AIM: To investigate the relationship between objective ocular torsion and near stereopsis in patients with primary superior oblique overaction(PSOOA).METHODS: Retrospective study. A total of 59 strabismus patients with PSOOA who underwent strabismus surgery at Renmin Hospital of Wuhan University between January 2019 and November 2023 were collected. Based on the collected fundus photographs and the position of the fovea relative to the horizontal line through the optic disc, the eyes were categorized as incyclotorsion, excyclotorsion, or no cyclotorsion. Additionally, the fovea-disc angle(FDA)and the relationship between objective ocular torsion status, FDA, and near stereopsis function in the patients were further measured and analyzed.RESULTS: Totally 59 patients(92 eyes)showed superior oblique overaction. There were no cases of excyclotorsion, 32 cases with no cyclotorsion, and 27 cases with incyclotorsion. The total binocular FDA was significantly smaller in the no-cyclotorsion group compared with the incyclotorsion group(2.83°±2.89° vs 16.12°±5.74°, P<0.001). The preservation rates of near stereopsis were 66% and 15% in the no-cyclotorsion and incyclotorsion groups, respectively, with a significant statistical difference(P<0.001), and the preservation rates of fine near stereopsis were 38% and 11% in the no-cyclotorsion and incyclotorsion groups, respectively, with a significant statistical difference(P=0.02). Among all patients, near stereopsis was correlated with total binocular FDA(r=-0.526, P<0.001), with the strongest correlation observed with the FDA of the incyclotorsion(r=-0.546, P<0.001). In the incyclotorsion group, there was no correlation between near stereopsis and total binocular FDA(r=-0.366, P=0.060), with a negative correlation between near stereopsis and the FDA of both the incyclotorsion and the overaction(r=-0.424, P=0.028; r=-0.485, P=0.010). In the no-cyclotorsion group, near stereopsis was not correlated with total binocular FDA, incyclotorsion FDA, or overaction FDA.CONCLUSION:PSOOA patients with incyclotorsion have a lower preservation rate of near stereopsis than those without cyclotorsion. Near stereopsis function of patients with PSOOA is negatively correlated with total binocular FDA, especially the greater the FDA of the incyclotorsion and overaction, the worse the near-stereoscopic function.

OBJECTIVE To optimize the formulation for sustained-release particles of matrine(MAT) and paeonol(PAE) and to primarily evaluate their quality. METHODS The sustained-release particles were fabricated by the extrusion-spheronization method. Single factor analysis was conducted on the main sustained-release materials and their dosage, auxiliary sustained-release materials, and the total amount and proportion of mixed sustained-release materials, using the cumulative release rates of MAT and PAE in vitro as evaluation indicators. By combining central composition design-response surface methodology, the formulation of sustained-release materials was optimized, and the effects of the total amount and mass ratio of ethyl cellulose(EC) and chitosan(CS) on the cumulative release rate and release synchronization of MAT and PAE were investigated. The formulation characteristics, in vitro release, and preliminary stability tests of MAT-PAE-SRPs were evaluated, and the release process kinetic equation was fitted. RESULTS The optimized formulation contained 23.5% EC and 17.1% CS as sustained-release materials. The yield, repose angle, bulk density and friability of final particles were 97.23%, 38.1°, 0.74 g·mL−1 and 0.74%, respectively. The particles showed sustained release pattern in various media and released faster in acidic media with its release percentage >90% at 12 h. The release profile of MAT was fitted best with first order equation, and that of paeonol with Higuchi equation. The formation of SRPs improved the stability of both drugs. CONCLUSION The sustained-release effect of MAT-PAE-SRPs prepared by sustained-release materials EC and CS is significant, and the cumulative release rate and release synchronization of MAT and PAE are good, which can provide reference for the research of dual loaded sustained-release formulations.

Malignant tumors have surpassed stroke and coronary heart disease to become the main cause of death before the age of 70 in the world. The incidence of malignant tumors is increasing year by year， which seriously affects the living standards and social and economic development of Chinese people. Surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy are the main means of Western medicine to intervene in tumors， which are of great significance for prolonging the survival time of patients. However， there are many disadvantages such as adverse reactions and drug resistance. Traditional Chinese medicine has become a research hotspot in recent years because of its definite curative effect and wide application in tumor treatment. Xiao Chaihutang is derived from the Treatise on Febrile and Miscellaneous Diseases. It is composed of Bupleuri Radix， Scutellariae Radix， Ginseng Radix， Pinelliae Rhizoma， Glycyrrhizae Preparata Radix， Ginger， and Jujube. It has the effects of reconciling Shaoyang， reconciling cold and heat Yin and Yang， soothing the liver， and relieving depression. This prescription and the prescriptions based on it are widely used in various stages of tumors. This study summarized the Chinese and foreign research of Xiao Chaihutang in the field of tumors in the past 10 years and explored the role and mechanism of Xiao Chaihutang in blocking precancerous lesions， controlling the development of malignant tumors， reducing the occurrence of adverse reactions after intervention， and alleviating common complications， with a view to expanding the clinical medication ideas.

Objective To evaluate the risk of cardiac adverse events in patients with malignant tumors after chemotherapy by using a combination of acoustic cardiography and blood indices.Methods A total of 171 patients with malignant tumor who received chemotherapy were included.They were divided into cardiac adverse event group and non-cardiac adverse event group in accordance with whether cardiac adverse events occurred after chemotherapy.The general data,blood indices before chemotherapy,and acoustic cardiography-related indices in the early stage(1-3 cycles)of chemotherapy of the two groups were analyzed.The possible influencing factors were determined by binary logistic regression analysis,and the nomogram was drawn.The receiver operating characteristic(ROC)curve was used to evaluate the prediction ability of the nomogram.Results Cardiac adverse events occurred in 44 of 171 patients with malignant tumors after chemotherapy,and the incidence of cardiac adverse events was 25.73%.Binary logistic regression results showed that age,red blood cell distribution width(RDW)before chemotherapy,activated partial throm-boplastin time(APTT),and electromechanical activation time(EMAT)at the early stage of chemother-apy were independent predictors of cardiac adverse events in chemotherapy patients.The area under the ROC curve of the nomogram was 0.768(95%CI:0.693-0.843,P<0.001).Conclusion A nomogram based on age,pre-chemotherapy RDW,APTT,and EMAT at the early stage of chemotherapy is useful for early assessment of the risk of cardiac adverse events in chemotherapy patients.

Objective To investigate the efficacy of rituximab combined with immunosuppressive pulse therapy for thyroid-associated ophthalmopathy(TAO)and analyze its influence on clinical activity score(CAS)and prognosis.Meth-ods A total of 136 patients(272 eyes)with TAO who were admitted to Huanggang Central Hospital from March 2020 to October 2022 were selected and divided into an observation group(68 patients)and a control group(68 patients)using a random number table method.Patients in the control group were given immunosuppressive pulse therapy,while patients in the observation group were given rituximab plus immunosuppressive pulse therapy.Both groups were treated for 4 courses(7 days per course).The clinical efficacy,eye signs,CAS score,thyroid conditions[thyrotropin receptor antibody(TRAb),thyroid peroxidase antibody(TPOAb),thyroid volume],T lymphocyte subsets,and adverse reactions were compared between the two groups.After a follow-up period of six months,the prognosis of patients in the two groups was compared.Results After 4 courses of treatment,the total effective rate of patients in the observation group was 94.12％(64/68),which was higher than that in the control group(82.35％,56/68)(P＜0.05).After 2 and 4 courses of treat-ment,the degree of exophthalmos,intraocular pressure,average palpebral fissure width,retrobulbar soft tissue volume,distance from the bulbus oculi,CAS score,TPOAb,TRAb,and thyroid volume of patients in the observation group were smaller than those in the control group,and all decreased compared to before treatment(all P＜0.05);the thickness of the tear film lipid layer was greater than that in the control group,and both increased compared to before treatment(all P＜0.05).There were no significant differences in the said indicators between the two groups before treatment(all P＞0.05).The CD3+,CD4+,and CD8+T lymphocyte levels of patients showed no significant difference between the two groups before treatment(all P＞0.05).After 2 and 4 courses of treatment,the levels of CD3+and CD4+T lymphocyte in both groups were higher than those before treatment.Except that the CD4+T lymphocyte level in the observation group was lower than that in the control group after 2 courses of treatment,the levels of CD3+and CD4+T lymphocyte in the obser-vation group were higher than those in the control group at other time points(all P＜0.05).After 2 and 4 courses of treat-ment,the level of CD8+T lymphocyte in both groups decreased compared to before treatment,and it was lower in the ob-servation group than the control group(all P＜0.05).There was no significant difference in the incidence of adverse reac-tions such as low fever,nausea,and hypokalemia between the two groups(all P＜0.05).After the 6-month follow-up,the improvement rate of patients in the observation group was 95.59％(65/68),which was higher than that in the control group(79.41％,54/68)(P＜0.05).Conclusion Rituximab combined with immunosuppressive pulse therapy is effec-tive for TAO.It can alleviate eye signs and thyroid conditions,reduce clinical activity,and promote prognosis.

Objective To rapidly evaluate the efficacy,safety,and economics of dexmedetomidine in patients on mechanical ventilation in intensive care unit(ICU),and to provide references for clinical and decision makers.Methods To search PubMed,Embase,Cochrane Library,CNKI,WanFang Data databases and official websites of domestic and foreign Health Technology assessment(HTA)institutions from the inception to June 14,2023.HTA reports,systematic reviews/Meta-analyses,and pharmacoeconomic studies of patients with mechanical ventilation in ICU compared with dexmedetomidine versus placebo or other traditional sedatives were included.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,and descriptive analyzed and summarised the results.Results A total of 13 literatures were included,including 10 systematic reviews/Meta-analyses and 3 economic studies.The analysis results of effectiveness showed that compared with placebo or other traditional sedatives,the use of dexmedetomidine in the sedation of mechanically ventilated patients in the ICU was associated with a shorter duration of mechanical ventilation and a shorter length of stay in the ICU.The analysis results of safety displayed treatment with dexmedetomidine could reduce the incidence of delirium,but may increase the incidence of bradycardia.The results of the economic analysis showed that the dexmedetomidine group had a higher cost of medication,but a lower overall ICU cost.Conclusion Dexmedetomidine has good efficacy,safety and economics in the sedation of patients on mechanical ventilation in ICU,but the economic studies included in the search were mainly foreign studies,and domestic economy studies needs to be further demonstrated.

Objective By employing surgically induced varicocele(VC)in SD rats and an apomorphine(APO)test,we screened rats with erectile dysfunction(ED)after VC and explored method to establish VC and ED models.Methods Sixty rats were randomly divided into Control,Sham,and Model groups with 20 rats in each group.Using the Turner method,we partially ligated the left renal vein to induce left VC three times.APO tests were conducted to screen rats with ED after inducing VC.The numbers of erections,genital grooming,and yawning were observed and recorded.The diameter of bilateral spermatic veins were measured.Both testises and kidneys were weighed.HE staining was used to observe pathological changes of penis and left testis.The success rate of modeling was calculated in the Model group.Results A VC and ED model was successfully established in 15 out of 20 rats in the Model group with a success rate of 75％.After modeling,the diameter of the left spermatic vein in the model group was increased significantly(P＜0.01)and was significantly larger than that before modeling(P＜0.01).The diameter of the right spermatic vein in the Model group was increased(P＜0.05)and higher(P＜0.05)than that before modeling.The weight of the left testis in the Model group was significantly decreased(P＜0.01)compared with that of the right testis.No significant difference in the bilateral kidney weights were observed between or within groups(P＜0.05).In the Model group,the numbers of erections,yawning,and genital grooming decreased significantly(P＜0.01)with the time of modeling.Pathological changes of the left testis and penis were significant in the Model group.Conclusions The Turner method increases the diameter of the spermatic vein in rats,causing testis injury and weight loss,and APO tests can be used to screen rats with ED after VC induction.The combination of the two method is suitable to establish an animal model of VC with an ED status similar to humans.

Objective To retrieve,evaluate and summarize the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis and to provide references for clinical practice.Methods We systematically searched computer decision support systems,guideline websites,association official websites and databases for evidence on prevention and nursing care of pregnancy-induced diastasis recti abdominis,including guidelines,expert consensuses,clinical decision-making,systematic reviews and randomized controlled trials.The retrieval period was from the inception of databases to January 2024.There were 4 researchers who evaluated the quality of the included literature independently,extracted and summarized the evidence according to the subject.Results A total of 18 articles were included,including 2 clinical decisions,4 guidelines,5 expert consensuses,3 systematic reviews,and 4 randomized controlled trials.24 pieces of best evidence were summarized from 5 aspects,including the antenatal prevention,team building,nursing assessment,intervention strategies,and effecti-veness evaluation.Conclusion This study summarizes the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis,which can provide a reference basis for nurses to manage diastasis recti abdominis and improve the life quality of maternal woman.

Objective:To analyze the research hot points and trend of general practice in China.Methods:It was a bibliometric analysis. Research papers presentated on Chinese Society of General Practice from 2014 to 2022 were collected. The distribution and its trend were analysed in terms of titles, submission time, research topics, methods and contents as well as authors′ affilation.Results:A total of 944 research papers were included in the analysis. The results showed a general increasing trend in number of research papers presented on annual conferences from 2014 to 2022 with some fluctuation. The papers covered 28 research dimensions; the highest number of papers was on the development of general practice system, the training and education system for general practitioners, and the construction of information technology (576 papers, 61.0%). The most common topic was on primary health services (230 papers, 24.4%), followed by education and training (225, 23.8%) and chronic disease management (212, 22.5%); while fewer papers were dealing with community-based care (39, 4.1%) and rational medication (7, 0.7%). In terms of the affiliation of the first author, 437 papers (46.3%) were from affiliated hospitals of medical universities/colleges, 223 (23.6%) from community health service institutions, 132 (14.0%) from higher education institutions, 118 (12.5%) from non-affiliated hospitals, and 35 (3.7%) were from administration institutions. In terms of regions, it covered all provinces (municipalities/autonomous regions) (including Hong Kong and Taiwan) with few overseas. Shanghai and Beijing contributed more papers than other regions. In terms of research methodology, most papers used quantitative studies (882, 93.7%), less used qualitative studies (39, 4.1%) or mixed studies (23, 2.4%).Conclusion:The analysis indicates that a wide range of contents are involved in general practice research in China, and more high-quality studies are from medical colleges/universities and their affiliated general hospitals, and most papers use quantitative studies.

Objective To establish the reference interval of glycosylated serum protein(GSP)and glycosylated hemoglobin(HbA1c)in healthy pregnant women in Korla region at 24-28 weeks of gestation,so as to provide a basis for clinical screening of gestational diabetes mellitus(GDM).Methods A total of 795 pregnant women who underwent obstetric examination and delivery in Korla Hospital of the Second Division of Xinjiang Production and Construction Corps were selected as the study objects.According to the results of oral glucose tolerance test at 24-28 weeks,pregnant women were divided into healthy study group(n=627)and GDM group(n=168).The pregnant women in health study group were divided into appropriate age group(age<35 years,n=491)and elderly group(age≥35 years,n=136)according to the age of delivery.A total of 131 healthy non-pregnant women were selected as control group.The levels of GSP and HbA1c in each group were detected,and the reference interval was established by percentile method(P2.5-P97.5).Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of GSP and HbA1c in screening GDM.Results There were statistically significant differences in GSP and HbA1c in appropriate age group,elderly group and control group(P<0.05).There was no significant difference in GSP and HbA1c between appropriate age group and elderly group(P>0.05).The reference interval of GSP and HbA1c was 188.15-257.75 μmol/L and 4.50%-5.70%in healthy pregnant women at 24 to 28 weeks of gestation,respectively.ROC curve results showed the area under the curve of GSP and HbA1c screening GDM alone was 0.803 and 0.708,respectively.Conclusion The reference interval of GSP and HbA1c were 188.15-257.75 μmol/L and 4.5%-5.7%in 24 to 28 weeks of gestation of healthy pregnant women in Kuerla region,respectively,and GSP and HbA1c had great application value in screening GDM population.