AIM: To evaluate the safety and efficacy of low-dose transscleral cyclophotocoagulation(TSCP)in the management of persistent ocular hypertension after an acute attack of angle-closure glaucoma(AACG).METHODS:This retrospective study enrolled patients diagnosed with persistent ocular hypertension after an acute AACG attack at the No.988 Hospital of the Joint Logistics Support Force of the Chinese PLA between September 2023 and September 2024. All patients underwent low-dose TSCP using a semiconductor diode laser. Subsequent cataract surgery combined with goniosynechialysis was performed once intraocular pressure(IOP)was stabilized. Changes in anterior chamber depth(ACD), best-corrected visual acuity(VA), and IOP were compared before and after TSCP, as well as before and after phacoemulsification. Post-TSCP complications were also documented.RESULTS: A total of 21 patients(21 eyes)were enrolled, including 8 males and 13 females, with a mean age of 67.95±7.25 y. Compared with pre-cyclophotocoagulation values, ACD increased significantly at 3 d post-TSCP(1.49±0.18 vs 1.22±0.21 mm; P<0.001). BCVA and IOP decreased significantly at 1 d post-TSCP, pre-phacoemulsification, 1 wk post-phacoemulsification, and 1 mo post-phacoemulsification compared with pre-TSCP IOP(all P<0.01). Regarding postoperative complications, 2 eyes experienced pain on the day of the procedure, 5 eyes developed mild corneal endothelial folds, 2 eyes exhibited moderate anterior chamber inflammatory reaction, and 12 eyes showed shallow ciliary body detachment. No serious complications occurred during the 1-month follow-up period.CONCLUSION:Low-dose TSCP appears to be an effective bridging therapy for patients with persistent ocular hypertension following an AACG attack. It facilitates rapid IOP reduction, alleviates symptoms, and helps preserve visual function with a favorable safety profile, thereby reducing the risks associated with subsequent intraocular surgery.

ObjectiveTo review the interoceptive assessment tools in terms of structure, content and psychometric properties, based on the framework of the International Classification of Functioning, Disability and Health (ICF). MethodsThe literature on interoceptive evaluation tools was retrieved from databases of CNKI, PubMed, Medline and EBSCO. The principal structures and contents of the assessment tools were analyzed based on the ICF framework, and the quality of the psychometric properties were appraised using COSMIN. ResultsA total of 13 interoceptive assessment tools were ultimately included, involving 16 literature references. There were five interoceptive sensitivity tools, four accuracy tools and four awareness tools. In terms of content, interoceptive sensitivity tools involved 33 categories of body functions, six categories of activities and participation, and one of environmental factors; while interoceptive accuracy tools only involved seven categories of body function, and two of activities and participation items; interoceptive awareness tools involved 30 categories of body function, four categories of activities and participation, and three of environmental factors. In terms of psychometric properties, Body Perception Questionnaire-Short Form (BPQ-SF) was the sensitivity tool with the best reliability and validity (qualified rate of 7/8), followed by Interoceptive Sensitivity Questionnaire (ISQ) (qualified rate of 6/8). Most of the accuracy tools adopted standardized measurement methods, but lacked sufficient reliability and validity verification. The awareness tools were good in reliability and validity (qualified rate above 5/8), especially Multidimensional Assessment of Interoceptive Awareness (MAIA-1) and Body Awareness Questionnaire (BAQ) (qualified rate of 8/8). ConclusionBPQ-SF and ISQ are recommended for interoceptive sensitivity assessment, Water-loading Test and Heart-beat Tracking Task for interoceptive accuracy assessment, and MAIA-1 and BAQ for interoceptive awareness assessment.

Objective To explore the characteristics of response to joint attention(RJA)under diverse guiding behaviors for pre-schoolers with moderate to severe autism spectrum disorder(ASD). Methods From March to May,2023,21 children with moderate to severe ASD and 16 children with developmental de-lays matched the physiological ages were selected from Jiaxing Sunlight Rehabilitation Kindergarten,and 16 typ-ical developmental children matched the physiological ages were selected from the kindergartens nearby.They accepted a behavioral experiment on RJA.The number of RJA,frequence of RJA and the coefficient of variation of guiding behaviors needed to RJA were compared among the three groups. Results About half of the ASD group responded after guiding of head-turning,and the others required higher levels of guiding.The frequence of RJA after guiding of head-turning was less in the ASD group than in the typical devel-opment group(χ2>6.170,P<0.05),and the coefficient of variation of guiding behaviors was more(d=4.039,P<0.001). Conclusion Preschoolers with moderate to severe ASD are able to respond to joint attention,and this ability is poorer than typically developing children.The guiding behavior of the evaluator should be considered in assessing and intervening RJA in preschoolers with ASD.

Objective To investigate the characteristics of spatial orientation language comprehension and expression behavior ofchildren with autism. MethodsA three-ladder test was designed to test the comprehension and expression of "(go/come) to" sentences, including general subject-predicate sentences, conjunctive-predicate sentences with displacement purposes, and conjunctive-predicate sentences with displacement modes. March to June, 2022, the test was conducted on 17 children with autism from a special education school and 17 healthy children matched the scores of Peabody Picture Vocabulary Test-Chinese revised from a kindergarten. The typical errors were analyzed for children with autism. ResultsThe main effects of sentence ladders (F > 3.718, P < 0.05) and children groups (F > 8.782, P < 0.001) were significant on comprehension and expression of sentences, while the performance was poor for the complex sentences and for the children with autism. The common types of errors in expression were missing components, mixed sentences, autonomous sentences, inaccurate wording, inconsistent content, blending errors and non-response. The numbers and the distribution of error types were quite different from the children with autism to the healthy children. ConclusionChildren with autism are more difficult to understand and express "(go/come) to" sentences, mainly manifested in a higher error frequency and more kinds of error.

ObjectiveTo construct rehabilitation competency framework (RCF) of the speciality of education and rehabilitation (SER-RCF) based on World Health Organization RCF, to innovate the curriculum system. MethodsThe competency for undergraduate level professionals in the speciality of education and rehabilitation were analyzed to develop curriculum using RCF theory and methodology. ResultsTalent training was a kind of competency-based and outcome-based education. SER-RCF integrated the competencies and activities in the areas of professionalism, practice, learning and development, management and leadership, and research required for professional work in education and rehabilitation around core values and beliefs. It also designed the training objectives of the speciality of education and rehabilitation: to be ethical and correct, to be physically and mentally healthy, to have a solid foundation, to be sustainable, to be co-operative and enjoyable, and to be reflective and enquiring. SER-RCF played a central role in developing the curriculum system of rehabilitation, education and psychology, and practice. ConclusionReshaping the undergraduate level curriculum system of education and rehabilitation based on RCF is not only the implementation of the construction concept of new medicine and new liberal arts, but also can effectively connect with the international standard of rehabilitation higher education.

Background Occupational stress and depressive symptoms of disease prevention and control personnel are serious. Objective To investigate the relationship between occupational stress, psychological capital, and depressive symptoms of disease prevention and control personnel, and analyze the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms. Methods From July to September 2020, a cluster random sampling method was used to select 2201 employees from 21 centers for disease control and prevention as study subjects covering all levels of administrative divisions in Jiangsu Province. A total of 2036 valid questionnaires were collected with a recovery rate of 92.5%. The Core Occupational Stress Scale, Patient Health Questionnaire, and Psychological Capital Questionnaire were used to investigate their occupational stress, depressive symptoms, and psychological capital. Stratified regression analysis was used to explore the effects of occupational stress and psychological capital on depressive symptoms. A mediating effect model was used to analyze and verify the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms. Results The total scores in M (P₂₅, P₇₅) of occupational stress, depressive symptoms, and psychological capital in the target population were 42.0 (37.0, 48.0), 8.0 (4.0, 9.0), and 4.6 (4.0, 5.0) respectively. The positive rate of occupational stress was 31.0% (631/2036), and the positive rate of depressive symptoms was 22.0% (448/2036). The dimensional scores of organization and reward, and demand and effort of occupational stress were positively correlated with the total score of depressive symptoms [Spearman correlation coefficients (r_s) were 0.371 and 0.269, P<0.05]. The dimensional scores of social support and autonomy of occupational stress and the score of psychological capital were negatively correlated with the total score of depressive symptoms (r_s=−0.373, −0.112, −0.494, P<0.05). The organization and reward, and demand and effort had positive effects on depressive symptoms (b=0.188, 0.177, P<0.05), while social support and autonomy had negative effects on depressive symptoms (b=−0.290, −0.078, P<0.05), and associated with a 22.5% increase of explanatory variance. Psychological capital had a negative effect on depressive symptoms (b=−0.368, P<0.05), and associated with an 11.0% increase of explanatory variance. Psychological capital had mediating effects on the associations of social support, organization and reward, and autonomy with depressive symptoms, and the mediating effect values were −0.210 (95%CI: −0.253-−0.171), 0.096 (95%CI: 0.071-0.122), and −0.164 (95%CI: −0.229-−0.103), respectively. The corresponding mediating effect percentages were 40.23%, 26.97%, and 45.56%, respectively. Conclusion Occupational stress of disease prevention and control personnel can directly affect depressive symptoms, but also indirectly through psychological capital. Psychological capital plays a partial mediating role in the associations of social support, organization and reward, and autonomy of occupational stress with depressive symptoms. The occurrence of depressive symptoms can be reduced by decreasing occupational stress and increasing psychological capital.

Objective:To study the intestinal flora specific differences with different lesional stages of metabolic (disorder) associated fatty liver disease (MAFLD), namely simple steatosis and steatohepatitis, so as to provide a new direction for MAFLD-related intestinal flora transplantation and targeted therapy.Methods:Mice were fed with normal diet, methionine-choline deficient diet (MCD) and a high-fat high-fructose diet (HFHF) for 12 weeks to construct simple steatosis and steatohepatitis models. HE and Sirius scarlet staining was performed to observe the liver pathological changes. The qPCR method was used to evaluate inflammation and liver fibrosis factors. A fully automatic biochemical analyzer was used to detect changes in liver transaminase and blood lipids. 16S rRNA sequencing method was used to observe the intestinal flora differences in the feces of each group of mice. The comparison of means between two groups was performed by t-test, and the comparison of means between multiple groups was performed by one-way analysis of variance. Kruskal-Wallis rank sum test was used for non-normally distributed data.Results:NAFLD scores were determined with pathological sections (HE and Sirius scarlet staining) of mice liver, which showed that the inflammation and liver fibrosis scores of the MCD and HFHF groups were 2.12 ± 0.18 and 1.06 ± 0.24, and 2.22 ± 0.16 and 0.46 ± 0.10, respectively. The degree of liver inflammation and fibrosis was significantly higher in the MCD than the HFHF group ( P < 0.001 and P < 0.01). Lipid deposition was higher in the HFHF than the MCD group ( P < 0.001), and the scores were 2.36 ± 0.17 and 1.60 ± 0.24 respectively. Simultaneously, the inflammatory [tumor necrosis factor-A (TNF-a), chemokine factor-2 (CXCL-2)] and hepatic fibrosis indicators [vascular smooth muscle actin alpha (a-SMA) and connective tissue growth factor (CTGF)] had confirmed the above-mentioned results at the transcription level. Moreover, the intestinal flora diversity was reduced ( P < 0.05) in the MCD group than the HFHF group, and the Simpson and Shannon index were 0.31 ± 0.10 and 0.42 ± 0.05, and 2.03 ± 0.33 and 1.70 ± 0.28, respectively, and the differences were significant between different intestinal flora groups. The levels of Desulfovibrio, Odoribacter, and Roseburia flora were significantly increased in the HFHF than the MCD group, and the levels of Faecalibaculum, Parasutterella, Alipis, Butyricimonas_virosa, Turicibacter_sp, and Romboutsia_ilealis were significantly increased in the MCD than the HFHF group, and the difference was statistically significant ( P < 0.05). Conclusion:There are significant differences in intestinal flora diversity between simple steatosis and steatohepatitis models. Therefore, clarifying the difference between the two may provide a new direction for the stage manner treatment of MAFLD.

Objective To investigate dermoscopic features of onychomycosis and nail psoriasis.Methods From March 2017 to March 2018,128 patients with onychomycosis and 128 with nail psoriasis were enrolled from Department of Dermatology,Xiangyang Central Hospital.Dermoscopic images of the lesional nails were compared.Enumeration data were analyzed by chi-square test and Fisher's exact test.Results There were 7 kinds of dermoscopic patterns in onychomycosis,including jagged edge (69/128,53.91％),longitudinal striae (72/128,56.25％),cone-shaped keratosis (30/128,23.44％),nail plate thickening (21/128,16.41％),black dots (5/128,3.91％),onycholysis (26/128,20.31％),and nail discoloration (23/128,17.97％).The jagged edge and longitudinal striae occurred more frequently in distal/ lateral subungual onychomycosis (DLSO) than in the other 3 clinical subtypes of onychomycosis (all P ＜ 0.001),and cone-shaped keratosis occurred more frequently in total dystrophic onychomycosis (TDO) than in the other 3 clinical subtypes of onychomycosis (x2 =42.020,P ＜ 0.001).There were no significant differences in the prevalance of nail plate thickening,black dots,onycholysis and nail discoloration among the 4 clinical subtypes of onychomycosis (all P ＞ 0.05).There were 7 kinds of dermoscopic patterns in nail psoriasis,including pitting corrosion (61/128,47.66％),oil drop sign (41/128,32.03％),splinter hemorrhage (41/128,32.03％),dilated hyponychial capillaries (23/128,17.97％),nail plate thickening (20/128,15.63％),onycholysis (20/128,15.63％),and nail discoloration (13/128,10.16％).The oil drop sign occurred more frequently in psoriasis vulgaris and psoriasis arthropathica than in the other 2 clinical subtypes of psoriasis (P =0.019).The dilated hyponychial capillaries occurred more frequently in pustular psoriasis than in the other 3 clinical subtypes of psoriasis (P =0.047).There were no significant differences in the prevalance of pitting corrosion,splinter haemorrhage,nail plate thickening and nail discoloration among the 4 clinical subtypes of psoriasis (all P ＞ 0.05).Conclusions The dermoscopic features of onychomycosis include jagged edge,longitudinal striae,cone-shaped keratosis and black dots,and the dermoscopic features of nail psoriasis include pitting corrosion,oil drop sign,splinter haemorrhage and dilated hyponychial capillaries.Their common dermoscopic features include nail plate thickening,onycholysis and nail discoloration.

Ackerman's pattern analysis is an epoch-making leap in the diagnosis of dermatopathology,which embodies a profound understanding of the whole dermatovenereology.To improve the teaching quality of Dermatovenereology for five year clinical medical students,pattern analysis is introduced into course educational practice,and the diseases that scattered throughout the whole textbook and listed in various chapters or sections are reclassified according to its pathological features.Thus the organic connection of related knowledge points and the lateral contrast network between different diseases is constructed by the central tache of dermatopathology,and therefore makes the course more logical and be more beneficial for the undergraduate students to learn and to remember.By the way,the thinking method of pattern analysis will also be an implicit teaching content and imperceptibly instilled to the undergraduate students,and inspired potential and motivation and aroused learning interest,expanded thought train ability to pursue advanced and further studies.

Aim To investigate the antitumor and antiangiogenic effects of combined low-dose cyclophosphamide(CTX)and recombined VEGF protein vaccine.Methods In this experiment,H22 hepatocellular carcinoma model was established in BALB/c mice.Mice were randomly divided into four groups: control group,CTX group(CTX),VEGF protein vaccine group(V2)and CTX plus V2 group(CTX+V2).The anti-tumor efficacy and antiangiogenic effect were investigated using a subcutaneous tumor model and an intradermal tumor model.Western blot and ELISAwere further adopted to detect the specific anti-VEGF antibody.Results CTX+V2 group displayed a lower tumor volume and tumor weight than either the single therapy group in the subcutaneous tumor model(P<005 vs V2,P<001 vs CTX).Meanwhile,CTX+V2 was more effective for antagonizing tumor-associated angiogenesis compared with either the single therapy(P<005 vs V2,P<001 vs CTX).After CTX+V2 immunization,high titer of anti-VEGF antibody was detected by ELISA and verified by Western blot.Conclusion The therapy of CTX combined with V2 has significant synergistic effect against H22 hepatocellular carcinoma.