ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

With the rapid development of population aging in various countries around the world,the health and elderly care industry has been paid high attention.The standardization of smart health and elderly care technology and services is particularly important.This paper firstly reviewed the policies related to healthy elderly care in China.By analyzing the industrial standards and provincial standards issued,this paper focused on the policies proposed by the Shanghai Municipal Government for the standardization of smart health and elderly care,as well as the researches on the standard system and the construction of standard families.Shanghai group standards in the field of smart health and elderly care were summarized,including the guidelines for the construction of standard systems,elderly care service platforms,community elderly cafeterias,portable health monitoring terminals,indoor sports services,and home-based elderly care safety monitoring.A series of case analyses of the standardized implementation of the above aspects were also provided.Through standardization research and practice in recent years,it has been fully demonstrated that the standard research plays an important leading role in the field of smart health and elderly care.

Purpose To investigate the clinicopathologic,molecular genetic features of metastatic adenoid cystic carcinoma(ACC)of the liver.Methods The histological morphological characteristics,immunophenotype and prog-nosis of metastatic ACC in 4 cases of liver biopsy specimens collected were retrospectively analyzed,and the genetic characteristics were analyzed by fluorescence in situ hybridization(FISH).Results There were 3 male patients and 1 female patients,ranging in age from 41 to 66 years,with an average age of 52.5 years.Pathologically,the tumor cells showed a variety of tubular,cribriform or solid structures.The tumor cells had a bland morphology,composed of two layers of cells:the luminal cells with eosinophilic cytoplasm and round nuclei,and the peripheral cell with deeply stained,triangular or irregular nuclei.Immunohistochemistry showed that CK7,CK19 and CD117 were positive in lu-minal cells.p63,Calponin,SMA and CK5/6 were positive in peripheral cells.TTF-1,Napsin A,CD10,CD56 and CRP were negative,and Ki67 proliferation index was 8％-20％.4 patients had a history of adenoid cystic carcinoma of lung or submandibular gland.FISH results showed that MYB gene rearrangement in case 3 and MYB gene amplifica-tion in case 2.All 4 patients were diagnosed with liver metastatic ACC.After 27 to 65 months of follow-up,all the 4 patients had multiple systemic metastases such as bone and lymph nodes,of which 1 patient died of disease 36 months after surgery,and 3 patients survived with tumor.Conclusion The histological morphology of metastatic ACC in the liver is similar to that of benign and malignant tumors and metastatic tumors of the primary bile duct in the liver,espe-cially when it presents as small tubular form.The characteristic morphology of the two layers of epithelia should be carefully observed during diagnosis,and the patient history should be asked.Combined with the histochemical results and molecular detection,it can distinguish from primary and metastatic tumors such as hepatic bile duct adenoma,in-trahepatic small bile duct type cholangiocarcinoma,hepatic metastatic epithelial-myoepithelial carcinoma and metastatic adenocarcinoma.

Purpose To investigate the clinicopathologic,molecular genetic features of metastatic adenoid cystic carcinoma(ACC)of the liver.Methods The histological morphological characteristics,immunophenotype and prog-nosis of metastatic ACC in 4 cases of liver biopsy specimens collected were retrospectively analyzed,and the genetic characteristics were analyzed by fluorescence in situ hybridization(FISH).Results There were 3 male patients and 1 female patients,ranging in age from 41 to 66 years,with an average age of 52.5 years.Pathologically,the tumor cells showed a variety of tubular,cribriform or solid structures.The tumor cells had a bland morphology,composed of two layers of cells:the luminal cells with eosinophilic cytoplasm and round nuclei,and the peripheral cell with deeply stained,triangular or irregular nuclei.Immunohistochemistry showed that CK7,CK19 and CD117 were positive in lu-minal cells.p63,Calponin,SMA and CK5/6 were positive in peripheral cells.TTF-1,Napsin A,CD10,CD56 and CRP were negative,and Ki67 proliferation index was 8％-20％.4 patients had a history of adenoid cystic carcinoma of lung or submandibular gland.FISH results showed that MYB gene rearrangement in case 3 and MYB gene amplifica-tion in case 2.All 4 patients were diagnosed with liver metastatic ACC.After 27 to 65 months of follow-up,all the 4 patients had multiple systemic metastases such as bone and lymph nodes,of which 1 patient died of disease 36 months after surgery,and 3 patients survived with tumor.Conclusion The histological morphology of metastatic ACC in the liver is similar to that of benign and malignant tumors and metastatic tumors of the primary bile duct in the liver,espe-cially when it presents as small tubular form.The characteristic morphology of the two layers of epithelia should be carefully observed during diagnosis,and the patient history should be asked.Combined with the histochemical results and molecular detection,it can distinguish from primary and metastatic tumors such as hepatic bile duct adenoma,in-trahepatic small bile duct type cholangiocarcinoma,hepatic metastatic epithelial-myoepithelial carcinoma and metastatic adenocarcinoma.

Objective To investigate the effects of total flavones of Dracocephalum moldavica L.(TFDM)on oxida-tive damage to retinal ganglion cells(RGCs)induced by high glucose(HG)and its mechanism.Methods RGCs of mice were taken as the research subjects.RGCs were inoculated in 24-well plates(with 2.5 × 104 cells in each well)and divided into control group(cultured with medium containing 10％fetal bovine serum for 48 h),HG group(cultured with medium containing 30 mmol·L-1 glucose for 48 h),HG+TFDM-L group(cultured with medium containing 30 mmol·L-1 glucose and 25 mg·L-1 TFDM for 48 h),HG+TFDM-M group(cultured with medium containing 30 mmol·L-1 glucose and 50 mg·L-1 TFDM for 48 h),HG+TFDM-H group(cultured with medium containing 30 mmol·L-1 glucose and 100 mg·L-1 TFDM for 48 h),miR-NC group(transfected with miR-NC and then cultured with medium containing 30 mmol·L-1 glu-cose for 48 h),miR-93-5p group(transfected with miR-93-5p mimics and then cultured with medium containing 30 mmol·L-1 glucose for 48 h),anti-miR-NC group(transfected with anti-miR-NC and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h),and anti-miR-93-5p group(transfected with anti-miR-93-5p and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h).Levels of RGCs oxidative stress indexes in each group were detected according to the kit instructions.The thiobarbituric acid method was used to measure the level of malondialdehyde(MDA),the colorimetric method was adopted to detect the levels of catalase(CAT)and 8-hydroxydeoxyguanosine(8-OHdG),apoptosis rate was detected by flow cytometry,the messenger ribonucleic acid(mR-NA)expressions were analyzed by real-time quantitative polymerase chain reaction,the targeting regulation of miR-93-5p and E2F transcription factor 1(E2F1)were verified by dual luciferase reporter assay,and the protein expressions were de-tected by Western blot.Statistical analysis was conducted on the data of each group.Results In the HG group,the lev-els of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were higher than those in the control group(all P＜0.05);the CAT level and Bcl-2 protein expression were lower than those in the control group(both P＜0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the levels of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were lower than those in the HG group(all P＜0.05);the CAT level and Bcl-2 protein expression were higher than those in the HG group,and those indexes gradually tended to those in the control group with the increase of TFDM concentrations(all P＜0.05).In the HG group,the miR-93-5p expression in RGCs was lower than that in the control group,and the mRNA and protein expressions of E2F1 were higher than those in the control group(all P＜0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the miR-93-5p expression in RGCs was higher than that in the HG group,and the mRNA and protein expressions of E2F1 were lower than those in the HG group(all P＜0.05).The protein expression of E2F1 in RGCs of the miR-93-5p group was lower than that in the miR-NC group,and the protein expression of E2F1 in RGCs of the anti-miR-93-5p group was higher than that in the anti-miR-NC group(both P＜0.05).In the miR-93-5p group,the miR-93-5p expression was higher than that in the miR-NC group,the levels of MDA and 8-OHdG,apoptosis rate,and protein expressions of Bax and E2F1 were lower than those in the miR-NC group,and the CAT level and Bcl-2 protein expression were higher than those in the miR-NC group(all P＜0.05).Con-clusion TFDM can inhibit oxidative stress and cell apoptosis,and then reduce the damage to RGCs induced by HG.The mechanism may involve the regulation of miR-93-5p/E2Fl expression.

BACKGROUND:In recent years,increasing studies have focused on the abnormal proliferation and differentiation of acinous cells in the meibomian gland,suggesting that this process is closely related to the occurrence and development of dry eye.Structural and functional abnormalities such as blockage of the lumen of the meibomian gland and atrophy of the glands can cause or exacerbate dry eye.Therefore,the study of changes in the meibomian glands in dry eyes is important for understanding the pathogenesis of dry eyes in depth and finding new targets for the treatment and prevention of dry eyes. OBJECTIVE:To investigate the changes of the meibomian gland in a mouse model of aqueous deficient dry eyes. METHODS:Thirty-two female C57/B6 mice at 6-8 weeks were selected and randomly divided into experimental and control groups with 16 mice in each group.The mice in the experimental group were constructed by removing both the extra-orbital and intra-orbital lacrimal glands,while those in the control group were not treated.After 2 weeks of normal feeding,the corneal changes of both groups were observed under a slit lamp,and the tear secretion of both groups was measured.The meibomian glands of the two groups of mice were removed after decapitation.The changes in the gross morphology of the meibomian glands were observed and the meibomian glands were made into frozen sections.Hematoxylin-eosin staining was used to observe the structure of the meibomian glands,oil red staining was used to evaluate the function of the meibomian glands,and immunofluorescence staining and RT-qPCR were used to observe the expression of cytokeratin 14,Ki67 and abnormally differentiated small proline-rich protein 1B in the meibomian glands of mice. RESULTS AND CONCLUSION:Two weeks after modeling,lamellar defects were seen in the corneas of the experimental mice,and neovascularization of the limbal corneal was generated and invaded the central cornea.(2)Tear secretion volume was significantly reduced in the experimental group compared with the control group(P<0.05).Microscopic findings showed that the ducts of the meibomian glands in the experimental group were interrupted and atrophied,and their arrangement was disorganized.Hematoxylin-eosin staining results showed a significant increase in lipid vacuoles in the meibomian glands of the experimental mice compared with the control group.Lipid deposition was seen in oil red staining in the experimental group.Immunofluorescence and RT-qPCR results showed a significant increase in the expression of cytokeratin 14,Ki67 and small proline-rich protein 1B in the meibomian glands of mice in the experimental group compared with the control group(P<0.05).To conclude,aqueous deficient dry eye can lead to compensatory hypertrophy,increased proliferation,and abnormal lipid metabolism in the meibomian gland,as well as abnormal differentiation of the meibomian gland.

Objective To compare and analyze the tilt and decentration of the intraocular lens in patients receiving four-point and two-point suspension fixation,as well as their relationship with visual prognosis.Methods A total of 80 patients(80 eyes)who underwent intraocular lens suspension fixation at the Ophthalmology Department of Baoding No.1 Central Hospital from June 2021 to April 2022 were selected as the subjects.These patients were randomly divided into the experimental group(41 patients,41 eyes,underwent four-point suspension fixation)and the control group(39 patients,39 eyes,underwent traditional two-point suspension fixation).They were followed up for at least 6 months after surgery to re-cord their uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)before surgery and at the last follow-up.The tilt angle and decentration distance of the intraocular lens of patients in the two groups were measured after surger-y by a panoramic ultrasound biomicroscope.The preoperative and last follow-up UCVA and BCVA of patients in the two groups,as well as tilt angle and decentration distance of the intraocular lens after surgery,were compared,and the corre-lation between tilt angle,decentration distance and postoperative UCVA,BCVA was analyzed by Person correlation analy-sis.Results The UCVA and BCVA at the last follow-up in the experimental group and control group were better than those before surgery(all P＜0.05).The difference in postoperative UCVA between the experimental group and the control group was statistically significant(t=-6.20,P=0.00),and the experimental group had better postoperative UCVA than the control group.There was no statistically significant difference in postoperative BCVA between the experimental group and the control group(t=-1.43,P=0.16).The postoperative horizontal and vertical tilt angles of the intraocular lens in the experimental group were 0.70°±0.24° and 0.60°±0.16°,respectively;while those in the control group were 2.66°± 1.40° and 3.76°±0.67°,respectively.The differences between the two groups were statistically significant(t=-8.51 and-29.42,P=0.00 and 0.00).The postoperative horizontal and vertical decentration distances of the intraocular lens in the experimental group were(0.24±0.10)mm and(0.25±0.10)mm,respectively,while those in the control group were(0.85±0.77)mm and(2.14±0.50)mm,respectively.The differences between the two groups were statistically signifi-cant(t=-4.82 and-21.68,P=0.00 and 0.00).In the experimental group,neither the horizontal and vertical tilt angles of intraocular lenses nor the horizontal and vertical decentration distances were correlated with postoperative UCVA and BCVA(all P＞0.05).In the control group,the horizontal tilt angle of intraocular lenses was positively correlated with post-operative UCVA and BCVA(both P＜0.05),while the vertical tilt angle was not correlated with postoperative UCVA and BCVA(both P＞0.05);the horizontal decentration distance was positively correlated with postoperative UCVA and BCVA(both P＜0.05),but the vertical decentration distance was not correlated with postoperative UCVA and BCVA(both P＞0.05).Conclusion Both four-point suspension fixation and traditional two-point suspension fixation can effectively im-prove postoperative vision of patients,while the tilt and decentration of the intraocular lens are smaller after four-point sus-pension fixation.

Objective To develop a training curriculum for specialist nurses in oral implantology and to provide a theoretical basis for professional development.Methods In September 2022,based on literature reviews,interviews and group discussions were conducted to formulate an preliminary draft of the"Training Curriculum for Nursing Specialists in Oral Implantology",which included 6 primary domains and 23 secondary items.Between October and November 2022,Delphi method was employed to conduct 2 rounds of expert consultations with 17 dentists and nursing specialists in oral implantology.The initial draft was improved based on the results of consultation and a final version of the curriculum was concluded.Results The response rate of the two rounds of expert consultation was both of 100%with an expert authority coefficient at 0.873.The importance scores for the items in the two rounds of expert correspondence ranged from 4.31 to 5.00 and 4.47 to 5.00,respectively,with the coefficients of variation ranged from 0 to 0.16 and 0 to 0.14,respectively.The proportion of maximum scores in the two rounds of expert consultation ranged from 43.75%to 100.00%and 47.10%to100.00%,respectively,with Kendall W coefficients of 0.196 and 0.310,respectively,indicating statistically significant differences(all P<0.001).The finalised curriculum encompassed 6 primary domains and 30 secondary items.The primary domains included basic knowledge about oral implantation,perioperative care of oral implantation,care during restoration period of oral implantation,infection management of oral implantation,emergency management of oral implantation,and nursing management in oral implantation.Conclusion The curriculum developed for training of specialist nurses in oral implantology is scientifically valid and reliable.It is in line with the training requirements for the specialists in oral implantology and provides guidance for the professional training.

Objective To develop a training curriculum for specialist nurses in oral implantology and to provide a theoretical basis for professional development.Methods In September 2022,based on literature reviews,interviews and group discussions were conducted to formulate an preliminary draft of the"Training Curriculum for Nursing Specialists in Oral Implantology",which included 6 primary domains and 23 secondary items.Between October and November 2022,Delphi method was employed to conduct 2 rounds of expert consultations with 17 dentists and nursing specialists in oral implantology.The initial draft was improved based on the results of consultation and a final version of the curriculum was concluded.Results The response rate of the two rounds of expert consultation was both of 100%with an expert authority coefficient at 0.873.The importance scores for the items in the two rounds of expert correspondence ranged from 4.31 to 5.00 and 4.47 to 5.00,respectively,with the coefficients of variation ranged from 0 to 0.16 and 0 to 0.14,respectively.The proportion of maximum scores in the two rounds of expert consultation ranged from 43.75%to 100.00%and 47.10%to100.00%,respectively,with Kendall W coefficients of 0.196 and 0.310,respectively,indicating statistically significant differences(all P<0.001).The finalised curriculum encompassed 6 primary domains and 30 secondary items.The primary domains included basic knowledge about oral implantation,perioperative care of oral implantation,care during restoration period of oral implantation,infection management of oral implantation,emergency management of oral implantation,and nursing management in oral implantation.Conclusion The curriculum developed for training of specialist nurses in oral implantology is scientifically valid and reliable.It is in line with the training requirements for the specialists in oral implantology and provides guidance for the professional training.

Oxidative stress by different oxygen concentrations can cause damage to the immature intestinal tract of newborns and preterm infants.Newborns, especially premature infants, have underdeveloped intestinal tracts, immature immune function, increased susceptibility to oxidative stress, and are prone to intestinal inflammatory diseases.Both hypoxia and hyperoxia can trigger oxidative stress, leading to intestinal damage.Histological changes include damage to the intestinal barrier, watery degeneration of the intestinal epithelium, and reduced goblet cells and villi.Hypoxia-induced intestinal injury is affected by a variety of signaling pathways including CRF-TLR4, Grx1-HIF-VEGF, NLRP3-Caspase-1, and miRNA-SIRT axis.The intestinal injury induced by hyperoxia is closely related to TLR4/NF-κB signaling pathway, Nrf2/IL-17D axis, and ASK1-MAPK cascade.This review focuses on the histological changes and molecular pathways of hypoxic or hyperoxic-induced intestinal injury to establish a framework for potential interventions.