Objective To investigate the therapeutic effect of folic acid combined with decitabine in diabetic retinop-athy(DR)mice with different methylenetetrahydrofolate reductase(MTHFR)genotypes.Methods The DR model mice were created by mating 20 MTHFR-/-mice with 20 wild-type C57 mice.A random number table method was employed to allocate 20 successfully modelled mice into the model group,DAC group,FA group,and FA+DAC group,with five mice assigned to each group.Five untreated MTHFR-/-and wild-type mice served as normal control.After constructing the DR model,the DAC group was injected intraperitoneally with 0.25 mg·kg-1 decitabine once every 5 days;the FA group was given 70 μg·kg-1 folic acid by tube feed once a day;the FA+DAC group was given 0.25 mg·kg-1 decitabine and 70μg·kg-1 folic acid at the same time;and the normal group was given an equal amount of physiological saline.All of the above groups were intervened for 30 days.OCT was employed for the measurement of retinal thickness,OCTA for retinal vascular density,histopathology(HE staining)for pathological changes in the mouse retina,real-time fluorescence quanti-tative PCR for mRNA expression,and Western blot analysis for protein expression levels.Results Compared with the wild-type model group,the degree of increase in retinal thickness and vascular density in the retinal layer was more pro-nounced in the MTHFR-/-mice model group(all P＜0.05).In wild-type mice,retinal thickness and retinal layer vessel den-sity were reduced in the DAC,FA and FA+DAC groups compared to the model group,with the FA+DAC group show-ing the greatest degree of reduction.The differences were all statistically significant(all P＜0.05);In MTHFR-/-mice,reti-nal thickness and vascular density in the retinal layer were reduced in the DAC group and the FA+DAC group compared to the model group(allP＜0.05).HE staining results showed an increased extent of retinal damage in the MTHFR-/-mice model group compared with the wild-type mice model group.Compared with the model group,the DAC group and the FA+DAC group had thinner retinas and more aligned ganglion cell layers in all types of mice,with the FA group having a worse effect and the FA+DAC group having a better treatment effect.The results of the polymerase chain reaction(PCR)revealed that the relative expression of the SAHH,MAT2A and DNMT1 proteins in the retinal tissues of the wildtype and MTHFR-/-mice model groups was elevated in comparison to the control group(all P＜0.05).Furthermore,the relative mR-NA expression of the DAC,FA and FA+DAC groups was reduced in comparison to the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein mRNA was decreased in the model group compared with the con-trol group,and increased in the DAC group,FA group,and FA+DAC group compared with the model group(all P＜0.05).Western blot results showed that the relative expression of DNMT1,MAT2A and SAHH proteins in the retinal tissues of the wild-type and MTHFR-/-mice model groups was higher than that of the control group(all P＜0.05),and the relative expression was lower in the DAC,FA,and FA+DAC groups compared with that in the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein in the retinal tissue of the model group was lower than that of the control group,and the relative expression of MTHFR protein in the FA group and the FA+DAC group was elevated com-pared with that of the model group(all P＜0.05).Conclusion The protective effect of folic acid combined with decit-abine on DR was superior to that of decitabine alone;treatment with folic acid in combination with decitabine may have yielded better efficacy in wild-type DR mice.

Objective To investigate the therapeutic effect of folic acid combined with decitabine in diabetic retinop-athy(DR)mice with different methylenetetrahydrofolate reductase(MTHFR)genotypes.Methods The DR model mice were created by mating 20 MTHFR-/-mice with 20 wild-type C57 mice.A random number table method was employed to allocate 20 successfully modelled mice into the model group,DAC group,FA group,and FA+DAC group,with five mice assigned to each group.Five untreated MTHFR-/-and wild-type mice served as normal control.After constructing the DR model,the DAC group was injected intraperitoneally with 0.25 mg·kg-1 decitabine once every 5 days;the FA group was given 70 μg·kg-1 folic acid by tube feed once a day;the FA+DAC group was given 0.25 mg·kg-1 decitabine and 70μg·kg-1 folic acid at the same time;and the normal group was given an equal amount of physiological saline.All of the above groups were intervened for 30 days.OCT was employed for the measurement of retinal thickness,OCTA for retinal vascular density,histopathology(HE staining)for pathological changes in the mouse retina,real-time fluorescence quanti-tative PCR for mRNA expression,and Western blot analysis for protein expression levels.Results Compared with the wild-type model group,the degree of increase in retinal thickness and vascular density in the retinal layer was more pro-nounced in the MTHFR-/-mice model group(all P＜0.05).In wild-type mice,retinal thickness and retinal layer vessel den-sity were reduced in the DAC,FA and FA+DAC groups compared to the model group,with the FA+DAC group show-ing the greatest degree of reduction.The differences were all statistically significant(all P＜0.05);In MTHFR-/-mice,reti-nal thickness and vascular density in the retinal layer were reduced in the DAC group and the FA+DAC group compared to the model group(allP＜0.05).HE staining results showed an increased extent of retinal damage in the MTHFR-/-mice model group compared with the wild-type mice model group.Compared with the model group,the DAC group and the FA+DAC group had thinner retinas and more aligned ganglion cell layers in all types of mice,with the FA group having a worse effect and the FA+DAC group having a better treatment effect.The results of the polymerase chain reaction(PCR)revealed that the relative expression of the SAHH,MAT2A and DNMT1 proteins in the retinal tissues of the wildtype and MTHFR-/-mice model groups was elevated in comparison to the control group(all P＜0.05).Furthermore,the relative mR-NA expression of the DAC,FA and FA+DAC groups was reduced in comparison to the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein mRNA was decreased in the model group compared with the con-trol group,and increased in the DAC group,FA group,and FA+DAC group compared with the model group(all P＜0.05).Western blot results showed that the relative expression of DNMT1,MAT2A and SAHH proteins in the retinal tissues of the wild-type and MTHFR-/-mice model groups was higher than that of the control group(all P＜0.05),and the relative expression was lower in the DAC,FA,and FA+DAC groups compared with that in the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein in the retinal tissue of the model group was lower than that of the control group,and the relative expression of MTHFR protein in the FA group and the FA+DAC group was elevated com-pared with that of the model group(all P＜0.05).Conclusion The protective effect of folic acid combined with decit-abine on DR was superior to that of decitabine alone;treatment with folic acid in combination with decitabine may have yielded better efficacy in wild-type DR mice.

Objective:To assess the capability of seven reference medical laboratories to detect BCR::ABL1 p210 transcription levels and to compare the results among those laboratories.Methods:The interlaboratory comparison was carried out in two stages. The samples were prepared by the reference laboratory. The quantitative values of BCR::ABL1 p210 of the comparison samples covered 0.001%-0.01%, 0.01%-0.1%, 0.1%-1%, 1%-10% and>10% in each stage. Real-time quantitative PCR (RT-PCR) and dPCR (digital PCR) were used to examine the samples. The conversion factor (CF) was calculated and validated for each laboratory.Results:In the RT-PCR comparison, one laboratory was failed to detect BCR::ABL1 p210 in fourteen samples at the first stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.133-0.338) and 95% limits of agreement within ±5 folds (upper limit 0.147-0.785, lower limit -0.770--0.109), and the corresponding CF values were calculated and validated. In the dPCR comparison, one laboratory did not report results at the second stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.026-0.267) and 95% limits of agreement within±5 folds (upper limit 0.084-0.991, lower limit -0.669--0.135), and the corresponding CF values were calculated and validated. The samples with BCR::ABL1 p210 quantitative values of 0.01%-0.1%, 0.1%-1%, 1%-10% and >10% could be detected by both RT-PCR and qPCR. When the quantitative value of BCR::ABL1 p210 was 0.001%-0.01%, the detection rate of dPCR was higher than that of RT-PCR (85.56% vs. 68.00%).Conclusions:A good consistency is present among various laboratories. The quantitative value of BCR::ABL1 p210 is comparable among laboratories as shown by the CF value conversion. For quantitative detection of BCR::ABL1 p210 deep molecular reaction, dPCR has a higher positive detection rate and more advantages than RT-PCR. To ensure the accuracy and reproducibility of the BCR::ABL1 p210 test, it is imperative for every laboratory to enhance their daily quality control practices.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.

Objective:Evaluation of the efficacy and safety of ultra-picosecond 1 064 nm laser treatment for enlarged facial pores.Methods:From November 2022 to April 2023, 31 female patients with enlarged facial pores, aged between 28 and 52 (35.2±5.5) years old, were treated at the Medical Aesthetics Center of Xi′an International Medical Center Hospital. They received ultra-picosecond 1 064 nm laser fractional handpiece treatment once every 4 weeks for a total of 3 times. One month after the last treatment, facial pore changes were evaluated using facial pore scores and VISIA pore feature count absolute values, and adverse reactions were assessed.Results:All 31 patients completed the treatment. The facial pore scores before and after treatment were 4 (4, 5) and 2 (2, 3), respectively, indicating a statistically significant ( Z=-4.99, P<0.001) decrease in facial pore scores compared to before treatment. The absolute values of VISIA facial pore counts before and after treatment were 859 (829, 1147) and 652 (632, 731), respectively. The absolute value of VISIA pore count after treatment was lower than that before treatment, and the difference was statistically significant ( Z=-4.86, P<0.05 ). Conclusions:Ultra-picosecond laser can effectively improve enlarged facial pores without significant adverse reactions.

Objective:To explore the therapeutic effect of CO 2 fractional laser with topical triamcinolone and intrakeloid injection of triamcinolone. Methods:From January 2019 to December 2021, 24 cases of keloid patients in the outpatient clinic of the Department of Plastic Surgery and Aesthetics Hospital, all female, aged 22-53 years, were randomly divided into treatment group 1 (12 cases), treated with CO 2 fractional laser + local topical triamcinolone, and treatment group 2 (12 cases), treated with intra-local triamcinolone injection. The treatment was done every 4 weeks for 4-9 times and followed up for 1 year. Keloid size was assessed before and after each treatment and scarring was evaluated with the Vancouver Keloid Scale. Results:After treatment, the change in keloid size was greater in the treatment group 2 than that in the treatment group 1 (85.4% and 60.1%, χ 2=6.19, P<0.05), and the Vancouver Keloid Scale score showed that it was significantly lower in the treatment group 1 (7.8±1.5 versus 4.4±1.3, t=4.58, P<0.05) compared with the treatment group 2 (8.6±0.9 versus 4.5±1.3, t=3.45, P<0.05). During and at the end of treatment, the pain scores of the treatment group 1 were significantly lower than those of the treatment group 2, and patients′ comfort and compliance were significantly improved. Conclusions:Fractional laser combined with topical triamcinolone is a more suitable treatment option for patients with pain-sensitive keloids.

Objective To develop a geriatric-friendly care plan for elderly patients with chronic heart failure based on the 4Ms theoretical model and to validate its clinical effectiveness.Methods Based on literature review and patient interviews,a 4Ms geriatric-friendly care plan for elderly patients with heart failure was developed.The convenience sampling method was used to select A total of 160 patients admitted to a tertiary hospital in Zhejiang Province from August 2022 to June 2023 were selected as the study subjects.Among them,80 patients from January to June 2023 were assigned to an experimental group,and 80 patients from August to December 2022 were assigned to a control group.The experimental group received the 4Ms geriatric-friendly care plan developed in this study,while the control group received routine care.The differences in elderly-related complications during hospitalization,length of hospital stay,total hospitalization costs,satisfaction,and post-discharge outcomes(including readmission rates,improper medication and exercise capacity)were compared between the 2 groups.Results A total of 3 cases were lost,resulting in 78 cases in the experimental group and 79 cases in the control group.The experimental group had higher hospital satisfaction,lower hospitalization days,and lower total hospitalization costs compared to the control group(all P＜0.01).Within 3 months post-discharge,the experimental group had lower readmission and inappropriate medication score,with better exercise capacity compared to the control group(all P＜0.05).Conclusion The 4Ms geriatric-friendly care plan developed in this study demonstrates scientific and practical value.It effectively improves patient satisfaction,medication compliance,and exercise capacity,while reducing hospitalization days and readmission rates.This plan has significant references.

Objective To develop a geriatric-friendly care plan for elderly patients with chronic heart failure based on the 4Ms theoretical model and to validate its clinical effectiveness.Methods Based on literature review and patient interviews,a 4Ms geriatric-friendly care plan for elderly patients with heart failure was developed.The convenience sampling method was used to select A total of 160 patients admitted to a tertiary hospital in Zhejiang Province from August 2022 to June 2023 were selected as the study subjects.Among them,80 patients from January to June 2023 were assigned to an experimental group,and 80 patients from August to December 2022 were assigned to a control group.The experimental group received the 4Ms geriatric-friendly care plan developed in this study,while the control group received routine care.The differences in elderly-related complications during hospitalization,length of hospital stay,total hospitalization costs,satisfaction,and post-discharge outcomes(including readmission rates,improper medication and exercise capacity)were compared between the 2 groups.Results A total of 3 cases were lost,resulting in 78 cases in the experimental group and 79 cases in the control group.The experimental group had higher hospital satisfaction,lower hospitalization days,and lower total hospitalization costs compared to the control group(all P＜0.01).Within 3 months post-discharge,the experimental group had lower readmission and inappropriate medication score,with better exercise capacity compared to the control group(all P＜0.05).Conclusion The 4Ms geriatric-friendly care plan developed in this study demonstrates scientific and practical value.It effectively improves patient satisfaction,medication compliance,and exercise capacity,while reducing hospitalization days and readmission rates.This plan has significant references.

ObjectiveTo observe the clinical efficacy of Feining Paidu decoction on refractory Mycoplasma pneumoniae pneumonia in child patients. MethodA randomized controlled trial （RCT） was conducted， with 96 child patients randomly divided into a control group and an observation group， each containing 48 cases. The control group received intravenous azithromycin （10 mg·kg^-1·d^-1） for 7 days， intravenous methylprednisolone （1 mg·kg^-1·d^-1） for 3 days， along with supportive treatments such as fluid infusion and antipyretics. The observation group received oral administration of Feining Paidu decoction once a day for 7 days. Changes in traditional Chinese medicine （TCM） syndrome scores， clinical efficacy， serum soluble B7-H3 （sB7-H3）， serum inflammatory factors， coagulation function， and lung imaging ［computer tomography（CT）］ scores were observed in both groups. Adverse reaction events were also recorded. ResultThe total effective rate in the observation group was 95.74% （45/47）， significantly higher than 80.43% （37/46） in the control group （Z=-3.702， P<0.01）. Compared with the results before treatment， TCM syndrome scores， lung imaging scores， sB7-H3， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， D-dimer （D-D）， and fibrinogen （FIB） levels in both groups all significantly decreased after treatment （P<0.05， P<0.01）. After treatment， the observation group showed significantly better results in these indicators than the control group （P<0.05， P<0.01）. There was no statistically significant difference in thrombin time （TT） in the control group before and after treatment， while the observation group showed a significant prolongation after treatment （P<0.05）. There were no statistically significant differences in activated partial thromboplastin time （APTT） and prothrombin time （PT） between the two groups before treatment， and no serious adverse reactions occurred in either group. ConclusionFeining Paidu decoction combined with conventional treatment can alleviate inflammatory responses， improve hypercoagulable states， promote the absorption of pulmonary inflammation， and enhance the clinical efficacy of refractory Mycoplasma pneumoniae pneumonia in children.

ObjectTo observe the clinical efficacy of Huangqin Beimutang on chronic rhinosinusitis in children. MethodA randomized controlled trial （RCT） was conducted on 70 children who met the criteria for chronic rhinosinusitis， with 35 cases in the Chinese medicine group and 35 cases in the western medicine group. In the western medicine group，children received mometasone furoate nasal spray，one spray per nostril，once a day for two weeks， and also received a small dose of azithromycin suspension at 4 mg·kg^-1·d^-1，once a day，3 days a week for 2 weeks. The children in the Chinese medicine group were treated with oral Huangqin Beimutang，one dose per day for 2 weeks. Before and after treatment，the scores of primary symptoms and signs of traditional Chinese medicine （TCM），visual analogue scale （VAS） symptom scores，sinus computed tomography （CT） efficacy scores，and clinical efficacy of TCM syndromes in the two groups were evaluated，and the occurrence of adverse events was recorded. ResultThe total effective rate of clinical efficacy of TCM syndrome in the Chinese medicine group was 88.57% （31/35）， which was higher than 71.43% （25/35） in the western medicine group（χ²=8.458，P<0.05）. The VAS scores， scores of TCM primary symptoms of nasal obstruction and runny nose， and physical sign scores in both groups were lower than those after treatment （P<0.01）. The above indicators in the Chinese medicine group were superior to those in the western medicine group after treatment （P<0.05， P<0.01）. Compared with the conditions before treatment， there was no significant improvement in headache in the western medicine group， while the headache score in the Chinese medicine group decreased after treatment （P<0.01）. The CT scores of the two groups showed a downward trend， but the difference was not statistically significant. There were no adverse reactions during treatment in both groups. ConclusionHuangqin Beimutang can effectively improve the clinical symptoms of patients with chronic rhinosinusitis， and it is safe and effective.