Objective To evaluate the effectiveness of preoperative immunosuppressive therapy combined with surgical intervention for Behçet's disease. Methods A retrospective study was conducted on Behçet's disease patients who underwent cardiovascular surgery at Guangdong Provincial People's Hospital from 2012 to 2021. Patients were divided into an immunosuppressive group and a non-immunosuppressive group based on whether they received immunosuppressive therapy before surgery. The complications and long-term survival rates of the two groups were analyzed. Results A total of 28 patients were included, among which 2 patients underwent reoperation, a total of 30 surgeries were performed, including 16 males (53.3%), and the age at diagnosis was 37 (31, 45) years. There were 15 surgeries in the immunosuppressive group and 15 surgeries in the non-immunosuppressive group. Compared with the non-immunosuppressive group, the incidence of complications during hospitalization in the immunosuppressive group was lower (13.3% vs. 53.3%, P=0.008). One patient died in hospital, and the rest were discharged and followed up, with a median follow-up time of 38.7 (15.1, 57.3) months, and there was no statistically significant difference in long-term survival rate between the two groups (73.3% vs. 93.3%, P=0.158). There was no statistical difference in the cumulative incidence of complications one month (20% vs. 53%, P=0.058) and one year (27% vs. 60%, P=0.065) after surgery between the immunosuppressive group and the non-immunosuppressive group, but there was a statistical difference in the cumulative incidence of complications three years after surgery (47% vs. 92%, P=0.002). Conclusion Surgical treatment can save lives in Behçet's disease patients with cardiovascular diseases, but the incidence of postoperative complications is high. Timely use of immunosuppressants before cardiovascular surgery can reduce the incidence of postoperative complications.

Objective To explore the nutritional status in elderly patients with type 2 diabetes mellitus (T2DM) and analyze its relationship with the risk of sarcopenia. Methods A retrospective analysis was conducted on 312 elderly patients with T2DM admitted to the 904th Hospital of the Joint Logistics Support Force of the People&#39;s Liberation Army between January 2023 and December 2025. Based on the presence or absence of sarcopenia, the patients were classified into a sarcopenia group (121 cases) and a non-sarcopenia group (191 cases). The nutritional status and related factors were compared between the two groups. Binary logistic regression analysis was adopted to analyze the correlation and influencing factors. Results The incidence rate of sarcopenia among elderly patients with T2DM was 38.78%. Compared with the non-sarcopenia group, the sarcopenia group had older age and higher proportions of patients with daily activity dependence, coronary heart disease, and gastrointestinal diseases. Conversely, the proportions of patients exercising ≥4 times per week and those paying attention to nutritional knowledge were lower in the sarcopenia group than those in the non-sarcopenia group (P<0.05). The body mass index (BMI), calf circumference (CC), body weight, albumin (ALB), hemoglobin (Hb), and MNA-SF score in the sarcopenia group were lower compared with those in the non-sarcopenia group (P<0.05). After logistic regression analysis, it was found that low BMI, exercising ≥4 times per week, dependence on daily activity, and low ALB and Hb were independent factors influencing sarcopenia in elderly patients with T2DM (P<0.05). Conclusion The incidence rate of sarcopenia is relatively high in elderly patients with T2DM. Low BMI, low ALB, low Hb, reduced weekly exercise frequency, and daily activity dependence are independent related factors. It is necessary to pay clinical attention to nutritional assessment and intervention.

Objective To analyze the clinical risk factors for chronic complications in patients with type 2 diabetes and their correlation with bone mineral density and 1,25-dihydroxyvitamin D3. Methods A total of 163 patients with type 2 diabetes mellitus were selected as research subjects and were divided into complication group and non-complication group according to the presence or absence of chronic complications. The independent related factors for chronic complications in patients with type 2 diabetes mellitus were analyzed. Spearman rank correlation analysis was used to evaluate the correlation between bone mineral density, 1,25-dihydroxyvitamin D3 and chronic complications. Results Among the 326 patients with type 2 diabetes mellitus, 202 developed chronic complications (61.96%), including 71 cases of cardiovascular disease, 59 cases of neuropathy, 33 cases of renal lesion, and 28 cases of retinopathy. There were statistically significant differences in the duration of diabetes mellitus, fasting blood glucose, systolic blood pressure, glycosylated hemoglobin, triglyceride, low density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 between the complication group and the non-complication group (P<0.05). Logistic multivariate regression analysis showed that the duration of diabetes mellitus, systolic blood pressure, glycosylated hemoglobin, ow density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 were all independent related factors for the occurrence of chronic complications in patients with type 2 diabetes mellitus (P<0.05). Spearman correlation analysis showed that bone mineral density and 1,25-dihydroxyvitamin D3 were negatively correlated with chronic complications (P<0.05). Conclusion Bone mineral density and 1,25-dihydroxyvitamin D3 in patients with type 2 diabetes mellitus are closely related to chronic complications.

Objective To investigate the HPV vaccination status of children aged 9-14 years, parents’ vaccine-related cognition, willingness to vaccinate children and their influencing factors. Methods From January to April 2021, the convenience sampling method was used to collect data based on the online platform and the Department of Pediatrics and Adolescent Gynecology of the Children&#39;s Hospital of Zhejiang University School of Medicine. The data were analyzed by descriptive analysis, Chi-square test, and logistic regression. Results A total of 864 questionnaires were collected, and 846 valid questionnaires were obtained after screening, with an effective rate of 97.9%. 13.57% of mothers and 3.09% of girls were vaccinated, and the vaccine awareness rate was 68.43%. 87.22% of parents were willing to bring their children for vaccination. Risk perception (OR=4.79, 95% CI: 2.22-10.35), willingness to vaccinate themselves (OR =29.01, 95% CI: 12.62-66.69), awareness of sex education (OR =3.73, 95% CI: 1.08-12.83) and whether the vaccines were free (P<0.001) were related to whether parents were willing to vaccinate their children. Conclusion Parents of children aged 9-14 have high awareness of HPV and HPV vaccine and are willing to vaccinate their children with HPV vaccine , but the vaccination rate in children is low. Disease perception, willingness to vaccinate, awareness of sex education, and whether vaccines are free are all the factors influencing parents&#39; willingness to vaccinate children.

Objective    To compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction. Methods    The clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively. The patients were divided into two groups: an endoscopic group (n=12, aged 41.3±8.9 years) and an open group (n=16, aged 41.6±8.8 years). The clinical data of the two groups of patients were compared. Results     There was no significant difference in demographic and oncological data between the two groups (P>0.05). There was a significant difference in the implants between the two groups (P=0.008). The operation time (298.2±108.6 min vs. 326.5±95.8 min, P=0.480) and anesthesia time (373.4±91.2 min vs. 400.3±97.1 min, P=0.463) were not significantly different. The total complications (P=0.035) and major complications (P=0.024) in the open group were more than those in the endoscopic group. For the comparison of breast satisfaction, psychosocial well-being and sexual well-being, the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group (P<0.05). Conclusion    The endoscopic reconstruction is safe and effective, with high satisfaction rates regarding  breast reconstruction and quality of life, and is superior to conventional open surgery.

Objective     To investigate the biological characteristics and clinical significance of cuproptosis-related genes in lung adenocarcinoma (LUAD) based on the multi-omics data from The Cancer Genome Atlas. Methods     The cuproptosis-related genes were obtained from a study published in Science in March 2022. The whole genome data were used to reveal the mutation spectrum and copy number variation landscape of cuproptosis-related genes in LUAD and analyze its effects on transcriptome expression. Cuproptosis-related genes were annotated using Metascape analysis to further understand the pathways or functions in which these genes were involved. Subsequent univariate Cox analysis and Kaplan-Meier methods determined the prognosis of these genes in LUAD patients, and CellMiner analysis were used to identify those potential anticancer drugs for potentially targeting cuproptosis-related genes. Results     Cuproptosis-related genes were less frequently mutated in LUAD, and the effect of gene mutations on transcriptomic expression may depend on the type of mutation. Gene copy number variation was an important factor resulting in the disordered expression of cuproptosis-related genes. The 16 cuproptosis-related genes were mainly involved in glyoxylate metabolism and glycine degradation, copper ion entry, proteolitidylation, cellular amino acid catabolism process, oxidative stress response, etc. Among them, 6 genes (DLD, FDX1, DLAT, DLST, PDHA1, CDKN2A) were prognostic risk genes in LUAD. The CellMiner analysis suggested that 13 drugs were associated with 7 cuproptosis-related genes and they might be potential  anticancer drugs for potentially targeting cuproptosis. Conclusion     This study reveals the biological characteristics and clinical significance of cuproptosis-related genes in LUAD, and provides some reference and theoretical basis for the subsequent research of cuproptosis in cancer.

Objective To analyze medication compliance and intervention measures of patients with schizophrenia inWeifang City, and to provide theoretical basis for improving medication compliance of discharged patients with schizophrenia. Methods Atotal of 379 schizophrenic patients discharged from our hospital from January 2020 to December 2020 were selected . According to the medication compliance Evaluation Scale (MARS) score one year after discharge, the patients were divided into good medication compliance group (n=284) and poor medication compliance group (n=95).The SDS scores, SAS scores, RBANS scores and MMAS scores were compared between the two groups. Pearson single factor analysis scores were used to analyze the correlation between medication compliance and SDS scores, SAS scores, RBANS scores and MMAS scores. Multiple linear regression was used to analyze the independent factors affecting medication compliance of schizophrenia patients. Results SDS score, SAS score and MMAS score of poor compliance group were significantly higher than those of good compliance group (P<0.05). The scores of immediate memory and delayed memory in good compliance group were significantly higher than those in poor compliance group (P<0.05). For each item, the scores of story repetition, vocabulary learning, number span, vocabulary recognition, vocabulary recall and graph recall in the good compliance group were significantly higher than those in the poor compliance group (P<0.05). According to Pearson correlation analysis, SDS score, SAS score, story repetition score, vocabulary recall score, RBANS total score were correlated with MARS score (P<0.05). Multiple linear regression analysis showed that SDS score, SAS score, vocabulary recall and RBANS were independent factors affecting medication compliance in schizophrenia patients (P<0.05). Conclusions The medication compliance of discharged schizophrenic patients in Weifang city is correlated with negative emotion. It is necessary to improve the negative emotion of patients, improve the cognitive function of patients and improve the medication compliance of discharged schizophrenic patients.

AIM:To compare the clinical effects of removing or reserving the epithelial flap in high myopia correction by laser subepithelial keratomileusis(LASEK).

METHODS: Retrospective analysis of 58 patients(115 eyes)with high myopia received LASEK were selected and divided into reserving the epithelial flap group(30 patients, 59 eyes)and removing epithelial flap group(28 patients, 56 eyes)according to the order of the alternating vists. The changes of corneal irritation, epithelial healing time,uncorrected visual acuity and the occurrence of haze after surgery were observed.

RESULTS:Postoperative 1d, 2d, 3d, respectively, the pain score of the two groups were 1.64±0.64, 1.57±0.57; 0.83±0.49, 0.84±0.56; 0.36±0.48, 0.34±0.47, respectively, the differences were not significant(P>0.05). Postoperative 1wk, 1mo, 3mo, respectively, the uncorrected visual acuity of two group was 0.15±0.06, 0.12±0.05; 0.032±0.004, 0.041±0.003; 0.018±0.004, 0.022±0.005, and the differences were not significant(P>0.05). After 1mo, 3mo of surgery, the differences of the haze less than grade one of the two group, respectively, and were not significant(P>0.05), the differences of the haze of grade two of the two groups, respectively, and the differences were significant(P<0.05). The epithelial healing time of the two groups were 4.22±0.30d, 3.89±0.32d(P<0.05). The number of epithelial delayed healing of two groups was 0 eye and 10 eyes(P<0.05).

CONCLUSION:It was similar both the changes of corneal irritation and uncorrected visual acuity of two groups,the rate of level two haze was higher in removing epithelial flap group. The time of healing of epithelium was quick than reserving the epithelial flap group,but the rate of delayed healing and poor healing of epithelium was higher than reserving the epithelial flap group. Therefore, for high myopia, it is worthy of clinical application of reserving the epithelial flap by LASEK.

AIM: To evaluate the relationship between obstructive sleep apnea syndrome(OSAS)and branch retinal vein occlusion(BRVO).

METHODS:Seventy consecutive patients with BRVO and 70 age- and sex-matched controls were evaluated retrospectively. All participants underwent Berlin questionnaire and full-night respiratory polysomnography(PSG)for estimating risk of OSAS and monitoring apnea-hypopnea index(AHI), minimal oxygen saturation(MOS).

RESULTS: Of the 70 BRVO patients, 49(70%)had OSAS,average AHI was(19.74±7.59), MOS was(82.45±9.17)%. For controls, only 23(33%)of 70 subjects had OSAS, average AHI was(13.69±6.35), average MOS was(88.44±8.72)% in controls. Incidence of OSAS, AHI and MOS between BRVO patients and controls were different significantly(χ2=19.331, t=5.115, 3.954, all P<0.01). There was a positive correlation between OSAS and BRVO(rs=0.319, P=0.033). Of the 39 patients with acute BRVO, average AHI was(16.905±6.31), average MOS was(85.14±8.22)%. For the 31 patients with chronic BRVO, average AHI was(17.84±5.47), average MOS was(83.81±7.87)%. There were no significantly differences between acute BRVO patients and chronic BRVO patients in average AHI or MOS(t=0.653, 0.685, P=0.516, 0.496).

CONCLUSION: OSAS could be a trigger in the pathogenesis of BRVO or an important risk factor of CRVO development.

AIM:To study the clinical efficacy of phase Ⅱ minimally invasive vitreous surgery in different stages in treatment of open ocular trauma with retinal detachment.

METHODS: A retrospective analysis was performed on 41 patients(41 eyes)with open eye trauma combined with retinal detachment from December 2013 to June 2018 in the Ophthalmology Department of Xiaolan People&#39;s Hospital of Zhongshan. According to the opportunity of phase Ⅱ vitrectomy, 41 eyes were divided into two groups: 24 eyes in the early group(6d after injury)and 17 eyes in the conventional group(7-14d after injury). Postoperative follow-up with 6mo as the time point, the retinal reattachment rate, TPVR incidence, visual acuity and complications were compared between the two groups.

RESULTS: The retinal reduction rate was 92% in the early group and 76% in the conventional group, and the difference was not statistically significant, there was no statistical difference(P=0.692)in retinal reduction rate between the two groups. The incidence of TPVR in the early group was lower than that in the conventional group(P=0.014). The improvement of postoperative visual acuity in early group was better than the conventional group(U=119.5, P=0.0018). There was no significant difference in complications between the two groups.

CONCLUSION: Open ocular trauma patients with retinal detachment have better prognosis after phase Ⅱ vitrectomy within 6d after injury than 7-14d.