AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS: This retrospective study included patients who first received conbercept injections for RVO-ME at Yijishan Hospital of Wannan Medical College from December 1, 2017, to March 31, 2022. Data on disease duration, age, hypertension, OCT images, central macular thickness(CMT), and best-corrected visual acuity(BCVA)were collected before and at 4-6 wk after treatment. Patients were divided into 4 groups according to different types of macular edema: cystoid macular edema(CME), sponge-like diffuse retinal thickening(SDRT), serous retinal detachment(SRD), and mixed type(FULL). Changes in CMT and visual acuity before and after treatment were compared among the groups to analyze differences in the effect of conbercept treatment on different ME types, and the effect of baseline CMT and visual acuity on post-treatment visual acuity.RESULTS: Totally 139 patients(139 eyes)were classified as having macular edema, including 62 males(44.6%)and 77 females(55.4%), with a mean age of 58.9±10.9 years, and they were divided into 4 groups based on different types of macular edema, including 54 cases(54 eyes)(mean age 59.6±11.1 years)in the CME group, 23 cases(23 eyes; mean age 56.6±10.2 years)in the SDRT group, 22 cases(22 eyes; mean age 57.8±12.0 years)in the SDR group, and 40 cases(40 eyes; mean age 60.0±10.7 years)in the FULL group. There were no significant differences in the duration of disease or age between groups(P>0.05). There was a significant difference in preoperative CMT between groups(P=0.01, one-way ANOVA), with the CMT in the FULL group being significantly greater than that in the SDRT group(P=0.03). There were no significant differences in pre-treatment visual acuity between the four groups(P=0.26). After conbercept treatment, the macular central recess thickness was reduced and visual acuity was improved in all four groups, among which the CMT in the CME and FULL groups was reduced significantly compared with the other two groups(P<0.05), and the visual acuity in the CME and SRD groups was improved significantly compared with the other two groups(P<0.05). Postoperative visual acuity was negatively correlated with preoperative CMT(P=0.044)and positively correlated with preoperative visual acuity(P<0.01).CONCLUSION:The efficacy of intravitreal conbercept in the treatment of RVO and macular edema may be related to the type of edema observed on OCT images, in which the efficacy is best in patients with CME but poor in patients with SDRT.

Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

A 72-year-old male patient presented with dry mouth and dry eyes, accompanied by decreased vision for more than 3 months, and the symptoms worsened over 5 weeks with parotid gland enlargement. PET/CT revealed increased metabolic activity in multiple nodules involving the lymph nodes, lacrimal glands, parotid glands, lungs, spleen, and muscles. Serum angiotensin-converting enzyme was significantly elevated. Biopsies of the parotid gland and lymph nodes revealed a large number of granulomatous lesions. The patient was given prednisone tablets combined with mycophenolate mofetil immunotherapy. Subsequently, the bilateral parotid gland swelling subsided, and the pulmonary patchy shadows, splenic nodules, and muscular nodules all either regressed or disappeared. A diagnosis of sarcoidosis involving multiple organs was established. However, during treatment, the pulmonary patchy shadows reappeared. After increasing the hormone dose, the pulmonary imaging manifestations again diminished or vanished, indicative of recurrent sarcoidosis. Therefore, atypical pulmonary manifestations of sarcoidosis may easily result in missed or incorrect diagnoses, emphasizing the importance of multisite histopathological biopsy. Besides, a favorable treatment response serves as additional supportive evidence for the diagnosis. Maintaining vigilance for disease recurrence is essential during hormone and immunosuppressive therapy.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objective To explore the influence of general medicine combined with family motivation management on the prognosis of cardiovascular and cerebrovascular disease patients.Methods A total of 120 cardiovascular and cerebrovascular diseases patients who received medical care at the First People's Hospital ofFuyang District from October 2023 to October 2024 were selected as subjects.They were divided into control group(n=60)and study group(n=60)by using a random number table method.Control group received standard nursing interventions,while study group underwent combined general medicine and family motivation management.Psychological status was assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),with quality of life and self-management ability evaluated using the World Health Organization quality of life brief scale(WHOQOL-BREF)and exercise of self-care agency scale(ESCA).The triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),readmission rate and average length of stay before and after intervention were compared between two groups.Results After intervention,both groups showed decreased SAS and SDS scores,while WHOQOL-BREF scores and ESCA levels increased.Score of study group were statistically significant better than that of control group(P＜0.05).After intervention,HDL-C levels rose in both groups,whereas LDL-C,TG,and TC levels decreased.The improvement of each index in study group was better than that in control group(P＜0.05).The rehospitalization rate and average length of stay in study group were significantly lower than those in control group(P＜0.05).Conclusion The combination of general medicine and family motivation management can effectively optimize the prognosis of cardiovascular and cerebrovascular disease patients.

To address the issue of reduced signal quality of photoplethysmography caused by local fluctuation,an approach called locally orthogonal weighted polynomial fitting(LOWPF)is proposed for signal smoothing.After determining the positions of the fluctuation sequences using the forward-backward difference XOR method,weighted polynomial fitting is applied to these sequences,and the fitted values are used to replace the fluctuation sequences to achieve signal smoothing.By constructing orthogonal basis functions,the condition number of the coefficient matrix is reduced,and the stability of the equation system solution for higher-order fitting is improved.Simulation results demonstrate that the smoothed signal's XOR smoothness of the proposed method surpasses that of the moving average algorithm and the empirical mode decomposition reconstruction algorithm.The smoothing results on 241 sets of measured PPG signals show that LOWPF achieves an efficiency of smoothness of 89.10%,significantly higher than the 78.05%of empirical mode decomposition and the 59.13%of the 5-point moving average algorithm.LOWPF has promising application prospects for smoothing signals with significant local fluctuations.

AIM:To study the effect of Sanhuang Gel on the expression of TLRs/NLRP3 signal path-way in auricle acne model rats,and to explore its mechanism in treating acne inflammatory injury.METHODS:A rat model of auricular acne was in-duced by applying 100％oleic acid to the opening of the right ear catheter and injecting Propionibac-terium acnes.Rats were divided into normal group,model group,positive control group(clindamycin hydrochloride gel 10 mg/g)and Sanhuang Gel high,medium and low dose groups(280,140 and 70 mg/g).Each drug group was given drug intervention for 28 days.The changes of auricle skin lesions in each group were observed;Hematoxylin-eosin(HE)staining was used to observe the pathological changes of auricle acne.The ultrastructural chang-es of auricle tissue cells were observed by transmis-sion electron microscope(TEM).The distribution and expression changes of TLR2 and TLR4 in rat au-ricle tissue were detected by immunofluorescence.The expressions of TLR2,TLR4,NLRP3,ASC and Cas-pase-1 mRNA in rat auricle were detected by Real-time PCR.The expressions of TLR2,TLR4,NLRP3,ASC and Caspase-1 in rat auricle were detected by Western blot.RESULTS:Compared with the normal group,papules,pustules,inflammatory cell infiltra-tion and obvious edema of mitochondria can be seen in the auricle tissue of the model group.The mRNA and protein expression levels of TLR2,TLR4,NLRP3,ASC andCaspase-1 increased significantly(P＜0.01).Compared with the model group,the ap-pearance and pathological damage of auricle in each treatment group were obviously alleviated,and the morphology and structure of mitochondria returned to normal.The mRNA expression levels of TLR2,TLR4,NLRP3,ASC and Caspase-1 decreased significantly(P＜0.01).The expression levels of TLR2,TLR4,NLRP3,ASC and Caspase-1 in positive control group and high and middle dose groups de-creased(P＜0.01,P＜0.05).The expression levels of ASC and Caspase-1 protein in low dose group were significantly decreased(P＜0.01),but there was no significant difference in the expression levels of TLR2,TLR4 and NLRP3 protein(P＞0.05).CONCLU-SION:Sanhuang Gel can improve the pathological damage of auricle tissue and reduce immune in-flammatory reaction in acne rats,and its mecha-nism may be related to regulating TLRs/NLRP3 sig-naling pathway.

Objective To investigate the CT and MRI features of giant cell reparative granuloma(GCRG)in lateral skull base.Methods The CT,MRI and clinicopathological data of 8 patients with GCRG in lateral skull base were collected and analyzed.Results All of the eight lesions were unilateral and solitary(three on the left side and five on the right side),with widespread involvement affecting two or more bony structures of the lateral skull base.All lesions showed expansile and lytic bone destruction on CT scans,the margins were clear(7/8),and the sclerotic changes could be seen at the margin of all eight lesions.On MRI,the lesions revealed heterogeneous isointense and hypointense on T1WI,and heterogeneous hypointense with focal cystic changes on T2WI,without fluid-fluid levels.The enhanced scan showed heterogeneous enhancement.Seven cases extended to the middle cranial fossa,caused com-pression of the temporal lobe brain tissue,with thickened and strengthened adjacent meninges.Conclusion The GCRG in lateral skull base has certain characteristic appearances on CT and MRI;understanding these characteristic manifestations can provide a basis for accurate diagnosis.