AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.

The paper reports a case of 2,8-dihydroxyadenine (2,8-DHA) crystalline nephropathy caused by mutation of adenine phosphoribosyltransferase ( APRT) gene. The female patient was 60 years old, and sought medical advice due to "foaming urine increased for half a year". Renal biopsy result showed irregular yellowish brown 2,8-DHA crystals with refraction under polarized light. 2,8-DHA crystals were found by urine sediment detection, and homozygous deletion of c.521_523delTCT on exon 5 of APRT gene was found by genetic testing. Finally this patient was diagnosed as 2,8-DHA crystalline nephropathy. Renal function improved after treatment with allopurinol. The case report aims to improve the clinician's understanding of 2,8-DHA crystalline nephropathy. Early recognition, correct diagnosis, and early drug intervention may delay the progression of renal failure and improve the prognosis.

Objective To study the levels of serum Periostin and interleukin(I1-)-18 in preterm infants with bronchopulmonary dysplasia(BPD),and to analyze their correlation with the severity of the disease and their predictive value for BPD.Methods A total of 62 preterm infants with BPD diagnosed and treated in the hospital from January 2019 to January 2022 were retrospectively selected as the BPD group,and 80 preterm in-fants without BPD during the same period were selected as the non-BPD group.According to the severity of BPD,the infants with BPD were divided into mild subgroup(22 cases),moderate subgroup(24 cases)and se-vere subgroup(16 cases).The serum levels of Periostin and IL-18 were detected by enzyme-linked immu-nosorbent assay.Pearson correlation analysis was used to analyze the correlation between the clinical parameters.Multivariate Logistic regression was used to analyze the influencing factors of BPD,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of each indicator for BPD.Results Compared with the non-BPD group,the BPD group had a significantly higher proportion of infants with pulmonary surfactant(PS)use,neonatal respiratory distress syndrome,apnea,patent ductus arteriosus,and serum levels of Periostin and IL-18,as well as a significantly longer duration of mechanical ventilation,noninvasive respiratory support,and length of hospital stay.The lung function parameters[tidal volume per kilogram(VT/kg),ratio of time to peak tidal expiratory flow to time(TPTEF/TE),ratio of volume to peak tidal expiratory flow to volume(VPEF/VE),expiratory flow at 50％tidal volume(50％TEF),expiratory flow at 75％tidal volume(75％TEF)]and 1,5 min Apgar score of BPD group were lower than that of non-BPD group,and the differences were statistically significant(P＜0.05).The serum levels of Periostin and IL-18 in mild subgroup,moderate subgroup and severe subgroup were increased in turn.The levels of serum Periostin and IL-18 were negatively correlated with pulmonary function indexes(VT/kg,50％TEF,75％TEF,TPTEF/TE,VPEF/VE,P＜0.05).Serum Periostin,IL-18 and neonatal respiratory distress syndrome were independent risk factors for BPD(P＜0.05),and PS was a protective factor(P＜0.05).Serum Periostin,IL-18 and neonatal respiratory distress syndrome were independent risk factors for the severity of BPD(P＜0.05).The area under the curve(95％CI)of serum Periostin and IL-18 alone and in combination for predicting BPD were 0.841(0.814-0.899),0.863(0.820-0.897),0.922(0.878-0.949),respectively.The sensitivity and specificity of combined prediction were 0.902 and 0.825,respectively.The area under the curve of the combination of the two indica-tors for predicting BPD was greater than that of each index alone,and the difference was statistically signifi-cant(Z=5.357,4.894,P＜0.001).Conclusion The levels of serum Periostin and IL-18 are increased in in-fants with BPD,which are related to the severity of BPD and lung function.The combination of serum Perios-tin and IL-18 has a high predictive value for BPD.

Objective: To investigate the effects of physical activity (PA) intensity and sedentary behavior (SB) on calcanues bone mineral density (BMD) in preschool children, so as to provide a basis for rationalizing the daily physical activity of preschool children to promote bone health. Methods: A total of 673 pre school children aged 3-6 years from nine kindergartens in Pingxiang City, Ganzhou City and Yingtan City of Jiangxi Province, were selected from September to December 2021 by using the whole stratified cluster random sampling method. The PA levels and SB were measured by using a three axis acceleration sensor, and left calcanues BMD was measured by an ultrasound bone densitometer. Multiple linear regression was used to explore the effects of changes in PA on calcanues BMD in pre school children of all ages. Results: Of the 673 preschoolers surveyed, 498 (74.0%) achieved an average of ≥60 min of moderate to vigorous physical activity (MVPA) per day, there were 265 boys (71.2%), and 233 girls ( 77.4 %). The difference between genders was not statistically significant ( χ 2=2.77, P >0.05). There was no statistically significant difference in the BMD test of the calcaneus bones of preschoolers by gender ( Z=0.42, P >0.05). The difference in BMD results of pre school children with 3, 4, 5 to 6 years was statistically significant ( H=2.65, P <0.05). Correlation analysis revealed a negative correlation between SB duration and calcaneus BMD ( r =-0.13), and a positive correlation between low intensity physical activity (LPA) duration, MVPA duration, and calcaneus BMD ( r =0.14, 0.25 ) ( P <0.05). Multivariate linear regression analysis showed that SB duration negatively correlated with calcaneus BMD, whereas LPA and MVPA duration positively correlated with calcaneus BMD ( P <0.05). Conclusions MVPA duration is positively correlated with the growth of BMD in the heel bone and negatively correlated with SB. The kindergartens can adjust their curricula according to the physical and mental developmental characteristics, gender and age differences of pre school children, increase the time of outdoor activities, and reduce the sedentary time to promote the bone health of young children.

Objective To investigate the level and influencing factors of quality of life in patients with osteoradionecrosis of the jaws (ORNJ) in order to provide theory basis for nursing intervention. Methods Ninety-five patients hospitalized from January 2015 to Febury 2017 and participated in the investigation by a convenient sampling method. The functional assessment of cancer therapy-head and neck (FACT-H&N), social support rating scale (SSRS) and general information questionnaire were used to assess the quality of life, social support and basic information in ORNJ patients in our hospital respectively. Results The score of quality of life was (79.99 ±15.72). The index value of common module of quality of life was higher than that of additional concern. The average scores of each dimension of common module from low to high were as follows: functional well-being, social/family well-being, physical well-being and emotional well-being. The multiple linear regression analysis showed that the influencing factors of quality of life were social support, severe mouth opening difficulty (grade Ⅲ and Ⅳ), the course of primary disease (3 ～5 years, 5 ～10 years), which explained 35.6％variation in the quality of life. Conclusions The quality of life of ORNJ patients is generally lower than that of other head and neck cancer patients. The social support, severe mouth opening difficulty and course of primary disease can affect the patients' quality of life.The smaller the mouth opening (≤1 cm), the longer the course of primary disease (3～5 years) and the worse the quality of life is. Thus, nursing staff should pay attention to the quality of life of ORNJ patients and give prospective nursing intervention to improve the quality of life according to the characteristics of the development of the disease.

Objective To observe the effect of preoperative intravitreal ranibizumab injection (IVR) on the operation duration of vitrectomy and postoperative vision for the treatment of proliferative diabetic retinopathy (PDR).Methods A prospective study was carried out with the 90 PDR patients (90 eyes) who underwent vitrectomy.The 90 patients(90 eyes)were assigned to the vitrectomy only group(43 eyes) and the IVR combined with vitrectomy group (47 eyes).The IVR was performed 5-13 days prior to vitrectomy in the IVR combined with vitrectomy group.There were 15 eyes with fibrous proliferation PDR (FPDR),16 eyes with advanced PDR (APDR) without involving the macular and 16 eyes with APDR involving the macular in the vitrectomy only group.There were 14 eyes with FPDR,15 eyes with APDR without involving the macular and 14 eyes with APDR involving the macular patients in the IVR combined with vitrectomy group.All the eyes in the two groups were regularly operated by the same doctor to complete the vitrectomy.The start and end time of vitrectomy were recorded.The average follow-up time was 10 months.The changes of best corrected visual acuity (BCVA) before and 1,3 and 6 months after surgery were compared between the two groups.Results The duration of operation of the FPDR type (t=-8.300) and the APDR involving the macular type (t=-2.418) in the IVR combined with vitrectomy group was shorter than vitrectomy only group (P＜0.05).The comparison of duration of operation of the APDR without involving the macular type in the two groups has no statistically significant difference (t=-1.685,P＞0.05).At 1 month after surgery,the comparison of BCVA of the IVR combined vitrectomy group and the vitrectomy only group in APDR involving the macular type has no statistically significant difference (t=0.126,P＞0.05).At 3,6 months after surgery,the BCVA of the IVR combined vitrectomy group in APDR involving the macular type was significantly better than the BCVA of the vitrectomy only group (t=8.014,7.808;P＜0.05).At 1,3,and 6 months after surgery,the BCVA of the IVR combined vitrectomy group in FPDR type (t=3.809,1.831,0.600) and APDR without involving the macular type (t=0.003,1.092,3.931) compared with pre-treatment,the difference were not statistically significant (P＞0.05);the BCVA in APDR without involving the macular type compared with pre-treatment,the difference was distinctly statistically significant (t=2.940,4.162,6.446;P＜0.05);the BCVA in APDR involving the macular type (t =0.953,1.682,1.835) compared with pre-treatment,the difference were not statistically significant (P＞0.05).Conclusion Preoperative IVR of PDR can shorten the operation duration and improve the BCVA of APDR involving the macular type.

Objective To investigate the safety of thyroid gland resection and primary resection in the treatment of thyroid nodule and its influence to thyroid function.Methods 86 patients with thyroid nodules were selected as the research subjects.The patients were randomly divided into two groups.43 cases in the observation group implemented the thyroid gland resection treatment.43 cases in the control group received thyroid gland subtotal resection.The curative effect,safety,thyroid function and other indicators were compared between the two groups.Results The operation time and hospitalization time in the observation group after operation[(105.65 ± 12.54)min;(6.35 ± 2.01)d]were shorter than those in the control group[(149.41 ± 13.68)min;(9.62 ± 2.45)d].The amount of bleeding during operation in the control group [(134.51 ± 9.64) mL] was significantly higher than the observation group [(84.62 ± 6.35) mL],there was significant difference between the two groups (P ＜ 0.05).The total effective rate of the observation group was 95.55％,which was significantly higher than 72.09％ in the control group,the difference was statistically significant (P ＜ 0.05).Before operation,the between the two groups had no significant difference (P ＞ 0.05).After surgical treatment,serum FT3 and serum FT4 levels in two groups were decreased,but those in the observation group[(11.62 ± 3.02),(51.24 ± 7.25)pmol/L] were significantly lower than the control group [(14.14 ± 5.11) pmoL/L;(60.52 ± 6.35) pmol/L],there were obvious differences (P ＜ 0.05).The incidence rate of complications such as throat edema,hemorrhage,postoperative hoarseness in the observation group was 9.30％,which in the control group was 23.26％,the difference was statistically significant (P ＜ 0.05).Conclusion The thyroid gland resection therapy for thyroid nodules has high safety and significant curative effect,it can quickly improve the thyroid function,reduce relapse rate,has higher application value in benign and malignant tumors indistinguishable after surgery.It can reduce the length of stay in hospital,is conducive to the recovery of patients,it is worthy of clinical promotion.

Objective To enhance and improve the accuracy of data,security of system and user friendliness of on-line editing system processing ancient TCM books.Methods Web and java technology were applied to implement and demonstrate the key algorithm.Results In these solutions,pictures could be watermarked,on-line editing was supported,picture-naming was standardized with 7-characters,multi-user on-line editing was available,etc.The ancient TCM books on-line editing system became more practical,effective and user-friendly.Conclusion The solutions mentioned above have achieved the expected effects in digitalization research of ancient TCM books,showing its feasibility and practicability.

This paper put forward a construction mode of ancient books protection system for special library of traditional Chinese medicine based on the survey and analysis of ancient books protecting status. With the working experience of protecting ancient books in our library, we studied the technical system and organization system for ancient books protection, listed out the standard of technical system and content of organization system, and formed an ancient books protection system for special library of traditional Chinese medicine. This system included scientific technology, advanced methods, effective management, orderly operation and right-hand protection, which can be widely applied in our industry to promote benign and sustainable development of work in ancient books protection.

This paper firstly introduced concept,advantages,disadvantages,and application prospect of free indexing. Then the theoretical feasibility of applying free indexing in the images of TCM ancient literatures was discussed with the combination of their characteristics.In the end,the article made examples to illustrate the application of free indexing in related subjects.