AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P<0.01). The α-SMA expression was the highest in the Trab and SIGS groups at 2 wk after surgery, while the α-SMA expression in the PHAP and TA/PVAH groups was significantly lower than that in the first two groups(P<0.01). Compared with the Trab group, the expression of FGF2 in the PVAH and TA/PVAH group was significantly increased at 1, 2, 3 and 4 wk after surgery(P<0.05). Compared with the SIGS group, FGF2 expression in the TA/PVAH group was significantly increased at 4 wk after surgery(P<0.05).CONCLUSION:In SIGS surgery of rabbit eyes, implanting hydrogel sustained-release sheeting loaded with TA under conjunctival flap can effectively inhibit the scarring of the filtering bleb, which may be the interaction of the anti-scar effect of TA and the stent function of hydrogel.

The impact of various anterior cervical surgeries on biomechanical properties of cervical vertebrae varies depending on the specific surgical techniques employed.However,accurately measuring the mechanical characteristics of individual parts of the cervical vertebrae or implants within them in a clinical setting can be challenging.As a result,the finite element method is commonly utilized in studies on anterior cervical surgery,allowing for the precise analysis of stress and strain distributions in different areas of interest through computer simulations.This method facilitates the study of biomechanical properties associated with different anterior cervical surgical approaches.This review discusses the progress of finite element analysis in anterior cervical surgery,summarizes current research findings on fusion and non-fusion procedures,hybrid surgeries,and minimally invasive techniques,so as to provide theoretical references for the selection of different anterior cervical surgical interventions from a biomechanical perspective.

Objective:To explore the imaging characteristics and clinical value of CT angiography (CTA) of the aorta in active arteritis.Methods:A retrospective analysis was conducted on the clinical data and laboratory examination results of 77 patients with Takayasu arteritis (TAK) admitted to the Rheumatology and Immunology Department of People′s Hospital of Xinjiang Uygur Autonomous Region from January 2015 to October 2022. They were divided into two groups: 62 cases in the TAK active group and 15 cases in the TAK inactive group. Among them, 17 patients were followed up, 13 cases became inactive, and 4 cases remained active. A total of 94 aortic CTA imaging results were divided into 2 groups, with 66 cases in the TAK active group and 28 cases in the TAK inactive group.All patients underwent plain chest and abdominal CT scans, aortic CTA, and post-processing examinations, with 12 active TAK patients undergoing delayed aortic enhancement scans. The t-test, Mann Whitney U test, χ2 Testing, Fisher′s exact probability method and Pearson/Spearman correlation analysis were used for data analysis. The imaging features of the two groups were measured and compared, the correlation between imaging features and laboratory results, Kerr score were investigated. The diagnositic efficacy of imaging features were explored and imaging features before and after treatment were analyzed. Results:In the TAK active and inactive groups, course of disease[14 (1, 29) months vs 33(8, 69)months, Z=2.70, P=0.007], Physical malaise or weight loss[32.3%(20/62) vs 20.0%(3/15), χ2=4.08, P=0.043], increased ESR [98.4% (61/62) vs 13.3% (2/15)], χ2=64.69, P<0.001], CRP level[69.4% (43/62) vs 6.7%(1/15), χ2=29.94, P<0.001] were statistically significant. The vascular wall thickness of the two groups was significantly different [(4.2±1.4)mm vs (2.4±0.8)mm, t=7.81, P<0.001], CT mean value of the garterial wall [(81±8) Hu vs (70±13)Hu, t=2.82, P=0.011], CT max value of the arterial wall [(106±12)Hu vs (96±12)Hu, t=2.38, P=0.024], relative CT value 1 of the arterial wall (0.20±0.08 vs 0.14±0.04, t=2.56, P=0.016), relative CT value 2 of the arterial wall (1.23±0.18 vs 1.06±0.17, t=2.63, P=0.013), CT mean value of periaortic adipose tissue [(-31±12)Hu vs (-58±20)Hu, t=4.80, P<0.001)], CT max value of periaortic adipose tissue [-35(-45,-25)Hu vs -87(-95, -42)Hu, Z=4.27, P<0.001], CT mean value of adipose tissue around branches[-28(-33, -14)Hu vs -76(-83, -31)Hu, Z=3.37, P=0.001], CT max value of adipose tissue around branches[-7(-13,-1)Hu vs -59(-72, -14)Hu, Z=3.74, P<0.001], relative CT values of adipose tissue around the aorta (0.26 ± 0.09 vs 0.51 ± 0.19, t=4.47, P<0.001)], relative CT values of adipose tissue around branches (0.17 ± 0.09 vs 0.28 ± 0.18, t=2.35, P=0.025) were significant different. The wall thickness value, relative CT value of periaortic adipose tissue, and CT mean value of periaortic adipose tissue had high diagnostic efficacy, with cut-off values of 3.25 mm, 0.455, and -55 Hu, respectively. The AUCs were 0.911, 0.887, and 0.863, respectively. The Youden index was 0.687, 0.730, and 0.715, respectively. The sensitivity and specificity were 0.758 and 0.929, 0.909 and 0.821, 0.894 and 0.821, respectively. After treatment, 11 active TAK patients became inactive, with reduced wall thickening, enhancement, and density of perivascular adipose tissue. Thirteen patients with active TAK underwent delayed aortic enhancement scanning, and it was found that the low-density loop sign of the aortic intima was more clearly displayed during this period, and the enhancement amplitude of the vascular wall tended to be uniform. Conclusion:Aortic CTA is an effective method for qualitative evaluation of TAK activity.

Objective To explore the mediating effect of emotion regulatory self-efficacy (ERSE) in the relationship between musculoskeletal disorders and turnover intention in operating room nurses. Methods A total of 372 operating room nurses from five hospitals in Shenyang City were selected as the research subjects using covenient sampling method. The Musculoskeletal Disorders Questionnaire, Turnover Intention Scale, and Emotional Self-Regulation Efficacy Scale were used to study the prevalence of work-related musculoskeletal disorders (WMSDs), turnover intention, and ERSE among the study subjects. The Bootstrap method was used for mediation effect analysis of ERSE. Results The prevalence of WMSDs among operating room nurses was 69.9%. The scores for turnover intention and ERSE among operating room nurses were (13.6±6.3) and (34.7±16.2), respectively. ERSE played a partial mediating role in the relationship between WMSDs and turnover intention among operating room nurses, with an effect value of 0.04 and the 95% confidence interval of 0.01 to 0.08, accounting for 8.1% of the total effect. Conclusion WMSDs and ERSE directly influence turnover intention among operating room nurses. WMSDs can indirectly increase turnover intention by reducing ERSE among operating room nurses.

Objective: To investigate the relationship between negative attentional bias and post traumatic stress disorder(PTSD) in the context of higher depression and anxiety symptoms after the outbreak of COVID 19, so as to provide scientific basis for mental health education in primary and secondary schools. Methods: From March to April 2021, a total of 708 students from primary school and junior high school (grade 6 through grade 9) in Beijing,Shanxi,Hunan,Shandong,Hebei,Hubei of China were selected. The Children s Revised Impact of Event Scale(CRIES), the Attention to Positive and Negative Information Scale （APNI）and Depression, Anxiety and Stress Scale-21(DASS-21) were used in a questionnaire survey. Results: A total of 242 students were diagnosed with PTSD, and the detection rate was 34.2%.The scores of intrusion and high arousal of boys（7.92±5.33,8.60± 5.41 ） were lower than those of girls（8.72±4.85,9.50±4.76），and the difference was statistically significant ( t =-2.04, -2.32, P < 0.05 ). There were statistically significant differences of negative attention bias,CRIES score, intrusion,debarb and high arousal among primary and middle school students of different grades ( F =3.57,5.99,4.45,4.60,7.40, P <0.05). Negative attention bias, anxiety, depression and post traumatic stress symptoms were significantly positively correlated ( r =0.27-0.84, P <0.05). Logistic regression analysis showed that anxiety ( OR =1.13, 95% CI =1.06-1.20) and negative attention bias ( OR =1.10, 95% CI =1.07- 1.12 ) were positively associated with PTSD symptoms in primary and middle school students( P <0.01). Conclusion Anxiety and depressive symptoms show impacts on negative attention bias and might exacerbate the symptoms of post traumatic stress disorder. Therefore, emotional adjustments can help reduce the post traumatic stress response in the post epidemic period.

Objective:To investigate the role and underlying mechanisms of inhibiting high mobility group box-1 (HMGB1) in the expression of matrix metalloproteinase-9 (MMP-9) in spinal cord astrocytes (AS) in rats after spinal cord injury (SCI).Methods:After an SCI model was established in Sprague-Dawley (SD) rats using a modified Allen's Weight-Dropping method and ethyl pyruvate (EP) or glycyrrhizin (GL) was used to inhibit the effect of HMGB1, the rats were divided into a sham group, an SCI group, an SCI+EP (50 mg/kg) group, and an SCI+GL (100 mg/kg) group. The expression levels of glial fibrillary acid protein (GFAP) and MMP-9 in spinal cord AS were observed. After the spinal cord AS in SD rats was cultured and incubated by the oxygen-glucose deprivation/reoxygenation (OGD/R) procedure, the expression of MMP-9 protein was detected at 6 h/R 6 h, 12 h, 24 h, and 48 h after OGD. The time point with the highest expression was chosen in the subsequent experiments as an OGD/R group. HMGB1 was inhibited by HMGB1 shRNA or EP to observe the effect of HMGB1 on the expression of MMP-9 protein in AS treated with OGD/R. Then, toll-like receptor 4 (TLR4) inhibitor, TIR-domain-containing adaptor inducing interferon- β (TRIF) inhibitor, and nuclear factor-kappa B (NF- κB) inhibitor were used to investigate the effects of TLR4/TRIF/NF- κB signaling pathway during the regulation of HMGB1 on MMP-9 in vitro. Results:Western blot showed that the expression of MMP-9 protein in the spinal cord was significantly increased in rats at 1 d after SCI, and the expression of MMP-9 protein in the SCI+EP group and the SCI+GL group was significantly lower than that in the SCI group ( P<0.001). Immunofluorescence showed that GFAP and MMP-9 proteins were co-localized in the spinal cord after SCI, and the expression of GFAP and MMP-9 proteins in the SCI+EP and SCI+GL groups was significantly lower than that in the SCI group ( P<0.05). Since the expression of MMP-9 protein in the spinal cord AS cultured in vitro was significantly higher in the OGD 6h/R 12h group than that in the normal group and the OGD 6h/R 6h, 24, and 48 h groups, the OGD 6h/R 12h was taken as the OGD/R group. The MMP-9 protein expression in AS in the OGD/R+HMGB1 shRNA group and the OGD/R+EP group was significantly lower than that in the OGD/R group ( P<0.001). In the cultured AS, moreover, inhibiting TLR4, TRIF, and NF- κB reduced MMP-9 protein expression after OGD 6 h/R 12 h when compared with that in the OGD/R group ( P<0.001). Conclusions:HMGB1 inhibition may result in a reduction in MMP-9 expression both in the spinal cord AS in SCI rats and in AS after OGD/R treatment in vitro. HMGB1 may regulate MMP-9 protein expression in AS after OGD/R treatment via the TLR4/TRIF/NF- κB signal pathway.

OBJECTIVE： To study the improvement effect and mechanism of methylated urolithin A on oleic acid-induced lipid accumulation in human liver cancer Huh-7 cells. METHODS： Oleic acid was adopted to induce lipid accumulation model cells. Huh-7 cells were divided into control group （culture medium）， model group （1 mmol/L oleic acid）， low-dose group （1 mmol/L oleic acid+10 μmol/L methylated urolithin A） and high-dose group （1 mmol/L oleic acid+20 μmol/L methylated urolithin A）. Oil red O staining was used to observe lipid accumulation in cells. Triglyceride（TG） enzyme assay was applied to determine the TG content in cells. PCR was employed to detect the mRNA expression of FASN， SREBP-1， PPAR-α and PPAR-γ in cells. Western blotting was used to determine the protein expression of FASN in cells. RESULTS： After induced by oleic acid， a large amount of lipid droplet accumulated around the cells； the intracellular lipid and TG content， mRNA expression levels of FASN， SREBP-1 and PPAR-γ， protein expression levels of FASN were increased significantly， while mRNA expression level of PPAR-α was decreased significantly （P＜0.01）. After intervened with methylated urolithin A， lipid droplet around the cells decreased significantly； the contents of lipid and TG in cells were decreased significantly， while the mRNA expression levels of FASN， SREBP-1 and PPARγ and protein expression level of FASN were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： Methylated urolithin A can improve oleic acid-induced lipid accumulation in Huh-7 cells， the mechanism of which may be associated with inhibiting fat synthesis， promoting lipid metabolism and down-regulating the expression of metabolism-related factors as FASN， SREBP-1 and PPAR-γ.

Objective To examine the evidence for the implementation of targeted interventions by adapting the Minimal Eating Observation Form (MEOF-Ⅱ).Methods A descriptive study was designed to investigate 125 patients with stroke in three hospitals in Shanghai.They were investigated using research tools including Demographic information questionnaire and the Chinese version of MEOF-Ⅱ.Results In the nine items of the scale,the most common eating difficulties were getting food from the plate,picking up food from the plate and transfer it to the mouth,eats more than 3/4 of served portionand sitting position.The patient's age had some influence on the incidence of eating difficulties.The correlation between eating difficulties and assistance in eating were significantly different.Conclusions Most stroke patients at least have one type of eating difficulties.This implies that structured observations are needed in order to detect eating difficulties and to individualize further assessment and proper interventions could be designed.

Objective To investigate the outcomes of unselected peripheral T cell lymphoma (PTCL) patients treated with in-tensive first-line chemotherapy with high-dose therapy followed by autologous stem cell transplantation (ASCT).Methods Here a nonrandom study was reported for 23 PTCL patients treated with first-line intensive chemotherapy followed by autologous stem cell trans-plantation and 23 PTCL patients treated with conventional chemotherapy during January in 2000 to 2011 .All patients had received E-CHOP for 6~8 cycles, and autologous stem cell transplantation group was administrated with intensive chemotherapy followed by ASCT after complete remission or partial remission .Results There was no statistically significant difference in short-term therapeutic effect between two groups( P >0.05), but the 5-year overall survival(OS) of autologous stem cell transplantation group( 58%) was higher than conventional chemotherapy group , as well as 5-year disease-free survival time (DFS) (45%in autologous stem cell transplanta-tion group, and 21%in conventional chemotherapy group ) with both statistical significance ( P <0.05).Only the incidence of Ⅳ° myelosuppression in autologous stem cell transplantation group ( 100%) was higher than that in conventional chemotherapy group ( 13%) ( P <0.01 ) .Conclusions First-line intensive chemotherapy followed by autologous stem cell transplantation for peripheral T cell lymphoma was quietly safe utility , it was better than conventional chemotherapy which would be considered as first -line method.

Objective To verify the reliability of dose parameters of radiotherapy under reference and non-reference conditions by using TLD.Methods Dose parameters were verified by using TLDs under reference and non-reference conditions,including the maximum dose in axel of 5 electron beams with energy of 9 MeV and the variations of dose by depth,source-skin distance,exposure field and 45° wedge for 10 photon beams with energy of 6 MV in 5 hospitals.Results The average relative deviation of 6 MV photon beam measured between TLDs and finger ionization chambers were 4.45％,within ± 7％ as required by IAEA.The average relative deviation of 9 MeV electron beam measured between TLDs and plane parallel chambers were 2.45％,within ± 5％ was required by IAEA.Conclusions Measuring dosimetric parameters by using TLDs under reference and non-reference conditions was reliable and feasible.