2016 and 2024 were enrolled. Pre-treatment serum TRUST/RPR and treponema pallidum particle agglutination (TPPA) assay results were collected for all 35 patients. Cerebrospinal fluid (CSF) biochemical, routine, TRUST/RPR, and TPPA results were obtained for 29 patients. Visual acuity (logMAR) before and after treatment was recorded for 21 patients (34 eyes). Pearson or Spearman correlation analysis was used to assess the relationship between pre-and post-treatment visual acuity, degree of visual recovery, and serum titers.Results:No significant differences in titer distribution were observed among the 35 ocular syphilis patients based on age or sex ( P>0.05). Among the 29 patients who underwent lumbar puncture, 17(58.62%) were diagnosed with ocular syphilis combined with neurosyphilis, while 12(41.38%) had isolated ocular syphilis. The proportion of patients with high pre-treatment serum titers did not differ significantly between the two groups ( P=0.294). The degree of post-treatment visual recovery showed a positive correlation with pre-treatment serum titers, indicating that higher initial titers were associated with better visual recovery (34 eyes, r=-0.302, P=0.081). Post-treatment visual acuity was positively correlated with pre-treatment visual acuity (34 eyes, r=0.547, P=0.001), suggesting that patients with poor baseline vision had worse post-treatment visual outcomes. The median visual improvement was logMAR 0.560 in the isolated ocular syphilis group and logMAR 0.202 in the neurosyphilis-combined group, with no significant difference between the two ( P=0.322). Conclusions:Ocular syphilis patients with higher pre-treatment titers exhibit better visual recovery, while poor post-treatment visual outcomes are associated with low baseline visual acuity.

ObjectiveTo investigate the effects of Buyang Huanwutang （BYWHT） on reducing inflammatory injury and improving neurological function after cerebral ischemia-reperfusion in rats via activating the adiponectin （APN） pathway. MethodMale SD rats were randomized into sham， model， BYHWT （16 g·kg^-1， twice a day）， and BYHWT + APN inhibitor （GW9662） groups. In the sham group， blood vessels were isolated. The rat model of middle cerebral artery occlusion （MCAO） was established. The rats in the BYHWT+GW9662 group was treated with subcutaneous injection of GW9662 at 4 m·kg^-1 30 min before MCAO surgery and BYHWT at 16 g·kg^-1 by gavage after MCAO surgery， once in the morning and once in the evening. The immunofluorescence （IF） assay was employed to observe the expression of adiponectin receptor 1 （AdipoR1） and the colocalization of AdipoR1 with neuronal nuclei （NeuN） and ionized calcium binding adaptor molecule 1 （Iba1） in the brain. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the expression of APN in the serum and brain. The balance beam test was carried out to examine the balance ability， and the grasping test to assess the recovery of limb strength. The immunofluorescence assay was used to detect the expression of myeloperoxidase （MPO）. Western blot was employed to determine the expression of tumor necrosis factor-alpha （TNF-α）， interleukin （IL）-1β， IL-6， and IL-10 and in the brain. ResultCompared with the sham group， the modeling promoted the expression of AdipoR1 （P<0.01）， lowered the APN levels in the serum and brain （P<0.05， P<0.01）， increased the score in the balance beam test （P<0.01）， and decreased the grasping strength of forepaw （P<0.01）， which were accompanied with increased MPO， TNF-α， IL-1β， and IL-6 levels （P<0.01） and decreased IL-10 level （P<0.01）. Compared with the model group， BYHWT promoted the expression of AdipoR1 （P<0.01）， elevated APN levels in the serum and brain （P<0.05， P<0.01）， and increased the grasping strength of forepaw （P<0.01）， which were accompanied with lowered MPO， TNF-α， IL-1β， and IL-6 levels （P<0.01） and elevated IL-10 level （P<0.01）. All the above effects were partially blocked by GW9662. ConclusionBYHWT can reduce inflammatory injury and improve neurological function in the rat model of cerebral ischemia-reperfusion by activating the APN pathway.

Objective:To develop serious games for pediatrics and to explore the effect of cultivating the clinical reasoning and reflection ability of pediatric trainee nurses.Methods:This was a non-randomized controlled trial study. The convenience sampling method was used to select 88 pediatric trainee nurses in the Second Xiangya Hospital of Central South University from April 2021 to January 2022. They were divided into the control group and the experimental group with 44 cases in each group by the method of random sampling. The control group was given clinical practice teaching in pediatrics according to the practice syllabus. Based on the teaching events of Gagne, the teaching links of serious games were designed, and teaching was carried out to the experimental group. The clinical reasoning and reflection ability, learning satisfaction and self-confidence of the two groups of pediatric trainee nurses before and after teaching were evaluated by the Self-Assessment of Clinical Reasoning and Reflection, Student Learning Satisfaction and Self-Confidence Scale, and examination scores of the two groups of pediatric trainee nurses were evaluated.Results:There was no significant difference in the clinical reasoning and reflection ability, learning satisfaction and self-confidence before teaching between the two groups( P>0.05). The total score of clinical reasoning and reflection evaluation after teaching was (101.13±6.69) points in the experimental group, which was higher than that in the control group (94.57 ± 8.86) points, the difference was statistically significant ( t=-3.92, P<0.05). The learning satisfaction and self-confidence scores after teaching were (20.82 ± 2.16), (33.20 ± 1.47) points in the experimental group, which were higher than those in the control group (19.52 ± 2.30), (31.89 ± 2.44) points, the differences were statistically significant ( t=-2.33, -3.07, both P<0.05). The scores on the theory and skill examination in the experimental group were also better than those in the control group, the differences were statistically significant ( t values were -2.59--2.14, all P<0.05). Conclusions:The serious game teaching method can effectively improve the clinical reasoning and reflection ability, practical learning satisfaction, self-confidence, and graduation performance of pediatric nursing interns, which can provide a reference for the reform of pediatric nursing practice teaching.

With the rapid development of nanotechnology, the research and development of nanomedicine has become one of the current development directions of drug innovation. The pharmacokinetic characteristics of nanomedicine are significantly different from general drugs because of the scale effect based on nanostructures, and pharmacokinetics studies of nanomedicine may be different from the general drugs. This article focuses on the research strategies and considerations on non-clinical pharmacokinetics of nanomedicine, including test agents, in vivo/in vitro assays, biological sample analysis, data evaluation and analysis etc., providing references for developers.

Abstract: Ovarian cancer is a gynecological malignant tumor with the highest fatality rate. It is characterized by concealed onset and poor prognosis. Recent studies have found that carbohydrate intake, food glycemic index and food glycemic load are closely related to the incidence of ovarian cancer. In this article, we summarize the current progress of the above-mentioned research and provide references for the prevention and future research of ovarian cancer.

Objective: To describe the dermoscopic features of extramammary Paget′s disease (EMPD) and chronic eczema of the vulva, and to explore the value of dermoscopy in the diagnosis and differential diagnosis of the above diseases. Methods: Dermoscopic images were collected from 20 patients with histopathologically confirmed vulvar EMPD and 16 patients with clinically confirmed chronic eczema of the vulva in Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Pekin Union Medical College from January 2017 to April 2018, and retrospectively analyzed. Fisher′s exact test was used to compare the prevalence of dermoscopic features between the two groups. Results: As dermoscopy showed, the milky red background was observed in 19 EMPD patients and in only 1 patient with chronic eczema, and there was a significant difference in the prevalence of milky red background between the two groups (P < 0.001) . White scales were the most common desquamation, and were observed in 9 EMPD patients and 13 patients with chronic eczema (P = 0.128) . Blood vessels were uniformly distributed in EMPD patients, including dotted-globular vessels in 19 and linear vessels in 14, while blood vessels were distributed in a patchy or clustered pattern in the patients with chronic eczema, including dotted-globular vessels in 16 and linear vessels in 7. There was a significant difference in the prevalence of different distribution patterns of blood vessels between the two groups (P < 0.001) . Bright white streaks, bright white structureless area and reticular structure were observed in 19, 20 and 19 EMPD patients respectively, and in 1, 1 and 1 patient with chronic eczema respectively, and there were significant differences in the prevalence of the above 3 structures between the two diseases (all P < 0.001) . Conclusion Vulvar EMPD and chronic eczema both show characteristic dermoscopic features, and dermoscopy is of great value to the diagnosis and differential diagnosis of EMPD.

According to the property of military health service positioning , armed forces all over the world invariably put military health service into combat team ranks .They want to strengthen the ties between the health system and the military system by adjusting the health command and management system in order to meet the needs of multi -level and multi-directional wartime support in the future .This paper summarizes the development of foreign ( the US.Germany and Russian Federation) and our military health command and management system , and make a detailed comparison .It may be a practical and valuable research for the current military health reform .

Objective To explore the efficacy of targeted care for sleep by analyzing polysomnography (PSG) of the different stages of night sleep in patients with depressive disorder. Methods 80 depressive patients met the recruited criteria from Feb 2015 to Feb 2016 were sample-randomly divided into research group with targeted care and controlled group with routine nurse by random number table. PSG of each case was analyzed and Hamilton Depression Scale (HAMD) and Self-Rating Depression Scale (SDS) were used to assess at baseline and endpoint during 4 weeks period. Results Total sleep time, sleep efficiency, N3 and rapid eyes movement ratio of PSG were (395.74 ± 29.31) min, (80.42±1.92)%, (19.11±2.29)%and (16.01±2.55)%in research group, (372.34±24.37) min, (72.61 ± 1.64)%, (13.61 ± 2.38)%and (13.87 ± 2.03)%in controlled group (t=2.892-13.361, P<0.05). SDS at 2nd week and 4th week were (45.28 ± 6.28) points and (32.62 ± 4.65) points in research group, (48.63±7.54) points and (36.32±4.34) points in controlled group (t=-4.12,-4.43, P<0.05). HAMD at 2nd week and 4th week were (15.92 ± 2.62) points, (9.94 ± 2.32) points in research group, (18.27 ± 3.41) points and (12.45 ± 2.21) points in controlled group (t=-3.51,-4.35, P<0.05). Conclusions Efficacy of targeted care for sleep in patients with depressive disorder is better and sooner, and the intervention is good for both sleep quality and mood level.

Objective To investigate the relationship of parity and other reproduction-associated factors with metabolic syndrome(MS) in middle-aged and elderly women in Nanchang community.Methods Female permanent residents over 40 years old were sampled for a routine examination and a questionnaire survey covering basic information,5 894 subjects were enrolled and identified as effective cases.MS was diagnosed according to the standard of China Diabetes Society in 2004.Factors including age,education,profession,marital status,parity,child-bearing history of macrosomia,breastfeeding,menarche age,and menopausal age were analyzed in order to find their relationship with MS.The univariate logistic analysis was followed by binary logistic regression analysis if P＜0.05,and OR value and confidence interval were calculated.Results Univariate logistic regression analysis showed that age,education,profession,parity,breastfeeding,and menopausal age were influencing factors of MS (all P ＜ 0.05).There was no correlation to marital status,miscarriage history,child-bearing history of macrosomia,menarche age with MS(all P＞0.05).Binary Logistic regression analysis showed that the risk of MS increased with age:OR =1.51 (95 ％ CI 0.98-2.32) during 50-59 years,OR =2.10 (95 ％ CI 1.34-3.30) during 60-69 years,and OR =2.63 (95 ％ CI 1.61-4.31) in cases aged over 70 years,as compared to the group aged 40-49 years.The risk in non-manual workers increased about 34 percent OR =1.33 (95 ％ CI 1.04-1.70),compared with manual workers.The risk of MS increased with parity,being OR =1.46 (95％ CI 1.14-1.88),OR =1.78 (95％ CI 1.30-2.43),and OR =1.84 (95％ CI 1.24-2.72),with 2,3,and 4 child-bearings respectively as compared to cases with only one childbearing.The risk of MS was reduced with advancing menopausal age being about 6 percent reduction with each increased year of menopausal age(OR =0.94,95％ CI 0.90-0.99).There was no difference between education,breastfeeding and MS(P＞005).Conclusion Multiple parity,earlier menopausal age,less manual work,and aging seem to be the risk factors of MS in women.