OBJECTIVE To establish standardized operating procedures,result interpretation guidelines,and clinical application protocols for dust mite-nasal allergen challenge(NAC),and to systematically evaluate its operational reliability and safety.METHODS Patients with positive serum-specific IgE(sIgE)against mites and healthy controls were enrolled between January 2023 and December 2024.Demographic and clinical information was systematically collected.A standardized mite allergen extract was utilized to prepare the challenge solution for all participants.Bilateral synchronous nasal spray challenges were conducted using progressively increasing concentrations(1 000,3 000,10 000,and 30 000 BU/ml).During the challenge,total nasal symptom scores,visual analogue scale,acoustic rhinometry,active anterior rhinomanometry,and four-phase rhinomanometry were assessed,and all evaluation data and diagnostic outcomes were documented accordingly.RESULTS Compared to the baseline measurements,both subjective symptom scores and objective evaluation indicators in patients demonstrated statistically significant changes following NAC(P≤0.001).Among these patients,40 individuals(81.6%)exhibited a positive response to the dust mite-NAC.All healthy control subjects showed negative results in the test.CONCLUSION This study established standardized operating procedures and clinical application guidelines for the dust mite-NAC.These encompass indications,contraindications,preparation of stimulation solutions,procedural steps,operational standards,criteria for positive results,and pre-/post-examination precautions,thereby providing a clinically actionable framework for dust mite-NAC implementation.

Objective To investigate the mechanisms by which miR-23 regulates the PI3K/AKT/mTOR signaling pathway to influence myocardial remodeling,fibrosis,and angiogenesis in hypertensive heart failure(HF)rats.Methods Forty rats were randomly divided into four groups(n=10 per group):a control group,a model group,an antagomir-NC group,and an antagomir-23 group.The HF model was established using a high-salt diet,and intervention was performed via tail vein injection of antagomir-23.Cardiac function parameters,the degree of myocardial fibrosis,cell apoptosis levels,and the expression of angiogenesis-related proteins including CD31,VEGF,and bFGF were measured in each group.Concurrently,the activity of the PI3K/AKT/mTOR signaling pathway was assessed.A dual-luciferase reporter assay was conducted to confirm that miR-23 targets PI3K.Results Inhibition of miR-23 significantly improved cardiac function in hypertensive HF rats,reduced myocardial fibrosis and apoptosis,and enhanced the expression of CD31,VEGF,bFGF,and activated the PI3K/AKT/mTOR signaling pathway in hypertensive HF rats(all P<0.05).The dual-luciferase assay confirmed that miR-23 negatively regulates PI3K expression.Conclusion Inhibition of miR-23 can activate the PI3K/AKT/mTOR signaling pathway,promote angiogenesis,reduce myocardial damage,thereby delaying the progression of hypertensive heart failure.

AIM: To compare the clinical effect of small incision lenticule extraction(SMILE)and implantable collamer lens(ICL)implantation on efficacy, safety and visual quality in patients with high myopia complicated with low astigmatism.METHODS: Retrospective study. A total of 80 cases(159 eyes)of high myopia and low astigmatism treated in the hospital from January 2021 to January 2022 were included, and they were divided into 46 cases(91 eyes)in SMILE group and 34 cases(68 eyes)in ICL implantation group by means of different surgical methods. The spherical equivalent, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), higher order aberrations of cornea and optical quality index, effectiveness and safety index were compared between the two groups before surgery and at 3 and 6 mo after surgery, and the surgical complications were counted.RESULTS: The spherical equivalent, UCVA and BCVA of both groups were all improved at 6 mo postoperatively(all P<0.05). At 6 mo after surgery, there were no differences in UCVA, BCVA, spherical equivalent, effectiveness and safety index between both groups(all P>0.05). The root mean square values of total higher order aberration, spherical aberration, coma, vertical coma and horizontal coma in the SMILE group were higher than those in the ICL implantation group, and Strehl ratio(SR)in the ICL implantation group was higher than that in the SMILE group at 3 and 6 mo after surgery(all P<0.05). CONCLUSION: SMILE and ICL implantation have good surgical efficacy in the treatment of patients with high myopia and low astigmatism, and both methods can achieve good postoperative visual acuity and objective visual quality. Furthermore, the ICL implantation has better postoperative visual quality than SMILE.

ObjectiveTo establish a method using ultra-high performance liquid chromatography-tandem mass spectrometry （UHPLC-MS/MS） for the detection of six common trichothecene toxins in oats. MethodsOats were selected as the research subject in this study. Response surface design was used to optimize the QuEChERS extraction method. Additionally， a rapid and efficient strategy for sample extraction and purification was developed. Combined with UHPLC-MS/MS， six commonly co-occurring trichothecene toxins in oats were quantitatively analyzed simultaneously. ResultsThis method demonstrated good analytical performance for each analyte across the corresponding concentration ranges （r>0.99）， with accuracy ranging from 87.26% to 99.64%. The inter-day and intra-day relative standard deviations were less than 6.8% and 5.5%， respectively， indicating its potential for practical application. This method was used to detect mycotoxins in 12 oat samples from China， and it was found that one sample exceeded the standard limits for deoxynivalenol （DON）， and the co-contamination of trichothecene toxin was prevalent. ConclusionThe risk posed by these toxins has been underestimated. Ongoing， extensive monitoring is necessary to provide contamination data to assess the consumer risk.

Human immunodeficiency virus (HIV) transmitted drug resistance (TDR) means the infection of HIV drug-resistant strains, which are detected in patients without a history of exposure to antiretroviral (ARV) drugs. TDR has the potential to reverse the effectiveness of first-line antiretroviral therapy, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP), and is the practical major threat to the realization of the targets for HIV prevention and control. The changes in fitness of HIV DR strains are the basic biological factor challenging the risk of its transmission, and related to the selection of the survey population, the determination of the time span between diagnosis of HIV infection and testing of DR, and the application of DR test assay. The integrated definition and interpretation of surveillance drug resistance mutations (SDRMs) is the key to obtaining accurate surveillance results. This article reviews the recent progress in research on the fitness of HIV DR strains, identification of SDRMs, and the selection of surveillance population. It also proposes key areas for TDR monitoring in China, including the development of SDRMs list tailored to the characteristics of Chinese strains, high-resolution sequencing to accurately identify mixed base pairs, and the standardization of TDR monitoring. These efforts will provide scientific support for accurate TDR monitoring results and effective containment of the transmission of drug-resistant strains.

AIM: To explore the clinical effect of small incision lenticule extraction(SMILE)on the treatment of myopic anisometropia.METHODS: Clinical data of 76 patients(146 eyes)with myopic anisometropia who received SMILE or femtosecond assisted laser in situ keratomileusis(FS-LASIK)in our hospital from January 2021 to December 2022 were retrospectively analyzed. The patients were divided into SMILE group(39 cases, 77 eyes)and FS-LASIK group(37 cases, 69 eyes)according to surgical methods. Uncorrected visual acuity(UCVA), diopter, anisometropia, corneal aberration and occurrence of postoperative complications were compared between the two groups at 1 wk, 1 and 3 mo after surgery.RESULTS: The UCVA of the two groups was improved after surgery compared with that before surgery, and the coma, trefoil, spherical aberration and total higher-order aberration were significantly increased compared to those before surgery(P<0.05), and the coma, trefoil, spherical aberration and total higher-order aberration in the FS-LASIK group were significantly higher than those in the SMILE group(P<0.05). After follow-up to 3 mo after surgery, the incidence of postoperative complications was significantly lower in the SMILE group than that in the FS-LASIK group(5.2% vs 15.9%, P<0.05).CONCLUSION: Both SMILE and FS-LASIK can effectively enhance the UCVA and improve the visual quality in patients with myopic anisometropia, but SMILE has lower corneal higher order aberrations, lower incidence of postoperative complications and better overall effect.

Selecting high-quality patient report outcome measures for patients with liver transplantation may properly assess health condition from their perspective, assist nurses in identifying patients′ reports of health issues, and deliver targeted nursing care for them. This paper reviewed the current status of researches on measurement tools for patient reported outcomes in liver transplantation both domestically and internationally, including the content, characteristics, disadvantages and situation recommendations of the generic and specific measurement tools. The purpose is to provide a reference for choosing patient reported outcomes measurements, symptom management as well as the caring strategies in liver transplantation.

Objective:To investigate the diagnostic performance of continuous-time random-walk (CTRW) diffusion model combined with vesical imaging-reporting and data system (VI-RADS) in the diagnosis of muscle invasion of bladder cancer.Methods:In this case-control study, 64 patients with pathologically confirmed bladder urothelial carcinoma in Peking University First Hospital were retrospectively enrolled from August 2022 to March 2023. The patients were divided into the muscle invasive bladder cancer (MIBC) group and the nonmuscle invasive bladder cancer (NMIBC) group (29 cases and 35 cases, respectively) according to the pathological results. All patients underwent bladder MRI within 4 weeks before surgery, including T 2WI, conventional diffusion weighted imaging (DWI), and multi-b-value DWI. The CTRW model was used to obtain three quantitative diffusion parameters, including D m (an anomalous diffusion coefficient), α (related to temporal diffusion heterogeneity), and β (related to spatial diffusion heterogeneity). The apparent diffusion coefficient (ADC) was calculated using a mono-exponential model. The VI-RADS scores were evaluated based on T 2WI and conventional DWI. The Mann-Whitney U test was used to compare the diffusion parameters between the MIBC group and the NMIBC group. The combination of the parameters was investigated with logistic regression analysis. The diagnostic performance for muscle invasion of bladder cancer was evaluated by receiver operating characteristic analysis and the area under the curve (AUC). The difference between AUC was compared using the DeLong test. Results:There were statistically significant differences in ADC, D m, and α between the MIBC group and the NMIBC group ( Z=-2.31, -2.91, -3.97, P=0.021, 0.004,<0.001). No significant difference was found in β between the two groups ( Z=1.69, P=0.091). The AUC (95% CI) of D m and α for diagnosing MIBC were 0.712 (0.587-0.838) and 0.790 (0.676-0.904) respectively, both of which were higher than that of ADC (AUC 0.669, 95% CI 0.537-0.801) with statistically significant differences ( Z=2.86, 2.27, P=0.004, 0.023). The AUC (95% CI) of CTRW (D m+α) was 0.782 (0.661-0.876), which was significantly higher than that of ADC ( Z=2.35, P=0.019). The AUC (95% CI) of VI-RADS score and VI-RADS combined with CTRW parameter (VI-RADS+D m+α) were 0.823 (0.716-0.930) and 0.900 (0.799-0.961) respectively, with a statistically significant difference between them ( Z=2.16, P=0.031). Conclusion:The D m and α parameters in the CTRW diffusion model show better performance than the ADC in the mono-exponential model for muscle-invasive evaluation of bladder cancer, and the CTRW diffusion model can enhance the diagnostic performance of VI-RADS.

The nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome is an inflammatory protein complex, and can participate into the inflammatory response. Upon activation, these inflammasomes can lead to Caspase-1 activation, thereby inducing a cascade of inflammatory factor activation and further cell pyroptosis. Excessive activation of inflammasomes will induce the overexpression of inflammatory factors, persistently triggering immune dysregulation and inflammatory chain reactions, even causing severe damage. The recent studies have confirmed a close association between retinal diseases, such as diabetic retinopathy(DR), retinal ischemia-reperfusion injury(RIRI), and proliferative vitreoretinopathy(PVR)with immune dysregulation and inflammatory responses, which is serving as crucial factors in the progression of retinal diseases. This article reviews the NLRP3 inflammasome signaling pathway and its role in the occurrence and development of retinal diseases, in order to provide new ideas for the pathogenesis and prevention of retinal diseases.

【Objective】 To observe the effect of tele-rehabilitation program on the articulation resolution of preschool children with functional articulation disorders (FAD), so as to provide reference for the clinical application of tele-rehabilitation in this context. 【Methods】 A total of 66 preschool children diagnosed with FAD in the outpatient department of Child Rehabilitation, Tangshan Maternal and Child Health Hospital from March 2022 to March 2023 were selected into this study, and were divided into tele-rehabilitation group (n=32) and control group (n=34) by random number table method. The control group received daily family rehabilitation guidance, while the tele-rehabilitation group underwent a tele-rehabilitation program lasting for 3 months. All children were assessed using the Chinese phonological ability evaluation lexicon before and 3 months after the treatment. 【Results】 After 3 months of treatment, both the tele-rehabilitation group and the control group showed significant improvements in articulation resolution compared to before treatment (t=12.165、12.986, P<0.05). Notably, the tele-rehabilitation group exhibited significantly greater improvement than the control group (t=2.138, P<0.05). Within the tele-rehabilitation group, children were further divided into three subgroups based on the severity of their dysphonia: mild, moderate, and severe. After 3 months of treatment, the articulation resolution of the mild and moderate groups improved significantly compared to before treatment (Z=2.226, 31.900, P<0.05), whereas no statistically significant improvement was observed in the severe group compared to before treatment (Z=1.857, P>0.05). 【Conclusion】 Tele-rehabilitation program effectively improves articulation resolution in preschool children with FAD, especially for mild to moderate preschool children with FAD.