AIM: To investigate the prevalence of dry eye symptoms among computer professionals in different climate zones and to identify the risk factors associated with dry eye disease.METHODS: A cross-sectional study was conducted by distributing questionnaires from December 2023 to January 2024 to computer professionals in six prefecture-level cities located in three distinct climate zones. Mixed-effects logistic regression analysis was employed to explore the relationship between environmental factors and the severity of dry eye disease. Environmental factors, including meteorological parameters and air pollutant concentrations, were obtained from the National Meteorological Information Center and the China Air Quality Online Monitoring and Analysis Platform, respectively. The annual mean values of environmental parameters served as independent variables, while the participants' Ocular Surface Disease Index(OSDI)scores were used as the dependent variable in the regression analysis.RESULTS:A total of 364 male participants aged 18-50 y were enrolled in this study. Among them, 80 participants presented with dry eye symptoms, corresponding to a detection rate of 22.0%.There was a significant difference in the detection rate of dry eye symptoms across different regions(P<0.05). Mixed-effects logistic regression analysis identified the following risk factors: daily eye use time(P<0.001, OR=1.669), relative humidity(P=0.047,OR=1.237), NO2 concentration(P=0.042, OR=1.283), PM2.5 concentration(P=0.006,OR=1.485), and CO concentration(P=0.018, OR=1.388). Temperature was found to be a protective factor(P=0.003, OR=0.701).CONCLUSION: Meteorological conditions and air quality significantly influence the occurrence of dry eye symptoms in male computer professionals. Prevention and treatment strategies for dry eye diseases should be tailored to the environmental characteristics of different regions to protect the ocular surface health of this occupational group.

[Objective] To analyze the serological characteristics and molecular biology results for a P^k phenotype. [Methods] One patient with P^k phenotype upon unexpected antibodies at Jining Blood Center in July 2022 was selected as the study subject. The blood groups and unexpected antibodies of the proband and his second son were identified using serological methods. The sequences of 3-β-N-acetylgalactosaminyltransferase gene (B3GALNT1) and the coding region of α-1,4-galactosyltransferase gene (A4GALT) were amplified and analyzed by PCR direct sequencing, and haploid sequence analysis was carried out on the variant sites of the B3GALNT1 gene. PROVEAN, SIFT, PolyPhen2 and Mutation Taster were used to analyze the effect of mutations on the protein. [Results] Serological test results suggested that the proband was a P2^k type, including anti-P antibody in his serum, and his son was the P2 phenotype. Sequencing analysis revealed that the proband had a compound heterozygous variants of the B3GALNT1 in c. 239T>A (p. Leu80Gln) and c. 433C>T (p. Arg145Ter). Further haploid analysis showed that the c. 239T>A had occurred in one haploid while c. 433C>T was present in the other haploid, and his son carried a heterozygous variant of c. 433C>T (p. Arg145Ter); the proband and his son all have homozygous mutation variants of the A4GALT in c. 903C>G. Bioinformatic analysis also predicted that the mutations were harmful to the protein function. [Conclusion] The compound heterozygous variants c. 239T>A (p. Leu80Gln) and c. 433C>T (p. Arg145Ter) in the B3GALNT1 gene may contribute to the P^k phenotype, of which the c. 239T>A variant has not been reported.

Metering unit is important component of medical service items and also serve as significant bases for scientifically estimating the costs of medical services.National Technical Specification of Medical Service Items(2023 Edition)has set up elements such as"metering unit"and"adjustment coefficient for resource consumption in special circumstances",which clearly stipulate the metering units of each medical service item and the multiples for discretionary increases or decreases in the overall resource consumption when special circumstances occur.These two elements are important references for the cost accounting in medical institutions.The project team has elaborated on the definitions,establishment principles and special circumstances of these two types of elements,namely"metering units"and"adjustment coefficient for resource consumption in special circumstances",providing references for the application of relevant governments and healthcare institutions.

The assignment of the"item code"element in National Technical Specification of Medical Service Items(Version 2023)continues the classification framework and coding rules of National Specification of Medical Service Price Items(Version 2012).The project team experts are members of the WHO-Family of International Classifications(WHO-FIC)China Classification,Terminology and Standards Collaborating Center.The design concept of project coding is the same as that of the International Classification of Health Interventions(ICHI).Both adopt an alphanumeric characters hybrid coding classification method based on multi-axis classification,clarified the definition and scope of these four key classification axis which including anatomy system,anatomical site,surgical procedure and surgical approach,and optimize and update item property,sub-classifications and coding.Unified medical service item code can make contribution to the comparability of statistics related to health care items across regions,promote cross-regional healthcare and healthcare insurance settlement at the national level;improve its refined management level in hospital,and play an important role in performance management and data statistical analysis.

Objective To investigate the effect of long non-coding RNA non-coding RNA-activated by DNA damage(LncRNA NORAD)on macrophage apoptosis induced by Mycobacterium tuberculosis infection via sponging microRNA-20a-5p(miR-20a-5p).Methods Healthy subjects(n=50)who came for health checkup,patients with active tuberculosis(n=50)and individuals with asymptomatic M.tuberculosis infection(n=50)were enrolled from Hebei Chest Hospital from March 2022 to April 2023.Venous blood samples were collected to prepare serum samples.The expression levels of LncRNA NORAD,miR-20a-5p,and inflammatory factors in the serum were measured.Human monocyte line THP-1 was induced to differentiate into macrophages and assigned into Control group,Model group,transfection of NORAD empty vector group(sh-NC group),transfection of sh-NORAD vector group(sh-NORAD group),co-transfection of sh-NORAD and miR-20a-5p inhibitor empty vector group(sh-NORAD+miR-20a-5p inhibitor NC group),co-transfection of sh-NORAD and miR-20a-5p inhibitor vector group(sh-NORAD+miR-20a-5p inhibitor group),transfection of miR-20a-5p empty vector group(miR-NC group),and transfection of miR-20a-5p vector group(miR-20a-5p mimics group).The expression levels of LncRNA NORAD and miR-20a-5p(qRT PCR method),cell proliferation ability(CCK-8 kit method),cell apoptosis(flow cytometry method),inflammatory factor levels(ELISA method),and protein expression levels of BCL2-Associated X(Bax),B-cell lymphoma-2(Bcl-2),and cleaved caspase 3 in cells were detected.The targeted relationship between LncRNA NORAD and miR-20a-5p was validated.Results Compared with healthy subjects,the patients with active tuberculosis and asymptomatic M.tuberculosis infection had significantly higher serum levels of inflammatory factors and expression of LncRNA NORAD,and significantly lower miR-20a-5p.Compared with Control group,Model group had significantly higher LncRNA NORAD level,cell proliferation ability,Bcl-2 protein expression,and inflammatory factor levels,but significantly lower miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the sh-NC group,the sh-NORAD group had significantly lower LncRNA NORAD level,Bcl-2 protein expression,inflammatory factor levels,and cell proliferation ability,but significantly higher miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the sh-NORAD+miR-20a-5p inhibitor NC group,the sh-NORAD+miR-20a-5p inhibitor group had significantly higher inflammatory factor levels,Bcl-2 protein expression,and cell proliferation ability,but significantly lower miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the miR-NC group,the miR-20a-5p mimics group had significantly increased inflammatory cytokines and proliferation ability,and significantly reduced apoptosis rate(P＜0.05).The targeted relationship between LncRNA NORAD and miR-20a-5p was further confirmed through experiments.Conclusions LncRNA NORAD is overexpressed in macrophages induced by M.tuberculosis.Silencing the expression of LncRNA NORAD can target the downregulation of miR-20a-5p expression,thereby inhibiting the inflammatory response of macrophages induced by M.tuberculosis and promoting cell apoptosis.

Metering unit is important component of medical service items and also serve as significant bases for scientifically estimating the costs of medical services.National Technical Specification of Medical Service Items(2023 Edition)has set up elements such as"metering unit"and"adjustment coefficient for resource consumption in special circumstances",which clearly stipulate the metering units of each medical service item and the multiples for discretionary increases or decreases in the overall resource consumption when special circumstances occur.These two elements are important references for the cost accounting in medical institutions.The project team has elaborated on the definitions,establishment principles and special circumstances of these two types of elements,namely"metering units"and"adjustment coefficient for resource consumption in special circumstances",providing references for the application of relevant governments and healthcare institutions.

The assignment of the"item code"element in National Technical Specification of Medical Service Items(Version 2023)continues the classification framework and coding rules of National Specification of Medical Service Price Items(Version 2012).The project team experts are members of the WHO-Family of International Classifications(WHO-FIC)China Classification,Terminology and Standards Collaborating Center.The design concept of project coding is the same as that of the International Classification of Health Interventions(ICHI).Both adopt an alphanumeric characters hybrid coding classification method based on multi-axis classification,clarified the definition and scope of these four key classification axis which including anatomy system,anatomical site,surgical procedure and surgical approach,and optimize and update item property,sub-classifications and coding.Unified medical service item code can make contribution to the comparability of statistics related to health care items across regions,promote cross-regional healthcare and healthcare insurance settlement at the national level;improve its refined management level in hospital,and play an important role in performance management and data statistical analysis.

Objective To investigate the effect of long non-coding RNA non-coding RNA-activated by DNA damage(LncRNA NORAD)on macrophage apoptosis induced by Mycobacterium tuberculosis infection via sponging microRNA-20a-5p(miR-20a-5p).Methods Healthy subjects(n=50)who came for health checkup,patients with active tuberculosis(n=50)and individuals with asymptomatic M.tuberculosis infection(n=50)were enrolled from Hebei Chest Hospital from March 2022 to April 2023.Venous blood samples were collected to prepare serum samples.The expression levels of LncRNA NORAD,miR-20a-5p,and inflammatory factors in the serum were measured.Human monocyte line THP-1 was induced to differentiate into macrophages and assigned into Control group,Model group,transfection of NORAD empty vector group(sh-NC group),transfection of sh-NORAD vector group(sh-NORAD group),co-transfection of sh-NORAD and miR-20a-5p inhibitor empty vector group(sh-NORAD+miR-20a-5p inhibitor NC group),co-transfection of sh-NORAD and miR-20a-5p inhibitor vector group(sh-NORAD+miR-20a-5p inhibitor group),transfection of miR-20a-5p empty vector group(miR-NC group),and transfection of miR-20a-5p vector group(miR-20a-5p mimics group).The expression levels of LncRNA NORAD and miR-20a-5p(qRT PCR method),cell proliferation ability(CCK-8 kit method),cell apoptosis(flow cytometry method),inflammatory factor levels(ELISA method),and protein expression levels of BCL2-Associated X(Bax),B-cell lymphoma-2(Bcl-2),and cleaved caspase 3 in cells were detected.The targeted relationship between LncRNA NORAD and miR-20a-5p was validated.Results Compared with healthy subjects,the patients with active tuberculosis and asymptomatic M.tuberculosis infection had significantly higher serum levels of inflammatory factors and expression of LncRNA NORAD,and significantly lower miR-20a-5p.Compared with Control group,Model group had significantly higher LncRNA NORAD level,cell proliferation ability,Bcl-2 protein expression,and inflammatory factor levels,but significantly lower miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the sh-NC group,the sh-NORAD group had significantly lower LncRNA NORAD level,Bcl-2 protein expression,inflammatory factor levels,and cell proliferation ability,but significantly higher miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the sh-NORAD+miR-20a-5p inhibitor NC group,the sh-NORAD+miR-20a-5p inhibitor group had significantly higher inflammatory factor levels,Bcl-2 protein expression,and cell proliferation ability,but significantly lower miR-20a-5p level,apoptosis rate,and Bax and cleaved caspase 3 protein expression(P＜0.05).Compared with the miR-NC group,the miR-20a-5p mimics group had significantly increased inflammatory cytokines and proliferation ability,and significantly reduced apoptosis rate(P＜0.05).The targeted relationship between LncRNA NORAD and miR-20a-5p was further confirmed through experiments.Conclusions LncRNA NORAD is overexpressed in macrophages induced by M.tuberculosis.Silencing the expression of LncRNA NORAD can target the downregulation of miR-20a-5p expression,thereby inhibiting the inflammatory response of macrophages induced by M.tuberculosis and promoting cell apoptosis.

Objective:To explore the effect of continuous blood purification (CBP) on the immunity and endothelial cell function of patients with sepsis.Methods:A prospective study was conducted. The patients aged ≥18 years old and meeting the diagnostic criteria of sepsis admitted to the department of critical care medicine of Binzhou Medical University Hospital from March 2019 to October 2020 were selected as the research subjects, and the patients were divided into standard treatment group and CBP treatment group according to random number table method. Both groups were given standard treatment including initial fluid resuscitation, infection source control and antibiotics according to the 2016 international guidelines for the management of sepsis and septic shock. CBP treatment group was additionally given continuous veno-venous hemofiltration (CVVH) at a dose of 25-30 mL·kg -1·h -1 and blood flow rate of 150-200 mL/min for more than 20 hours a day for 3 days. The clinical data of patients including blood lactic acid (Lac), procalcitonin (PCT), lymphocyte count (LYM), acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment (SOFA) score were recorded before treatment and 1 day and 3 days after treatment. At the same time, the venous blood was collected, and the immune function related indexes [interleukins (IL-4, IL-7), programmed death receptor-1 (PD-1), programmed death ligand-1 (PD-L1), interferon-γ (IFN-γ)] and endothelial cell injury related markers [soluble thrombomodulin (sTM), angiopoietin-2 (Ang-2), von Willebrand factor (vWF), heparan sulfate (HS), syndecan-1 (SDC-1)] levels in serum were determined by enzyme-linked immunosorbent assay (ELISA). The length of intensive care unit (ICU) stay of patients in the two groups was recorded, and the outcomes of patients in the two groups were followed up for 28 days. Results:Finally, 20 patients were enrolled in the standard treatment group, and 19 patients were enrolled in the CBP treatment group. There were no significant differences in gender, age and infection site between the two groups. The length of ICU stay in the standard treatment group was (10±5) days, and 5 patients died and 15 patients survived after 28 days. The length of ICU stay in the CBP treatment group was (9±4) days, and 8 patients died and 11 patients survived after 28 days. There were no significant differences in the length of ICU stay and number of patients who died within 28 days between the two groups (both P > 0.05). There were no significant differences in the Lac, PCT, LYM, APACHEⅡ score, SOFA score and immune function and endothelial cell injury related indexes before treatment and 1 day after treatment between the two groups. After 3 days of treatment, the Lac, PCT, APACHEⅡ score and SOFA score of the CBP treatment group were significantly lower than those before treatment, and pro-inflammatory and anti-inflammatory cytokines such as IFN-γ and IL-4, apoptosis-related indicators such as PD-1 and IL-7, and endothelial injury related factors such as sTM, SDC-1 and HS were significantly improved compared with the pre-treatment, the improvement degree of the above indicators was more obvious than that of the standard treatment group, and LYM was significantly higher than that of the standard treatment group (×10 9/L: 1.3±0.3 vs. 0.9±0.4, P < 0.05), IL-4, IFN-γ, IFN-γ/IL-4 ratio, IL-7, PD-1, sTM, SDC-1, HS, and Ang-2 were significantly lower than those of the standard treatment group [IL-4 (ng/L): 2.8 (1.5, 3.2) vs. 3.3 (2.7, 5.2), IFN-γ (ng/L): 6.3 (5.4, 106.5) vs. 217.9 (71.4, 517.1), IFN-γ/IL-4 ratio: 3.7 (1.8, 70.3) vs. 59.1 (18.3, 124.9), IL-7 (ng/L): 4.6 (3.2, 5.1) vs. 6.3 (5.2, 8.0), PD-1 (μg/L): 0.04 (0.03, 0.06) vs. 0.08 (0.05, 0.12), sTM (μg/L): 4.9 (4.3, 7.4) vs. 8.7 (6.0, 10.8), SDC-1 (μg/L): 0.6 (0.3, 1.1) vs. 0.9 (0.8, 2.5), HS (ng/L): 434.8 (256.2, 805.0) vs. 887.9 (620.1, 957.3), Ang-2 (ng/L): 934.0 (673.3, 1 502.1) vs. 2 233.9 (1 472.5, 3 808.4)], the differences were statistically significant (all P < 0.05). Conclusion:CBP treatment can eliminate the patient's immunosuppressive state, reduce a variety of endothelial injury markers and the degradation of glycocalyx, but cannot decrease the 28-day death risk or shorten the length of ICU stay.

ObjectiveTo explore the clinical efficacy of Huanglian Jiedutang as an adjunctive treatment for acute cerebral infarction complicated with gastric motility disorder. MethodSixty patients with acute cerebral infarction complicated with gastric motility disorder with fire toxin syndrome were randomly divided into a western medicine control group （control group） and a traditional Chinese medicine （TCM） combined treatment group （observation group）， with 30 cases in each group. The control group received basic treatment for cerebral infarction and relevant western medical symptomatic treatment based on the patients' gastrointestinal symptoms. The observation group received Huanglian Jiedutang in addition to the treatment provided to the control group. The treatment course was 7 days. Neurological deficit scores and gastrointestinal dysfunction scores were assessed in both groups before treatment and on the 4^th and 7^th days of treatment. Gastrointestinal electrographic parameters， serum citrulline （CIT）， and motilin （MTL） levels were measured in both groups before treatment and on the 7^th day of treatment. Clinical efficacy was compared between the two groups. ResultCompared with the baseline in both groups， the neurological deficit scores and gastrointestinal dysfunction scores were significantly reduced on the 4th and 7^th days of treatment （P<0.05）. The reductions in these scores were more significant on the 7^th day compared with those on the 4^th day of treatment （P<0.05）. On the 4^th and 7^th days of treatment， the observation group showed a significantly greater reduction in neurological deficit scores and gastrointestinal dysfunction scores compared with the control group （P<0.05）. On the 7th day of treatment， compared with the baseline， both groups showed a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. On the 7th day of treatment， compared with the control group， the observation group had a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. After 7 days of treatment， the total effective rate in the observation group was 90.00% （27/30）， higher than 76.67% （23/30） in the control group， but the difference was not statistically significant. ConclusionAdjunctive treatment with Huanglian Jiedutang can effectively improve the symptoms of neurological function impairment and gastrointestinal dysfunction in patients with acute cerebral infarction complicated with gastric motility disorder， increase gastric antral and gastric body electric wave amplitudes， improve gastric motility disorder， and increase serum CIT and MTL levels， thereby improving the imbalanced secretion function of the gastrointestinal tract.