Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke. The evaluation of its structure and function is of great significance for formulating clinical intervention strategies. The indications for endovascular treatment of ICAS lesions in the past were mainly based on the degree of luminal stenosis showed by cerebral angiography, which had certain limitations. The translesional pressure ratio (PR), as an important indicator for functional assessment after arterial stenosis, has gradually received attention in the evaluation of ICAS lesions in recent years. This article reviews the evaluation methods and clinical significance of PR in ICAS lesions.

Objective To explore the predictive value of peripheral blood inflammatory indicators such as neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR)and platelet-to-lymphocyte ratio(PLR)on the prognosis of patients with primary diagnosis of multiple myeloma(MM).Methods Using a retrospective method,77 patients with first diagnosis of MM admitted to the Department of Hematology of Baise People's Hospital and 77 healthy medical checkups with peripheral blood NLR,MLR and PLR were collected and compared the differences.Then the patients with primary diagnosis of MM were categorized into high NLR group,low NLR group,high MLR group,low MLR group,high PLR group,low PLR group using the mean value as the critical value,and the prognosis of the patients in each group as well as the relationship with overall survival time(OS)were compared.Results The NLR,MLR,and PLR of patients with initial diagnosis of MM were significantly higher than those of healthy controls,and the differences were statistically significant(all P<0.05).Serum β2-microglobulin(β2-MG)levels were higher in patients with high NLR and high MLR than in the low NLR and low MLR groups,and the difference was statistically significant(P<0.05).Patients in the high NLR,high MLR and high PLR groups had less OS and poorer prognosis than those in the low NLR,low MLR and low PLR groups,and the differences were statistically significant(all P<0.05).Univariate Cox regression analysis showed that international staging system(ISS)stage,creatinine(Cr),β2-MG,albumin(ALB),NLR,MLR and PLR were associated with overall survival(P<0.05);multivariate Cox proportional risk regression analysis showed that NLR,MLR,and PLR were not independent risk factors affecting the prognosis of patients with primary diagnosis of MM,and the difference was not statistically significant(P>0.05).According to the number of inflammatory indexes(high NLR,high MLR,high PLR)that affected the prognosis,the patients were divided into 0 or 1 risk factor group,2 risk factor groups and 3 risk factor groups,and the comparison of OS between the three groups was statistically significant(P=0.001).The greater the number of concomitant risk factors for prognosis,the shorter the OS.Conclusion Elevated inflammatory indicators(NLR,MLR,PLR)in patients with primary diagnosis of MM were associated with less OS and poorer prognosis of the patients,and they may be used as indicators to assess the condition and prognosis of patients with primary diagnosis of MM.

A combined radiation-wound injury refers to a radiation injury combined with a traumatic wound, with the characteristics of repeated ulceration and a long and difficult healing process, which is a focus in the field of research on difficult-to-heal wounds. To research combined radiation-wound injuries, the establishment of animal models is a key part, and appropriate animal models are a guarantee of reliable experimental results. This review summarizes the current research progress on various animal models of combined radiation-wound injuries in terms of radiation types, animal species, and injury types and location, aiming to provide a scientific basis for establishing standardized animal models, studying injury mechanisms, and evaluating prevention and treatment efficacy for combined radiation-wound injuries.

Objective To explore the mechanism underlying the anti-hemorrhoid effects of Qingji Liangxue mixture(QLM).Methods Models of acute hemorrhoid in rats were established using a croton oil preparation(COP)and glacial acetic acid.A total of 80 SD female rats were randomly divided into two major groups:the COP group and the glacial acetic acid group,each consisting of 40 rats.In the COP group,rats were further randomly assigned to the following subgroups:control group 1(group CA),model group 1(group CB),low-dose QLM group 1-1(group CC),high-dose QLM group 1-2(group CD),and diosmin group 1(group CE),with eight rats in each subgroup.In the glacial acetic acid group,rats were randomly divided into the following subgroups:control group 2(group GA),model group 2(group GB),low-dose QLM group 2-1(group GC),high-dose QLM group 2-2(group GD),and diosmin group 2(group GE),with eight rats in each subgroup.Except for the control groups,all other subgroups were treated with COP or glacial acetic acid then treated with various drugs for 7 days.HE staining was used to observe anorectal histomorphology induced by COP and glacial acetic acid.ELIS As were used to measure serum levels of IL-6 and TNF-α induced by COP.Additionally,the area of perianal ulcers induced by glacial acetic acid was recorded.Twenty-four C57 mice were randomly divided into a control group(group A),low-dose QLM group(group B),high-dose QLM group(group C),and adrenal chromazone tablet group(group D).Results QLM significantly improved the pathological injury of animal models with similar hemorrhoids,reduced the score of pathological changes induced by COP(P＜0.05),reduced the serum levels of IL-6 and TNF-α(P＜0.05),reduced the area of perianal ulcers induced by glacial acetic acid(P＜0.05),and shortened the time of coagulation and bleeding(P＜0.05).Conclusions QLM has a good anti-hemorrhoid activity,which may be achieved by anti-inflammatory effects,hemostasis,and reducing tissue damage.

Objective:To investigate the risk factors and cumulative risk of myopia in children and adolescents, providing a basis for identifying cumulative risk factors in preventing and controlling myopia.Methods:Baseline data from the mental and physical health cohort of children and adolescents established in Inner Mongolia Autonomous Region were used. A stratified random cluster sampling method was adopted to select 138 974 students from fourth to twelfth grade as participants. Distance visual exams, refractive assessments, and questionnaires were conducted on the included students. Logistic regression analysis was used to evaluate each risk factor's impact on myopia's prevalence. The number of risk factors was summed to form a cumulative risk score, and logistic regression analysis was conducted to examine the association between the cumulative risk score and the prevalence of myopia. Additionally, the association between the cumulative risk score of myopic students and their degree of refractivity was analyzed using a generalized estimating equation.Results:The study found a high prevalence of myopia among children and adolescents at baseline (70.2%). Girls exhibited a higher prevalence (74.8%) than boys (65.6%), urban areas (74.3%) surpassed suburban ones (68.6%), and the incidence was greater in high schools (80.3%) compared to middle schools (75.3%), which, in turn, was higher than in elementary schools (57.7%) (all P<0.05). Analysis of risk factors revealed that children and adolescents experiencing improper reading and writing distances ( OR=1.10, 95% CI: 1.07-1.13), excessive homework ( OR=1.09, 95% CI: 1.06-1.12), insufficient sleep ( OR=1.10, 95% CI: 1.07-1.13), having myopic father ( OR=1.98, 95% CI: 1.91-2.05), having myopic mother ( OR=2.04, 95% CI: 1.97-2.10), or using classroom chairs not matched to their height faced ( OR=1.04, 95% CI: 1.01-1.07) increased myopia risks. Additionally, the prevalence and significant odds ratio of myopia increased with the increase in cumulative risk score, with every additional unit of cumulative risk score increasing the right eye's refractive error by -0.10 D. Conclusion:The presence of multiple factors and their comprehensive score increases the prevalence of myopia in children and adolescents.

This article mainly analyzed the clinical application of Zhizichi Decoction should focus on the following four aspects:Firstly,based on the concept of prescription,the main application of formula of Zhizichi Decoction is chest tightness and stuffiness,often accompanied by burning pain,restlessness,and insomnia;the second is to follow the traditional dosage method,using 48-55 g of Sojae Preparatum Semen for Zhizichi Decoction.If patients are particularly restless,they can reuse up to 90 g of Sojae Preparatum Semen;the third is to analyze the syndromes and clinical applications of Zhizichi Decoction;fourthly,based on clinical experience,the main application of formula of the commonly used overlapping classic formulas in Zhizichi Decoction.The changes in clinical symptoms are complex.In order to achieve comprehensive therapeutic effects,the concept of similar formulas and the addition and subtraction of ancient formulas can be followed.Classic formulas can be used in combination to expand the scope of clinical treatment of Zhizichi Decoction.

Spinal cord injury (SCI) is a serious nervous system disease that usually leads to the impairment of the motor, sensory, and autonomic nervous functions of the spinal cord, and it places a heavy burden on families and healthcare systems every year. Due to the complex pathophysiological mechanism of SCI and the poor ability of neurons to regenerate, the current treatment scheme has very limited effects on the recovery of spinal cord function. In addition, due to their unique advantages, exosomes can be used as carriers for cargo transport. In recent years, some studies have confirmed that treatment with mesenchymal stem cells (MSCs) can promote the recovery of SCI nerve function. The therapeutic effect of MSCs is mainly related to exosomes secreted by MSCs, and exosomes may have great potential in SCI therapy. In this review, we summarized the repair mechanism of mesenchymal stem cells-derived exosomes (MSCs-Exos) in SCI treatment and discussed the microRNAs related to SCI treatment based on MSCs-Exos and their mechanism of action, which is helpful to further understand the role of exosomes in SCI.

Objective To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation. Methods Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups. Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05). Conclusions When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.

Objective:To explore the effects of hospital-family multidisciplinary 5E rehabilitation model on clinical status, athletic ability, respiratory muscle strength, quality of life and psychological states of patients with myasthenia gravis (MG).Methods:This was a quasi-experimental study. According to the convenient sampling method, patients with type 2 MG treated in the First Affiliated Hospital of Harbin Medical University from January 2020 to September 2021 were divided into intervention group and control group. The control group was treated with routine nursing methods, and the intervention group was treated with hospital-family multidisciplinary 5E rehabilitation model for 12 weeks. The effects of intervention were compared by using Myasthenia Gravis Composite (MGC), 6-minute walking test (6MWT), maximum inspiratory pressure (MIP), Fatigue Scale-14 (FS-14), Myasthenia Gravis Quality of Life-15(MGQOL-15), Herth Hope Level Scale(HHI) and Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C).Results:Repeated measurement analysis of variance showed that there were significant differences between 6MWT score and MGQOL-15 score twelve weeks after intervention, the intervention group scores were (477.95 ± 29.23), (6.25 ± 3.40) points, the control group scores were(435.85 ± 19.82), (9.95 ± 3.22) points, the differences were statistically significant ( t= 4.51, -3.58, both P<0.05). Besides, the differences of MIP, FS-14 score, SES6C score and HHI score were also statistically significant, the intervention group scores were (102.09 ± 19.56), (2.56 ± 1.31), (34.78 ± 8.68), (33.43 ± 6.39) points, the control group scores were (90.85 ± 12.25), (4.65 ± 2.50), (24.15 ± 6.62), (25.90 ± 8.30)points, the differences were statistically significant ( t values were -4.46-3.35, all P<0.05). Repeated measurement analysis of variance showed that there were significant differences in the time effect and interaction effect of MGQOL-15 score between the two groups ( F=28.28, 22.01, both P<0.05), there were also significant differences in the group effect, time effect, and interaction effect of 6MWT between the two groups ( F=13.94, 8.24, 12.85, all P<0.05). Conclusions:The rehabilitation of patients with MG could be promoted by the hospital-family multidisciplinary 5E rehabilitation model. Detailed research should be further strengthened to lay a foundation for the development of rehabilitation guidelines for patients with MG.

Objective:To explore the feasibility of applying BOPPPS (B-bridge in, O-objective, P-pre-assessment, P-participatory learning, P-post-assessment, S-summary) course design mode in the teaching of internal medicine practice for nursing undergraduates.Methods:A total of 73 nursing interns of Kunming Medical University were selected as subjects and divided into the experimental group ( n=30) and the control group ( n=43). The experimental group adopted the practice teaching method based on BOPPPS model, while the control group adopted the traditional teaching method. Students' evaluation was collected by questionnaire. The students' comprehensive reasoning ability, holistic nursing skills ability and clinical nursing evaluation ability were evaluated by taking out questions from the question bank. And the results of teachers' evaluation on the participation of case study and problem solving in the process of students' internship were collected. SPSS 20.0 was used for t-test. Results:The students' evaluation of the practice process in the experimental group (86.81±2.85) was significantly better than that in the control group (82.61±3.82) ( P<0.001). The experimental group was significantly better than the control group in comprehensive reasoning of clinical thinking and assessment of holistic nursing ability ( P <0.001). Teachers' evaluation in the experimental group was better than that in the control group ( P <0.05). The overall effect of the experimental group (20.60±1.73) was significantly better than that of the control group (17.84±1.70) ( P <0.001). Conclusion:BOPPPS mode is helpful for teachers to carry out and demonstrate holistic nursing teaching with symptoms as the core according to the overall teaching objectives of nursing internal medicine, optimize the time arrangement and knowledge structure, improve the practice efficiency, and promote the establishment of holistic nursing thinking mode of students.