AIM: To evaluate safety, efficacy, visual quality, and patient satisfaction after optimized monovision Q-value-customized femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia, astigmatism, and presbyopia. METHODS: This prospective study enrolled patients suffering myopia, astigmatism, and presbyopia. At 1 y post operation, uncorrected distance, intermediate and near visual acuity(UDVA, UIVA, UNVA), refraction, corneal higher order aberrations(HOAs), Q value, objective visual quality, and near stereoacuity were evaluated. The impact of surgery on patients' living quality and their satisfaction were evaluated based on National Eye Institute Refractive Error Quality of Life Instrument(NEI RQL)scores at 1-year follow-up.RESULTS:The study enrolled 36 patients(72 eyes)including 12 males(33%)and 24 females(67%)with an average age of 46.03±3.60(range 40-53)y. One year postoperatively, 97% of patients achieved binocular UDVA of 1.0 or better, 89% achieved UIVA of 0.63 or better, and 97% achieved UNVA of 1.0 or better. The spherical equivalent refraction(SE)in dominant eye within ±1.00 D was 100%. SE in non-dominant eyes was uncorrected compared with the preoperative target correction, with a mean difference of -0.27±0.34 D before and after surgery(P<0.001). while in the non-dominant eyes, the anterior corneal Q-value within the 5 mm zone increased negatively compared with the preoperative value(-0.33±0.24 vs -0.21±0.09, P<0.001). In the non-dominant eye, spherical aberration and longitudinal spherical aberration were lower than preoperative values(both P<0.001). Besides, there were no significant changes in objective scatter index(OSI), modulation transfer function cutoff frequency(MTF cut off)and Strehl ratio(SR)in both dominant and non-dominant eyes(all P>0.05), and the near stereoacuity was better after surgery(P=0.007). Additionally, the patient satisfaction rate with the surgery was 94%, the satisfaction rates for UDVA and UNVA were both 98%. The 11% of patients required to wear low-diopter glasses when driving at night.CONCLUSION:Optimized monovision Q-value-customised FS-LASIK is a safe and effective procedure for correcting myopia, astigmatism, and presbyopia. It provides favorable subjective and objective visual quality and high patient satisfaction. The under correction in non-dominant eyes is observed, indicating the further optimization of nomogram is needed.

Objective To study the inhibitory effect of secondary metabolites of Pseudomonas aeruginosa(PA)on Candida albicans(CA)and to explore some of the mechanisms.Methods PA and CA strains were i-solated from clinical specimens from the hospital.Then,PA strains with inhibitory effects on CA were screened through cross-line test and co-incubation test,and crude extracts of PA secondary metabolites were prepared,and were tested together with pyocyanin,phenazine-1-carboxylic acid,1-hydroxyphenazine,and 3-ox-ododecyl-l-homoserine lactone(3-oxo-HSL).The inhibitory effects of various PA secondary metabolites on CA were determined through minimum inhibitory concentration test,minimum bactericidal concentration test,time-sterilization curve measurement,and XTT method activity measurement test,and some mechanisms by which PA secondary metabolites inhibited CA were explored.Results The strongest inhibitory effect on CA was 1-hydroxyphenazine,and at a concentration of 6.250 μg/mL,the relative activity of CA decreased to 0.00%.Next were pyocyanin and PA crude extract,and the relative fungal activity of CA decreased to 0.00%at concentrations of 200 and 100 μg/mL.1-hydroxyphenazine,pyocyanin,3-oxo-HSL and PA crude extract all had inhibitory effects on the formation of CA hyphae.Reactive oxygen species(ROS)were generated in CA cells treated with 1-hydroxyphenazine,phenazine 1-carboxylic acid,pyocyanin,and PA crude extract,and the highest levels of ROS were induced by pyocyanin and 1-hydroxyphenazine.Conclusion Phenazine secondary metabolites 1-hydroxyphenazine and pyocyanin have significant inhibitory effects on the growth and activity of CA,and both induce the highest amount of ROS.The quorum-sensing signal molecule 3-oxo-HSL have no in-hibitory effect on CA growth,but have a significant inhibitory effect on the formation of fungal hyphae.

ObjectiveTo explore the establishment of performance assessment indicators for the classification and grading of public health staff in district-level Centers for Disease Control and Prevention (CDCs), and to provide a basis for such evaluations. MethodsThrough literature review and group interviews, performance evaluation indicators were developed based on competency evaluation. Experts were invited to evaluate the weight of performance evaluation indicators for public health staff from different categories, with the average value used to represent the weight of each indicator. ResultsTwenty-nine experts from universities in Shanghai, municipal CDCs, and district CDCs participated, yielding an expert authority coefficient of 0.86. The performance evaluation indicators for department managers were categorized into three levels, with 4 indicators at the primary level, 16 indicators at the secondary level, and 42 indicators at the tertiary level, while those for general staff included 4 primary indicators, 15 secondary indicators, and 36 tertiary indicators. Significant differences were observed in the weight coefficients of the primary indicators (internal operations, professional work, and learning and growth) between department managers and general staff. The top three secondary indicators for department managers were department management, monitoring and prevention, and level of expertise. For mid-level and senior staff, the top three secondary indicators were monitoring and prevention, level of expertise, and research work. The top three secondary indicators for junior staff were monitoring and prevention, professional expertise, and professional attitude. No significant statistical differences were found among tertiary indicators. ConclusionThe developed performance evaluation indicators are reliable. Staff at different levels and classifications should be evaluated using different performance evaluation standards to accurately reflect individual performance and contributions.

ObjectiveTo analyze the reported cases of infectious diseases across different tiers of public medical and healthcare institutions in Minhang District, Shanghai from 2013 to 2023, to investigate the status and changes in reported infectious diseases in this district from a temporal, etiological, and demographic perspectives, so as to provide a scientific basis for the construction of a hierarchica early-warning surveillance system under the grading diagnosis and treatment model in medical institutions, as well as for optimizing sentinel surveillance at facilities of different levels. MethodsA retrospective analysis was performed using surveillance data from the China Disease Prevention and Control Information System in Minhang District from 2013 to 2023. Reported infectious diseases were categorized into three categories based on transmission routes: respiratory infectious diseases, intestinal infectious diseases, and sexually transmitted and blood borne infectious diseases. According to the implementation phase of the grading diagnosis and treatment policy, the research time was divided into four time periods: 2013‒2016, 2017‒2019, 2020‒2022, and 2023. The distribution and temporal changes of reported cases of infectious diseases were compared across community health service centers (CHCs), secondary hospitals, tertiary grade-A hospitals and tertiary grade-B hospitals. Chi-square test was used for univariate analysis of differences in the number of reported cases. Quantitative data with normal distribution were analyzed using parametric tests, otherwise, Kruskal⁃Wallis H tests were used. ResultsThe proportions of total reported cases of infectious diseases in medical institutions at all levels in Minhang District, Shanghai from 2013 to 2023 were 10.66% in CHCs, 9.10% in secondary hospitals, 64.95% in tertiary grade-B hospitals, and 15.29% in tertiary grade-A hospitals, with an overall decline and then rebound trend in the reported cases. After the implementation of grading diagnosis and treatment policy, the number of reported cases in CHCs and secondary hospitals showed a trend of first decreasing and then increasing, while that in tertiary grade-B hospitals showed a steady decreasing trend and that in tertiary grade-A hospitals showed an increasing trend. In terms of the research periods divided above, a total of 10 392 cases were reported in 2013‒2016 (70.34% from tertiary grade-B hospitals and 12.59% from CHCs), including 2 922 cases of respiratory infectious diseases, 1 241 cases of intestinal infectious diseases, and 6 229 cases of sexually transmitted and blood-borne infectious diseases. Between 2017 and 2019, a total of 6 967 cases were reported (73.49% from tertiary grade-B hospitals and 11.84% from tertiary grade-A hospitals), including 2 983 cases of respiratory infectious diseases, 279 cases of intestinal infectious diseases, and 3 705 cases of sexually transmitted and blood-borne infectious diseases. Between 2020 and 2022, a total of 4 599 cases were reported (69.92% from tertiary grade-B hospitals and 24.57% from tertiary grade-A hospitals), including 1 627 cases of respiratory infectious diseases, 123 cases of intestinal infectious diseases, and 2 849 cases of sexually transmitted and blood-borne infectious diseases. In 2023, a total of 4 648 cases were reported (35.20% from tertiary grade-B hospitals and 27.50% from tertiary grade-A hospitals), including 3 165 cases of respiratory infectious diseases, 69 cases of intestinal infectious diseases, and 1 414 cases of sexually transmitted and blood-borne infectious diseases. The proportion of reported cases from tertiary grade-B hospitals was the highest in all the four research periods, but exhibited an obvious decrease in 2023. The differences in the reported cases of infectious diseases with different transmission routes among medical institutions at all levels were statistically significant (χ²=3 225.628, P<0.05). The differences in the mean age of patients among medical institutions at all levels were statistically significant (H=1 325.927, P<0.05). ConclusionThere are significant differences in the number of reported cases of infectious disease in the medical institutions at different levels. Tertiary grade-B hospitals have historically dominated the number of reported cases, but its share has declined recently. Whereas, CHCs and tertiary grade-A hospitals have played an increasingly important role in the surveillance and early warning of respiratory and intestinal infectious diseases. Therefore, it is recommended to leverage the strengths of grading diagnosis and treatment to establish targeted sentinel sites and deploy specialized teams tailored to the epidemiological characteristics of specific disease categories.

Objective:To explore the clinical efficiency of cognitive behavioral training combined with methylphenidate hydrochloride sustained-release tablets on children with attention-deficit hyperactivity disorder (ADHD).Methods:118 children with ADHD in Northwest Women' s and Children' s Hospital were selected from June 2022 to July 2023. Based on the principle of baseline feature matching between groups, they were randomly divided into MPH group and combined group by coin tossing method, with 59 cases in each group. Children in the MPH group were treated with MPH sustained-release tablets orally (The initial dose was 18mg each time, whole tablet was swallowed in the morning, dose adjustment was increased by 18 mg each time, once a week, and maximum dose was not more than 54 mg), while the children in the combined group were combined with cognitive behavior training on the basis of the treatment in the MPH group. Children in both groups were continuously treated for 3 months. The clinical efficacy, scores of dimensions of Swanson Nolan and Pelham, rating scale-version IV (SNAP-IV) parent edition, scores of Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), scores of Wisconsin Card Sorting Test (WCST) and serological indicators [dopamine, 25 (OH)D 3, cortisol, brain-derived neurotrophic factor (BDNF)] before and after treatment and incidence of adverse reactions were compared between groups. Results:After 3 months of treatment, the combined group [93.2%(55/59)] had higher total effective rate than the MPH group [79.7% (47/59)] ( χ2=4.63, P=0.031). The scores of three dimensions, including attention deficit, hyperactivity-impulsion and oppositional defiance in both groups were lower than those before treatment, and the scores in combined group were lower than those in MPH group, the differences were statistically significant [(1.27±0.19) points vs (1.65±0.23) points, (1.35±0.25) points vs (1.78±0.27) points, (1.55±0.13) points vs (1.86±0.22) points, t=9.78, 8.98, 9.32,respectively, all P<0.001]. The control quotient score and attention quotient score were higher than those before treatment, and the scores in combined group were higher than those in MPH group, the differences were statistically significant [(99±6) points vs (91±3) points, (98±5) points vs. (92±3) points, t=8.47, 7.46,respectively, all P<0.001]. The total response count, completed categories count and correct response count were all higher than those before treatment, and the scores were higher in combination group than those in MPH group, the differences were statistically significant [(116±16) points vs(105±14) points, (4.57±0.35) points vs (4.15±0.25) points, (83±12) points vs (72±10) points, t=4.07, 7.50, 5.48, respectively, all P<0.001). Perspective response count was lower than that before treatment, and the score in combined group was lower than that in MPH group, the difference was statistically significant [(15.6±1.8) points vs (18.2±2.0) points, t=7.35, P<0.001]. Serum levels of dopamine, 25(OH)D 3 and BDNF were higher than those before treatment, and the levels in combined group were all higher than those in MPH group, the differences were statistically significant [(16.2±2.8) pmol/L vs (13.8±2.4) pmol/L, (78±10) nmol/L vs. (70±9) nmol/L, (1 060±135) pmol/L vs (986±126) pmol/L, t=5.00, 4.59, 3.08, respectively, all P<0.05]. Serum cortisol level was lower than that before treatment, and the level in combined group was lower than that in MPH group, the difference was statistically significant [(255±27) nmol/L vs (271±28) nmol/L, t=3.16, P=0.002]. There was no statistical significance difference in the incidence rate of adverse reactions between combined group and MPH group during treatment [6.8% (4/59) vs 5.1% (3/59)] ( χ2=0.00, P=1.000). Conclusion:Cognitive behavioral training combined with MPH sustained-release tablets in the treatment of children with ADHD can significantly enhance the efficacy, improve the ADHD symptoms and cognitive function, and increase the levels of serum dopamine and 25 (OH)D 3, and have good safety.

Objective To evaluate the quality of Shuanghuanglian Oral Liquid after mutual substitution of honeysuckle and wild honeysuckle using total quantum statistical moment(TQSM)and molecular connectivity index(MCI).Methods UPLC fingerprint of Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian oral liquid(wild honeysuckle)were established,the TQSM parameters and similarity of the fingerprint were calculated;by reviewing relevant literature,as well as the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),chemical composition databases for Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was established,all components were divided into different component groups,and MCI and its similarity were calculated.Results The number of chromatographic peaks and total zero order moment(AUCT)of 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)were higher than those of Shuanghuanglian Oral Liquid(wild honeysuckle),but there was no significant difference in total first order moment(MRTT)and total second order moment(VRTT);the total quantum statistical moment similarity(TQSMS)between 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)was 1.000 0-0.824 6,the TQSMS between 15 batches of Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.659 0,and the TQSMS between 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.619 8.The MCI similarity of various components between Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.984 9,with an overall MCI similarity of 0.995 8.Conclusion There is no significant difference in the various components and overall"imprinting template"between Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle).It is speculated that the substitution of honeysuckle and wild honeysuckle will not affect the pharmacological properties of Shuanghuanglian Oral Liquid,but there may be differences in the intensity of pharmacological effects,with Shuanghuanglian Oral Liquid(honeysuckle)being the most effective.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To explore the clinical efficiency of cognitive behavioral training combined with methylphenidate hydrochloride sustained-release tablets on children with attention-deficit hyperactivity disorder (ADHD).Methods:118 children with ADHD in Northwest Women' s and Children' s Hospital were selected from June 2022 to July 2023. Based on the principle of baseline feature matching between groups, they were randomly divided into MPH group and combined group by coin tossing method, with 59 cases in each group. Children in the MPH group were treated with MPH sustained-release tablets orally (The initial dose was 18mg each time, whole tablet was swallowed in the morning, dose adjustment was increased by 18 mg each time, once a week, and maximum dose was not more than 54 mg), while the children in the combined group were combined with cognitive behavior training on the basis of the treatment in the MPH group. Children in both groups were continuously treated for 3 months. The clinical efficacy, scores of dimensions of Swanson Nolan and Pelham, rating scale-version IV (SNAP-IV) parent edition, scores of Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), scores of Wisconsin Card Sorting Test (WCST) and serological indicators [dopamine, 25 (OH)D 3, cortisol, brain-derived neurotrophic factor (BDNF)] before and after treatment and incidence of adverse reactions were compared between groups. Results:After 3 months of treatment, the combined group [93.2%(55/59)] had higher total effective rate than the MPH group [79.7% (47/59)] ( χ2=4.63, P=0.031). The scores of three dimensions, including attention deficit, hyperactivity-impulsion and oppositional defiance in both groups were lower than those before treatment, and the scores in combined group were lower than those in MPH group, the differences were statistically significant [(1.27±0.19) points vs (1.65±0.23) points, (1.35±0.25) points vs (1.78±0.27) points, (1.55±0.13) points vs (1.86±0.22) points, t=9.78, 8.98, 9.32,respectively, all P<0.001]. The control quotient score and attention quotient score were higher than those before treatment, and the scores in combined group were higher than those in MPH group, the differences were statistically significant [(99±6) points vs (91±3) points, (98±5) points vs. (92±3) points, t=8.47, 7.46,respectively, all P<0.001]. The total response count, completed categories count and correct response count were all higher than those before treatment, and the scores were higher in combination group than those in MPH group, the differences were statistically significant [(116±16) points vs(105±14) points, (4.57±0.35) points vs (4.15±0.25) points, (83±12) points vs (72±10) points, t=4.07, 7.50, 5.48, respectively, all P<0.001). Perspective response count was lower than that before treatment, and the score in combined group was lower than that in MPH group, the difference was statistically significant [(15.6±1.8) points vs (18.2±2.0) points, t=7.35, P<0.001]. Serum levels of dopamine, 25(OH)D 3 and BDNF were higher than those before treatment, and the levels in combined group were all higher than those in MPH group, the differences were statistically significant [(16.2±2.8) pmol/L vs (13.8±2.4) pmol/L, (78±10) nmol/L vs. (70±9) nmol/L, (1 060±135) pmol/L vs (986±126) pmol/L, t=5.00, 4.59, 3.08, respectively, all P<0.05]. Serum cortisol level was lower than that before treatment, and the level in combined group was lower than that in MPH group, the difference was statistically significant [(255±27) nmol/L vs (271±28) nmol/L, t=3.16, P=0.002]. There was no statistical significance difference in the incidence rate of adverse reactions between combined group and MPH group during treatment [6.8% (4/59) vs 5.1% (3/59)] ( χ2=0.00, P=1.000). Conclusion:Cognitive behavioral training combined with MPH sustained-release tablets in the treatment of children with ADHD can significantly enhance the efficacy, improve the ADHD symptoms and cognitive function, and increase the levels of serum dopamine and 25 (OH)D 3, and have good safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To evaluate the quality of Shuanghuanglian Oral Liquid after mutual substitution of honeysuckle and wild honeysuckle using total quantum statistical moment(TQSM)and molecular connectivity index(MCI).Methods UPLC fingerprint of Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian oral liquid(wild honeysuckle)were established,the TQSM parameters and similarity of the fingerprint were calculated;by reviewing relevant literature,as well as the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),chemical composition databases for Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was established,all components were divided into different component groups,and MCI and its similarity were calculated.Results The number of chromatographic peaks and total zero order moment(AUCT)of 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)were higher than those of Shuanghuanglian Oral Liquid(wild honeysuckle),but there was no significant difference in total first order moment(MRTT)and total second order moment(VRTT);the total quantum statistical moment similarity(TQSMS)between 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)was 1.000 0-0.824 6,the TQSMS between 15 batches of Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.659 0,and the TQSMS between 15 batches of Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.619 8.The MCI similarity of various components between Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle)was 1.000 0-0.984 9,with an overall MCI similarity of 0.995 8.Conclusion There is no significant difference in the various components and overall"imprinting template"between Shuanghuanglian Oral Liquid(honeysuckle)and Shuanghuanglian Oral Liquid(wild honeysuckle).It is speculated that the substitution of honeysuckle and wild honeysuckle will not affect the pharmacological properties of Shuanghuanglian Oral Liquid,but there may be differences in the intensity of pharmacological effects,with Shuanghuanglian Oral Liquid(honeysuckle)being the most effective.