Objective To explore the risk factors and incidence of epiretinal membrane(ERM)formation following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD),and to construct a risk prediction model to facilitate screening of high-risk populations and prevent ERM formation.Methods RRD patients who underwent SB in the Second Affiliated Hospital of Harbin Medical University between February 2022 and April 2024 were included in the study.The pa-tients were divided into occurrence and non-occurrence groups according to whether they developed ERM.Patient data were analyzed,and univariate Cox regression analysis was performed to select variables,which were then incorporated into the multivariate Cox regression model for the identification of risk factors for ERM formation after SB in RRD patients.A predictive model for ERM risk in RRD patients was constructed based on this data,and nomograms,receiver operating characteristic(ROC)curves,and calibration curves were drawn to evaluate and validate the diagnostic performance of the model.Results A total of 126 RRD patients(126 eyes)who underwent SB were included.There were 27 cases develo-ping ERM(occurrence group)and 99 not developing ERM(non-occurrence group),with an ERM incidence of 21.4％.Multivariate Cox regression analysis revealed that a history of diabetes mellitus[Hazard ratio(HR)=3.52,95％CI:1.37-9.02,P=0.009],preoperative proliferative vitreoretinopathy(PVR)(HR=13.00,95％CI:5.18-32.63,P＜0.001),and ≥4 retinal holes(HR=2.33,95％CI:1.04-5.23,P=0.041)were independent influence factors for ERM formation in RRD patients.ROC curve analysis showed that the area under the curve(AUC)was 0.840(95％CI:0.740-0.940)at 30 days and 0.904(95％CI:0.834-0.975)at 90 days.Conclusion A history of diabetes mellitus,preoperative PVR,and ≥4 retinal holes are factors influencing the development of ERM after SB in RRD patients.It is verified that the risk prediction model constructed based on these factors can accurately predict the risk of ERM formation within 6 months in RRD patients.

Objective To explore the risk factors and incidence of epiretinal membrane(ERM)formation following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD),and to construct a risk prediction model to facilitate screening of high-risk populations and prevent ERM formation.Methods RRD patients who underwent SB in the Second Affiliated Hospital of Harbin Medical University between February 2022 and April 2024 were included in the study.The pa-tients were divided into occurrence and non-occurrence groups according to whether they developed ERM.Patient data were analyzed,and univariate Cox regression analysis was performed to select variables,which were then incorporated into the multivariate Cox regression model for the identification of risk factors for ERM formation after SB in RRD patients.A predictive model for ERM risk in RRD patients was constructed based on this data,and nomograms,receiver operating characteristic(ROC)curves,and calibration curves were drawn to evaluate and validate the diagnostic performance of the model.Results A total of 126 RRD patients(126 eyes)who underwent SB were included.There were 27 cases develo-ping ERM(occurrence group)and 99 not developing ERM(non-occurrence group),with an ERM incidence of 21.4％.Multivariate Cox regression analysis revealed that a history of diabetes mellitus[Hazard ratio(HR)=3.52,95％CI:1.37-9.02,P=0.009],preoperative proliferative vitreoretinopathy(PVR)(HR=13.00,95％CI:5.18-32.63,P＜0.001),and ≥4 retinal holes(HR=2.33,95％CI:1.04-5.23,P=0.041)were independent influence factors for ERM formation in RRD patients.ROC curve analysis showed that the area under the curve(AUC)was 0.840(95％CI:0.740-0.940)at 30 days and 0.904(95％CI:0.834-0.975)at 90 days.Conclusion A history of diabetes mellitus,preoperative PVR,and ≥4 retinal holes are factors influencing the development of ERM after SB in RRD patients.It is verified that the risk prediction model constructed based on these factors can accurately predict the risk of ERM formation within 6 months in RRD patients.

Chemogenetic technology is a receptor-ligand system that regulates cell viability and function by changing receptor specificity and affinity, and it achieves precise neuronal regulation by specifically regulating neurons and neural circuits. At present, this technique is widely used in the study of neural circuits. This article briefly describes the application and progress of chemogenetic technology in the study of depression neural circuits, reviews the application of chemogenetic technology in several brain regions closely related to depression, such as ventral tegmental area, nucleus accumbens, prefrontal cortex, hippocampus and lateral habenula, and discusses the potential and challenges of chemogenetic technology as a technology for precise regulation of neural activity in future research, in order to provide reliable ideas and directions for chemogenetic technology in the study of depression neural circuits.

Objective:To analyze the interim clinical efficacy of laparoscopic and open distal gastrectomy for gastric cancer in elderly patients.Methods:The prospective randomized controlled study was conducted. The clinicopathological data of 102 patients aged ≥65 years who underwent distal gastrectomy for gastric cancer in the Nanfang Hospital of Southern Medical University from September 2014 to May 2018 were collected. After excluding 6 patients, 96 patients were finally included. Based on random number table, patients were allocated into two groups. Patients undergoing laparoscopic distal gastrectomy were allocated into laparoscopic group, and patients undergoing open distal gastrectomy were allocated into open group, respectively. Obser-vation indicators: (1) grouping situations of the enrolled patients; (2) intraoperative situations; (3) postoperative situations; (4) follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect complications in the postoperative 30 days up to July 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( P25, P75) or M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 96 patients were selected for eligibility. There were 66 males and 30 females, aged from 65 to 85 years, with a median age of 69 years. There were 49 of 96 patients in the laparoscopic group and 47 patients in the open group. (2) Intraoperative situations: patients in the two groups underwent distal gastrectomy successfully with D 2 lymphadenectomy, without intra-operative conversion to laparotomy. The volume of intraoperative blood loss and surgical incision length were 50 mL(50 mL,100 mL) and (7.1±1.7)cm for the laparoscopic group, respectively, versus 100 mL(100 mL,200 mL) and (19.1±1.7)cm for the open group, showing significant differences between the two groups ( Z=?3.779, t=?34.880, P<0.05) . (3) Postoperative situations: the number of lymph node dissected, time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative first liquid food intake, time to postoperative first semi-liquid food intake, time to drainage tube removal, duration of postoperative hospital stay were 49(35,62), 1.9 days(1.3 days,2.9 days), 2.6 days(2.2 days,2.9 days), 3.4 days(2.7days,4.0 days), 5.9 days(4.7 days,7.7 days), 4.9 days(3.5 days,6.8 days), 7.7 days(6.7 days,8.9 days) for the laparoscopic group, respectively, versus 40(27,51), 2.5 days (1.8 days,3.3 days), 2.6 days(2.2 days,2.9 days), 3.9 days(2.9 days,5.7 days), 4.9 days(3.9 days, 5.9 days), 6.3 days(4.7 days,8.9 days), 8.7 days(6.9 days,11.7 days), showing significant differences between the two groups ( Z=?2.354, ?2.210, ?2.743, ?2.474, ?2.906, ?2.503, ?2.359, P<0.05). (4) Follow-up: patients in the two groups received 30 days of follow-up. During the follow-up, 8 patients in the laparoscopic group had postoperative complications, including 1 case with Clavien-Dindo grade Ⅰ complications, 7 cases with Clavien-Dindo grade Ⅱ complications, and no patient with Clavien-Dindo grade Ⅲ complications. Thirteen patients in the open group had postoperative complications, including 2 cases with Clavien-Dindo grade Ⅰ complications, 10 cases with Clavien-Dindo grade Ⅱ complications, and 1 case with Clavien-Dindo grade Ⅲ complications. There was no significant difference in the above indicators between the two groups ( χ2=1.135, 1.973, 1.054, P>0.05). The overall complication rate was 16.3%(8/49) and 27.7%(13/47) for the laparoscopic group and open group, respectively, showing no significant difference between the two groups ( χ2=1.803, 99.7% confidence interval as ?∞ to 2.4%, P>0.05). The upper limit of 99.7% confidence interval was less than non-inferiority level of 15%, interim analysis of which showed that the complication rate of the laparoscopic group was non-inferior to the open group. Conclusion:For elderly patients undergoing laparoscopic or open distal gastrectomy for gastric cancer, laparoscopic surgery does not increase intraoperative or postoperative complications, and has advantages of minimally invasiveness, fine operation, quicker recovery, and shorter hospital stay. Registry: this study was registered at clinicaltrials.gov in United States, with the registry number of NCT02246153.

Pheochromocytoma and paraganglioma are rare neuroendocrine tumors. Because of the abnormal secretion of catecholamine, the risk of disease is high. At present, the choice of drug treatment for these diseases is still controversial. The further understanding of the research has showed that the different molecular subtypes have different carcinogenic mechanism and therapeutic response. And a variety of corresponding targeted drugs have entered the clinical trial stage, showing a certain therapeutic potential. This article reviews the current treatment and the progress of targeted drugs for pheochromocytoma and paraganglioma.

Objective:To investigate the effect of pressurization on the recovery of exercise-induced fatigue in rats in plateau environment.Methods:A total of 24 rats in natural environment were transported from altitude of 1 520 m to 2 260 m, then randomly divided into three groups: group A (quiet control group), group B (natural recovery group), and group C (pressurized recovery group), with 8 rats in each group. After the exercise fatigue model training on the running platform every day, the rats in the group B recovered naturally, while the rats in the group C had a 1-hour-recovery in a pressurized cabin of 0.2 MPa for 6 days. On the day 7, the rats in the group B and the group C exercised to exhaustion, and then were killed 24 hours later for sampling. The exercise time of exhaustion was recorded; gastrocnemius HIF-1α, lung iNOS, myocardial CaMKⅡ, and BNP protein expressions, and serum SOD, TAOC, GSH-Px and CAT, ROS, MDA concentration were determined; the morphological chages of myocardium after HE staining, and gastrocnemius were observed.Results:(1) The exhaustive exercise time of the group B (99.00±69.37 min) was lower than that of group C (126.14±59.09 min). (2)The expression level of HIF-1α protein in skeletal muscle was 0.220±0.170 in the group A, 0.070±0.003 in the group B, and 0.360±0.140 in the group C. The expression level of the group C was significantly higher than that in the group B ( P<0.05). The expression level of CaMKⅡ protein in myocardium was 1.18±0.17 in the group A, 1.07±0.13 in the group B, and 1.40±0.22 in the group C. There were no statistical difference between each group. The expression level of BNP protein in myocardium was 0.29±0.05 in the group A, 0.29±0.08 in the group B, 0.53±0.01 in the group C. There were significant differences comparing the group C with the group A and the group B respectively ( P<0.01). The expression level of iNOS in lung was 0.130±0.002 in the group A, 0.450±0.004 in the group B, and 0.360±0.005 in the group C. It was significantly lower in the group A than those in the group C and the group B ( P<0.01). (3) Compared with the group A, the serum SOD ( P<0.05) and GSH-Px decreased, ROS and MDA increased in the group B ( P<0.05). Compared with the group B, the serum SOD ( P<0.05), GSH-Px and TAOC increased, ROS and MDA decreased in the group C ( P<0.05). (4) Under light microscope, muscle fiber in the group B showed atrophy, thinning, rupture, increase of cell gap, and local lytic necrosis; while muscle fiber in the group C showed shrinking gap, decreased rupture, and relieved cell infiltration. Conclusion:In the plateau and hypoxia environment, the application of pressurization to the rats in exercise-induced fatigue can prolong the exhaustive exercise time, alleviate the morphological changes of muscle fibers in myocardium and skeletal muscles, e. g. thinning, rupture, and increase of cell gap, enhance the expressions of HIF-1α, CaMKⅡand BNP in gastrocnemius muscle, increase the levels of serum SOD, GSH Px, and TAOC, reduce the levels of serum ROS and MDA, and contribute to sports fatigue recovery.

Objective:To investigate the effect of pressurization on the recovery of exercise-induced fatigue in rats in plateau environment.Methods:A total of 24 rats in natural environment were transported from altitude of 1 520 m to 2 260 m, then randomly divided into three groups: group A (quiet control group), group B (natural recovery group), and group C (pressurized recovery group), with 8 rats in each group. After the exercise fatigue model training on the running platform every day, the rats in the group B recovered naturally, while the rats in the group C had a 1-hour-recovery in a pressurized cabin of 0.2 MPa for 6 days. On the day 7, the rats in the group B and the group C exercised to exhaustion, and then were killed 24 hours later for sampling. The exercise time of exhaustion was recorded; gastrocnemius HIF-1α, lung iNOS, myocardial CaMKⅡ, and BNP protein expressions, and serum SOD, TAOC, GSH-Px and CAT, ROS, MDA concentration were determined; the morphological chages of myocardium after HE staining, and gastrocnemius were observed.Results:(1) The exhaustive exercise time of the group B (99.00±69.37 min) was lower than that of group C (126.14±59.09 min). (2)The expression level of HIF-1α protein in skeletal muscle was 0.220±0.170 in the group A, 0.070±0.003 in the group B, and 0.360±0.140 in the group C. The expression level of the group C was significantly higher than that in the group B ( P<0.05). The expression level of CaMKⅡ protein in myocardium was 1.18±0.17 in the group A, 1.07±0.13 in the group B, and 1.40±0.22 in the group C. There were no statistical difference between each group. The expression level of BNP protein in myocardium was 0.29±0.05 in the group A, 0.29±0.08 in the group B, 0.53±0.01 in the group C. There were significant differences comparing the group C with the group A and the group B respectively ( P<0.01). The expression level of iNOS in lung was 0.130±0.002 in the group A, 0.450±0.004 in the group B, and 0.360±0.005 in the group C. It was significantly lower in the group A than those in the group C and the group B ( P<0.01). (3) Compared with the group A, the serum SOD ( P<0.05) and GSH-Px decreased, ROS and MDA increased in the group B ( P<0.05). Compared with the group B, the serum SOD ( P<0.05), GSH-Px and TAOC increased, ROS and MDA decreased in the group C ( P<0.05). (4) Under light microscope, muscle fiber in the group B showed atrophy, thinning, rupture, increase of cell gap, and local lytic necrosis; while muscle fiber in the group C showed shrinking gap, decreased rupture, and relieved cell infiltration. Conclusion:In the plateau and hypoxia environment, the application of pressurization to the rats in exercise-induced fatigue can prolong the exhaustive exercise time, alleviate the morphological changes of muscle fibers in myocardium and skeletal muscles, e. g. thinning, rupture, and increase of cell gap, enhance the expressions of HIF-1α, CaMKⅡand BNP in gastrocnemius muscle, increase the levels of serum SOD, GSH Px, and TAOC, reduce the levels of serum ROS and MDA, and contribute to sports fatigue recovery.

Severe acute pancreatitis (SAP) is an acute abdominal disease and a critical illness commonly seen in clinical practice. Infection complications in the middle and late stages of SAP have a great impact on the prognosis of SAP and are often difficult to avoid. This article introduces the pathogenesis of secondary pancreatic and extra-pancreatic infections and summarizes the pathogen spectrum of infections secondary to SAP in the past 10 years. This article also summarizes and evaluates the current strategies for preventing secondary infections and briefly describes the advances in surgical interventions for SAP secondary infections. These analyses show that the pathogenesis, pathogenic features, and immunological features of SAP secondary infection remain unclear. There are various control strategies for such infection, but there are still no effective measures to prevent infection except early enteral nutrition. Conclusions will be achieved on the issues including the timing of percutaneous catheter drainage, and surgical interventions have developed rapidly on the basis of the STEP-UP approach. Endoscopic STEP-UP approach is slightly superior to conventional STEP-UP approach in the treatment of critically ill patients with SAP.

Objective To understand the current management situation of hand hygiene (HH)among health care workers(HCWs)in stomatology medical institutions in Zunyi,and provide basis for the scientific management of HH.Methods In October-December 2014,the on-site observation and questionnaire survey were adopted to investigate current management situation of HH in 127 stomatology medical institutions in Zunyi.Results The rates of qualified installation of sink,faucet,detergent,alcohol-based hand rub,and hand-drying facilities were 60.63%, 11 .02%,92.13%,22.05%,and 37.80% respectively.Except detergent and sink,the installation of other HH supplies in stomatology medical institutions in Zunyi were not ideal.The correct rate of HH among HCWs was 33.07%(42/127),qualified rates of HH methods among HCWs in departments of stomatology,comprehensive out-patient departments, stomatological clinics,and teeth-cleaning clinics were 50.00%,23.08%,23.53%,and 0 respectively.Conclusion HH facilities are not perfect in primary stomatology medical institutions in Zunyi,health ad-ministrative departments’supervision on HCWs’HH is inadequate,the awareness rate of HH knowledge and com-pliance to HH among HCWs are both low.

Objective To study the relationship between the expression of cytochrome c ( Cyt c) and programmed cell death 4 (PDCD4) in pancreatic cancer, and investigate the pathway of PDCD4 inducing the apoptosis of pancreatic cancer cells. Methods Pancreatic cancer specimens from 69 patients who received pancreatic resection from 1990 to 2002 in First Affiliated Hospital of China Medical University were collected. The expression of Cyt c in the 69 paraffin specimens of pancreatic cancer was detected by immunohistochemistry, and the expression of Cyt c in 8 samples of cold-preserved fresh pancreatic cancer and normal pancreatic tissues were detected by Western blot. The expression of PDCD4 and Cyt c in pancreatic cancer was analyzed by paired t test and chi-square test. Results Compared with normal pancreatic tissues, the expression of Cyt c in pancreatic cancer was significantly decreased. The positive expression rate of Cyt c in 69 samples of pancreatic cancer was 41% (28/69). The expression of Cyt c was positive in most patients with positive expression of PDCD4, and the expression of PDCD4 was negative in most patients with negative expression of Cyt c. The expression of PDCD4 and Cyt c was closely correlated with each other (χ2= 10.52, P < 0.05). Conclusions There is a close relationship between the expression of PDCD4 and Cyt c in pancreatic cancer. PDCD4 may induce the apoptosis of pancreatic cancer cells through mitochondrial pathway.