Objective To compile the"expert consensus on preventive and management of exposure keratopathy"(hereinafter referred to as"consensus"),aiming to standardize and promote the prevention of exposure keratopathy(EK)in medical institutions at different levels.Methods The evidence-based methods were used to retrieve,evaluate and summarize evidence in this field according to the level of evidence,and relevant recommendations and research conclusions were extracted,and the first draft of consensus was formed.After 2 rounds of Delphi expert letters and expert meetings,combined with evidence and expert opinions,the consensus content is written,adjusted and modified,and recommendations were made.Results 58 experts were invited to participate in the consultation.The expert positive coefficient was 100％;the expert judgment basis of the 2 rounds were 0.940 and 0.936;the degree of familiarity of the 2 rounds were 0.779 and 0.797;the coefficient of authority of the 2 rounds were 0.859 and 0.866.The Kendall W coefficients of the 2 rounds of inquiry were 0.099 and 0.117,and the difference was statistically significant(P＜0.05).The consensus includes 5 aspects of EK:risk factors,assessments,protection measures,symptom management and training and management.Conclusion The consensus was based on the existing evidence and clinical practical requirements and recommendations of experts in the field.Consensus can provide guidance for clinical nursing staff in prevention,nursing and management of EK effectively.

Objective:To observe the effectiveness of combining mirror therapy with pneumatic flexible glove training in treating hand dysfunction after a stroke. Its effect on cerebral cortex activation was documented using near-infrared functional imaging of the brain.Methods:A total of 84 stroke survivors with hand dysfunction were randomly divided into a Mirror Group, a Glove Group and a Combined Group, each of 28. In addition to standard rehabilitation training, the Glove Group received 20 minutes of training with a pneumatic soft glove, 5 days per week for 6 consecutive weeks. The Mirror Group received mirror therapy (MT). The Combined Group was given both simultaneously. Before and after the treatment, everyone′s upper limb functioning was evaluated (using the Fugl-Meyer Upper Limb Assessment (FMA-U)), along with their hand motor skills (using the Arm Action Test (ARAT)) and their ability in daily living activities (using the Barthel Index (BI)). Functional near-infrared spectroscopy (fNIRS) was employed to measure any changes in oxygenated hemoglobin (HBO) concentration at 730nm and 850nm wavelengths.Results:The FMA-U, ATAT and BI scores in both the proximal and distal regions of all three groups showed significant improvement after the treatments compared to pre-treatment levels. The combined group demonstrated significantly better distal FMA-U and ARAT scores after the treatment (12.25±8.80 and 20.93±15.68 respectively), outperforming both the glove and mirror groups. The infrared spectroscopy revealed that bilateral SM1 activation, affected-side somatosensory association cortex (SAC) and supplementary motor cortex excitability in both the mirror and combined groups were significantly better than among the glove group after the experiment.Conclusions:Combined with pneumatic flexible glove training, mirror therapy can not only significantly improve the hand function of stroke survivors, but also activate the relevant brain regions of both hemispheres through bilateral motor patterns combined with multisensory stimulation, promoting the balance between hemispheres.

Objective To compile the"expert consensus on preventive and management of exposure keratopathy"(hereinafter referred to as"consensus"),aiming to standardize and promote the prevention of exposure keratopathy(EK)in medical institutions at different levels.Methods The evidence-based methods were used to retrieve,evaluate and summarize evidence in this field according to the level of evidence,and relevant recommendations and research conclusions were extracted,and the first draft of consensus was formed.After 2 rounds of Delphi expert letters and expert meetings,combined with evidence and expert opinions,the consensus content is written,adjusted and modified,and recommendations were made.Results 58 experts were invited to participate in the consultation.The expert positive coefficient was 100％;the expert judgment basis of the 2 rounds were 0.940 and 0.936;the degree of familiarity of the 2 rounds were 0.779 and 0.797;the coefficient of authority of the 2 rounds were 0.859 and 0.866.The Kendall W coefficients of the 2 rounds of inquiry were 0.099 and 0.117,and the difference was statistically significant(P＜0.05).The consensus includes 5 aspects of EK:risk factors,assessments,protection measures,symptom management and training and management.Conclusion The consensus was based on the existing evidence and clinical practical requirements and recommendations of experts in the field.Consensus can provide guidance for clinical nursing staff in prevention,nursing and management of EK effectively.

Objective:To observe the effectiveness of combining mirror therapy with pneumatic flexible glove training in treating hand dysfunction after a stroke. Its effect on cerebral cortex activation was documented using near-infrared functional imaging of the brain.Methods:A total of 84 stroke survivors with hand dysfunction were randomly divided into a Mirror Group, a Glove Group and a Combined Group, each of 28. In addition to standard rehabilitation training, the Glove Group received 20 minutes of training with a pneumatic soft glove, 5 days per week for 6 consecutive weeks. The Mirror Group received mirror therapy (MT). The Combined Group was given both simultaneously. Before and after the treatment, everyone′s upper limb functioning was evaluated (using the Fugl-Meyer Upper Limb Assessment (FMA-U)), along with their hand motor skills (using the Arm Action Test (ARAT)) and their ability in daily living activities (using the Barthel Index (BI)). Functional near-infrared spectroscopy (fNIRS) was employed to measure any changes in oxygenated hemoglobin (HBO) concentration at 730nm and 850nm wavelengths.Results:The FMA-U, ATAT and BI scores in both the proximal and distal regions of all three groups showed significant improvement after the treatments compared to pre-treatment levels. The combined group demonstrated significantly better distal FMA-U and ARAT scores after the treatment (12.25±8.80 and 20.93±15.68 respectively), outperforming both the glove and mirror groups. The infrared spectroscopy revealed that bilateral SM1 activation, affected-side somatosensory association cortex (SAC) and supplementary motor cortex excitability in both the mirror and combined groups were significantly better than among the glove group after the experiment.Conclusions:Combined with pneumatic flexible glove training, mirror therapy can not only significantly improve the hand function of stroke survivors, but also activate the relevant brain regions of both hemispheres through bilateral motor patterns combined with multisensory stimulation, promoting the balance between hemispheres.

Innate immunity is the first line of the host cell defensing against viral infection,in which the pattern recognition re-ceptors(PRRs)such as Toll-like receptors(TLRs)and retinoic acid induces gene Ⅰ-like receptors(RLRs)play an important role.After virus infection,mitochondrial antiviral signaling protein(MAVS)in PRRs-mediated signaling pathway,which are of the com-mon linker molecule for downstream signal transmission,can receive signals transmitted by upstream TLR and RIG-Ⅰ,activate down-stream NF-κB and IRF3/7 signaling pathways leading to the activation of interferon(IFN)expression.Therefore MAVS acts as a bridge in the innate immune signaling pathway.More and more studies have shown that viruses have evolved a series of mechanism to escape the innate immune response over the long course of their evolution,and evaded the host's antiviral immune response by interfer-ing with multiple sites in the MAVS-mediated signaling pathway so as to complete its own replication and proliferation.In this paper,the role of MAVS in IFN-Ⅰ pathway and its latest research progress in the mechanism of anti-DNA viruses and anti-RNA viruses reac-tion are reviewed,providing theoretical basis for further studying the detailed mechanism of anti-virus of MAVS.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective To explore the effectiveness of a double preemptive analgesia protocol in the perioperative period for adolescents undergoing arthroscopic medial patellofemoral ligament(MPFL)re-construction.Methods Totally 104 adolescents with recurrent patellar dislocation and undergoing ar-throscopic MPFL reconstruction between April 2023 and November 2023 were analyzed retrospectively.Among them,47 were selected into a double preemptive analgesia(DPA)group,while the rest 57 were chosen into the control group.DPA group received preemptive analgesia on the days before and of the surgery,and the control group was given traditional perioperative and individualized postopera-tive analgesia.The Numerical Rating Scale(NRS)pain scores were recorded for both groups at admis-sion,right after returning to the ward postoperatively,at 6,12,24 and 48 hours after operation post-operatively,as well as at the time of the first attempt to bear weight.The time and frequency of res-cue analgesia,the time to the first straight leg raise,and the time to first bearing weight were record-ed for both groups.Moreover,adverse reactions were observed,and patient satisfaction scores were col-lected from family members before their discharge.Results There was no significant difference in pain scores between the two groups at admission.However,from 6 to 48 hours postoperatively,the NRS pain scores of DPA group were significantly lower than the control group at the same time points(P＜0.05).Moreover,compared with the control group,DPA group had significantly fewer times of rescue analgesia,higher patient satisfaction,and earlier time for first straight leg raise(P＜0.05).There were no severe postoperative complications in either DPA group or the control.However,mild adverse reac-tions occurred in 7(14.8％)of the DPA group and 8(14.1％)of the control group,mainly nausea,which mostly appeared on the day of surgery and improved without special treatment on the same day.Conclusions The double preemptive analgesia protocol can effectively reduce postoperative pain in ado-lescents undergoing arthroscopic MPFL reconstruction,accelerate postoperative recovery,enhance the confidence of adolescents and their families in rehabilitation,and improve satisfaction,providing a ref-erence for future clinical practice.

Objective To explore the effectiveness of a double preemptive analgesia protocol in the perioperative period for adolescents undergoing arthroscopic medial patellofemoral ligament(MPFL)re-construction.Methods Totally 104 adolescents with recurrent patellar dislocation and undergoing ar-throscopic MPFL reconstruction between April 2023 and November 2023 were analyzed retrospectively.Among them,47 were selected into a double preemptive analgesia(DPA)group,while the rest 57 were chosen into the control group.DPA group received preemptive analgesia on the days before and of the surgery,and the control group was given traditional perioperative and individualized postopera-tive analgesia.The Numerical Rating Scale(NRS)pain scores were recorded for both groups at admis-sion,right after returning to the ward postoperatively,at 6,12,24 and 48 hours after operation post-operatively,as well as at the time of the first attempt to bear weight.The time and frequency of res-cue analgesia,the time to the first straight leg raise,and the time to first bearing weight were record-ed for both groups.Moreover,adverse reactions were observed,and patient satisfaction scores were col-lected from family members before their discharge.Results There was no significant difference in pain scores between the two groups at admission.However,from 6 to 48 hours postoperatively,the NRS pain scores of DPA group were significantly lower than the control group at the same time points(P＜0.05).Moreover,compared with the control group,DPA group had significantly fewer times of rescue analgesia,higher patient satisfaction,and earlier time for first straight leg raise(P＜0.05).There were no severe postoperative complications in either DPA group or the control.However,mild adverse reac-tions occurred in 7(14.8％)of the DPA group and 8(14.1％)of the control group,mainly nausea,which mostly appeared on the day of surgery and improved without special treatment on the same day.Conclusions The double preemptive analgesia protocol can effectively reduce postoperative pain in ado-lescents undergoing arthroscopic MPFL reconstruction,accelerate postoperative recovery,enhance the confidence of adolescents and their families in rehabilitation,and improve satisfaction,providing a ref-erence for future clinical practice.

The classic formula Wuyaotang is the 49^th of the 100 formulas in the Catalogue of Ancient Classic Prescriptions (First Batch) issued by the National Administration of Traditional Chinese Medicine, and is from the Secrets from the Orchid Chamber (《兰室秘藏》) by LI Dongyuan of the Jin Dynasty. It is composed of Angelicae Sinensis Radix, Glycyrrhizae Radix et Rhizoma, Aucklandiae Radix, Linderae Radix, and Cyperi Rhizoma, and has the effect of moving Qi, regulating meridians, and relieving pain. It is mainly indicated for Qi stagnation and blood stasis syndrome. Based on the ancient books on Wuyaotang, this study systematically reviewed the formula source, composition, dosage, preparation, usage, functions, indications, preparation principle, drug processing, modification, etc. of Wuyaotang with the bibliometrics method, explored its historical evolution, and determined the key information. Statistical analysis of its modern literature shows that there are few studies of the original formula of Wuyaotang, and the clinical studies mainly focus on modified Wuyaotang. It has a wide range of treatment scope and can be used for the treatment of dysmenorrhea, delayed menstrual cycle, hypomenorrhea, and menstrual fever, as well as ulcerative colitis, spleen distortion, sciatica, child intestinal spasm, and other internal, surgical, gynecological, and pediatric diseases. The pathogenesis in traditional Chinese medicine (TCM) is Qi stagnation. Through the analysis and research on ancient books and modern literature recording Wuyaotang, this study is expected to provide a scientific basis for the clinical application, in-depth research, and development of the classic formula Wuyaotang.

Background Based on numerous epidemiological studies, radionuclide ¹³¹I can result in thyroid disease. Objective To study the contamination level of thyroid ¹³¹I in ¹³¹I treatment associated radiation workers in nuclear medicine departments in Shanghai. Methods Based on a general survey on basic situation of nuclear medicine in Shanghai, the level of internal exposure of radiation workers involved in ¹³¹I treatment was assessed with questionnaires and on-site monitoring. A portable γ spectrometer was used for on-site detection, the intake and annual effective dose were estimated according to the measurement results. Physical examination reports were collected for radionuclide positive workers, and chromosome testing was performed. Results There were 579 nuclear medicine workers and 175 were engaged in ¹³¹I treatment in Shanghai. ¹³¹I was detected in thyroid of 18 workers, with a detection rate of 10.3%. Among them, the detection rates of thyroid ¹³¹I in nurses and cleaners were 23% and 25% respectively. The mean measured activity of thyroid ¹³¹I was 306.1 Bq and the maximum measured activity was 3716.9 Bq (nurse). The maximum intake was estimated at 37544 Bq and the median was 786.4 Bq. The average annual committed effective dose was 1.22 mSv and the maximum value was 14.87mSv. The chromosomal aberration rates of all detected workers were negative, and all blood indicators were normal except one with low hemoglobin. Conclusion The annual dose of nuclear medical staff engaged in ¹³¹I treatment does not exceed the national standard limit, but the internal exposure of nurses and cleaners should not be ignored. On the basis of strengthening protection and decontamination, routine internal exposure monitoring should be carried out.