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.

Objective To investigate the association of estimated glucose disposal rate(eGDR)with metabolic dysfunction-associated liver steatosis and fibrosis,and to analyze the difference of the association in different population.Methods A total of 10,549 participants from 2017 to 2020 in National Health and Nutrition Examination Survey(NHANES)database who underwent vibration-controlled transient elastography(VCTE)were included.eGDR was calculated based on waist circ-umference,hypertension,and glycated hemoglobin(HbA1c).The controlled attenuation parameter(CAP)≥248 dB/m was used as diagnostic criterion for liver steatosis,and liver stiffness measure-ment(LSM)≥ 8.2 kPa was used as criterion for liver fibrosis.Multivariable Logistic regression a-nalysis was conducted to assess the relationship between eGDR and liver steatosis and fibrosis,with subgroup analysis and interaction tests performed.Results After adjusting for confounding factors,eGDR level was significantly negatively associated with the risks of both liver steatosis and fibrosis.The participants were divided into tertiles based on eGDR levels(Q1,Q2,Q3).Compared with the Q1 group,the risk ratios for liver steatosis in the Q2 and Q3 groups were 0.485(95％CI,0.394 to 0.597)and 0.286(95％CI,0.239 to 0.343),respectively(P＜0.001);the risk ratios for liver fibrosis were 0.457(95％CI,0.363 to 0.576)and 0.162(95％CI,0.100 to 0.263),respective-ly(P＜0.001).Subgroup analysis showed that the negative association between eGDR and liver steatosis differed among populations of different ages and smoking statuses,with statistically signifi-cant differences in interaction tests(P for interaction＜0.001);similarly,the negative association between eGDR and liver fibrosis differed among populations with different levels of physical activity,with statistically significant differences in interaction tests(P for interaction＜0.001).The associa-tions of eGDR levels with liver steatosis and fibrosis remained stable(P for interaction＞0.05).Conclusion eGDR levels are closely associated with the risks of liver steatosis and fibrosis and can serve as an effective indicator for assessing liver metabolic abnormalities.This finding provides new insights into early screening,risk stratification,and prognosis assessment for liver steatosis and fibrosis.

Objective To study the intervention effect of Ladder Model conversation training strategy on im-proving the conversation skills of children with autism.Methods A multi-probe design across participants was a-dopted to examine the intervention effectiveness of the strategy on two 7～8 year old autistic children.Intervention lasted for 4 weeks for subjuct A and 3 weeks for subject B.Thirty-five minutes each time,three times a week.The number and type of conversation initiation,maintenance and interruption were evaluated in the baseline period,in-tervention period,maintenance period and generalization period.The overlap rate and simplified time-series analysis were used to evaluate the outcome.Results The number of conversation initiation of subject A(overlap rate 8.33％,C=0.89,P＜0.01)and subject B(overlap rate 20％,C=0.83,P＜0.01)was significantly higher in in-tervention periods than that in baseline,but no significant difference was observed between the other adjacent peri-ods.The number of conversation maintenance of subject A(overlap rate 0％,C=0.89,P＜0.01)and subject B(o-verlap rate 10％,C=0.91,P＜0.01)was significantly higher in intervention periods than that in baseline,but no significant difference was found between the other adjacent periods.The type of conversation initiation and mainte-nance that subjects improved were mainly in verbal forms.The main type of interruption was"unexplained re-sponse",the proportion of interruption decreased obviously after intervention.Conclusion The strategy has posi-tive effect on improving conversation initiation and maintenance of children with autism,and reducing the proportion of interruption.

As a new hypoglycemic drug,Dapagliflozin has attracted much attention because of its unique hypoglycemic mechanism. It has been used in many studies on type 2 diabetes mellitus,but the application of type 1 diabetes mellitus(T1DM)in the eastern population is rare. This article uses Dapagliflozin through a case of obese T1DM to provide new ideas for the treatment of T1DM.

Objective:To explore the application effect of 5E nursing guided by empowerment theory in patients undergoing liver cancer resection.Methods:Using the purposive sampling method, a total of 88 patients who underwent liver cancer resection surgery in Zhumadian Central Hospital from July 2020 to July 2022 were selected as the research objects. They were divided into the control group ( n=44) and the observation group ( n=44) by the random number table method. The control group was given 5E nursing, while the observation group was given 5E nursing guided by empowerment theory. The improvement of gastrointestinal function between the two groups was compared by the first anal defecation time, the first anal exhaust time and the recovery time of bowel sound. Visual Analogue Scale (VAS) was used to evaluate postoperative pain, General Self-Efficacy Scale (GSES) was used to evaluate self-efficacy, and hope level was assessed by Herth Hope Index (HHI). After treatment, the compliance and occurrence of digestive tract discomfort were compared between the two groups. Results:The first anal defecation time, first anal exhaust time and bowel sound recovery time in observation group were less than those in control group ( P<0.05). Postoperative pain score of observation group was lower than that of control group 48 hours after operation ( P<0.05). After nursing, the GSES, HHI and compliance scores of the observation group were higher than those of the control group ( P<0.05), and the incidence of gastrointestinal discomfort symptoms in the observation group was lower than that in the control group ( P<0.05) . Conclusions:The 5E nursing guided by empowerment theory can effectively improve the compliance, self-efficacy and hope level of liver cancer resection patients, reduce pain, promote postoperative recovery and reduce the incidence of gastrointestinal discomfort symptoms.

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.

Although current direct anti-hepatitis B virus (HBV) drugs have good effects in controlling viral replication and limiting the progression to liver cirrhosis, there is still a long way to go in the treatment of chronic hepatitis B (CHB). Immune tolerance and immune dysfunction may be the two most important immunopathogenic factors. With reference to the development of new strategies and new drugs for anti-HBV immunotherapy and the latest research findings around the world, this article reviews the research advances in immunotherapy for CHB in recent years.

Objective To introduce a self- assembled adjustable traction frame for the patients with severe trauma and lower limb fracture in ICU, compared with Brawns traction frame. Methods 96 patients with severe trauma and lower limb fracture diagnosed by clinical signs and X-ray who had to be transferred to ICU were randomly divided into the study group (46 cases) and the control group (50 cases) by sealing letters method.The study group were tracted by the self-assembled adjustable traction frame, and the control group were tracted by the Brawns traction frame. The fracture alignment, degree of pain, incidence of pressure ulcers, nursing limit time of changing the sheets of the two groups were observed. Results The results declared that 37 cases with 2 pain score points, 9 cases with 0-1 points in the study group and 19 cases with 2 pain score points, 3 cases with 0-1 points, 28 cases with Grade 3 in the control group (χ2=38.683, P<0.01). In the control group, pressure ulcer were occurred, 5 of them at Level one, 1 of them at Level two, 1 of them at Level three and the incidence rate was 14.00% (7/50). In the study group, pressure ulcer were occurred, 1 of them at Level two and the incidence rate was 2.17%(1/46). The pain level and incidence of pressure sore in the study group were decreased and the difference between the two groups was significant (χ2=8.197, P < 0.05). Conclusions The self-assembly adjustable traction rack can not only ensure the same effect as the Brawns traction frame but also reduce the deficiency caused by Brown traction frame. It is safer and more comfortable for the patients and can reduce nursing complications and improve the quality and efficiency of the nursing work.

Objective To investigate the expression of miR-200c in endometrial carcinoma and its correlation with ZEB2 protein. Methods The expression levels of miR-200c and ZEB2 gene and protein in tissues were detected. The expression of miR-200c in endometrial carcinoma RL95-2 cell line was inhibited by using antisense oligonucleotides and its effect on cell invasiveness was tested. The expressions of ZEB2 gene and protein in cells were detected. Results The expression levels of miR-200c and ZEB2 mRNA and protein in endometrial tissues were significantly higher than those in adjacent tissues and control group (P < 0.05). The average penetrating number in antisense miR-200c transfected group was significantly less than negative control group and liposome group (P < 0.05). The expression levels of ZEB2 gene and protein in antisense miR-200c transfected group were lower than the negative control group and liposome group (P < 0.05). Conclusion The expression of mRNA-200c in endometrial carcinoma was high and it might be promoting tumor cell invasion and metastasis by regulating ZEB2.