Objective To evaluate the efficacy of combining the replenishing qi and nourishing yin empirical formula with anti-vascular endothelial growth factor (VEGF) in diabetic macular edema (DME). Methods A retrospective analysis was conducted on 59 patients diagnosed with DME at Tongji Hospital of Tongji University or Shanghai Nanxiang Hospital, Jiading District from June 2019 to December 2022. Among them, 29 cases received intravitreal injection of ranibizumab (anti-VEGF group), while 30 cases received both intravitreal injection of ranibizumab and oral administration of the replenishing qi and nourishing yin empirical formula (combined treatment group). The best corrected visual acuity (BCVA), central macular thickness (CMT), and the traditional Chinese medicine (TCM) syndrome score were compared between the two groups before treatment and at 4, 8, 12, 16, 20, and 24 weeks after treatment. Results Compared with before treatment, BCVA significantly improved (P＜0.05) and CMT significantly decreased (P＜0.05) at different time points after treatment in both groups. At 16, 20, and 24 weeks after treatment, BCVA in the combined treatment group was superior to that in the anti-VEGF group (P＜0.01). At 12, 16, 20, and 24 weeks after treatment, CMT in the combined treatment group was lower than that in the anti-VEGF group (P＜0.01). Starting from week 8 after treatment, the TCM syndrome scores in the combined treatment group were lower than those in the anti-VEGF group (P＜0.01). Conclusions The replenishing qi and nourishing yin empirical formula could improve the efficacy of anti-VEGF therapy in DME patients, indicating that integrating traditional Chinese and Western medicine has certain clinical application value in treating DME.

Objective To investigate the cross-sectional associations between different fatty liver classifications and cardiac structure and function in people undergo health examination. Methods A total of 6 545 adults who underwent health examinations at the Health Management Center of Zhongshan Hospital, Fudan University between January 1 and December 31, 2017, were retrospectively included. Demographic characteristics and laboratory data were collected. The hepatic steatosis was graded by ultrasonography. And patients with fatty liver were further stratified according to alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels, as well as the degree of liver fibrosis. Cardiac morphology and function were assessed by transthoracic echocardiography, and left ventricular geometric patterns were classified accordingly. Multivariate logistic regression analysis was performed to evaluate the associations between fatty liver classifications and cardiac abnormalities. Results There were 2 795 patients (42.7%) with fatty liver, of whom 832 (29.8%) had significant cardiac structural alterations and 1 500 (53.7%) had diastolic dysfunction. Severe fatty liver was risk factor for concentric remodeling and increased relative wall thickness (RWT), with odds ratios (ORs) of 1.27 (P＝0.012) and 1.27 (P＝0.009), respectively. Fatty liver accompanied by elevated ALT or AST was risk factor for concentric remodeling (OR＝1.45,1.56; P＝0.001, 0.001), increased RWT (OR＝1.48,1.57; P＜0.001, ＜0.001), and diastolic dysfunction (OR＝1.27, 1.32; P＝0.035, 0.040), respectively. Fatty liver with liver fibrosis was risk factor for concentric remodeling (OR＝1.83, P＝0.046) and diastolic dysfunction (OR＝2.64, P＝0.034). Conclusions Advanced fatty liver, including severe hepatic steatosis, accompanied by elevated liver enzymes or liver fibrosis, could increase risks of cardiac remodeling and diastolic dysfunction, while systolic function is preserved. For patients with fatty liver, it is recommended to undergo regular ultrasonography examination.

AIM: To compare objective visual quality and vision-related quality of life after implantation of different presbyopia-correcting intraocular lenses(PC-IOLs).METHODS:A prospective, non-randomized controlled study. Cataract patients who underwent phacoemulsification combined with PC-IOL implantation at Jinan Mingshui Eye Hospital from September 2023 and December 2025 were included. These patients were divided into three groups according to the type of IOL: the Trifocal IOL group,the Vivity group, and the Synergy group. Follow-ups were conducted at 1 wk,1 and 3 mo postoperatively. Uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA), objective scatter index(OSI), modulation transfer function cut off(MTF-cut off), and Strehl ratio(SR), as well as contrast visual acuity(CVA)at 100%, 20%, and 9% contrast were assessed. Postoperative defocus curves were plotted. Vision-related quality of life and spectacle independence were evaluated using questionnaires.RESULTS: This study included 101 cataract patients(101 eyes),aged 30-70(53.8±9.7)y,with 59 males and 42 females.The Trifocal group consisted of 33 patients(33 eyes), aged 30-71(51.7±11.3)y, with 21 males and 12 females; the Vivity group consisted of 37 patients(37 eyes), aged 36-71(54.2±9.0)y, with 18 males and 19 females; and the Synergy group consisted of 31 patients(31 eyes), aged 30-73(55.9±8.5)y, with 20 males and 11 females.No significant differences were observed among the three groups in UDVA or UIVA(all P>0.05). Significant differences were found in UNVA among groups(P<0.05). UDVA differed significantly across different time points(P<0.05), while there were no significant differences in UIVA and UNVA(all P>0.05). At 3 mo postoperatively, significant differences were found among the three groups in OSI, MTF -cut off, SR, and CVA at all contrast levels(all P<0.05). The defocus curve at postoperative 1 mo showed that the Trifocal group had a smooth and continuous profile from +1.0 D to -3.0 D, providing good distance, intermediate, and near vision. All groups demonstrated smooth transitions in the intermediate range(-1.0 D to -1.5 D), with LogMAR visual acuity better than 0.2. In the near range(-2.5 D to -3.5 D), the Trifocal and Synergy groups performed significantly better than the Vivity group. No significant differences were observed in VF-14 questionnaire scores among groups(P>0.05). For night driving(motorized or non-motorized), the Vivity group performed better than the Trifocal and Synergy groups. Spectacle independence rates were 92.3% in the Trifocal group, 54.1% in the Vivity group, and 80.0% in the Synergy group(P<0.05).CONCLUSION: All types of PC-IOLs can effectively improve postoperative full-range visual acuity in cataract patients. There are discrepancies in the objective visual quality between Trifocal IOLs and extended depth of focus(EDOF)IOLs. Some patients suffer from postoperative optical disturbances, which result in certain difficulties with night driving, although patients generally report favorable subjective visual perceptions.

Objective To analyze the prevalence of hyperuricemia (HUA) among adults in Hebei Province and its influencing factors related to comorbidities with ^“three highs^”, and to provide a theoretical basis for the prevention and control of HUA and multi-disease co-management. Methods Data were derived from the 2018 China Chronic Disease and Risk Factors Surveillance program conducted in Hebei Province. A multi-stage stratified cluster random sampling method was used to select permanent residents aged ≥18 years. All statistical analyses were adjusted for complex weighting. Design-based logistic regression was employed to analyze factors influencing HUA prevalence, and ordinal logistic regression was used to analyze the influencing factors of HUA patients and their comorbidity with ^“three highs^”. Results The prevalence of HUA among adults in Hebei Province was 10.42%, with males showing higher rates than females (P<0.05). The highest prevalence of HUA was observed in the 18-39 age group, followed by a declining trend, and a resurgence in those aged ≥70 (P<0.05). Among HUA patients with comorbidities, isolated HUA, 1 comorbidity, 2 comorbidities, and 3 comorbidities accounted for 13.94%, 33.33%, 39.17%, and 13.56%, respectively. HUA combined with hypertension and dyslipidemia represented the highest proportion (31.07%). Analysis of the influencing factors of HUA revealed that higher education levels, obesity, central obesity, and dyslipidemia increased the risk of HUA (P<0.05). Ordinal logistic regression analysis of HUA combined with three highs showed that HUA patients aged ≥50 years, overweight individuals, and those with chronic kidney disease had a higher number of patients with three highs (P<0.05). Conclusion HUA exhibits insidious onset, and it is recommended to include uric acid testing in routine physical examinations. Targeted prevention measures, such as early uric acid testing and health education, should be implemented by Hebei authorities for populations with higher education levels, obesity, central obesity, and dyslipidemia to reduce HUA incidence. Additionally, health education and regular medical check-ups are recommended for overweight HUA patients and those with chronic kidney disease to prevent comorbidities and alleviate disease burden.

Based on the viewpoint of "sweat pore-qi and liquid-kidney collaterals"， it is believed that children's nephrotic syndrome is caused by the core mechanism of sweat pore constraint and closure， qi and liquid imbalance， and kidney collaterals impairment， and it is proposed that the treatment principle is to nourish the sweat pore， regulate qi and fluid， and supplement the kidney and unblock the collaterals. In clinic， guided by sequential therapy and according to the different disease mechanism characteristics of the four stages， including early stage of the disease， hormone induction stage， hormone reduction stage， hormone maintenance stage， the staged dynamic identification and treatment was applied. For early stage of the disease with edema due to yang deficiency， modified Zhenwu Decoction （真武汤） was applied to warm yang and drain water； for hormone induction stage with yin deficiency resulting in effulgent fire， modified Zhibai Dihuang Pill （知柏地黄丸） plus Erzhi Pill （二至丸） was used to enrich yin and reduce fire； for hormone reduction stage with qi and yin deficiency， modified Shenqi Dihuang Decoction （参芪地黄汤） was used to boost qi and nourish yin； for hormone maintenance stage， modified Shenqi Pill （肾气丸） was used to supplement yin and yang. Meanwhile， the treatment also attaches importance to the combination of vine-based or worm medicinals to dredge collaterals， so as to providing ideas for clinical treatment.

Objective To investigate the correlation between total oxidation state(TOS),superoxide dis-mutase(SOD),glutathione reductase(GR)and androgen receptor(AR)expression,as well as their predictive value for castration-resistant prostate cancer(CRPC).Methods A retrospective analysis was conducted on the clinical data of 382 patients with prostate cancer who received endocrine therapy in our hospital from Janu-ary 2021 to March 2023.These patients were divided into a CRPC group(91 cases)and a non-CRPC group(291 cases)based on whether they progressed to CRPC within one year.The clinical data of the two groups were compared,and the levels of TOS,SOD,GR,and AR expression before and after treatment were com-pared between the two groups.The correlation between TOS,SOD,GR,and AR expression was analyzed using the Spearman method.The relationship between TOS,SOD,GR,and AR expression in the CRPC group was analyzed using partial correlation analysis.Logistic regression analysis was used to investigate the impact of TOS,SOD,and GR on the occurrence of CRPC after 1 month of treatment,and receiver operating charac-teristic(ROC)curve analysis was used to evaluate the predictive efficacy of TOS,SOD,and GR on CRPC af-ter 1 month of treatment.Results Gleason score ≥8 and T4 in clinical stage in CRPC group were higher than those in non-CRPC group,and the difference was statistically significant(P＜0.05).After 1 month and 1 year of treatment,the positive expression rates of TOS and AR in both groups were higher than before treatment,while the levels of SOD and GR were lower than before treatment,with a statistically significant difference(P＜0.05).After 1 month and 1 year of treatment,the TOS level and AR positive expression rate in the CRPC group were higher than those in the non-CRPC group,while the SOD and GR levels were lower than those in the non-CRPC group,with statistical significance(P＜0.05).Spearman correlation analysis showed that TOS was positively correlated with AR expression in the CRPC group after 1 month and 1 year of treat-ment(P＜0.05),while SOD and GR were negatively correlated with AR expression(P＜0.05).Logistic re-gression analysis showed that,Gleason score ≥8,T4 in clinical stage,and TOS,SOD,and GR after 1 month of treatment were all associated with the occurrence of CRPC(P＜0.05).It was found that after adjusting for Gleason score and clinical stage,TOS,SOD,and GR were still independent factors for CRPC after 1 month of treatment(P＜0.05).The ROC curve analysis results showed that the area under the curve of TOS,SOD,and GR combined to predict CRPC after 1 month of treatment was 0.938(95％CI:0.908-0.960),which was higher than that of each indicator alone.Conclusion The expression of TOS,SOD,GR,and AR is correlated to some extent,and combined detection has certain predictive value for CRPC.It can be used as an auxiliary indicator for clinical prediction of CRPC and has certain guiding value for subsequent clinical decisions for patients.

Objective:To investigate the effects of rehabilitation nursing based on knowledge-action framework on compliance behavior and coping styles in patients with chronic respiratory failure (CRF), and provide scientific basis and practical guidance for clinical nursing of patients with CRF.Methods:A historical control study was conducted. A retrospective analysis was performed on the clinical data of patients with CRF in Yiwu Central Hospital between January and April 2024. According to admission time, the patients were divided into the control group (admitted from January to February 2024, received routine rehabilitation nursing) and the study group (admitted from March to April 2024, received rehabilitation nursing based on knowledge-action framework). All patients were intervened for 1 month. The differences in self-care ability, compliance behavior, coping styles, quality of life between the two groups were compared using Exercise of Self-Care Agency Scale (ESCA), Compliance Behavior Questionnaire, Trait Coping Style Questionnaire (TCSQ), St. George′s Respiratory Questionnaire (SGRQ).Results:A total of 60 patients with CRF were included, 30 patients in the study group, with 16 males and 14 females, aged (68.72 ± 4.67) years old; 30 patients in the control group, with 17 males and 13 females, aged (69.21 ± 4.18) years old. Before intervention, there were no significant differences in ESCA score, TCSQ score and SGRQ score between the 2 groups (all P>0.05). After 1 month of intervention, ESCA score in the study group was (134.79 ± 5.62) points, higher than (125.34 ± 5.51) points in the control group, the difference was statistically significant ( t=6.58, P<0.05). The compliance behavior (adherence to medical regimens, reasonable diet, work and rest, regular checking) in the study group were 30, 28, 27, 29 cases, higher than 25, 20, 20, 22 cases in the control group, the differences were statistically significant ( χ2 values were 4.81-6.68, all P<0.05). The positive coping score of TCSQ in the study group was (39.67 ± 4.54) points, higher than (32.19 ± 4.38) points in the control group, and score of negative coping score was (13.55 ± 2.28) points, lower than (18.31 ± 2.43) points in the control group, the differences were statistically significant ( t=6.49, 7.82, both P<0.05). The SGRQ score in the study group was (30.23 ± 3.29) points, lower than (35.87 ± 3.66) points in the control group, the difference was statistically significant ( t=6.28, P<0.05). Conclusions:For patients with CRF, rehabilitation nursing based on knowledge-action framework can effectively improve self-care ability and compliance behavior, form more positive coping styles, improve quality of life.

Objective:Through imaging analysis, the association between the degree of paravertebral muscle fat infiltration (fat infiltration, FI), trabecular bone score (TBS) and the fracture risk of postmenopausal osteoporosis (OP) patients was explored.Methods:A retrospective selection was made of 110 postmenopausal female patients diagnosed with OP at Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University from Mar. 2023 to Mar. 2024. Additionally, healthy postmenopausal individuals who underwent physical examinations during the same period were included in the healthy postmenopausal group. The levels of paravertebral muscle FI and TBS in the two groups were compared. Postmenopausal patients with OP were followed up for one year, and the incidence of fractures in the patients was analyzed by Kaplan-Meier curve. The patients were divided into the fracture group ( n=29) and the non-fracture group ( n=81). The clinical data of the two groups of patients at admission were compared. Binary Logistic regression was used to analyze the independent risk factors for fractures in patients. Spearman was used to analyze the correlation of fracture risk within one year among FI, TBS and postmenopausal OP patients. ROC was used to evaluate the predictive value of each independent risk factor. Results:The proportion of severe paraverteal muscle FI in the postmenopausal OP group was significantly higher than that in the healthy physical examination group (multifisis FI, erector spinae FI, psoas major muscle FI, χ2=14.96, 17.17, 16.08, all P=0.00), and the lumbar TBS level was significantly lower (t=4.52, P=0.00). The Kaplan-Meier curve indicated that the degree of paravertebral muscle FI affected the incidence of fractures in patients ( χ2=14.58, P=0.00), and the level of lumbar TBS also affected the incidence of fractures in patients ( χ2=6.02, P=0.01). The bone mineral density (BMD), cross-sectional area of the multifidus muscle (CSA), erectus spinae muscle area (CSA), and psoas major muscle area (CSA) of patients in the fracture group were significantly lower than those in the non-fracture group ( t=10.72, 3.40, 3.46, 2.12). P=0.00, 0.00, 0.00, 0.04), while the indicators of TNF-α, IL-6 and PCT were higher than those in the non-fracture group ( t=4.11, 4.96, 5.48, all P=0.00). Binary Logistic regression analysis showed that high-level BMD ( OR=0.52, 95%CI: 0.27-0.77, P=0.01) and TBS ( OR=0.68, 95 %CI: 0.48-0.93 ,P=0.02) were protective factors for fractures in postmenopausal patients with OP. Multifidus FI ( OR=1.73, 95 %CI: 1.48-1.98, P=0.03), erector spinae FI ( OR=1.25, 95%CI:1.10-1.50, P=0.01), and psoas major FI ( OR=1.96, 95 %CI: 1.71-2.21, P=0.03) is the risk factor. Spearman analysis indicated that the paravertebral muscle FI of patients at the first diagnosis of OP was positively correlated with the risk of fracture within one year after diagnosis ( r=0.88, 0.91, 0.82, P=0.01, 0.01, 0.02), while the BMD and TBS values were negatively correlated ( r=-0.92, -0.77, P=0.00, 0.02). ROC showed that the values of multifidus FI, erector spinae FI, psoas major FI, BMD and TBS at admission all had good predictive efficacy for fractures within one year in patients [area under the ROC curve (AUC) =0.88, 0.84, 0.86, 0.73, 0.82]. Moreover, the predictive efficiency of the joint model is higher (AUC=0.89) . Conclusions:Higher BMD and TBS levels protect against fractures in postmenopausal OP patients ( OR=0.523-0.675), while severe paraspinal muscle FI (multifidus: OR=1.726; erector spinae: OR=1.248; psoas: OR=1.961) increases risk. The combined model shows excellent predictive value (AUC=0.890), serving as effective clinical warning indicators for fracture risk assessment.

Objective The optimum formulation process was selected to prepare the ethosomes of Cortex Dictamni-Fructus Kochiae,and its prescription was verified and its properties were studied.Methods The formulation was optimized by single factor and response surface test.The appearance,particle size,Zeta potential and stability were investigated.The encapsulation rate was used as the evaluation index.Results The optimum preparation process of ethosomes of Cortex Dictamni-Fructus Kochiae is as follows:Using the dosage of lyophilized powder 409.06 mg,soybean lecithin 258.07 mg,cholesterol 90.87 mg,ethanol volume fraction 22.76％,stirred for 2 hours at 700 r·min-1 at 50 ℃ water bath temperature,The appearance of the prepared ethosomes suspension was light yellow,and the particles were nearly spherical in shape.The average particle size was(103.1±0.78)nm,the Zeta potential was(-36.0±3.65)mV,and the average encapsulation rates of Xibutanone,ash,and saponin Ⅰc were(89.25±0.91)％,(80.16±1.52)％,(86.59±0.58)％,respectively.After 14 days of storage at room temperature,the results showed that:The ethosomal suspension is still a light yellow,uniform,and stable liquid,and there is no stratified precipitation phenomenon.Conclusion The method of ethanol injection is easy to operate,high encapsulation rate and good stability,which lays a foundation for further study on the skin administration of this preparation.

Objective:To investigate the characteristics of visual and auditory sustained attention and sex differences in pupils of different grades.Method:Totally 231 students from grades 1 to 6 participated in this stud-y.The development and sex differences of sustained attention were measured by average reaction times,coefficients of variation for reaction times,omission error rates and commission error rates in visual and auditory two-choice re-action time(CRT)tasks.Result:The students in grade 5 had significantly slower visual average reaction times and coefficients of variation for reaction times(P＜0.001 or P＜0.05)than those in grade 3.The students in grade 5 had significantly lower auditory average reaction times,coefficients of variation for reaction times,omission error rates and commission error rates(P＜0.001 or P＜0.01)than those in grade 1.There was no significant sex differ-ences in visual or auditory average reaction times,coefficients of variation for reaction times or omission error rates(Ps＞0.05).Conclusion:There would be age differences in characteristics of both visual and auditory sustained at-tention in pupils,and may be no sex difference in visual or auditory sustained attention.