AIM: To investigate the impact of corneal fluorescein sodium(NaF)staining on the examination results of iTrace visual function analyzer(iTrace).METHODS: Prospective cohort study. Totally 100 patients(100 eyes)with ametropia who visited the outpatient department of Anhui Eye Hospital from April to November 2024 were recruited. They were divided into an experimental group and a control group, with 50 patients(50 eyes, and only the right eyes were selected for inclusion)in each group. In the experimental group, corneal staining was performed using fluorescein sodium staining test strips, while in the control group, 1 drop of 0.9% normal saline was instilled into the eyes. The iTrace examination was conducted before the intervention and at 5, 10, and 20 min after the intervention. The total corneal higher-order aberrations, spherical aberration, coma aberration, trefoil aberration, best sphere value(RO value), asphericity factor(Q value), and corneal vertical refractive power difference(IS value)at each time of examination were recorded and compared.RESULTS: There was no statistically significant difference in the baseline levels between the two groups(all P>0.05). Intra-group comparison revealed that the total higher-order aberrations, spherical aberration, coma aberration, and trefoil aberration measured 5 min after NaF staining in the experimental group were significantly increased compared with those before staining(all P<0.05). Inter-group comparison showed that the changes(differences from the baseline)in the total corneal higher-order aberrations, spherical aberration, coma aberration, and trefoil aberration measured by iTrace 5 min after the intervention in the experimental group were significantly greater than those in the control group(all P<0.05). There was no statistically significant difference in the changes(differences from the baseline)of various iTrace parameters measured at 10 and 20 min after the intervention between the two groups(all P>0.05). There was no statistical significance in the RO value, Q value, and IS value in the two groups(all P>0.05).CONCLUSION: Corneal NaF staining can cause a short-term increase in the wavefront aberration values(total corneal higher-order aberrations, spherical aberration, coma aberration, trefoil aberration)measured by iTrace, and it gradually disappears with the passage of time. However, it has no impact on the measurement of corneal topography parameters(RO value, Q value, IS value).

It is believed that psoriasis with anxiety and depression presents the pathogenesis of "depression-blood-spirit"， with qi depression as the initiating factor， and that the disease mechanism is understood from three aspects， including "qi depression transforming into fire， blood stasis disturbing the spirit"， "depressed fire consuming yin， causing blood dryness and spirit agitation"， "qi stagnation leading to blood stasis， resulting in obstructed channels and spirit depression". The treatment proposes three methods， firstly， cooling blood and resolving depression， secondly， nourishing blood and soothing depression， and thirdly， activating blood and regulating depression， which applies prescriptions as modified Liangxue Huoxue Decoction （凉血活血汤） combined with Zhiqiao （Poncirus trifoliata）， Foshou （Citrus medica）， and Lianqiaoxin （Forsythia suspensa） for cooling blood and resolving depression； modified Yangxue Jiedu Decoction （养血解毒汤） combined with Baishao （Paeonia lactiflora Pall）， Zhenzhumu （Margaritifera Concha）， and calcined Muli （Ostreidae） for nourishing blood and soothing depression； and modified Huoxue Sanyu Decoction （活血散瘀汤） combined with Yujin （Curcuma aromatica） and Hehuanpi （Albiziae Cortex） for activating blood and regulating depression. These three methods integrate the "depression-blood-spirit" pathogenesis to achieve harmony of body and spirit by clearing blood heat， nourishing yin and blood， and removing blood stasis， complemented with medicinals that soothing the liver， calming the spirit， and regulating depression.

OBJECTIVE: Peritoneal dialysis(PD)-associated peritonitis is a common and major complication of PD and the most common cause of technical failure of PD. The presence of bacterial biofilm may be an important factor leading to refractory or recurrence of peritonitis. To investigate the formation and characteristics of bacterial biofilms on PD catheters after peritonitis-associated catheter removal. METHODS: The patients with maintenance PD who were regularly followed up in the Peking University People' s Hospital from June 2007 to January 2022 were retrospectively analyzed. The patients who withdrew from PD because of peritonitis and removed the PD catheter in our hospital and underwent the scanning electron microscope examination of the catheter were selected. The general information of the patients, the electron microscope results of the PD catheter and the bacterial culture results of the PD fluid were summarized. RESULTS: (1) A total of 18 patients were included, 11 were female (accounting for 61.1%). The average age of the patients was (59.1±11.5) years, and the average duration of dialysis was (80.1±47.4) months. Primary kidney diseases were predominantly chronic glomerulonephritis (55.6%), followed by diabetic nephropathy (27.8%), and others (16.6%). The reasons for catheters removal in 18 patients were refractory peritonitis in 11 cases, recurrent peritonitis in 5 cases, and fungal peritonitis in 2 cases. (2) 16 of the 18 patients (88.9%) had catheter bacterial biofilm, and the bacterial biofilm forms were all cocci. Some were arranged in grape-like shapes, and their diameters ranged from about 500 nm to 1 000 nm. The bacterial culture results of peritoneal dialysis fluid showed that the three most common pathogens were Escherichia coli, methicillin-sensitive Staphylococcus aureus (MSSA), and Staphylococcus epidermidis. (3) Among the 18 patients enrolled, 13 patients (72.2%) had peritonitis in the past. The causative bacteria of peritonitis in 9 patients were cocci, including coagulase-negative Staphylococci (Staphylococcus suis, Staphylococcus surface, Staphylococcus xylosus, Staphylococcus warneri), Staphylococcus aureus, Streptococcus (Streptococcus salivarius and Aerococus viridans). CONCLUSION Bacterial biofilm formation on the inner surface of PD catheter is common in peritonitis-associated catheter removal patients. Not all PD catheters removed due to peritonitis have bacterial biofilms. Bacterial biofilms and peritonitis pathogens may not be consistent.
Humans ; Biofilms/growth & development* ; Peritonitis/etiology* ; Peritoneal Dialysis/instrumentation* ; Middle Aged ; Female ; Male ; Retrospective Studies ; Catheters, Indwelling/microbiology* ; Device Removal ; Catheter-Related Infections/microbiology* ; Aged ; Adult

Objective To explore the diagnostic value of lung ultrasound(LUS)score,computed tomo-graphy(CT)combined with serum CXC chemokine ligand 8(CXCL8)and soluble co stimulatory molecule B7-H3(sB7-H3)for severe Mycoplasma pneumoniae pneumonia(MPP)in children.Methods From April 2022 to April 2024,a total of 210 children with MPP who visited Maternal and Child Health Hospital of Zhan-gqiu District were included as research subjects,and they were separated into severe MPP group and non se-vere MPP group according to the severity of the disease.Enzyme-linked immunosorbent assay was applied to detect serum levels of CXCL8 and sB7-H3.LUS score and CT diagnosis were conducted.The value of LUS score,CT and serum CXCL8,sB7-H3 in the diagnosis of severe MPP was analyzed using the receiver operating characteristic curve.Results There were no statistically significant differences in height,age,fever days,weight,hospital stay,and gender between the severe MPP group and the non severe MPP group(P>0.05).Compared with the non severe MPP group,the serum levels of CXCL8,sB7-H3,and LUS score were all in-creased in the severe MPP group(P<0.05).The area under the curve(AUC)of LUS score,serum CXCL8,and sB7-H3 for diagnosing severe MPP was 0.865,0.785,and 0.750,respectively.The CT diagnosis results showed 35 false positives and 22 false negatives,with Kappa value of 0.459 compared to clinical examination results(P<0.05).The diagnostic results of LUS score,CT combined with serum CXCL8 and sB7-H3 showed 3 false positives and 15 false negatives,with Kappa vale of 0.828 compared to clinical examination results(P<0.05).The diagnosis of LUS score,CT combined with serum CXCL8,and sB7-H3 had higher specificity and accuracy than those of single detection of the four(P<0.05),and the sensitivity of the combined diagno-sis of the four was increased(P<0.05)and the missed diagnosis rate was reduced compared to the single de-tection of CXCL8 and sB7-H3(P<0.05).Conclusion The serum levels of CXCL8,sB7-H3,and LUS score in children with MPP increase.The specificity and accuracy of LUS score,CT combined with serum CXCL8,sB7-H3 in diagnosing severe MPP increase.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective To investigate the anxiety and its related factors in medical staff during field training,so as to provide evidence for psychological education before field training.Methods A total of 81 medical staff who participated in field training were recruited in this cross-sectional study as research objects.The Hamilton Anxiety Scale(HAMA)and self-compiled questionnaires of related factors were used to measure the general states of the staff.Univariate analysis was used to screen relevant variables that affect anxiety,and then a logistic regression model was used for multivarate analysis to determine independent influencing factors.Results The detection rate of anxiety was 14.81%in the research objects.There were significant differences in the degree of anxiety among the medical staff with different variables such as gender,the number of exercises attended,childlessness,parental physical condition,tolerable training time,pastime activities,and personal title(P<0.05).Multivariate regression analysis indicated that gender and parental physical status were independent factors affecting anxiety(P<0.05).Conclusion During field training,a part of medical staff has anxiety,which may affect by multi-factors such as personal,family,and training environment.Therefore,psychological education and counseling before field training should be performed from multiple aspects.

The sealing performance is directly related to the safety,reliability and mission success rate of aerospace equipment.The sealing performance of rubber seals and the optimized design of the compression force directly affect the performance and work efficiency of the equipment.Based on the hyperelastic Mooney-Rivlin model of nonlinear materials,the mechanical properties of rubber are simulated,and a finite element model of rubber seals is established.Through simulation analysis,the effects of different cross-section dimensions and compression amounts on the sealing performance are studied and compared,and key parameters such as the contact stress distribution,maximum contact stress,and compression force.The size of the fillet affects the final deformation and the contact state.By optimizing the geometric parameters,the compression force can be reduced while ensuring the sealing performance,providing a theoretical basis for the optimized design of rubber seals.

Objective To compare and analyze the differences between customized models and commercial universal models in the segmentation of organs-at-risk in cervical cancer,and to investigate the feasibility of customized models.Methods A retrospective analysis was conducted on 270 cervical cancer patients.Senior clinicians manually delineated organs-at-risk,including the bladder,rectum,small intestine,pelvic bone marrow,femoral heads,and kidneys.The cases were randomly selected to develop customized models,with 202 cases allocated to the training set,38 cases to the test set,and 30 cases to the validation set.The universal and customized models were used for segmentation on the test set,and the automatic segmentation results obtained by the two models were compared with manual segmentation results to assess the performance of the customized model.Results Both customized model and universal model had comparable DSC values to manual segmentation,demonstrating satisfactory delineation outcomes(DSC values ranging from 0.7 to 0.9).However,in terms of deviation of centroid and 95％Hausdorff distance,the customized model surpassed the universal model.Conclusion Compared with the universal model,the customized model offers superior accuracy in delineating the structures of organs-at-risk in cervical cancer.As the customized model is optimized based on specific datasets,it provides precise support for clinical decision-making and holds promising applications in the treatment of cervical cancer.

In the past decades, significant progress has been achived in cartilage regeneration. The traditional techniques for constructing tissue engineering cartilage scaffold mainly include pore agent method (or template method), phase separation method, gas foaming method, freeze-drying method, electrospinning method, etc. Cartilage is heterogeneous, and it is difficult for traditional scaffolds to simulate the high anisotropy of cartilage. Therefore, functional regeneration of cartilage is challenging. With the progress of three-dimensional(3D) printing technology, it is possible to prepare functional bionic scaffolds with fine structure and gradient changes through co-deposition of biomaterials, cells and active biomolecules, so as to achieve functional cartilage regeneration. This article reviewed 3D printing technology of cartilage tissue engineering, and the application of 3D printing technology in cartilage regeneration at different anatomical positions (articular cartilage, auricle cartilage, nasal cartilage). In addition, the importance of preparing bionic constructs with regional structure gradient and regional composition gradient was discussed. 3D bioprinting technology, 4D printing techniques, smart biomaterials brought hope for the construction of bionic tissues and organs.

Objective:To examine the clinical subtypes of patients with multisystem atrophy(MSA)that may indicate the prognosis of patients.Additionally, we aim to compare the ability to perform daily activities among patients of each subtype using cluster analysis.Methods:The retrospective analysis included demographic data, clinical symptoms and signs, scale scores, and ancillary examinations of 94 patients diagnosed with multisystem atrophy at Xuanwu Hospital of Capital Medical University.The study aimed to analyze the clinical characteristics of each subtype obtained through clustering.Additionally, a comparison was made between patients with traditional motor subtypes and those with new subtypes in terms of activities of daily living.The study consisted of 94 MSA patients, with an average age of 61 years and a female representation of 51.1%.Using the data collected on the continuum, a full linkage hierarchical cluster analysis was performed to classify MSA patients into four clinical subtypes: gait disorder(17 cases, 18.1%), malignant tonic hyperkinetic with premature haircut(25 cases, 26.6%), intermediate(43 cases, 45.7%), and autonomic benign type(9 cases, 9.6%).Each subtype exhibited various clinical motor and non-motor symptoms, including UPDRS-Ⅲ( χ2=27.90, P<0.001), gait disturbance( χ2=33.23, P<0.001), MoCA( χ2=10.98, P=0.012), HAMA( χ2=12.14, P=0.007), HAMD( χ2=13.62, P=0.003), smell score( χ2=10.16, P=0.017), postural hypotension( χ2=14.59, P=0.028), and a statistically significant difference in the ability to perform daily living score( χ2=25.35, P<0.001).No statistically significant differences in non-motor symptoms and activities of daily living abilities were observed between the cerebellar and Parkinsonian types of traditional motor typing( P>0.05). Conclusions:The hierarchical clustering analysis conducted in this study reveals that the clinical phenotype of MSA provides a more accurate reflection of patients' clinical characteristics and their impact on quality of life compared to the traditional motor phenotype.Additionally, it may help predict variations in the underlying pathological impairment and the rate of disease progression.These findings offer a foundation for precise diagnostic interventions in patients with MSA.