This paper summarizes Professor Gao Jiansheng's clinical experience in treating herpes simplex keratitis （HSK） based on the theory of hidden pathogens. It is believed that the core pathogenesis of HSK involves deficiency of vital qi and the internal presence of pathogenic factors. In the early stage， the pathogenesis is characterized by lung and spleen qi deficiency and invasion of external pathogens. In the middle stage， pathogenesis worsens due to latent pathogens damaging the vital qi and spleen deficiency with dampness. In the late stage， kidney yang deficiency and lingering pathogenic toxins are the root cause of recurrent attacks. In clinical practice， it is recommended to strengthen and protect the vital qi. In the early stage， the Modified Yupingfeng Powder （玉屏风散） is used. In the middle stage， the Modified Linggui Zhugan Decoction （苓桂术甘汤） is used. In the late stage， a self-formulated Modified Bushen Tuodu Fomulation （补肾托毒方） is applied. Additionally， herbs of tonifying qi and strengthening the exterior are used throughout the treatment to reduce recurrence.

Benign essential blepharospasm(BEB)is a neurological disorder characterized by involuntary contractions of periocular muscles, which can lead to functional blindness and significantly impair patients' quality of life. This article systematically reviews the epidemiology, clinical manifestations, pathogenesis, and therapeutic advances in BEB. Epidemiological data indicate that the global prevalence of BEB is approximately 1 in 200000, with a predilection for individuals over 50 years of age and a significantly higher incidence in female than in male. The exact pathogenesis of BEB remains incompletely understood, though current evidence suggests close associations with neurotransmitter dysfunction, reduced cortical inhibition, and genetic susceptibility. Therapeutic strategies primarily focus on symptomatic management. Botulinum toxin type A(BTX-A)injection remains the first-line treatment but requires repeated administrations due to transient efficacy. Other treatments, including oral drugs, surgery, and repetitive transcranial magnetic stimulation, also have major limitations. By synthesizing recent research progress from domestic and international studies, this review aims to provide novel insights for the clinical management of BEB, ultimately improving patient outcomes.

Objective: The study aims to explore the neural mechanism of cognitive differences in college students with posttraumatic stress disorder under verbal fluency task based on functional near infrared spectroscopy (fNIRS), so as to provide neuroimaging support for the evaluation, diagnosis and treatment of posttraumatic stress disorder(PTSD). Methods: Posttaumatic Stress Disorder Checklist Combat(PCL-C) was used to screen the subjects, including 21 students in PTSD group (PCL-C≥38) and 30 students in control group from September to Novenber in 2020. A 53 channel near infrared spectroscopy device was used to collect cerebral blood oxygen signals under the verbal fluency task, and correlation analysis, Mann Whitney U test and independent sample t test were performed on the results. Results: The difference in the total average score of PCL-C Scale between PTSD group and the control group(46.38±6.96，25.57±6.09) was statistically significant ( t=11.33, P <0.05). Correlation analysis showed that Avg-HbO in left dorsolateral prefrontal lobe was negatively correlated with PCL-C Score ( r=-0.37, P <0.05). Mann Whitney U test showed that in the left dorsolateral prefrontal lobe (Ch6), the Avg-HbO change in PTSD group [0.19(-0.09, 0.86)mmol/(L〖KG*7〗·mm)] was significantly lower than the control group [0.79( 0.37 , 1.47)mmol/(L ·mm)] ( Z=2.16, P <0.05), which was statistically significant. Conclusions The degree of PTSD was negatively correlated with the index of oxygenated hemoglobin in the left dorsolateral prefrontal lobe, and the oxygenated hemoglobin content in the PTSD group was lower than that in the normal group. In the future, fNIRS may be used to collect blood oxygen signals from the left dorsolateral prefrontal lobe in cognitive tasks to provide imaging evidence for the identification of PTSD.

Objective To understand the impact of system reform of salt industry on iodine nutrition of people in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments. Methods The investigation period (2014-2021) was divided into two sub-periods: before system reform of salt industry (2014-2016) and after system reform of salt industry (2017-2021). Thirty counties were selected according to the method of ^“population proportional probability sampling (PPS)^” in 2014. According to the iodine deficiency disease monitoring program of Gansu Province, from 2016 to 2021, children aged 8-10 years and pregnant women were taken as research objects to collect urine samples for urine iodine detection. Children in 2014 and 2018 were selected to measure thyroid volume. Results A total of 90 989 children urine iodine samples were investigated, and the median urinary iodine (MUI) of children was 194.70µg/L; 7 663 and 83,326 children's urinary iodine samples were investigated in the two periods, the MUI was 180.73 µg/L and 196.00 µg/L, respectively, and the difference was statistically significant (P<0.05). A total of 44 741 pregnant women's urinary iodine samples were investigated, and the MUI of pregnant women was 176.50 µg/L; 4 480 and 40 261 pregnant women's urinary iodine samples were investigated in the two periods, the MUI was 160.61 µg/L and 178.10 µg/L, respectively, and the difference was statistically significant (P<0.05). The thyroid volume of 1 555 children and 8 509 children was investigated in the two periods, the median thyroid volume was 2.70 mL and 2.55 mL , respectively, and the difference was statistically significant (P<0.05). The rates of goiter in children were 3.15% and 1.26%, respectively, and the difference was statistically significant (P<0.05). Conclusion The iodine nutrition of people in Gansu Province has not fluctuated significantly after the reform of salt industry system and has maintained an appropriate level. It is necessary to pay attention to the potential risk of insufficient iodine nutrition level and thyroid health of key populations such as children and pregnant women and strengthen health education of scientific iodine supplementation.

Objective:To explore the behavioral intention of nurses for pain management after abdominal surgery based on the planned behavior theory.Methods:According to the framework of planned behavior theory, an interview outline was developed. Using the purposive sampling method, a total of 11 General Surgical Department nurses from the First Affiliated Hospital of Wenzhou Medical University from July to November 2022 were selected as the interview subjects for semi-structured interviews to understand their behavioral intentions regarding postoperative pain management in abdominal surgery. Colaizzi 7-step analysis was used to analyze the original data. Two researchers repeatedly compared, verified, analyzed and summarized the interview data. When different opinions were generated, the group members discussed and decided together to ultimately determine the code and theme.Results:Based on the three dimensions of behavioral attitude, subjective norms and perceived behavioral control in the theoretical framework of planned behavior, three themes and seven sub-themes were extracted, such as behavioral attitude (positive attitude, negative attitude), pressure sources (group pressure, leadership pressure, patient and family pressure), subjective perception and behavior (imprisonment of comfort zone, insufficient support from external resources) .Conclusions:Most nurses hold a positive attitude towards pain management behavior after abdominal surgery, and the behavioral intention of postoperative pain management is affected by colleagues, leaders, patients and their families. At the same time, there are also obstacles such as insufficient personal ability and insufficient support from external resources.

Objective:To evaluate the testing capability of urinary iodine laboratories in Gansu Province and analyze the existing problems.Methods:Z-score method and uncertainty analysis were used to analyze the external quality control assessment results of urinary iodine laboratories in Gansu Province from 2017 to 2021 (data were collected from Gansu Center for Disease Prevention and Control).Results:From 2017 to 2021, the participation rate in the assessment of urinary iodine laboratories in the province was 100.0% (473/473), the feedback rate was 99.8% (472/473), and the pass rate was 91.9% (434/472). The pass rates for assessment from 2017 to 2021 were 82.7% (62/75), 93.9% (93/99), 94.9% (93/98), 92.0% (92/100), and 94.0% (94/100), respectively. The pass rates for provincial, municipal, and county assessments were 5/5, 98.6% (69/70), and 90.7% (360/397), respectively. The proportions of │Z│≤2, 2 <│Z│ < 3, and│Z│≥3 between laboratories in the province were 84.5% (399/472), 9.3% (44/472), and 6.2% (29/472), respectively. The proportions of│Z│≤2, 2 <│Z│ < 3, and│Z│≥3 within the laboratories were 88.6% (418/472), 9.1% (43/472), and 2.3% (11/472), respectively. There was a significant difference in the composition of │Z│ scores between laboratories annually (χ 2 = 24.60, P = 0.002), the proportion of│Z│≤2 increased from 66.7%(50/75) in 2017 to 90.0% (90/100) in 2021. The│Z│ scores between and within provincial laboratories were both ≤2. The proportion of │Z│≤2 between municipal and county-level laboratories was 91.4% (64/70) and 83.1% (330/397), respectively, the proportion of│Z│≤2 within laboratories was 92.9% (65/70) and 87.7% (348/397), respectively. There was no difference in the composition of│Z│ scores between and within provincial, municipal, and county-level laboratories( P < 0.05). The proportion of two concentration quality control blind sample results in the province that were both within the uncertainty range was 89.2% (421/472). From 2017 to 2021, they were 81.3% (61/75), 91.9% (91/99), 84.7% (83/98), 92.0% (92/100), and 94.0% (94/100), respectively, with statistically significant differences (χ 2 = 9.69, P = 0.021); provinces, cities, and counties were 5/5, 95.7% (67/70), and 87.9% (349/397), respectively, with statistically significant differences (χ 2 = 23.60, P = 0.023). Conclusions:Through continuous external quality control assessments of all established urinary iodine laboratories in Gansu Province, the overall testing capacity of urinary iodine laboratories at all levels has been continuously improved. However, in the future, it is still necessary to strengthen laboratory testing capabilities and improve the level of urine iodine detection.

Objective To explore the correlation between the expression levels of neutrophil extracellular traps(NETs)markers circulating free DNA(cfDNA),citrullinated histone 3(CitH3),myeloperoxidase(MPO)-DNA in plasma and the degree of retinopathy in patients with type 2 diabetes mellitus(T2MD).Methods A sum of 80 patients with type 2 diabetes mellitus(T2DM)in First Affiliated Hospital of Henan University of Science and Technology from January to September 2023 were selected as the study objects.According to the retinopathy of T2DM patients,they were divided into non-diabetic retinopathy(NDR)group(n=30),nonproliferative diabetic retinopathy(NPDR)group(n=26)and proliferative diabetic retinopathy(PDR)group(n=24).General data of enrolled patients were collected and plasma cfDNA,CitH3,MPO-DNA levels were detected.Spearman correlation was used to analyze the relationship between cfDNA,CitH3,MPO-DNA and the severity of retinopathy in T2DM patients.ROC curves were used to analyze the efficacy of cfDNA,CitH3,MPO-DNA and their combination in predicting the occurrence of diabetic retinopathy(DR)in T2DM patients.Results The levels of cfDNA(65.13±18.28,83.34±20.10,114.52±32.36 ng/ml),CitH3(17.76±4.24,22.03±5.01,26.06±8.13 ng/ml)and MPO-DNA(0.31±0.04,0.35±0.05,0.45±0.05)in NDR group,NPDR group and PDR group were increased successively,and the differences were statistically significant(F=28.755,13.335,62.470,all P＜0.001).The levels of cfDNA,CitH3 and MPO-DNA in PDR group and NPDR group were higher than those in NDR group(t=7.076,4.837,11.436;3.550,3.455,3.324),and the levels of cfDNA,CitH3,and MPO-DNA in PDR group were higher than those in NPDR group(t=4.127,2.128,7.065),and the differences were statistically significant(all P＜0.05).Spearman correlation analysis showed that cfDNA,CitH3 and MPO-DNA were positively correlated with the severity of retinopathy in T2DM patients(r=0.659,0.470,0.744,all P＜0.001).ROC curves showed that the AUC(95%CI)of cfDNA,CitH3,MPO-DNA and combined detection were 0.846(0.758～0.934),0.776(0.674～0.878),0.847(0.764～0.930)and 0.938(0.889～0.987),respectively,and it had certain predictive value for DR in T2DM patients.Conclusion The levels of NETs markers cfDNA,MPO-DNA and CitH3 in the plasma of DR Patients are increased,and their levels are positively correlated with the degree of diabetic retinopathy,which can predict the occurrence of DR in T2DM patients to a certain extent,and the combined prediction value is the highest.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

Objectives:To investigate the potential classification of quality of life in HIV-infected men who have sex with men (HIV-infected MSM) and to analyze possible influencing factors of different categories.Methods:A questionnaire survey was conducted among HIV-infected MSM who received antiretroviral treatment (ART) in an infectious disease hospital in Ji'nan, Shandong Province from October to December 2020. The quality of life scores in six domains were analyzed by latent profile analysis (LPA), and possible related factors of potential classification were explored by ordinal logistic regression analysis.Results:A total of 584 HIV-infected MSM were included in this study. LPA divided their quality of life into three categories, named low score, medium score and high score groups, accounting for 34.4% (201/584), 49.8% (291/584), and 15.8% (92/584), respectively. Multivariate ordinal logistic regression analysis showed that age above 40 years (a OR=1.77, 95% CI:1.11-2.80), monthly average income of 3 000 Yuan and below (a OR=3.15, 95% CI:1.72-5.76), monthly average income of 3 001-5 000 Yuan (a OR=2.26, 95% CI:1.41-3.62), distance to the hospital to receive drugs farer than 40 kms (a OR=1.76, 95% CI:1.07-2.89), and adverse reactions after taking drugs (a OR=2.31, 95% CI:1.65-3.23) were factors associated with low level of quality of life. Conclusions:The qualities of life of HIV-infected MSM showed group heterogeneity and were at high levels. Attention should be focused on HIV-infected MSM who are at older age, with low income, and long distance to access the health facilities. The measures should be taken to reduce the adverse reactions of ART drugs and improve the quality of life.

Objectives:To understand the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and related factors in men who have sex with men (MSM) in Shandong Province, and provide reference for the promotion of PrEP and PEP in MSM.Methods:From April to July in 2022, MSM were recruited from 7 sentinel surveillance sites in Shandong Province for a questionnaire survey, and the sample size of each city site was 400. The information about sociodemographic characteristics, sexual behaviors, the uses of PrEP and PEP and others were collected from the MSM, and blood samples were collected from them for HIV and syphilis testing.Results:A total of 2 815 MSM were investigated, the majority of them were aged less than 30 years (55.7%, 1 569/2 815), unmarried (68.6%, 1 931/2 815) and had education background of college and above (56.5%, 1 590/2 815). Only 9.2% (258/2 815) had used PrEP and 10.8% (305/2 815) had used PEP. Multivariate logistic regression showed that factors associated with high likelihood of PrEP use in MSM included age ≤30 years (a OR=4.04, 95% CI:1.25-13.01), self-perceived lower risk of HIV infection (a OR=1.76, 95% CI:1.16-2.68), group sex and commercial sex in the past six months (a OR=1.51, 95% CI: 1.10-2.09; a OR=1.69, 95% CI: 1.16-2.47), new-type drug use (a OR=1.53, 95% CI: 1.11-2.11), receiving peer education (a OR=1.56, 95% CI: 1.03-2.37), other people using PrEP (a OR=3.29, 95% CI: 2.48-4.36), and being HIV negative (a OR=8.40, 95% CI:1.12-63.12). Factor associated with low likelihood of PrEP use in MSM was anal sex with casual partner (a OR=0.67, 95% CI:0.49-0.90). Factors associated with high likelihood of PEP use in MSM included age under 50 years (≤30 years old: a OR=2.41, 95% CI:1.02-5.69; 31-49 years old: a OR=3.33, 95% CI:1.42-7.85), no self-perceived risk for HIV infection (a OR=1.87, 95% CI:1.12-3.11), group sex in the past six months (a OR=1.68, 95% CI:1.23-2.29), new-type drug use (a OR=3.86, 95% CI:2.94-5.07) and receiving no peer education (a OR=1.54, 95% CI:1.12-2.12). Conclusions:In Shandong, a higher proportion of MSM used PrEP and PEP. Peer education and self-perceived HIV infection risk education should be strengthened to increase the rates of PrEP and PEP use in MSM.