AIM: To evaluate the clinical efficacy of Mongolian medicine Mingmu-11 Pills combined with conbercept in the treatment of wet age-related macular degeneration(wARMD).METHODS: Prospective study. All cases in this study were wARMD patients(72 cases, 72 eyes)admitted to the Ophthalmology Department of Affiliated Hospital of Inner Mongolia University from November 2020 to December 2021. They were randomly divided into a combined treatment group and a control group, each with 36 eyes, and the control group received intravitreal injection of conbercept 0.05 mL for 3 consecutive months. The combined treatment group was given Mingmu-11 Pills twice a day after surgery, with 3 wk as a course of treatment, a total of 3 courses, and the control group was not given Mongolian medicine treatment. The best corrected visual acuity(BCVA), changes in central macular thickness(CMT)in the macular area, and changes in N1, P1 wave amplitude density and latency were observed after treatment in both groups.RESULTS:The BCVA(letter number)of the two groups were improved(P<0.05), and the CMT were decreased(P<0.05). The improvement of BCVA(letter number)in the combined treatment group was better than that in the control group at 3 mo(17.42±3.29 vs 14.61±3.14, P<0.001)and 5 mo(19.75±3.25 vs 16.81±2.77, P<0.001)after treatment; compared with the control group, CMT of the combined treatment group was thinner than that of the control group at 3 mo(304.58±53.34 vs 351.94±52.99 μm, P<0.001)and 5 mo(274.17±62.26 vs 321.78±63.22 μm, P<0.05)after treatment. The amplitude density of N1 and P1 wave in mfERG in both groups at 3 mo after treatment was higher than that before treatment(P<0.05), and r1-r3 latency of P1 wave was shorter than that before treatment(P<0.05), with no differences in the r1-r3 latency of N1 wave(P>0.05). In addition, the amplitude density of N1 and P1 wave in the combined treatment group was higher than that in the control group at 3 mo after treatment(P<0.05), the latency of P1 wave in the treatment group was significantly shorter than that in the control group(P<0.05), and there was no significant difference in the latency of N1 wave between the two groups(P>0.05).CONCLUSIONS:Mingmu-11 Pills combined with intravitreal injection of conbercept in the treatment of wARMD has obvious efficacy in improving vision and reducing macular edema.

Objective:To compare the effects of invisible orthodontic appliances without brackets and labial fixed orthodontic appliances on periodontal status and root resorption in orthodontic patients.Methods:A retrospective study was conducted on 102 orthodontic patients who visited the Affiliated Hospital of Jining Medical University from January 2019 to October 2022. According to different treatment methods, they were divided into group A ( n=52) and group B ( n=50). Group A was treated with invisible orthodontic appliances without brackets, while group B was treated with labial fixed orthodontic appliances. We compared two groups of treatment completion time, root resorption, and periodontal health indicators before and after treatment, including plaque index (PLI), gingival index (GI), gingival sulcus bleeding index (SBI), and levels of inflammatory factors in gingival crevicular fluid, including interleukin-1β (IL-1β) and soluble intercellular adhesion molecule-1 (sICAM-1). Results:The completion time of treatment in the Group A was longer than that in the group B [(34.62±4.28)months vs (28.93±3.11)months] ( P<0.01). After treatment, the incidence of root resorption in the group A was 50.96%, while in the group B it was 78.00%. The group A was significantly lower than the group B ( P<0.05), with no root resorption greater than 3 mm in the group A and 0.50% in the group B. After treatment, the levels of PLI, GI, SBI, and IL-1β and sICAM-1 in gingival crevicular fluid increased in both groups, with the group A being lower than group B [(1.26±0.39)points vs (1.73±0.54)points, (1.33±0.25)points vs (2.06±0.46)points, (1.73±0.40)points vs (2.48±0.50)points, (173.74±25.81)ng/ml vs (196.33±31.52)ng/ml, (42.28±5.16)μg/L vs (56.59±7.38)μg/L] (all P<0.05). Conclusions:Although invisible orthodontic appliances without brackets cannot shorten the completion time of treatment, they have advantages in inhibiting root resorption, improving periodontal health, and reducing inflammatory reactions. Clinically, appropriate appliances can be selected based on the specific situation of patients.

Objective:To gain a deeper understanding of the cognitive differences between lactating women and obstetric nurses regarding their breastfeeding counselling abilities.Methods:This study was a descriptive phenomenology qualitative study. From October 2021 to June 2022, purposive sampling was used to select 11 lactating women who received breastfeeding counselling and 13 obstetric nurses who provided breastfeeding counselling services in Department of Obstetrics at Peking Union Medical College Hospital for semi-structured interviews. Giorgi analysis method was used to extract and analyze data.Results:The cognitive differences between lactating women and obstetric nurses regarding breastfeeding counselling abilities were mainly manifested in four aspects, namely breastfeeding knowledge and skills, counselling practice ability, improving counselling ability, and personality traits.Conclusions:Lactating women and obstetric nurses have cognitive differences in breastfeeding counselling abilities. Obstetric nurses should improve their breastfeeding counselling skills based on the needs of lactating women and provide personalized breastfeeding counselling services.

Objective To investigate the mechanism underlying the suppressive effect of Porphyromonas gingivalis(P.gingivalis)on ferroptosis in esophageal squamous cell carcinoma(ESCC).Methods ESCC cells infected with P.gingivalis and uninfected control cells were treated with ferroptosis inducer RSL3 followed by measurements of cell viability,malondialde-hyde(MDA),reactive oxygen species(ROS),and the expression of glutathione peroxidase 4(GPX4).Moreover,the expression of hypoxia-inducible factor-1α(HIF-1α)and its target genes were detected by qPT-PCR,Western blotting or immunohistochem-istry in ESCC tissue and cells under the condition of P.gingivalis infection.The effect of P.gingivalis infection combined with the HIF-1α inhibitors LW6 and RSL3 on ferroptosis in ESCC was detected in vitro and in vivo.Results P.gingivalis infection of the ESCC cells resulted in an increase of the cell viability(P＜0.05),decreased levels of intracellular ROS(P＜0.05)and MDA(P＜0.05)and increased the expression of GPX4 compared with RSL3 treatment alone.In ESCC tissues,the increased a-bundance of P.gingivalis was correlated with upregulation of HIF-1α.Furthermore,P.gingivalis infection induced upregula-tion of HIF-1α and its target genes.LW6 promoted ferroptosis via inhibiting the HIF-1α upregulation induced by P.gingivalis infection in vitro and in vivo.Conclusion HIF-1α renders resistance to ferroptosis in P.gingivalis infected ESCC.Combination of HIF-1α inhibitory agents and ferroptosis inducing agents might be a novel therapeutic strategy in ESCC care.

Objective: To analyze the clinical features, the efficacy of131I therapy and its effect on granulopoiesis in Graves′ hyperthyroidism(hyperthyroidism) patients with neutropenia. Methods: 144 hyperthyroidism patients were retrospectively studied after131I therapy, among which 42 cases(HT group) accompanied neutropenia due to hyperthyroidism itself, 52 cases(ATD group) appeared neutropenia after anti-thyroid drug(ATD)treatment, and the remaining 50 cases(control group) were hyperthyroidism patients with normal neutrophil count. The clinical features, the efficacy of131I treatment for hyperthyroidism and the change of neutrophil count after131I treatment were analyzed and compared in three groups. Results: Mild neutropenia was commoner in both the HT group and the ATD group. The curative rate of hyperthyroidism in the HT group, the ATD group and the control group were80. 95%, 84. 62% and 84. 00%, respectively. There was no significant difference in the efficacy of131I therapy among the three groups. Compared with the baseline value before treatment, neutrophil count increased in all three groups 2-4 weeks after131I treatment(allP<0. 05). The neutrophil recovery rates of the HT group and the ATD group were 61. 90% and 84. 62%, respectively. The ATD group had a higher recovery rate(P<0. 05). Conclusion Mild neutropenia is commoner in hyperthyroidism patients with neutropenia due to either hyperthyroidism itself or ATD treatment. Normative131I treatment for hyperthyroidism patients with neutropenia is safe and effective.

Viral infectious diseases are a class of major diseases that seriously affect human life and health, and the causes of emerging infectious diseases are mostly viral pathogens. Rapid and accurate viral pathogen tests are of great significance for the clinical diagnosis and control of such infectious diseases. As an indispensable auxiliary diagnostic method, viral nucleic acid tests have the advantages of high sensitivity and specificity, etc., and have become an important method to identify the cause, determine the treatment schedule, and evaluate the treatment effect and prognosis. A series of method based on polymerase chain reaction, isothermal amplification technology or genome sequencing, respectively, have been successfully applied to viral nucleic acid detection. In this review, we will discuss the tests and applications of viral nucleic acid detection commonly used in clinical practice, as well as the issues that need attention in the interpretation of the result, to help the accurate diagnosis and treatment of viral infectious diseases.

Objective:To investigate the clinical features and long-term prognosis of pediatric acute lymphoblastic leukemia (ALL) with renal involvement as the initial manifestation, thus enhancing the diagnostic and therapeutic efficacy.Methods:Twenty-four cases of pediatric ALL with renal involvement as the initial manifestation treated in the First Affiliated Hospital of Zhengzhou University from March 2013 to March 2019 were analyzed retrospectively, and their clinical characteristics were analyzed.According to renal imaging examination findings, they were divided into abnormal group and normal group.The differences in clinical features between the two groups were compared, and the cumulative survival rate was evaluated by Kaplan-Meier method.Results:Among 1 030 newly treated cases of pediatric ALL, 24 cases(2.33%) had renal involvement as the initial manifestation, involving 20 males and 4 females, with a male/female ratio of 5∶1 and the median age of 4.3 years (1.3-14.0 years). There were 16 cases of superficial lymph node enlargement and 21 cases of hepatosplenomegaly.Immature cells in peripheral blood were found in 15 cases.Nine cases were examined with abnormal renal imaging, involving 8 cases returned normal after chemotherapy, and 1 died of renal failure.At the end of follow-up on August 1, 2020, there were 9 cases of bone marrow relapse, 11 survival cases, 10 death cases and 3 cases of loss to follow-up.There were no significant differences in the sex, age, immunophenotype, organ infiltration and urinary protein between the two groups (all P>0.05). The proportion of high creatinine level and intramedullary recurrence rate in the abnormal group were significantly higher than those in the normal group [55.6%(5/9 cases) vs.0(0/15 cases), P=0.003; 66.7%(6/9 cases) vs.20.0%(3/15 cases), P=0.036]. The survival analysis indicated that the 3-year cumulative survival in the abnormal group was significantly lower than that of normal group (17.3% vs.72.7%, χ2=4.047, P< 0.05). Conclusions:For children with unexplained renal involvement as the initial manifestation, clinicians should consider the possibility of leukemic renal infiltration or nephrogenic lymphoma.Physical examinations of the liver, spleen and lymph nodes, morphological analysis of peripheral blood cells, bone marrow examination and renal biopsy are important to make a definite diagnosis in time.Children with imaging abnormalities caused by leukemic renal infiltration are more likely to relapse and have a lower survival rate, which may be a poor prognostic factor for ALL.

Objective:To compare the efficacy and safety of subcutaneous endoscope assisted suction-curettage shaver and small-incision scissor in the treatment of axillary osmidrosis.Methods:A total of 71 cases (142 sides) of patients with osmidrosis were treated. Among them, 38 cases (76 sides) were treated with subcutaneous endoscope assisted suction-curettage shaver for the resection of apocrine sweat glands, and 33 cases (66 sides) were treated with small-incision scissor. The postoperative recovery was evaluated by Tung grading. The postoperative complications, efficacy, operative time and satisfaction rate were also included in the comparison evaluation.Results:The effective rate of the subcutaneous endoscope assisted suction-curettage shaver group was 100% (75/75), which was significantly higher than that of the small-incision scissor group (89.39%, 59/66), with a statistically significant difference ( χ2=8.479, P=0.004). Complications in subcutaneous endoscope assisted suction-curettage shaver group(3.95%, 3/76) were significantly lower than that in small-incision scissor(25.76%, 17/66), χ2=39.699, P<0.001. The operative time of the endoscope group [(58.212±4.897) min] was slightly longer than that of small-incision scissor group [(54.079±6.096) min]. But the dressing time, stitches removal time and rehabilitation exercise time were significantly shorter than those of the small-incision scissor group, with statistically significant differences ( P<0.05). The satisfaction rate of subcutaneous endoscope assisted suction-curettage shaver group(97.37%, 74/76) was significantly higher than that of the small-incision scissor group(74.24%, 49/66), χ2=33.102, P<0.001. Conclusions:Subcutaneous endoscope assisted suction-curettage shaver has more significant efficacy, less postoperative complications, faster recovery and higher satisfaction than small-incision scissor in the treatment of axillary osmidrosis.

Objective:To compare the efficacy and safety of subcutaneous endoscope assisted suction-curettage shaver and small-incision scissor in the treatment of axillary osmidrosis.Methods:A total of 71 cases (142 sides) of patients with osmidrosis were treated. Among them, 38 cases (76 sides) were treated with subcutaneous endoscope assisted suction-curettage shaver for the resection of apocrine sweat glands, and 33 cases (66 sides) were treated with small-incision scissor. The postoperative recovery was evaluated by Tung grading. The postoperative complications, efficacy, operative time and satisfaction rate were also included in the comparison evaluation.Results:The effective rate of the subcutaneous endoscope assisted suction-curettage shaver group was 100% (75/75), which was significantly higher than that of the small-incision scissor group (89.39%, 59/66), with a statistically significant difference ( χ2=8.479, P=0.004). Complications in subcutaneous endoscope assisted suction-curettage shaver group(3.95%, 3/76) were significantly lower than that in small-incision scissor(25.76%, 17/66), χ2=39.699, P<0.001. The operative time of the endoscope group [(58.212±4.897) min] was slightly longer than that of small-incision scissor group [(54.079±6.096) min]. But the dressing time, stitches removal time and rehabilitation exercise time were significantly shorter than those of the small-incision scissor group, with statistically significant differences ( P<0.05). The satisfaction rate of subcutaneous endoscope assisted suction-curettage shaver group(97.37%, 74/76) was significantly higher than that of the small-incision scissor group(74.24%, 49/66), χ2=33.102, P<0.001. Conclusions:Subcutaneous endoscope assisted suction-curettage shaver has more significant efficacy, less postoperative complications, faster recovery and higher satisfaction than small-incision scissor in the treatment of axillary osmidrosis.

Objective: To carry out the 4^th round of third-party evaluation on the implementation and effect of the 1^st year of the 2^nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. Methods: The 4^th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. Results: The 4^th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.