AIM: To observe clinical outcomes of visual function training combined with surgical intervention in children with intermittent exotropia.METHODS: Retrospective study. A total of 100 pediatric patients with intermittent exotropia admitted to the Children's Hospital of Soochow University from January 2022 to December 2024 were selected and divided into two groups based on treatment modality. Both groups underwent intermittent exotropia correction surgery. The control group did not follow a visual rehabilitation program postoperatively, while the visual rehabilitation group did. The differences were compared between the two groups in preoperative and postoperative 12 wk results of perceptual eye position examinations, visual perception stereopsis function tests, multifocal visual evoked potential outcomes, Chinese version of the Child-International Quality of Life for Children with Strabismus(Child-IXTQ)scores, and strabismus angle.RESULTS: The baseline data of the two groups were comparable. Both groups showed reduced horizontal and vertical perceptual eye position deviation at 12 wk postoperatively compared to preoperative levels, with the visual group exhibiting lower values than the control group(all P<0.01). At 12 wk postoperatively, the number of children in the visual group who recovered fine and dynamic stereopsis increased compared to preoperative levels, and this number was higher than that in the control group(all P<0.05). There was no significant difference between the two groups in the number of children who recovered coarse stereopsis preoperatively and 12 wk postoperatively(all P>0.05). Both groups showed reduced latency for the first and second rings at 12 wk postoperatively compared to pre-surgery, with the visual group exhibiting lower latency than the control group(all P<0.01). There was no significant difference in latency for the third and fourth rings between pre-surgery and 12 wk postoperatively in either group(all P>0.05). Both groups showed increased Child-IXTQ scores at 12 wk postoperatively compared to preoperatively, with the visual group scoring higher than the control group(all P<0.05). Both groups exhibited reduced strabismus angles at 33 cm and 6 m at 12 wk postoperatively compared to preoperatively(all P<0.01), but the visual group showed no difference compared to the baseline group(all P>0.05).CONCLUSION: Combining visual function training with surgical intervention for intermittent exotropia can improve multifocal visual evoked potentials, promote visual function recovery, and enhance quality of life.

Background: High-mobility group box protein 1 (HMGB1) is a chromatin-binding protein involved in arthritis, ischemia, sepsis, atherosclerosis, neurodegenerative disorders, meningitis, and cancer. HMGB1 exhibits dual roles in cancer, acting as either a tumor suppressor or oncoprotein depending on context. Objective: This research aimed to elucidate HMGB1’s functional significance in cutaneous squamous cell carcinoma (cSCC). Methods: We overexpressed HMGB1 in cSCC cell lines using recombinant adenovirus and examined its effects on cell proliferation, colony formation, and cell migration. Results: Immunohistochemical analysis revealed elevated HMGB1 expression levels in cSCC tissue relative to normal epidermis. To assess the influence of HMGB1, we employed recombinant adenoviruses expressing HMGB1 to transduce SCC cell lines (SCC12 and SCC13). Enhanced HMGB1 expression significantly promoted cellular proliferation and colony formation capacity.Notably, HMGB1 overexpression elevated the levels of proliferation regulators, including P63, SOX2, CDK4 and CDK6. Furthermore, HMGB1 overexpression substantially enhanced tumor invasiveness, accompanied by upregulation of epithelial-mesenchymal transition (EMT) biomarkers. Mechanistically, overexpression of HMGB1 enhanced transforming growth factor-β signaling by increasing phosphorylation of SMAD2/3, the key mediators of EMT. Conclusion These data imply that HMGB1 acts as a tumor-promoting factor in cSCC.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

Based on the opening-closing-pivot theory， this paper proposes that adolescent bipolar disorder is closely associated with taiyin （太阴）， shaoyang （少阳）， and jueyin （厥阴） channels. The principal pathogenesis involves dysfunction of the opening function of taiyin， impaired pivot function of shaoyang， and failure of the closing function of jueyin. Accordingly， the therapeutic principles include regulating taiyin to restore the ascending and descending movement of qi， harmonizing shaoyang to facilitate the pivot mechanism， and balancing yin and yang to reinforce the closing and storing function of jueyin. In clinical practice， Yihuang Powder （益黄散） and Tongxie Important Formula （痛泻要方） are commonly prescribed to regulate the qi movement of taiyin and restore its ascending and transporting functions， while Xiaochaihu Decoction （小柴胡汤） and Sini Powder （四逆散） are used to regulate the shaoyang pivot， and Wumei Pill （乌梅丸）， Danggui Sini Decoction （当归四逆汤）， and Huanglian Ejiao Decoction （黄连阿胶汤） combined with Shaoyao Gancao Decoction （芍药甘草汤） are employed to harmonize the jueyin closing mechanism. In addition， traditional daoyin （导引） exercise yi jin jing （易筋经） is incorporated to simultaneously regulate the body and mind by guiding internal regulation through external movement， thereby calming the body and tranquilizing the mind.

Based on the opening-closing-pivot theory， this paper proposes that adolescent bipolar disorder is closely associated with taiyin （太阴）， shaoyang （少阳）， and jueyin （厥阴） channels. The principal pathogenesis involves dysfunction of the opening function of taiyin， impaired pivot function of shaoyang， and failure of the closing function of jueyin. Accordingly， the therapeutic principles include regulating taiyin to restore the ascending and descending movement of qi， harmonizing shaoyang to facilitate the pivot mechanism， and balancing yin and yang to reinforce the closing and storing function of jueyin. In clinical practice， Yihuang Powder （益黄散） and Tongxie Important Formula （痛泻要方） are commonly prescribed to regulate the qi movement of taiyin and restore its ascending and transporting functions， while Xiaochaihu Decoction （小柴胡汤） and Sini Powder （四逆散） are used to regulate the shaoyang pivot， and Wumei Pill （乌梅丸）， Danggui Sini Decoction （当归四逆汤）， and Huanglian Ejiao Decoction （黄连阿胶汤） combined with Shaoyao Gancao Decoction （芍药甘草汤） are employed to harmonize the jueyin closing mechanism. In addition， traditional daoyin （导引） exercise yi jin jing （易筋经） is incorporated to simultaneously regulate the body and mind by guiding internal regulation through external movement， thereby calming the body and tranquilizing the mind.

Under the background of rapid development of artificial intelligence(AI),this paper systematically proposes AI-based education(AIBE).It empowers the teaching process,learning process,research process,and teaching management with AI,and constructs an AI-based educational paradigm,including AI-based teaching(AIBT),AI-based learning(AIBL),AI-based re-search(AIBR),and AI-based management(AIBM).Taking the AI course of immunology teaching as an example,this paper deeply analyzes the practices and explorations of implementing AIBT,AIBL,AIBR and AIBM based on the AI course,so as to accelerate the promotion of the transformation of the fourth generation of medical education.

Objective To explore the effects of different education and examination methods on the examination results during the screening/evaluation of patent foramen ovale by contrast-enhanced transcranial Doppler(cTCD).Methods Patients who underwent cTCD screening/evaluation for patent foramen ovale in our hospital from May 2023 to February 2024 were retrospectively selected as the research subjects.The patients were divided into the observation group and the control group according to different education and examination methods during the peri-examination period.Patients who received video education,modified Valsalva maneuver,and injection of contrast agent with 20 mL syringe were included into the observation group,and patients who received artificial education,Valsalva maneuver,and injection of contrast agent with 10 mL syringe were included into the control group.The positive detection rate of patent foramen ovale,right-to-left shunt microbubble grading during Valsalva/modified Valsalva maneuver,systolic blood flow velocity,pulsatility index(PI),resistive index(RI),examination duration,total physician-patient communication time,whether occlusion surgery was performed,and patient satisfaction were compared between the two groups.Results The positive detection rate of patent foramen ovale by cTCD(82.93%vs.95.92%),the detection rate of the maximum amout(grade Ⅲ)of microbubbles(39.02%vs.61.22%),the total physician-patient communication time during the peri-examination period[11.30(10.00,14.00)minutes vs.8.23(7.00,10.00)minutes],the rate of occlusion surgery(48.78%vs.73.47%),and the total patient satisfaction(80.49%vs.91.84%)showed statistically significant differences between the control group and the observation group(P<0.05).Additionally,the receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for diagnosing patent foramen ovale were 0.718 in the control group and 0.855 in the observation group.Conclusion Peri-examination interventions such as video education,modified Valsalva maneuver,and injection of contrast agent with 20 mL syringe can improve the positive detection rate of patent foramen ovale,reduce ineffective physician-patient communication,and improve patient satisfaction.

We reported the clinical,imaging,and treatment process of a patient with severe cranial penetrating injury caused by a nail from a nail gun that accidentally shot into the eye and penetrated into the skull while working.The patient was admitted to the Qingpu Branch of Zhongshan Hospital,Fudan University after being injured by the nail gun.The patient was admitted to the hospital 1 hour after injury with coma.After admission,the foreign body was completely removed and part of the hematoma was cleared through emergency surgery.After surgery,there were high-risk complications such as cerebral edema peak,intracranial hypertension,intracranial infection,cerebrospinal fluid leakage,and intracranial pseudoaneurysm.The patient eventually regained consciousness and was transferred to rehabilitation treatment.

Objective To develop a nomogram diagnostic model to differentiate peripheral small cell lung cancer(PSCLC)from peripheral lung adenocarcinoma(PADC)using clinical and multi spiral computed tomography features.Methods A retrospective analysis was conducted on the CT characteristics and clinical presentations of 50 PSCLC and 100 PADC.Univariate and multivariate logistic regression analyses were employed to identify significant features.A nomogram was constructed to quantify the influencing factors.The efficacy and clinical applicability of the model were assessed using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Smoking,neuron-specific enolase(NSE),smooth margin,spindle/branching shape,and lymphadenopathy were independent risk factors for PSCLC(P＜0.05),whereas rough margin and lobulation sign were independent risk factors for PADC(P＜0.05).The nomogram model demonstrated high diagnostic efficacy,and the calibration curve exhibited a good degree of calibration(Brier=0.079).The DCA indicated that the nomogram model possesses substantial clinical utility.Conclusion The nomogram model developed based on six indicators,including smoking,NSE≥17 ng/mL,margin characteristics,spindle/branching shape,lobulation sign,and lymphadenopathy can well distinguish PSCLC from PADC.