AIM: To compare the efficacy of simple autologous blood coverage with ILM flap tamponade combined with autologous blood coverage after pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling in treating macular hole retinal detachment(MHRD)of high myopia patients with moderately long axial length.METHODS: This retrospective study enrolled 45 patients(45 eyes)with high myopia and MHRD, and axial lengths of 26-29 mm treated at our institution between January 1, 2020 and January 1, 2024. Patients were divided into two groups based on surgical technique: group A(24 eyes)underwent PPV with ILM peeling, ILM flap tamponade, autologous blood coverage, and silicone oil injection; group B(21 eyes)received PPV with ILM peeling followed by autologous blood coverage and silicone oil injection. Intraocular pressure, best-corrected visual acuity(BCVA), retinal reattachment and macular hole closure status were compared at 1 wk, 1, 3, and 6 mo postoperatively. Silicone oil removal was performed at 6 mo postoperatively, with additional 2-month follow-up.RESULTS:At 8-month postoperative follow-up, both groups achieved complete retinal reattachment. Macular hole closure rates showed no significant intergroup difference(88% vs 86%, P=0.860). Significant improvement in BCVA was observed in both groups compared to preoperative values, with the group B demonstrating better visual outcomes than the group A(P<0.001). Transient parafoveal subretinal fluid persistence was noted in 2 eyes of the group A(resolved spontaneously at 5 and 8 mo post-PPV, respectively), and 1 eye of the group B(resolved by 4 mo post-PPV). Serial optical coherence tomography(OCT)monitoring revealed no macular hole reopening, with complete subretinal fluid resolution confirmed in all cases at final follow-up.CONCLUSION:For high myopic MHRD patients with moderately long axial length, both surgical approaches effectively promote macular hole closure and retinal reattachment. However, the autologous blood coverage technique demonstrates better BCVA than the combined ILM tamponade.

Objective: To understand the relationship between working hours and occupational stress among front-line employees in manufacturing enterprises, so as to provide a basis for the prevention and control of occupational stress. Methods: Front-line employees from 5 manufacturing enterprises in Hangzhou City were selected from June to November 2024 using random cluster sampling. Demographic information and occupational information such as daily average working hours and weekly working hours, were collected through questionnaires. The effort-reward imbalance questionnaire was used to investigate occupational stress. The association between working hours and occupational stress was analyzed using a multivariable logistic regression model. Results: A total of 926 people were surveyed, among whom 572 were male, accounting for 61.77%, and 354 were female, accounting for 38.23%. The average age was (32.98±8.28) years. There were 515 people (55.62%) who had a monthly personal income of more than 5 000 yuan but less than 9 000 yuan. There were 353 people (38.12%) who had a working seniority of less than 5 years. There were 784 people (84.67%) who had an average daily working hours of >8 hours and 645 people (69.65%) who had a weekly working day of more than 5 days. There were 338 people (36.50%) on the shift work system, and 331 people (35.75%) worked night shifts. A total of 707 people were detected with occupational stress, with a detection rate of 76.35%. Multivariable logistic regression analysis showed that after adjusting for gender, age, educational level, marital status, number of children, only-child status, monthly personal income, working seniority, weekly working hours, assembly-line work, shift work system and night shift, compared with employees with an average daily working hours of ≤8 hours, the risk of occupational stress increased by 118.7% for those with an average daily working hours of >8-<10 hours (OR=2.187, 95%CI: 1.434-3.336) and by 248.4% for those with an average daily working hours of ≥10 hours (OR=3.484, 95%CI: 2.034-5.966). Conclusions The detection rate of occupational stress among front-line employees in manufacturing enterprises in Hangzhou City is high. Long average daily working hours can increase the risk of occupational stress among employees in manufacturing enterprises. It is recommended to reasonably arrange work intensity and working hours.

OBJECTIVE: To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms. METHODS: Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR. RESULTS: Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway. CONCLUSION Biodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Animals ; Rotator Cuff Injuries/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Wound Healing/drug effects* ; Alloys/pharmacology* ; Rats ; Proto-Oncogene Proteins c-akt/metabolism* ; Rotator Cuff/metabolism* ; Macrophages/metabolism* ; Magnesium/pharmacology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Biocompatible Materials ; Bone Morphogenetic Protein 2/metabolism*

AIM: To observe the variation characteristics of postoperative optical coherence tomography(OCT), optical coherence tomography angiography(OCTA)examination indicators in patients with high myopia and macular hole retinal detachment(MHRD), and analyze their correlation with visual function.METHODS: A total of 78 MHRD patients with high myopia who were treated in the Baoding No.1 Central Hospital from January 2019 to October 2023 were selected as the study objects, all of which underwent vitrectomy combined with internal limiting membrane tamponade. The changes in the best corrected visual acuity(BCVA), OCT and OCTA parameters, including choriocapillary blood flow area(CBFA), diameter of ellipsoid zone absence(DEZA)and blood flow density were observed at 1, 3 and 6 mo after surgery. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation between BCVA and CBFA, DEZA, and blood flow density at different time points after surgery.RESULTS: BCVA of enrolled patients at 1, 3, and 6 mo after surgery were 1.75±0.79, 1.49±0.53, and 1.08±0.44, respectively, and the differences at different points were statistically significant(all P<0.05). At 1, 3, and 6 mo after surgery, the patient's CBFA was 1.67±0.24, 1.82±0.13, and 1.94±0.15 mm2, respectively, the DEZA was 813.27±453.16, 590.89±421.38, and 427.58±385.34 μm, respectively, and the blood flow density was 24.36±7.81, 27.74±8.12, and 31.54±8.59, respectively. The differences in above indicators at different time points were statistically significant(all P<0.05). Pearson correlation analysis found that there was no significant correlation between DEZA, blood flow density and BCVA in patients with high myopia and MHRD at 1 mo after surgery(all P>0.05). However, CBFA was negatively correlated with BCVA(LogMAR; P<0.05); at 3 and 6 mo after surgery, CBFA and blood flow density were negatively correlated with BCVA(LogMAR)in patients with high myopia and MHRD, while DEZA was positively correlated with BCVA(LogMAR; all P<0.05). Multiple linear regression analysis showed that CBFA, blood flow density, and DEZA were important influencing factors of BCVA at 3 and 6 mo after surgery(all P<0.05).CONCLUSION:Visual function of patients with high myopia and MHRD gradually increases after surgery, and is closely related to postoperative CBFA, DEZA and blood flow density. It is recommended to regularly monitor changes in OCT and OCTA indicators after surgery.

Objective:To explore the characteristics of blood lipid profile and its correlation with clinical features and cytokines in patients with active systemic sclerosis (SSc).Methods:In this study, from January 2018 to March 2023, a total of 102 SSc patients visited the Second Hospital of Shanxi Medical University and the First Hospital of Shanxi Medical University were enrolled, among which 57 cases were localized skin type, 25 cases were diffuse skin type, 20 cases were overlap syndrome. At the same time, 89 gender and age-matched health check-up subjects in the Second Hospital of Shanxi Medical University were selected as the healthy control group. The total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were compared between the two groups. According to the blood lipid level, they were grouped into normal blood lipid group and abnormal group, TG elevated group and normal group, HDL-C decreased group and normal group. The association between various lipid groups and organ involvement, modified Rodnan skin score (mRSS), laboratory examination and cytokines were analyzed. Continuous data were analyzed using t-test or Mann-Whitney U test, count data were tested with chi-square test, and Spearman correlation analysis was used for correlation analysis. Results:The level of TG [1.31 (1.04, 1.77) mmol/L vs. 1.05 (0.79, 1.35) mmol/L] and LDL-C [(2.33±0.69)mmol/L vs. (2.12±0.64) mmol/L] in active SSc patients were higher than that in HCs, and the level of TC [(4.27±1.11)mmol/L vs. (4.85±0.98)mmol/L] was lower than that in HCs ( Z=3.821, P<0.001; t=2.171, P=0.031; t=-3.791, P<0.001). Fifty-six (54.9%) SSc patients had dyslipidemia, the incidence of the TG increase and the HDL-C reduction was significantly higher. ESR, mRSS score and renal involvement in the dyslipidemia group were higher than that in normal blood lipid group. mRSS score and the incidence of cardiac and renal involvement were higher in the TG elevated group than that in normal group. TG was positively correlated with the mRSS scores ( r=0.321, P=0.001). The incidence of ESR increase and cardiac involvement was higher in HDL-C decreased group than that in normal group, while anti-Scl-70 positive rate was lower. HDL-C was negatively correlated with the ESR ( r=-0.411, P<0.001). In active SSc patients, levels of IL-2[2.78(2.04, 4.96)pg/ml], IL-6[14.71(7.74,28.38)pg/ml], IL-17[10.73(4.38, 26.62)pg/ml], and IFN-γ[5.40(3.11, 10.45)pg/ml] in the dyslipidemia group were higher than those in normal blood lipid group [IL-2:1.73(0.96, 3.75)pg/ml, Z=2.452, P=0.014; IL-6:6.78(4.38, 9.17)pg/ml, Z=3.726, P<0.001; IL-17:4.46(2.98, 12.53)pg/ml, Z=2.176, P=0.030;IFN-γ:3.76(2.20, 4.87)pg/ml, Z=2.960, P=0.003]. TG was positively associated with IL-2( r=0.358, P=0.002), IL-6( r=0.324, P=0.006), IL-10( r=0.270, P=0.024), IL-17( r=0.279, P=0.019), and IFN-γ( r=0.297, P=0.012)in patients with active SSc. HDL-C was negatively associated with levels of IL-2( r=-0.292, P=0.014), IL-6( r=-0.348, P=0.003), IL-10 ( r=-0.261, P=0.029)and TNF-α( r=-0.251, P=0.036). Conclusion:The incidence of dyslipidemia is higher in active SSc patients than that in HCs, the main manifestations are increased TG and LDL-C and decreased TC and HDL-C. Active SSc patients with dyslipidemia have higher levels of ESR and inflammatory cytokines, higher incidence of cardiac and renal involvement, and relatively severe skin fibrosis, which suggest that abnormal lipid metabolism plays an important role in the development of active SSc and organ involvement.

Objective To analyze the basic characteristics of patients with acute myocardial infarction in a tertiary hospi-tal from 2014 to 2023,and provide references for the prevention,treatment,management,and quality control of this disease.Methods Based on the data from the medical records of patients with acute myocardial infarction admitted to a tertiary hospital from January 1,2014,to December 31,2023,the basic characteristics of hospitalized patients and trends in hospitalization costs were analyzed to summarize the development patterns.Results Over the past decade,the number of hospitalized patients with a-cute myocardial infarction has been increasing,while the average length of hospital stay,average cost per hospitalization,and mortality rate have been decreasing.Among the 19 937 patients,there were 16 037 male patients(80.44％)and 3 900 female patients(19.56％),with a male-to-female ratio of 4.11∶1.The median age for male patients was 60 years,while for female patients it was 68 years,indicating that males tend to develop the disease approximately 10 years earlier than females.Among pa-tients aged 60 and above,the mortality rate is positively correlated with age,while among patients below 60,the mortality rate is negatively correlated with age.The decision to undergo surgery has a significant impact on hospitalization costs.From the per-spective of cost structure,the proportion of consumables has decreased from 69.81％to 54.60％in the past decade but remains relatively high.Conclusion With the advancement of hospital management and medical insurance policies,the diagnosis,treat-ment,and quality of care for acute myocardial infarction have significantly improved.However,consumables management remains a key focus.Men and individuals aged 50 and above should be given special attention.During the diagnosis and treatment process,greater attention should also be given to younger or older patients and female patients to reduce the mortality rate.

Objective To analyze the basic characteristics of patients with acute myocardial infarction in a tertiary hospi-tal from 2014 to 2023,and provide references for the prevention,treatment,management,and quality control of this disease.Methods Based on the data from the medical records of patients with acute myocardial infarction admitted to a tertiary hospital from January 1,2014,to December 31,2023,the basic characteristics of hospitalized patients and trends in hospitalization costs were analyzed to summarize the development patterns.Results Over the past decade,the number of hospitalized patients with a-cute myocardial infarction has been increasing,while the average length of hospital stay,average cost per hospitalization,and mortality rate have been decreasing.Among the 19 937 patients,there were 16 037 male patients(80.44％)and 3 900 female patients(19.56％),with a male-to-female ratio of 4.11∶1.The median age for male patients was 60 years,while for female patients it was 68 years,indicating that males tend to develop the disease approximately 10 years earlier than females.Among pa-tients aged 60 and above,the mortality rate is positively correlated with age,while among patients below 60,the mortality rate is negatively correlated with age.The decision to undergo surgery has a significant impact on hospitalization costs.From the per-spective of cost structure,the proportion of consumables has decreased from 69.81％to 54.60％in the past decade but remains relatively high.Conclusion With the advancement of hospital management and medical insurance policies,the diagnosis,treat-ment,and quality of care for acute myocardial infarction have significantly improved.However,consumables management remains a key focus.Men and individuals aged 50 and above should be given special attention.During the diagnosis and treatment process,greater attention should also be given to younger or older patients and female patients to reduce the mortality rate.

Objective:To explore the characteristics of blood lipid profile and its correlation with clinical features and cytokines in patients with active systemic sclerosis (SSc).Methods:In this study, from January 2018 to March 2023, a total of 102 SSc patients visited the Second Hospital of Shanxi Medical University and the First Hospital of Shanxi Medical University were enrolled, among which 57 cases were localized skin type, 25 cases were diffuse skin type, 20 cases were overlap syndrome. At the same time, 89 gender and age-matched health check-up subjects in the Second Hospital of Shanxi Medical University were selected as the healthy control group. The total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were compared between the two groups. According to the blood lipid level, they were grouped into normal blood lipid group and abnormal group, TG elevated group and normal group, HDL-C decreased group and normal group. The association between various lipid groups and organ involvement, modified Rodnan skin score (mRSS), laboratory examination and cytokines were analyzed. Continuous data were analyzed using t-test or Mann-Whitney U test, count data were tested with chi-square test, and Spearman correlation analysis was used for correlation analysis. Results:The level of TG [1.31 (1.04, 1.77) mmol/L vs. 1.05 (0.79, 1.35) mmol/L] and LDL-C [(2.33±0.69)mmol/L vs. (2.12±0.64) mmol/L] in active SSc patients were higher than that in HCs, and the level of TC [(4.27±1.11)mmol/L vs. (4.85±0.98)mmol/L] was lower than that in HCs ( Z=3.821, P<0.001; t=2.171, P=0.031; t=-3.791, P<0.001). Fifty-six (54.9%) SSc patients had dyslipidemia, the incidence of the TG increase and the HDL-C reduction was significantly higher. ESR, mRSS score and renal involvement in the dyslipidemia group were higher than that in normal blood lipid group. mRSS score and the incidence of cardiac and renal involvement were higher in the TG elevated group than that in normal group. TG was positively correlated with the mRSS scores ( r=0.321, P=0.001). The incidence of ESR increase and cardiac involvement was higher in HDL-C decreased group than that in normal group, while anti-Scl-70 positive rate was lower. HDL-C was negatively correlated with the ESR ( r=-0.411, P<0.001). In active SSc patients, levels of IL-2[2.78(2.04, 4.96)pg/ml], IL-6[14.71(7.74,28.38)pg/ml], IL-17[10.73(4.38, 26.62)pg/ml], and IFN-γ[5.40(3.11, 10.45)pg/ml] in the dyslipidemia group were higher than those in normal blood lipid group [IL-2:1.73(0.96, 3.75)pg/ml, Z=2.452, P=0.014; IL-6:6.78(4.38, 9.17)pg/ml, Z=3.726, P<0.001; IL-17:4.46(2.98, 12.53)pg/ml, Z=2.176, P=0.030;IFN-γ:3.76(2.20, 4.87)pg/ml, Z=2.960, P=0.003]. TG was positively associated with IL-2( r=0.358, P=0.002), IL-6( r=0.324, P=0.006), IL-10( r=0.270, P=0.024), IL-17( r=0.279, P=0.019), and IFN-γ( r=0.297, P=0.012)in patients with active SSc. HDL-C was negatively associated with levels of IL-2( r=-0.292, P=0.014), IL-6( r=-0.348, P=0.003), IL-10 ( r=-0.261, P=0.029)and TNF-α( r=-0.251, P=0.036). Conclusion:The incidence of dyslipidemia is higher in active SSc patients than that in HCs, the main manifestations are increased TG and LDL-C and decreased TC and HDL-C. Active SSc patients with dyslipidemia have higher levels of ESR and inflammatory cytokines, higher incidence of cardiac and renal involvement, and relatively severe skin fibrosis, which suggest that abnormal lipid metabolism plays an important role in the development of active SSc and organ involvement.

Background: Currently, traditional methods of treating acute gastric ulcer (AGU) have many drawbacks, necessitating an alternative therapy with fewer adverse effects. Atractylodis Macrocephalae Rhizoma (BZ) is known for strengthening the spleen and harmonizing the stomach. BZ processed with Aurantii Fructus Immaturus juice (ZSZBZ), a classic decoction since the Han Dynasty, can enhance the efficacy of BZ. However, the key active components and targets of action of ZSZBZ remain undiscovered. Aim of the study: This study aimed to investigate the bioactive chemical constituents of ZSZBZ against AGU and their possible mechanisms of action, elucidating the scientific content of ZSZBZ processing. Materials and methods: Initially, we examined rat stomach histopathology and conducted ELISA for oxidative stress and inflammation. Subsequently, we investigated underlyingmechanisms using metabolomics. Further analysis of potent components and key targets in ZSZBZ was conducted through liquid chromatography-mass spectrometry analysis combined with network pharmacology. Finally, key targets were analyzed by Western blot. Results: ZSZBZ improved gastric histopathology, reversing high alcohol-induced oxidative stress (SOD, CAT) and inflammatory level (TNF-α, IL-6) disorders. This is associated with ZSZBZ’s regulation of amino acid metabolism, energy metabolism, and inflammatory response-related metabolic pathways, along with key targets PTGS2, MAPK1, and KDR. The significant increase in potency of ZSZBZ may be attributed to elevated levels of naringenin, hesperidin, hesperidin, and rhamnoceroside after concoction. Conclusions: Combining metabolomics and network pharmacology, this study elucidated that ZSZBZ enhanced gastroprotection by modulating amino acid metabolism, antioxidant, and inflammation-related targets and pathways, providing insights into the bioactive compounds and potential mechanisms of herbal concoctions.

Objective:To explore the application of game-based teaching combined with Jeffries simulation teaching in training orthopedic trauma nursing interns.Methods:Totally 120 intern nurses who received orthopedic trauma nursing training from 2021 to 2023 were selected. They were divided into two groups according to their start dates, with 60 nurses in each group. The control group (started before December 2022) adopted routine teaching, whereas the observation group received game-based teaching combined with Jeffries simulation teaching. The assessment results, core competence [Competency Inventory for Registered Nurse (CIRN)], and learning enthusiasm [Active Learning Scale (ALS)] were compared both between the groups and within each group before and after the training. The course experience [Course Experience Questionnaire (CEQ)] of the trainees after training was recorded.Results:After the internship, the theoretical exam scores [(89.64±6.73) vs. (83.71±6.20)], practical operation scores [(80.82±5.94) vs. (75.61±5.73)], CIRN scores [(180.69±7.61) vs. (157.33±6.83)], and ALS scores [(89.48±6.83) vs. (73.22±6.25)] of two groups of nursing students increased compared to their scores before the internship, and the observation group showed significantly higher scores than the control group ( P<0.05). After the internship, the CEQ score was higher in the observation group than in the control group [(49.65±2.58) vs. (36.57±1.94)]. Conclusions:In the training of orthopedic trauma nursing interns, game-based teaching combined with Jeffries simulation teaching can not only improve course experience and learning enthusiasm, but also enhance the assessment results, core competence, and critical thinking.