AIM: To compare the effectiveness of foldable capsular body(FCB)with traditional scleral buckling(SB)in the treatment of experimental retinal detachment animal models.METHODS: After successfully establishing rhegmatogenous retinal detachment(RRD)animal models, 24 New Zealand white rabbits were randomly divided into three groups(RRD models group, SB group, and FCB group), with 8 rabbits in each group. The FCB and SB groups underwent SB and FCB surgeries for the RRD animal models, while the RRD models group only consists of RRD models without any surgical intervention during the follow-up period. The follow-up duration was 3 mo. Wide-field neonatal fundus imaging system and ophthalmic B-ultrasound were used to assess the fundus conditions before and after surgery. The Icare® TONOVET Plus tonometer was utilized to evaluate intraocular pressure changes before and after surgery. The Eaton and Draize scoring systems were selected to monitor postoperative inflammatory reactions.RESULTS: The retinal reattachment rates in the FCB and SB groups were 87.5% and 75.0%, respectively, with no statistically significant difference between the groups(P>0.05). The intraocular pressure in both the FCB and SB groups increased postoperatively compared to preoperative levels(P<0.01), and there were no significant differences in intraocular pressure at any time points during the follow-up period between the groups(P>0.05). The intraocular pressure in the RRD models group remained at a low level throughout the follow-up period. The average surgical time for the FCB group was 16.87±2.29 min, which was shorter than 46.25±4.74 min in the SB group(t=-15.166, P<0.001). According to the Eaton and Draize scoring systems, the FCB group had lower grades of conjunctival hyperemia and edema in the early postoperative period compared to the SB group, indicating milder inflammatory reactions(P<0.05).CONCLUSION: Both FCB and SB are effective in treating experimental RRD. Compared to SB, FCB is simpler to operate, and also has a shorter surgical time and milder postoperative inflammatory reactions.

Objective Under the operation background of Diagnosis-Intervention Packet(DIP),whether there is interaction between reducing medical cost and average length of stay combined with pre-hospitalization mode,and whether there is difference between different departments and diseases in interaction.Methods Based on real-world data from 71 453 patients admitted to Guizhou Provincial People's Hospital from July to December 2021,a two-way analysis of variance was employed.When the interaction effect was statistically significant,parameter estimation was used to determine the magnitude and direction of the interaction effect,followed by subgroup analyses by department and disease.Results Without adjustment,both total medical costs and average length of stay exhibited a negative interaction effect(P＜0.05).Subgroup analyses revealed that in terms of total medical costs,the effect size for the surgical system was 0.18％,lower than that for the internal medicine system(0.70％);for core diseases,it was 6.62％,lower than that for comprehensive diseases(7.71％).Regarding average length of stay,the effect size for the surgical system was 0.55％,better than that for the internal medicine system(0.22％);for core diseases,it was 8.70％,higher than that for comprehensive diseases(2.90％).Conclusion The combination of DIP payment reform and pre-admission management model demonstrates a synergistic effect,effectively reducing patients' medical costs and length of stay.This effect is influenced by disease complexity and the standardization of diagnostic and treatment processes.

Objective:To carry out a scoping review on health recommender system (HRS) in out-of-hospital management of diabetic patients.Methods:Following the guidelines for scoping reviews, relevant literature was systematically searched in PubMed, Cochrane Library, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, and VIP. The search period was from database establishment to September 19, 2024. The retrieved literature was screened, extracted, and summarized.Results:A total of 12 papers were included. The application of HRS in out-of-hospital management of diabetic patients involved four functional modules of self-care guidance, blood glucose management, health information push, and decision support. Evaluation indicators mainly included usability, effectiveness, accuracy, security, satisfaction and cost-effectiveness.Conclusions:HRS can provide personalized management support for patients with diabetes, but research on the out-of-hospital management of HRS for diabetes is still in its infancy. The target users of diabetes HRS still need to be broadened, the recommendation function and recommendation technology need to be developed, and the evaluation method still needs to be optimized.

Objective Under the operation background of Diagnosis-Intervention Packet(DIP),whether there is interaction between reducing medical cost and average length of stay combined with pre-hospitalization mode,and whether there is difference between different departments and diseases in interaction.Methods Based on real-world data from 71 453 patients admitted to Guizhou Provincial People's Hospital from July to December 2021,a two-way analysis of variance was employed.When the interaction effect was statistically significant,parameter estimation was used to determine the magnitude and direction of the interaction effect,followed by subgroup analyses by department and disease.Results Without adjustment,both total medical costs and average length of stay exhibited a negative interaction effect(P＜0.05).Subgroup analyses revealed that in terms of total medical costs,the effect size for the surgical system was 0.18％,lower than that for the internal medicine system(0.70％);for core diseases,it was 6.62％,lower than that for comprehensive diseases(7.71％).Regarding average length of stay,the effect size for the surgical system was 0.55％,better than that for the internal medicine system(0.22％);for core diseases,it was 8.70％,higher than that for comprehensive diseases(2.90％).Conclusion The combination of DIP payment reform and pre-admission management model demonstrates a synergistic effect,effectively reducing patients' medical costs and length of stay.This effect is influenced by disease complexity and the standardization of diagnostic and treatment processes.

Extensive epigenetic reprogramming involves in memory CD8+ T-cell differentiation. The elaborate epigenetic rewiring underlying the heterogeneous functional states of CD8+ T cells remains hidden. Here, we profile single-cell chromatin accessibility and map enhancer-promoter interactomes to characterize the differentiation trajectory of memory CD8+ T cells. We reveal that under distinct epigenetic regulations, the early activated CD8+ T cells divergently originated for short-lived effector and memory precursor effector cells. We also uncover a defined epigenetic rewiring leading to the conversion from effector memory to central memory cells during memory formation. Additionally, we illustrate chromatin regulatory mechanisms underlying long-lasting versus transient transcription regulation during memory differentiation. Finally, we confirm the essential roles of Sox4 and Nrf2 in developing memory precursor effector and effector memory cells, respectively, and validate cell state-specific enhancers in regulating Il7r using CRISPR-Cas9. Our data pave the way for understanding the mechanism underlying epigenetic memory formation in CD8+ T-cell differentiation.
CD8-Positive T-Lymphocytes/metabolism* ; Cell Differentiation ; Chromatin/immunology* ; Animals ; Mice ; Immunologic Memory ; Epigenesis, Genetic ; SOXC Transcription Factors/immunology* ; NF-E2-Related Factor 2/immunology* ; Mice, Inbred C57BL ; Gene Regulatory Networks ; Enhancer Elements, Genetic

Objective To comprehensively understand the map of transcripts during mitosis and their regulatory mechanisms of HAP 1 cells by conducting transcriptome sequencing analysis after being released by mitotic synchro-nization arrest.Methods HAP1 cells were subjected to mitotic synchronous arrest with nocodazole and samples were collected after 0,20,80 min release,and RNA sequencing(RNA-seq)were performed.The transcriptome data was cleaned and the differentially expressed genes,expression trend clustering and functional enrichment com-bined with the protein interaction network were analyzed to explore the changes of signaling pathways in HAP 1 cells during mitosis.Results The transcriptome of HAP1 cells after synchronous release from mitosis underwent significant changes in time series,and differential gene cluster analysis revealed four gene clusters were enriched in important biological processes such as p53 signaling and cytoplasmic translation.Conclusions The transcriptome time-dependent dynamic changes during mitosis in HAP1 cells are coordinated regulation of key signaling pathways including cellular stress response,translational control and chromatin remodeling,ensuring a balance between growth and stress response upon mitotic exit.

Objective:To investigate the effect and mechanism of Jiedu Xiaoying Patch in rats with Hashimoto's thyroiditis (HT).Methods:Totally 32 rats were randomly divided into a blank group of 8 rats and a model group of 24 rats. The HT rat model was prepared by freely drinking 0.064% sodium iodide solution in the modeling module. 24 successfully modeled rats were randomly divided into model group, selenium yeast group, and patch group, with 8 rats in each group. Starting from the 9th week, the application group applied Jiedu Xiaoying Patch to the surface projection area of the thyroid gland in the neck of rats for 6 hours, once a day, for a total of 6 weeks; the selenium yeast group was orally administered with 21 μg/ml selenium yeast solution at a dose of 0.5 ml/100 g, while the blank group, model group, and patch group were orally administered with equal volumes of physiological saline solution once a day for a total of 6 weeks. The levels of TGAb,TPOAb, Sema 5A, and IL-17A in rat serum were detected by ELISA. The changes of thyroid tissue was observed with HE staining. The relative expression levels of plexin-A1 and plexin-B3 were determined through RT-PCR.Results:Compared with the model group, the levels of TPOAb, TGAb, Sema 5A, and IL-17A decreased ( P<0.05), and the expressions of plexin-A1 and plexin-B3 decreased in the selenium yeast group and the patch group ( P<0.05). The thyroid follicles in the model group were severely damaged, with a large number of lymphocytes infiltrating the interstices; the thyroid follicular structure of the selenium yeast group was relatively intact, and lymphocyte infiltration was reduced compared to the model group. The thyroid follicular structure of the patch group was basically intact, with a small amount of lymphocyte infiltration observed. Conclusion:Jiedu Xiaoying Patch can significantly reduce the levels of TPOAb and TGAb in HT rats. The mechanism may be related to reducing the content of Sema 5A, inhibiting the expressions of receptors plexin-A1 and plexin-B3, reducing the production of inflammatory cytokines such as IL-17A, and inhibiting immune and inflammatory responses.

This report described a case of neonatal alloimmune thrombocytopenic purpura presenting with generalized petechiae. The infant was admitted at Nanfang Hospital, Southern Medical University on March 30, 2022, following detection of wide spread petechiae 30 minutes post-delivery. Blood tests revealed severe thrombocytopenia (platelet count 5×10 9/L) with leukopenia, decreased hemoglobin, and hepatomegaly, though coagulation function remained normal. Initial treatments—random donor platelet transfusion, and intravenous immunoglobulin—proved ineffective. Pretreatment blood samples showed strongly positive platelet antibodies (3+). Further typing confirmed human leukocyte antigen (HLA) antibodies in both infant and mother, establishing HLA-negative neonatal alloimmune thrombocytopenia. HLA-negative platelet transfusion resolved petechiae and normalized platelet counts, enabling discharge on postnatal day 14. Subdural hemorrhage was detected on MRI at day 29. Platelet levels remained normal at six-month follow-up, with age-appropriate development confirmed at 2.5 years.

Purpose To quantitatively evaluate the change of left ventricular myocardial work in well-functioning bicuspid aortic valves(BAV)by using left ventricular pressure-strain ring technology,and to explore the correlation between aortic dilation and myocardial work.Materials and Methods A total of 65 patients with well-functioning BAVs admitted to General Hospital of Ningxia Medical University from June 2022 to June 2023 were selected and divided into two groups according to the adjusted inner diameter of the aorta by body surface area:aortic undilated group(35 cases,theaortic diameter<40 mm or aortic size index<22 mm/m2)and aortic dilation group(30 cases,aortic diameter≥40 mm or aortic size index>22 mm/m2),34 healthy patients were enrolled in our study as the control group.The study subjects were analyzed by echocardiography to obtain the left ventricular myocardial work[global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work efficiency(GWE),global wasted work(GWW)]and conventional two-dimensional ultrasound parameters,and the parameters between the three groups were compared and analyzed.Results Compared with the control group,the absolute value of GLS and GWE in the non-dilated aortic group and the aortic dilated group decreased,and the GWI,GCW,GWW,ascending aortic inner diameter and ascending aortic stiffness index were significantly increased(P<0.05).Compared with the non-dilated aortic group,the absolute value of GLS and GWE in the aortic dilation group decreased,and the aortic stiffness index and GWW increased,and the difference was statistically significant(t=-3.567,-2.219,5.266,3.339,all P<0.05).The internal diameter of the ascending aorta was negatively correlated with the absolute value of GLS and GWE(r=-0.219,-0.324,both P<0.001),and positively correlated with GWI,GCW,GWW and ascending aortic stiffness index(r=0.178,0.229,0.315,0.529,all P<0.001).Conclusion Myocardial work is a new method for early detection of subclinical left ventricular myocardial dysfunction in well-functioning BAV,and has potential application value for evaluating the changes in left ventricular myocardial work under the progression of aortic disease in BAV patients.

Purpose To quantitatively evaluate the change of left ventricular myocardial work in well-functioning bicuspid aortic valves(BAV)by using left ventricular pressure-strain ring technology,and to explore the correlation between aortic dilation and myocardial work.Materials and Methods A total of 65 patients with well-functioning BAVs admitted to General Hospital of Ningxia Medical University from June 2022 to June 2023 were selected and divided into two groups according to the adjusted inner diameter of the aorta by body surface area:aortic undilated group(35 cases,theaortic diameter<40 mm or aortic size index<22 mm/m2)and aortic dilation group(30 cases,aortic diameter≥40 mm or aortic size index>22 mm/m2),34 healthy patients were enrolled in our study as the control group.The study subjects were analyzed by echocardiography to obtain the left ventricular myocardial work[global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work efficiency(GWE),global wasted work(GWW)]and conventional two-dimensional ultrasound parameters,and the parameters between the three groups were compared and analyzed.Results Compared with the control group,the absolute value of GLS and GWE in the non-dilated aortic group and the aortic dilated group decreased,and the GWI,GCW,GWW,ascending aortic inner diameter and ascending aortic stiffness index were significantly increased(P<0.05).Compared with the non-dilated aortic group,the absolute value of GLS and GWE in the aortic dilation group decreased,and the aortic stiffness index and GWW increased,and the difference was statistically significant(t=-3.567,-2.219,5.266,3.339,all P<0.05).The internal diameter of the ascending aorta was negatively correlated with the absolute value of GLS and GWE(r=-0.219,-0.324,both P<0.001),and positively correlated with GWI,GCW,GWW and ascending aortic stiffness index(r=0.178,0.229,0.315,0.529,all P<0.001).Conclusion Myocardial work is a new method for early detection of subclinical left ventricular myocardial dysfunction in well-functioning BAV,and has potential application value for evaluating the changes in left ventricular myocardial work under the progression of aortic disease in BAV patients.