Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Objective:To investigate the utility of a computational pathology-based tumor microenvironment(TME)score derived from whole slide images(WSIs)in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)in patients with EGFR mutation-positive non-small cell lung cancer(NSCLC).Methods:This retrospective study collected 240 EGFR-mutant NSCLC pa-tients treated with EGFR-TKIs at The First Affiliated Hospital of Wannan Medical College and analyzed hematoxylin-eosin(H&E)-stained WSIs of biopsy specimens,along with clinical and imaging data.The patients were randomly assigned into a training cohort(n=160)and an inde-pendent validation cohort(n=80)in a 2:1 ratio.Treatment response was assessed based on CT findings at 3 months after EGFR-TKIs initi-ation.Computational pathology was employed to automatically quantify the proportions of four TME components(tumor epithelium,stroma,lymphocytes,and vasculature)within the tumor regions of WSIs.Multivariate Logistic regression in the training cohort identified TME components independently predictive of treatment response(P<0.05),which were then integrated into a TME-score.The predictive performance was evaluated using receiver operating characteristic(ROC)curve analysis and area under the curve(AUC).The TME-score model was compared with a clinical-feature-based model and a combined model(TME-score+clinical features).Finally,the models were val-idated in the independent cohort.Results:In the training cohort,the TME-score,incorporating epithelial and stromal proportions,achieved an AUC of 0.827(95%CI:0.749-0.892)for predicting treatment response,while the validation cohort yielded an AUC of 0.845(95%CI:0.735-0.937).Both outperformed the clinical model(AUCs=0.730[95%CI:0.645-0.804]and 0.712[95%CI:0.586-0.824],respectively).The combined model(TME-score+clinical features,including cytokeratin 19 fragment and non-contrast CT values)further improved predictive performance(AUCs=0.884[95%CI:0.827-0.932]and 0.882[95%CI:0.798-0.950],respectively).Delong's test for pairwise model comparis-ons showed significant differences(all P<0.05)except TME-score and the combined model in the validation cohort(P=0.289).Conclusions:TME-score outperformed clinical models in predicting EGFR-TKIs efficacy in EGFR mutation-positive NSCLC patients and may serve as a novel tool for identifying patients likely to benefit from targeted therapy.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Objectives:The aim of this study was to investigate the value of assessing Selvester QRS score in evaluating myocardial fibrosis in hypertrophic cardiomyopathy(HCM)patients.Methods:A total of consecutive 149 patients with HCM,who were admitted in Fuwai Hospital from October 2008 to September 2013,were enrolled in this study.Qualitative and quantitative analyses of myocardial fibrosis were conducted based on late gadolinium enhancement(LGE)derived from enhanced cardiac magnetic resonance imaging(CMR).According to the qualitative analysis of myocardial fibrosis by CMR-LGE,the patients were divided into the LGE-negative group(n=46)and the LGE-positive group(n=103).Standard 12-lead electrocardiogram examination was performed and the Selvester QRS score was calculated.Multivariate binary Logistic regression analysis was used to analyze the predictive factors of positive LGE,and the correlation analysis between the Selvester QRS score and the LGE score was also performed.Results:Compared with the LGE-negative group,the proportion of patients with a family history of HCM(12.8%vs.28.2%),the proportion of patients with a positive Selvester QRS score(65.2%vs.83.5%)and the Selvester QRS score([1.65±1.81]points vs.[5.71±3.80]points)were higher,the maximum thickness of the left ventricular wall([20.5±3.2]mm vs.[24.5±5.0]mm)and the percentage of left ventricular myocardial scar area([5.0±5.5]%vs.[17.1±11.4]%)were larger in the LGE-positive group(all P<0.05).Multivariate binary logistic regression analysis showed that the Selvester QRS score(OR=1.429,95%CI:1.128-1.802,P=0.003)and the maximum left ventricular wall thickness(OR=1.257,95%CI:1.029-1.537,P=0.025)were independent predictors of positive LGE.Pearson correlation analysis showed that in all HCM patients,the Selvester QRS score was positively correlated with the LGE score(r=0.682,P<0.001),and the percentage of left ventricular myocardial scar area was positively correlated with the percentage of enhanced area to the total mass of left ventricular myocardium(LGE%)(r=0.682,P<0.001);In the LGE positive group,the Selvester QRS score was positively correlated with the LGE score(r=0.569,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cut-off values of Selvester QRS score and maximum left ventricular wall thickness for predicting positive LGE were≥3.5 points and≥21 mm,respectively.Conclusions:In HCM patients,the Selvester QRS score is significantly associated with myocardial fibrosis,and the total score≥3.5 serves as a good predictive cutoffvalue for identifying the presence of LGE.

Objective:To develop an electronic information platform-based assessment tool for entrustable professional activities (EPAs) of master of nursing specialist (MNS) students.Methods:The study used the content analysis method to construct the draft of the assessment tool, which was finalized using the expert meeting method. An electronic information platform was developed based on the assessment tool. The functions of the platform was optimized using the focus group interview method.Results:Based on previous research on the EPA framework for MNS students, an EPA assessment tool was developed, including an assessment form and an assessment protocol. The assessment form consisted of three parts: description of the EPAs, supervision level, and narrative feedback. The assessment protocol covered the assessment objects, assessment initiation strategy, assessment implementation-entrustment decision making, assessment cycle, and quality control. The electronic information platform includes both web-based and mobile app interfaces, with user roles for clinical instructors, graduate students, and project administrators, and with functions such as assessment application, assessment initiation, historical assessment review, and assessment information management.Conclusions:The study developed an EPA assessment tool for MNS students. The tool relies on the convenience and efficiency of the electronic information platform, facilitates clinical instructors in observing the comprehensive performance of MNS students in multiple competencies, and promotes postgraduate students' professional development. Future research will further explore the effectiveness of this tool in assessing clinical practice competencies of MNS students, with the aim of advancing the practice of EPAs in nursing masters' education.

Objectives:The aim of this study was to investigate the value of assessing Selvester QRS score in evaluating myocardial fibrosis in hypertrophic cardiomyopathy(HCM)patients.Methods:A total of consecutive 149 patients with HCM,who were admitted in Fuwai Hospital from October 2008 to September 2013,were enrolled in this study.Qualitative and quantitative analyses of myocardial fibrosis were conducted based on late gadolinium enhancement(LGE)derived from enhanced cardiac magnetic resonance imaging(CMR).According to the qualitative analysis of myocardial fibrosis by CMR-LGE,the patients were divided into the LGE-negative group(n=46)and the LGE-positive group(n=103).Standard 12-lead electrocardiogram examination was performed and the Selvester QRS score was calculated.Multivariate binary Logistic regression analysis was used to analyze the predictive factors of positive LGE,and the correlation analysis between the Selvester QRS score and the LGE score was also performed.Results:Compared with the LGE-negative group,the proportion of patients with a family history of HCM(12.8%vs.28.2%),the proportion of patients with a positive Selvester QRS score(65.2%vs.83.5%)and the Selvester QRS score([1.65±1.81]points vs.[5.71±3.80]points)were higher,the maximum thickness of the left ventricular wall([20.5±3.2]mm vs.[24.5±5.0]mm)and the percentage of left ventricular myocardial scar area([5.0±5.5]%vs.[17.1±11.4]%)were larger in the LGE-positive group(all P<0.05).Multivariate binary logistic regression analysis showed that the Selvester QRS score(OR=1.429,95%CI:1.128-1.802,P=0.003)and the maximum left ventricular wall thickness(OR=1.257,95%CI:1.029-1.537,P=0.025)were independent predictors of positive LGE.Pearson correlation analysis showed that in all HCM patients,the Selvester QRS score was positively correlated with the LGE score(r=0.682,P<0.001),and the percentage of left ventricular myocardial scar area was positively correlated with the percentage of enhanced area to the total mass of left ventricular myocardium(LGE%)(r=0.682,P<0.001);In the LGE positive group,the Selvester QRS score was positively correlated with the LGE score(r=0.569,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cut-off values of Selvester QRS score and maximum left ventricular wall thickness for predicting positive LGE were≥3.5 points and≥21 mm,respectively.Conclusions:In HCM patients,the Selvester QRS score is significantly associated with myocardial fibrosis,and the total score≥3.5 serves as a good predictive cutoffvalue for identifying the presence of LGE.

Objective:To investigate the utility of a computational pathology-based tumor microenvironment(TME)score derived from whole slide images(WSIs)in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)in patients with EGFR mutation-positive non-small cell lung cancer(NSCLC).Methods:This retrospective study collected 240 EGFR-mutant NSCLC pa-tients treated with EGFR-TKIs at The First Affiliated Hospital of Wannan Medical College and analyzed hematoxylin-eosin(H&E)-stained WSIs of biopsy specimens,along with clinical and imaging data.The patients were randomly assigned into a training cohort(n=160)and an inde-pendent validation cohort(n=80)in a 2:1 ratio.Treatment response was assessed based on CT findings at 3 months after EGFR-TKIs initi-ation.Computational pathology was employed to automatically quantify the proportions of four TME components(tumor epithelium,stroma,lymphocytes,and vasculature)within the tumor regions of WSIs.Multivariate Logistic regression in the training cohort identified TME components independently predictive of treatment response(P<0.05),which were then integrated into a TME-score.The predictive performance was evaluated using receiver operating characteristic(ROC)curve analysis and area under the curve(AUC).The TME-score model was compared with a clinical-feature-based model and a combined model(TME-score+clinical features).Finally,the models were val-idated in the independent cohort.Results:In the training cohort,the TME-score,incorporating epithelial and stromal proportions,achieved an AUC of 0.827(95%CI:0.749-0.892)for predicting treatment response,while the validation cohort yielded an AUC of 0.845(95%CI:0.735-0.937).Both outperformed the clinical model(AUCs=0.730[95%CI:0.645-0.804]and 0.712[95%CI:0.586-0.824],respectively).The combined model(TME-score+clinical features,including cytokeratin 19 fragment and non-contrast CT values)further improved predictive performance(AUCs=0.884[95%CI:0.827-0.932]and 0.882[95%CI:0.798-0.950],respectively).Delong's test for pairwise model comparis-ons showed significant differences(all P<0.05)except TME-score and the combined model in the validation cohort(P=0.289).Conclusions:TME-score outperformed clinical models in predicting EGFR-TKIs efficacy in EGFR mutation-positive NSCLC patients and may serve as a novel tool for identifying patients likely to benefit from targeted therapy.

Objective:To develop an electronic information platform-based assessment tool for entrustable professional activities (EPAs) of master of nursing specialist (MNS) students.Methods:The study used the content analysis method to construct the draft of the assessment tool, which was finalized using the expert meeting method. An electronic information platform was developed based on the assessment tool. The functions of the platform was optimized using the focus group interview method.Results:Based on previous research on the EPA framework for MNS students, an EPA assessment tool was developed, including an assessment form and an assessment protocol. The assessment form consisted of three parts: description of the EPAs, supervision level, and narrative feedback. The assessment protocol covered the assessment objects, assessment initiation strategy, assessment implementation-entrustment decision making, assessment cycle, and quality control. The electronic information platform includes both web-based and mobile app interfaces, with user roles for clinical instructors, graduate students, and project administrators, and with functions such as assessment application, assessment initiation, historical assessment review, and assessment information management.Conclusions:The study developed an EPA assessment tool for MNS students. The tool relies on the convenience and efficiency of the electronic information platform, facilitates clinical instructors in observing the comprehensive performance of MNS students in multiple competencies, and promotes postgraduate students' professional development. Future research will further explore the effectiveness of this tool in assessing clinical practice competencies of MNS students, with the aim of advancing the practice of EPAs in nursing masters' education.

Objective: Since its development in 2002 by the Korean College of Neuropsychopharmacology and the Korean Society for Affective Disorders, the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) has undergone five revisions. Methods: To improve survey efficiency, reflect general clinical practice, and facilitate comparisons with previous KMAP-DD revisions, the overall structure of the questionnaire was retained. The six sections of the questionnaire were as follows:1) pharmacological treatment strategies for major depressive disorder with and without psychotic features; 2) pharmacological treatment strategies for persistent depressive disorder and other depressive disorder subtypes; 3) consensus on treatment-resistant depression; 4) selection of an antidepressant in consideration of safety, adverse effects, and comorbid physical conditions; 5) treatment strategies for special populations (children/adolescents, elderly, and women); and 6) non-pharmacological biological therapies. First-, second-, and third-line treatment recommendations were statistically derived. Results: Compared to KMAP-DD 2021, only minor changes were noted, due to the limited introduction of new medications or treatment modalities. Nonetheless, notable shifts included an increased preference for atypical antipsychotics (AAPs), and higher preference of combination strategies involving AAPs and mood stabilizers, indicating a more proactive and intensive treatment trend in Korea. Conclusion KMAP-DD is expected to serve as a valuable clinical resource by providing expert consensus-based recommendations on specific treatment strategies and pharmacological options for major depressive disorders, thereby supporting the integration of real-world clinical practice with evidence-based medicine.