Objective To compare the distribution characteristics of retinal capillary non-perfusion areas(NPAs)across different layers and regions in patients with neovascular glaucoma(NVG)secondary to proliferative diabetic retinop-athy(PDR)versus those with PDR alone through wide-field swept-source optical coherence tomography angiography(SS-OCTA)and to analyze the impacts of NPAs on the development of NVG.Methods This prospective cross-sectional study enrolled 33 patients with PDR(33 eyes,the PDR group)and 30 patients with NVG(30 eyes,the PDR+NVG group)diag-nosed at Affiliated Hospital of Shandong Second Medical University(formerly Weifang Medical University)from January 2022 to June 2023.The fundus examination was performed using SS-OCTA,and the NPA boundaries of the superficial capil-lary plexus(SCP)and deep capillary plexus(DCP)of the retina were manually delimited with the aid of ImageJ.The reti-na was divided based on two methods.Specifically,according to different concentric circles,the retina could be divided in-to the foveal area,parafoveal area,perifoveal area,annulus6-9,annulus9-12,annulus12-retinal boundary;besides,the ret-ina could also be divided into four quadrants(supratemporal,infratemporal,supranasal,and infranasal quadrants)based on the horizontal and vertical lines centered on the macular fovea.Based on that,the NPA area and ischemia index(ISI)in each layer and subdivision of the two groups of patients were counted.Additionally,the NPA and ISI in different concentric circles and different quadrants of the SCP and DCP were compared between the two groups.Moreover,the distribution characteristics of NPAs as well as the effect of NPAs on NVG were analyzed.Results(1)The NPA area and ISI in the DCP were larger than those in the SCP in both groups(all P＜0.001);the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.001).(2)In the supratemporal,infratemporal,supranasal,and infranasal quadrants,the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.01).The NPA area in the inferotemporal quadrant was the largest in the SCP and DCP,respectively,within each group(all P＜0.01).(3)The differences in the NPA area and ISI between the two groups were statistically significant in the annulus6-9,annulus9-12,and annulus12-retinal boundary in the SCP and DCP(all P＜0.01).The differences in the NPA area and ISI were statistically significant between different annular subdivisions in the SCP and DCP within each group(all P＜0.001).The multiple comparison results showed that the NPA area and ISI of the annulus12-retinal boundary in the SCP and DCP were larger than those in other annuli in both groups(all P＜0.05).The NPA area and ISI of the annulus9-12 were larger than those of the parafoveal and perifoveal areas;the NPA area and ISI of the annulus6-9 were larger than those of the parafoveal area(all P＜0.05).There was no statistically significant differ-ence in the NPA area and ISI in the remaining annuli(all P＞0.05).(4)The multivariate logistic regression analysis showed that the NPA area and ISI in the subnasal quadrant of the SCP were negatively correlated with the risk of NVG sec-ondary to PDR(P=0.036 and 0.038).The increased NPA area and ISI in the subnasal quadrant of the DCP were risk fac-tors for NVG secondary to PDR,and they may increase the risk of NVG(P=0.029 and 0.028).Conclusion The in-creased NPA area and ISI in the subnasal quadrant of the DCP were risk factors for secondary NVG in patients in the PDR group.

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

Objective To compare the distribution characteristics of retinal capillary non-perfusion areas(NPAs)across different layers and regions in patients with neovascular glaucoma(NVG)secondary to proliferative diabetic retinop-athy(PDR)versus those with PDR alone through wide-field swept-source optical coherence tomography angiography(SS-OCTA)and to analyze the impacts of NPAs on the development of NVG.Methods This prospective cross-sectional study enrolled 33 patients with PDR(33 eyes,the PDR group)and 30 patients with NVG(30 eyes,the PDR+NVG group)diag-nosed at Affiliated Hospital of Shandong Second Medical University(formerly Weifang Medical University)from January 2022 to June 2023.The fundus examination was performed using SS-OCTA,and the NPA boundaries of the superficial capil-lary plexus(SCP)and deep capillary plexus(DCP)of the retina were manually delimited with the aid of ImageJ.The reti-na was divided based on two methods.Specifically,according to different concentric circles,the retina could be divided in-to the foveal area,parafoveal area,perifoveal area,annulus6-9,annulus9-12,annulus12-retinal boundary;besides,the ret-ina could also be divided into four quadrants(supratemporal,infratemporal,supranasal,and infranasal quadrants)based on the horizontal and vertical lines centered on the macular fovea.Based on that,the NPA area and ischemia index(ISI)in each layer and subdivision of the two groups of patients were counted.Additionally,the NPA and ISI in different concentric circles and different quadrants of the SCP and DCP were compared between the two groups.Moreover,the distribution characteristics of NPAs as well as the effect of NPAs on NVG were analyzed.Results(1)The NPA area and ISI in the DCP were larger than those in the SCP in both groups(all P＜0.001);the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.001).(2)In the supratemporal,infratemporal,supranasal,and infranasal quadrants,the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.01).The NPA area in the inferotemporal quadrant was the largest in the SCP and DCP,respectively,within each group(all P＜0.01).(3)The differences in the NPA area and ISI between the two groups were statistically significant in the annulus6-9,annulus9-12,and annulus12-retinal boundary in the SCP and DCP(all P＜0.01).The differences in the NPA area and ISI were statistically significant between different annular subdivisions in the SCP and DCP within each group(all P＜0.001).The multiple comparison results showed that the NPA area and ISI of the annulus12-retinal boundary in the SCP and DCP were larger than those in other annuli in both groups(all P＜0.05).The NPA area and ISI of the annulus9-12 were larger than those of the parafoveal and perifoveal areas;the NPA area and ISI of the annulus6-9 were larger than those of the parafoveal area(all P＜0.05).There was no statistically significant differ-ence in the NPA area and ISI in the remaining annuli(all P＞0.05).(4)The multivariate logistic regression analysis showed that the NPA area and ISI in the subnasal quadrant of the SCP were negatively correlated with the risk of NVG sec-ondary to PDR(P=0.036 and 0.038).The increased NPA area and ISI in the subnasal quadrant of the DCP were risk fac-tors for NVG secondary to PDR,and they may increase the risk of NVG(P=0.029 and 0.028).Conclusion The in-creased NPA area and ISI in the subnasal quadrant of the DCP were risk factors for secondary NVG in patients in the PDR group.

Objective:To investigate impact of leonurine(Leo)on necrotic apoptosis in rats with myocardial ischemia/reperfu-sion(MIR)injury by regulating receptor interacting protein 1(RIP1)-receptor interacting protein 3(RIP3)-mixed lineage kinase domain-like protein(MLKL)pathway.Methods:Fifteen rats were randomly selected as sham surgery group(Sham),left anterior descending coronary artery of remaining rats were ligated to construct MIR model,and randomly grouped into MIR group,Leo group(15 mg/kg),Compound 6i group(1 mg/kg RIP1-RIP3-MLKL pathway activator Compound 6i)and Leo+Compound 6i group(15 mg/kg Leo+1 mg/kg Compound 6i),with 15 rats in each group.MIR group and Sham group were injected with equal amounts of physiological saline.Cardiac function indicators were observed through ultrasound electrocardiogram;ELISA was applied to detect myocardial injury indicators and inflammatory factor levels;HE staining was applied to observe pathological damage of heart;TTC staining was applied to detect myocardial infarction area;TUNEL staining was applied to detect cell apoptosis;Western blot was applied to detect expres-sions of RIP1-RIP3-MLKL pathway proteins.Results:Myocardial cells in Sham group were intact and arranged in an orderly manner;arrangement of myocardial cells was disordered and swollen,myofibril contracted,and sarcolemma was destroyed in MIR group,ejec-tion fraction(EF)and cardiac output(CO)level were obviously lower than Sham group(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously increased(P<0.05);compared with MIR group,Leo group had improved cell arrangement disorder and edema,and obviously increased EF and CO levels(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously reduced(P<0.05),trend of Compound 6i group was opposite;myocardial tissue structure of Leo+Compound 6i group was similar to MIR group,and Compound 6i eliminated cardioprotective effect of Leo on MIR rats.Conclusion:Leo may alleviate myocardial necrosis apoptosis in MIR rats by down-regulating RIP1-RIP3-MLKL pathway,thus playing a therapeutic role in MIR.

Objective To explore the protective effect of 7,8-dihydroxyflavone(7,8-DHF)on the retina of diabetic rats and its mechanism.Methods A total of 18 SPF-grade male Sprague-Dawley(SD)rats were selected and randomly divided into three groups:the normal group,the model group,and the experimental group,with six rats in each group.Rats in the normal group were fed with a normal diet,while those in the remaining two groups were fed with a high-fat emulsion through oral gavage continuously for 2 weeks to establish a diabetes model.Rats in the experimental group were provided with 7,8-DHF(5 mg?kg-1)by continuous intraperitoneal injection,while those in the normal and model groups were provided with an equal volume of normal saline.The rats in all groups received intervention once a day for 2 weeks.The changes in the body mass and fasting blood glucose(FBG)were observed before and after modeling.Besides,the changes in the retina of rats in each group were observed by fundus fluorescence angiography(FFA)after 2 weeks.Moreo-ver,the changes and apoptosis of retinal neuronal cells were detected by hematoxylin and eosin(HE)staining,CD31 im-munofluorescence,and terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)assays.Results After 2 weeks of continuous intervention,compared with the normal group,the body mass of rats in the model and experimental groups decreased(both P＜0.05),and the FBG increased significantly(both P＜0.05);compared with the model group,the experimental group showed an increase in the body mass(P＜0.05)and a decrease in the FBG(P＜0.05).The fundus photography and FFA of rats in the three groups did not reveal any fundus features of diabetic retinopathy.The HE staining results showed that the retina of rats in the normal and experimental groups was structurally intact,with neatly arranged cells and uniform thickness;the retinal structure of rats in the model group remained clear.However,the thickness of the inner layers of the retina of rats in the model group was thinner compared with the normal and experimental groups,exhibi-ting significant differences(both P＜0.05).The CD31 immunofluorescence assay results indicated that the CD31 immuno-fluorescence intensity values of rats in the three groups were roughly comparable,without significant differences(all P＞0.05).The TUNEL assay results suggested that the apoptosis of retinal neurons increased in rats in the model group com-pared with the normal group,exhibiting significant differences(P＜0.001);compared with the model group,the apoptosis of retinal neurons of rats in the experimental group decreased significantly,displaying significant differences(P＜0.001).Conclusion The apoptosis of retinal neurons in diabetic rats may precede vascular endothelial cell injury.7,8-DHF can improve the body mass,decrease the blood glucose level,and protect the retinal neurons in diabetic rats.

Objective:To study and analyze radiation doses to the eye of the lens dose in interventional radiology staff of Guandong medical institutions from 2019 to 2023.Methods:Employing a convenience sampling method, the lens dose and chest dose was monitored with TLD dosimeters in 34 level A tertiary medical institutions. The monitoring data were analyzed on the basis of a summary, and the relationship between the two was explored.Results:A total of 1 033 interventional radiology staff were monitored. The ocular lens doses were in the range of (

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

Objective:To construct a teaching model for Geriatric Nursing based on metacognitive strategy and to test its effectiveness in teaching undergraduate nursing students.Methods:A quasi-experimental research design was adopted. The intervention group consisted of 49 undergraduate nursing students enrolled in 2019 at Sun Yat-sen University, while the control group was made up of 49 undergraduate nursing students enrolled in 2018. The same teaching staff were assigned to both groups. Geriatric Nursing was taught in the intervention group using a teaching model based on metacognition from April to June 2022, while the control group was taught using the traditional teaching model from April to June 2021. Student satisfaction and teaching effectiveness in the intervention group were assessed using a self-designed teaching evaluation questionnaire. SPSS 25.0 software was used for two-sample t test. Results:The intervention and control groups showed individual assignment scores of (85.33±5.96) and (82.36±7.25) and total scores of (84.44±4.31) and (82.61±5.05), respectively. The individual assignment score of the intervention group was significantly higher than that of the control group, while there was no significant difference in the total score. In terms of satisfaction, over 90% of the students in the intervention group expressed satisfaction with the teaching model. The item with the highest proportion of students rating it as "very good" was "being required to submit a plan for completing individual assignments in advance" ( n=32, 76.19%). In terms of teaching effectiveness, all students recognized the teaching effectiveness of this course. Conclusions:It is necessary to adopt the teaching model based on metacognitive strategies in teaching Geriatric Nursing for undergraduates, which can significantly promote their individual assignment performance as well as the evaluation of teaching strategies and teaching effectiveness.

Objective:To investigate impact of leonurine(Leo)on necrotic apoptosis in rats with myocardial ischemia/reperfu-sion(MIR)injury by regulating receptor interacting protein 1(RIP1)-receptor interacting protein 3(RIP3)-mixed lineage kinase domain-like protein(MLKL)pathway.Methods:Fifteen rats were randomly selected as sham surgery group(Sham),left anterior descending coronary artery of remaining rats were ligated to construct MIR model,and randomly grouped into MIR group,Leo group(15 mg/kg),Compound 6i group(1 mg/kg RIP1-RIP3-MLKL pathway activator Compound 6i)and Leo+Compound 6i group(15 mg/kg Leo+1 mg/kg Compound 6i),with 15 rats in each group.MIR group and Sham group were injected with equal amounts of physiological saline.Cardiac function indicators were observed through ultrasound electrocardiogram;ELISA was applied to detect myocardial injury indicators and inflammatory factor levels;HE staining was applied to observe pathological damage of heart;TTC staining was applied to detect myocardial infarction area;TUNEL staining was applied to detect cell apoptosis;Western blot was applied to detect expres-sions of RIP1-RIP3-MLKL pathway proteins.Results:Myocardial cells in Sham group were intact and arranged in an orderly manner;arrangement of myocardial cells was disordered and swollen,myofibril contracted,and sarcolemma was destroyed in MIR group,ejec-tion fraction(EF)and cardiac output(CO)level were obviously lower than Sham group(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously increased(P<0.05);compared with MIR group,Leo group had improved cell arrangement disorder and edema,and obviously increased EF and CO levels(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously reduced(P<0.05),trend of Compound 6i group was opposite;myocardial tissue structure of Leo+Compound 6i group was similar to MIR group,and Compound 6i eliminated cardioprotective effect of Leo on MIR rats.Conclusion:Leo may alleviate myocardial necrosis apoptosis in MIR rats by down-regulating RIP1-RIP3-MLKL pathway,thus playing a therapeutic role in MIR.

AIM: To investigate the influence of relevant inflammatory markers in peripheral blood on the progression of neovascular glaucoma(NVG)secondary to diabetic retinopathy(DR)patients.METHODS: Retrospective case-control study. Patients were categorized into two groups based on the presence or absence of NVG: those with proliferative diabetic retinopathy(PDR)alone(PDR group, n=148)and those with NVG secondary to PDR(NVG secondary to PDR group, n=142). Peripheral blood inflammatory markers were evaluated, including white blood cell-related indices, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), monocyte-to-lymphocyte ratio(MLR), and systemic immune-inflammation index(SII). The distinctions in peripheral blood inflammatory markers between the two groups of patients and their relationships with NVG secondary to PDR were analyzed.RESULTS:No statistically significant differences were observed in basic characteristics between the two groups, confirming their comparability. However, significant differences were found in eosinophil percentage and MLR between the PDR group and the NVG secondary to PDR group(all P<0.05), with both values being significantly higher in the NVG secondary to PDR group. Multivariate Logistic regression analysis revealed that the eosinophil percentage and the MLR were factors influencing the development of patients with NVG secondary to PDR.CONCLUSION: Eosinophil percentage and MLR may be associated with the progression of PDR to NVG, and could serve as potential predictive markers for NVG development in PDR patients.