Objective:To observe the clinical efficacy of manual therapy based on the Discovery of Posture Secret (DPS) in treating adolescent idiopathic scoliosis (AIS).Methods:Thirty-six AIS patients were randomly divided into an observation group of 17 and a control group of 16. In addition to 10 minutes of side-shift training each week, the control group was given 20 minutes of sling exercise training (SET), while the observation group underwent weekly 20-minute manual therapy sessions based on DPS on the days without SET. Before and after the 4 weeks of treatment spine curvature (Cobb angle), clavicular angle (CA), angle of trunk rotation (ATR) and vertebral rotation (VR) were measured, and the Scoliosis Research Society′s patient questionnaire 22 (SRS-22) was administered.Results:After the treatment the average Cobb angle, CA, ATR and SRS-22 score of the observation group had improved significantly compared with before the treatment. The average Cobb angle, ATR and SRS-22 score of the control group were also significantly higher, but the improvements were not as great as in the observation group. There was no significant difference in VR improvement between the two groups.Conclusion:Manual therapy based on the DPS can effectively ameliorate the scoliosis and shoulder imbalance of AIS patients.

Objective To investigate causal relationship between gut microbiota and stroke by using Mendelian randomization(MR).Methods The gut microbiota genome wide association study(GWAS)data of MiBioGen study in public database(n=13 266)and stroke GWAS data of IEU Open GWAS were used.Independent genetic loci significantly correlated with the relative abundance of gut microbiota at genus level were used for instrumental variables(Ⅳs)according to preset thresholds.The inverse variance weighted method was used to analyse,results were evaluted according to odds ratio(OR)of effect index and 95％confidence interval(CI).The stability and reliability of the results were verified by leave one out,heterogeneity test and horizontal gene pleiotropy test.Results The rise of abundance of LachnospiraceaeFCS020group genera,Lachnospiraceae NK4A136group genera,RuminococcaceaeUCG004 genera and Intestinimonas genera,could reduce the risk of stroke,the OR(95％CI)were 0.914(0.845-0.988),0.909(0.838-0.985),0.919(0.849-0.995),0.924(0.866-0.987),respectively.The increase of abundance of Allisonella genera,Gordonibacter genera,Paraprevotella genera and Streptococcus genera can increase the risk of stroke,and the OR(95％CI)were 1.103(1.039-1.171),1.056(1.009-1.105),1.078(1.013-1.147),1.110(1.020-1.209),respectively.Leave one out showed that the results were stable,there were no IVs that had a strong influence on the results,and the influence of heterogeneity and horizontal gene pleiotropy on the estimation of causal effect could be eliminated.Conclusion The levels of Lachnospiraceae FCS020group genera,LachnospiraceaeNK4A136group genera,RuminococcaceaeUCG004 genera and Intestinimonas genera protect factors of brain stroke,with the increase of bacterial abundance,the incidence of stroke may be reduced.On the contrary,the levels of Allisonella genera,Gordonibacter genera,Paraprevotella genera and Streptococcus genera are positively correlated with stroke occurrence.Probiotics in the treatment of stroke may become the trend of future clinical or mechanism research.

Background: Melasma is a common and chronic pigmentary disorder with complex pathogenesis, and the relationship between melasma and metabolic syndrome remains elusive. Thus, metabolomics might contribute to the early detection of potential metabolic abnormalities in individuals with melasma. Objective: The present study aims to analyze changes in plasma metabolites of female melasma patients and identify disease markers as well as explore potential therapeutic targets. Methods: Plasma samples from 20 female patients with melasma and 21 healthy female controls that were comparable in terms of age and body mass index were collected for untargeted metabolomics investigations. Ultra-high performance liquid chromatography-mass spectrometry was used to analyze metabolites in the plasma. Metabolic pathway analyses were employed to identify significantly differentially expressed metabolites in melasma patients. Receiver operating characteristic curves were constructed, and correlation analyses were performed using the modified Melasma Area and Severity Index and oxidative stress levels. Results: In contrast to healthy subjects, melasma patients showed significant alterations in 125 plasma metabolites, including amino acids, lipids, and carbohydrate-related metabolites.KEGG pathway analysis suggested that primary pathways associated with the development of melasma include tryptophan metabolism, as well as the biosynthesis of phenylalanine, tyrosine, and tryptophan. Importantly, based on receiver operating characteristic curves and correlation analyses, several metabolites were identified as robust biomarkers for melasma. Conclusion Collectively, this study identified significant changes in plasma metabolites in melasma patients, providing new insights into the pathogenesis of melasma and opening novel therapeutic avenues.

Objective:To evaluate the effectiveness of hands-on training and video demonstration in training of forceps delivery for residents.Methods:Forty nine residents who were rotating in the obstetrics department of Peking Union Medical College Hospital from 2019 to 2021 were enrolled. The residents were randomly divided into two groups: the instructor group ( n=24) was taught by hands-on training of forceps delivery and the video group ( n=25) was instructed by watching video demonstration. All the trainees completed the self-confidence questionnaire survey, and were evaluated by written tests and objective structured assessment of technical skills scoring system. Results:The scores of self-confidence in each item after the simulation training were higher than those before training in both groups; and there were no significant differences between two groups in the increment of scores(mastering knowledge: 1.54±0.98 vs. 1.40±0.71, U=266.68, P=0.480;mastering operation skills: 1.42±0.93 vs.1.80±0.87, U=233.47, P=0.161; mastering forceps structure: 1.63±1.10 vs. 1.88±0.93, U=261.63, P=0.416; confidence in independent operation: 1.13±0.90 vs. 1.00±1.08, U=287.74, P=0.799; evaluation of simulation training: 0.21±0.51 vs. 0.16±0.55, U=288.27, P=0.776). In the written tests, the scores of the instructor group were significantly higher than those of the video group (83.00±7.18 vs.70.56±10.37; t=4.86, P<0.001). In the practical operation, the instructor group significantly outperformed the video group in items of “right blade placement” (0.71±0.46 vs. 0.20±0.41, U=147.54, P<0.001), “objective total score” (6.17±1.46 vs. 4.72±1.65, U=155.49, P=0.003) and “correct traction” (0.85±0.31 vs. 0.56±0.51, U=213.86, P=0.036). Conclusion:Training delivered via hands-on instruction and demonstration was generally more effective than that delivered via video, although both groups show a increased self-confidence in learning and performing forceps delivery.

A case of IgG4-related hypertrophic pachymeningitis was reported. The patient was an elderly female, with the course of disease more than 8 years. Clinical manifestations included recurrent headache, vision and hearing loss, exophthalmos and thyroid dysfunction. Finally, she was diagnosed as IgG4-related disease and IgG4-related hypertrophic pachymeningitis by PET-CT and dural biopsy. After treatment with methylprednisolone and mycophenolate mofetil, the patient′s clinical symptoms improved.

Objective: To determine the influencing factors of electronic screen time of urban preschoolers before and after the COVID-19 outbreak, so as to provide a scientific basis for the control of digital screen use and early prevention of myopia among preschoolers. Methods: Using multi stage cluster random sampling method, a cross sectional survey of 8 244 kindergarten students in a district of Shanghai was implemented, through parent questionnaire collecting the time child spent on various electronic screens before and after the COVID-19 outbreak, estimated the weighting screen time, and emphatically analyzed the relationship between family electronic screen supervision behavior and preschoolers weighting screen time. Results: The proportion of daily over use time on average of mobile phones, computers and TV/projection screens among the surveyed preschool children during COVID-19 was 30.52%, 51.40% and 56.82%, respectively. On school days before the epidemic, the proportion was 21.94%, 41.80% and 47.51% respectively. After controlling for primary covariates, parents frequent control of children s electronic screen use, parents guidance for electronic screen use were significantly associated with lower weighted screen refractive time ( OR =0.60-0.77, P < 0.05 ). The use of electronic screen when parents accompanied their children, the use of electronic screen time by parents but not strictly implemented were significantly associated with higher weighted screen refractive time and increased screen refractive time ( OR =1.18-1.80, P <0.05). Conclusion Urban preschoolers electronic screen time was high during and before COVID-19. In the control measures of preschool children s electronic screen time, attention should be paid to the management of electronic screen use within the family and parents role model.

Objective: To development teacher health literacy on students visual protection questionnaire for kindergarten, primary and middle schools, and to provide a basis for quantitative assessment of visual protection health literacy of school teachers. Methods: Based on official documents related to prevention and control of myopia as well as the integrated definition of health literacy of WHO Europe, the framework for technical evaluation was established. Totally 24 multi disciplinary experts in related fields conducted two round Delphi expert consultation. Evaluation items, questions and corresponding weights were determined based on experts opinions and scores. Results: In two rounds of Delphi consultation, the response rates were 83.3% and 79.2% respectively, and the authority coefficient was 0.91. The final questionnaire was composed by dimensions of core knowledge of myopia, daily instruction, guidance for myopic behaviors, promotion of outdoor activities, and creation of teaching light environment, including 30 and 23 items for middle and primary school teachers and kindergarten teachers respectively. The coefficient of variation ( CV ) of the five dimensions ranged from 0.07 to 0.15, and that of each question ranged from 0.08 to 0.29. Expert opinions were accordant and credible. Conclusion A reliable questionnaire of teacher health literacy on students visual protection health literacy for school teachers is established, which can be used as the entry point and effectiveness evaluation basis for the school based intervention of myopia.

Objective: The current situation and associated factors of primary and middle school students screen time and related eye hygiene in different periods before and after COVID-19 were investigated, so as to provide a scientific basis for taking targeted measures of preventing and controlling myopia among those students. Methods: A total of 11 402 students were selected from 24 primary schools, 18 junior high schools and 16 high schools by multi stage stratified cluster sampling method. And a questionnaire survey was conducted among students and their parents to understand students screen time and screen hygiene behaviors and related factors in different periods before and after the outbreak of COVID-19. Results: The rate of screen overuse was 7.26%, 9.12% and 35.30% during school days, weekends and home study, respectively. The overuse rate of mobile phones and tablets at home increases with the increase of school stage. Totally 16.30% of students use mobile phones for online learning. The screen overuse rate of those who have not been diagnosed with myopia was lower than that of those who have been diagnosed during home study( OR=0.77, P <0.05). The higher the parents educational level was, the lower the screen overuse rate of children during the weekends became( P <0.05). In any period, the high proportion of screens used in homework and poor home screen eye environment increased the risk of screen overuse and poor eye hygiene ( P <0.05). Parental good behavior was conducive to reducing the risk( OR= 0.65-0.97, P <0.05). When the family had regulation on the screen use time, the implementation of laxity would increase the risk of screen overuse ( OR=1.18-2.48, P <0.05). Conclusion The screen overuse rate of urban primary and middle school students during home study is high, and a certain proportion of students still use mobile phones for online learning. The proportion of screens used in homework, home screen eye environment and screen use management are related to screens overuse. More attention should be paid to those with myopia and low educational level of parents.

Objective:To evaluate the effects of adipose-derived stem cells (ADSCs) and ADM microparticle on diabetic wound healing.Methods:ADSCs was co-cultured with ADM microparticle in vitro. The models of diabetic nude mice were established by intraperitoneal injection of STZ and the full-thickness skin defects were designed on the back. All 24 diabetic mice were randomly divided into 4 group: experimental groups were transplanted with ADSCs and ADM microparticle and the other groups were transplanted with ADSCs, ADM microparticle and blank control group was set up. On the 7th and 14 th days, the wound healing rate of 3 mice randomly selected from each group was calculated, and the thickness between dermis and epidermis was measured by hematoxylin and eosin staining. The density of neovascularization was measured by immunohistochemical staining. The differences were compared between the groups.Results:Compared to the ADSCs groups, the mice of the experimental groups showed higher cell survival rate. The wound healing rate in the experimental groups was (86.0±2.7)% (7 days) and (98.5±1.1)% (14 days), thicker dermis-epidermis distance was (99.1±1.8) μm (7 days) and (124.3±4.3) μm (14 days) ( P<0.05), and higher density of neovascularization was noted. Conclusions:The transplantation with active ADM microparticle can significantly promote neovascularization and wound healing of diabetic wound.

Premature ovarian failure （POF） is a common gynecological endocrine disease ，which can cause follicular development stagnation or premature failure in the ovary ，leading to ovarian function loss ，and seriously affecting women ’s physical and mental health . Traditional Chinese medicine shows less toxicity and side effects but significant effect in the treatment of POF . Chinese herb monomers are the active ingredients of traditional Chinese medicine that exert their effects ，and their chemical structure are determined . From the perspective of Chinese herb monomers ，the author reviewed the mechanism of their effect on improving POF . The results showed that icariin ，quercetin，resveratrol and ginsenoside Rg 1 could improve the ovarian function of POF model animals by activating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway ，inhibiting oxidative stress and apoptosis of granulosa cells ，promoting ovarian autophagy ，and regulating the level of sex hormones ；puerarin and resveratrol can improve the ovarian function of POF model by interfering with Wnt/ β-catenin signaling pathway ，reducing oxidative stress response ，and inhibiting follicular atresia . Although the Chinese herb monomers have certain effect in improving POF，most of them remain in the experimental stage ，and the clinical efficacy in improving POF cannot be objectively evaluated . In the future ，the development of new dosage forms of Chinese herb monomers should be strengthened to lay a foundation for the development of new drugs for treating POF .