AIM: To evaluate the postoperative clinical efficacy of non-diffractive extended depth of focus intraocular lens(EDOF IOL)in patients with highly myopic cataract(HMC).METHODS:A retrospective analysis was conducted on the clinical data of patients diagnosed with HMC at the hospital from January 2022 to December 2024. Patients were divided into an observation group [undergoing femtosecond laser-assisted cataract surgery(FLACS)combined with non-diffractive EDOF IOL implantation] and a control group(undergoing FLACS combined with aspheric monofocal IOL implantation)according to the type of implanted IOL. Postoperative visual acuity(LogMAR), visual quality, and patient satisfaction were compared between the two groups.RESULTS: A total of 33 patients(47 eyes)were finally included in this study, including 10 patients(17 eyes)in the observation group and 23 patients(30 eyes)in the control group. The observation group had a median age of 59.0(52.8, 63.8)y, with 8 males(13 eyes)and 2 females(4 eyes). The control group had a median age of 56.0(53.5, 60.0)y, with 13 males(17 eyes)and 10 females(13 eyes). At 3 mo postoperatively, the best-corrected distance visual acuity(BCDVA)was 0.10(0.08, 0.12)in the observation group and 0.20(0.10, 0.40)in the control group(P=0.586). However, the best-corrected intermediate visual acuity(BCIVA)[0.10(0.10, 0.10)vs 0.50(0.40, 0.90), P=0.032] and best-corrected near visual acuity(BCNVA)[0.20(0.18, 0.20)vs 0.60(0.45, 1.45), P=0.044] in the observation group were significantly better than those in the control group. The defocus curve showed that the uncorrected visual acuity(UCVA)in the observation group was relatively stable within the range of -2.00 to +1.00 D, which was superior to that in the control group. Postoperative questionnaires showed that the spectacle independence rate(76%)and overall satisfaction(88%)in the observation group were significantly higher than those in the control group(10% and 60%, respectively).CONCLUSION: Non-diffractive EDOF IOL significantly improves intermediate and near visual acuity, reduces spectacle dependence, and maintains distance visual acuity by extending the depth of focus, providing better postoperative visual quality and life satisfaction for HMC patients.

Objective: To examine the changing trajectories of sleep problems and teacher support among first year middle school students and their covariant relationship,so as to provide theoretical basis for the prevention strategy of sleep problems for the first year junior high school students. Methods: In September 2020, a multistage cluster random sampling method was used to select 1 027 first year junior high school students from two schools of Anshun and Guiyang cities in Guizhou Province for survey and follow up assessments (T1:September 2020, T2:October 2020, T3:November 2020, T4:December 2020). The Student Perceived Teacher Support Behavior Questionnaire and Pittsburgh Sleep Quality Index Scale were administered to assess sleep problems and teacher support among first year junior high school students. Spearman correlation analysis was used to examine the relationship between sleep problems and teacher support. A multivariate latent growth curve model was employed to analyze the changing trajectories and covariant relationship between teacher support and sleep problems, followed by a multi group analysis. Results: For first year junior high school students, teacher support scores at T1-T4 were 4.00 (3.47, 4.53), 4.00 (3.47, 4.58), 3.95 (3.47, 4.61) and 4.00 (3.48, 4.67), respectively; sleep problem scores were 0.83 (0.50, 1.17), 0.67 (0.50, 1.17), 0.83 (0.50, 1.17) and 0.67 (0.33, 1.17), respectively. Spearman correlation analysis revealed that teacher support and sleep problems were negatively correlated across all four period ( r =-0.28 to -0.14, all P <0.01). Teacher support perceived by students showed a linear increasing trend (intercept=3.98, slope=0.02), while sleep problems showed a linear decreasing trend (intercept=0.86, slope= -0.02 ) (all P <0.05). The multivariate latent growth model indicated that the rate of increase in teacher support after enrollment effectively predicted the rate of decrease in sleep problem levels ( β=-0.34, P <0.01). Multigroup analysis showed that the covariant relationship was not moderated by gender or boarding status (both P >0.05). Conclusions The increase in teacher support experienced by first year junior high school students during the transition period after enrollment, accompanied by a reduction in sleep problems, constitutes a dynamic protective process. The process is not moderated by gender or boarding status.

Objective To analyze the effect of serum lactate dehydrogenase(LDH)and β2-microglobulin(β2-MG)on therapeutic efficacy of the first-line chemotherapy regimen for Waldenstr?m Macroglobulinemia(WM).Methods Data were collected from 113 WM patients admitted from March 2019 to February 2024.All patients completed the established first-line chemotherapy regimen and were divided into the response group(n=85)and the non-response group(n=28).The general data between the two groups were compared,with a focus on analyzing the risk factors for non-response to first-line chemotherapy in WM patients and evaluating the predictive value of serum LDH and β2-MG for the efficacy of first-line chemotherapy.Result The non-responsive group had a higher risk of prognosis based on International Prognostic Scoring System(IPSS),a higher rate of MYD88 L265P mutation,higher TP53 deletion/mutation ratio,and higher proportion of bone marrow lymphoplasmacytic cells,as well as higher serum LDH and β2-MG expression than the response group(P＜0.01).Multivariate logistic regression analysis revealed that risk factors for non-response to first-line chemotherapy in WM patients included a high-risk prognosis based on IPSS,an increased proportion of bone marrow lymphoplasmacytic cells,and higher rate of MYD88 L265P mutation and TP53 deletion/mutation,as well as elevated serum LDH and β2-MG levels(P＜0.05).The area under the curve of serum LDH and β2-MG for predicting the risk of non-response to first-line chemotherapy in WM patients was 0.796 and 0.783 respectively.Through interaction analysis,serum LDH and β2-MG had a positive interaction effect on non-response to chemotherapy in WM patients.Conclusion The non-response to first-line chemotherapy in WM patients is related to abnormal increase in serum LDH and β2-MG.Pre-chemotherapy detection of LDH and β2-MG level has certain predictive value for the risk of non-response to chemotherapy,and the simultaneous increase of both may lead to a higher risk of non-response to chemotherapy.

Rheumatoid arthritis(RA)is a chronic autoimmune disease with a high risk of disability.Macrophages,as important immune cells,participate in the regulation of inflammatory response and bone homeostasis in RA by polarization to different phenotypes.This article reviewed the etiology and pathogenesis of RA in TCM.It was found that imbalance in macrophage polarization is a key factor contributing to inflammation and imbalance in bone homeostasis in RA.During the development of RA,M1 and M2 macrophages have different characteristics of yin and yang attributes and play different roles,which are similar to the connotation of mutual opposition,mutual restriction and mutual transformation of yin and yang theory of TCM.Based on yin-yang theory of TCM,it is proposed to regulate the balance of yin and yang and restore the homeostasis of macrophage to delay the progression of RA,hoping to provide ideas for clinical treatment of RA.

Objective To analyse medication patterns for treating menstrual disorders with disharmony between the Chong and Ren pattern based on data mining.Methods Medical records from the gynecological outpatient department of Wenzhou TCM Hospital of Zhejiang Chinese Medical University from October 2023 to March 2024 were collected.A database was established based on Traditional Chinese Medicine Inheritance Computer System(V3.0),and data mining methods such as frequency statistics,association rule analysis and cluster analysis were used to analyze the medication patterns of traditional Chinese medicine in the treatment of menstrual disorders with disharmony between the Chong and Ren pattern.Results A total of 9003 effective prescriptions were collected,involving 410 Chinese medicinal herbs.The top five herbs by frequency were Danggui,Tusizi,Cuxiangfu,Xuduan,and Danshen.Tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines were used more frequently.The four qi were mainly warm and cold,the five lavours were mainly bitter and sweet,and the channel were mainly liver and spleen channel.By association analysis,a combination of drugs with Tusizi,Gouqizi,Danggui,Xuduan,Cuxiangfu were obtained.After cluster analysis,five groups of effective class squares were obtained.Conclusion Treatment of menstrual disorders with disharmony between the Chong and Ren pattern is used to tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines,pay attention to the balance of liver,spleen,kidney.The prescribing strategy considers both superficial and underlying conditions,employs a gradual rather than abrupt approach,integrates both cold and warm remedies,and ensures mutual reinforcement and restriction among the treatments.

Synovium is the target organ of rheumatoid arthritis.The excessive proliferation of synovial cells and insufficient apoptosis lead to synovial hyperplasia,which in turn causes damage to the surrounding tissues of the joint and bone destruction."Yang transforming qi and yin forming elements"is derived from Su Wen and is a highly summarized description of the functions of yin and yang,which runs through the entire course of the disease.This article elucidated the theoretical connotation of"yang transforming qi and yin forming elements"and its connection with synovial hyperplasia,proposing that the insufficiency of"yang transforming qi"is the root of synovial hyperplasia,while the excess of"yin forming elements"is the manifestation of synovial hyperplasia.Based on this,it put forward that"assisting yang qi as the priority,and according to the bias of pathogenic factors of yin,supplementing the method of reducing yin forming elements"is an important principle for treating this disease,which could provide new ideas for the treatment of the disease.

Objective To explore the mechanism of Quhan Zhufeng Mixture on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte(RA-FLS)based on NDRG2/JAK2/STAT3 signaling pathway.Methods RA-FLS cells were cultured in vitro,and were divided into ① blank serum group,methotrexate group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups;② blank serum group,AG490 group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups.Different concentrations of drug-containing serum were used to intervene cells.Cell proliferation was detected by CCK-8 method,apoptosis was detected by flow cytometry,and mRNA expressions of Bax,Bcl-2,Caspace-3,Caspace-9,N-myc downstream regulatory gene 2(NDRG2),Janus kinase 2(JAK2)and signal transduction and transcription activator 3(STAT3)were detected by RT-qPCR,Western blot was used to detect the protein expressions of Bax,Bcl-2,Caspace-3,Caspace-9,NDRG2,JAK2,STAT3,p-JAK2 and p-STAT3 in cells.Results Compared with the blank serum group,cell survival rate in methotrexate group,Quhan Zhufeng Mixture all dosage groups significantly decreased(P<0.01),the apoptosis rate significantly increased(P<0.01),the mRNA and protein expressions of Bax and Caspase-9 significantly increased(P<0.05,P<0.01),while the mRNA and protein expression of Bcl-2 significantly decreased(P<0.01),and Caspase-3 mRNA and protein expression in methotrexate group and Quhan Zhufeng Mixture medium-and high-dosage groups significantly increased(P<0.01).Compared with the blank serum group,the mRNA and protein expression of NDRG2 significantly increased in Quhan Zhufeng Mixture all dosage groups(P<0.05,P<0.01),the mRNA and protein expressions of JAK2 and STAT3 were significantly reduced in AG490 group and Quhan Zhufeng Mixture medium-and high-dosage groups(P<0.05,P<0.01),and the expressions of p-JAK2 and p-STAT3 proteins were significantly reduced(P<0.01).Conclusion Quhan Zhufeng Mixture can regulate the proliferation and apoptosis of RA-FLS by regulating the activity of NDRG2/JAK2/STAT3 signaling pathway,playing a role in treating rheumatoid arthritis.

Objective To analyze the effect of serum lactate dehydrogenase(LDH)and β2-microglobulin(β2-MG)on therapeutic efficacy of the first-line chemotherapy regimen for Waldenstr?m Macroglobulinemia(WM).Methods Data were collected from 113 WM patients admitted from March 2019 to February 2024.All patients completed the established first-line chemotherapy regimen and were divided into the response group(n=85)and the non-response group(n=28).The general data between the two groups were compared,with a focus on analyzing the risk factors for non-response to first-line chemotherapy in WM patients and evaluating the predictive value of serum LDH and β2-MG for the efficacy of first-line chemotherapy.Result The non-responsive group had a higher risk of prognosis based on International Prognostic Scoring System(IPSS),a higher rate of MYD88 L265P mutation,higher TP53 deletion/mutation ratio,and higher proportion of bone marrow lymphoplasmacytic cells,as well as higher serum LDH and β2-MG expression than the response group(P＜0.01).Multivariate logistic regression analysis revealed that risk factors for non-response to first-line chemotherapy in WM patients included a high-risk prognosis based on IPSS,an increased proportion of bone marrow lymphoplasmacytic cells,and higher rate of MYD88 L265P mutation and TP53 deletion/mutation,as well as elevated serum LDH and β2-MG levels(P＜0.05).The area under the curve of serum LDH and β2-MG for predicting the risk of non-response to first-line chemotherapy in WM patients was 0.796 and 0.783 respectively.Through interaction analysis,serum LDH and β2-MG had a positive interaction effect on non-response to chemotherapy in WM patients.Conclusion The non-response to first-line chemotherapy in WM patients is related to abnormal increase in serum LDH and β2-MG.Pre-chemotherapy detection of LDH and β2-MG level has certain predictive value for the risk of non-response to chemotherapy,and the simultaneous increase of both may lead to a higher risk of non-response to chemotherapy.

Teicoplanin,currently one of the preferred drugs for treating infections caused by multidrug-resistant Staphylococcus aureus and Enterococcus in clinical practice,has a high plasma protein binding rate.Most of the drug binds to protein after entering the body,only a portion of the drug exists in a free form.Since the free drug can pass through biological membranes and enter the target tissue to exert its therapeutic effect,monitoring the free teicoplanin blood concentration is clinically important and plays a role in guiding individualized drug therapy.This article summarizes and compares the current methods for determining the concentration of free teicoplanin in the blood,and analyzes their advantages and disadvantages.Based on this,it analyzes the possible factors affecting the concentration of free teicoplanin in the blood,providing a reference for the development of new methods for detecting free teicoplanin concentration and providing more accurate individualized medication plans based on free concentration.

Objective:To analyze and elaborate on the concept connotation of fertility preservation, so as to provide guidance for clinical nursing practice.Methods:Research on fertility preservation was retrieved from databases including China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Cochrane Library, and CINAHL. The search period was from the establishment of the database to January 31, 2025. Literature was selected based on inclusion criteria and analyzed using Rodgers' evolutionary concept analysis method.Results:A total of 43 articles were included. The conceptual attributes of fertility preservation encompassed five aspects, including targeting individuals with reproductive needs, prioritizing prevention, covering multi-level medical interventions, relying on assisted reproductive technologies for preservation, and being oriented toward enhancing fertility capacity and quality. The implementation of fertility preservation was influenced by demographic factors, disease factors, medical resources, and cultural factors. The anticipated outcomes included not only delayed childbirth but also improved in patients' mental health, quality of life, and interpersonal relationships. However, this may also raise ethical concerns.Conclusions:Fertility preservation plays a vital role in maintaining birth rates and enhancing population quality. Defining the concept of fertility preservation helps healthcare providers understand its essence and provides a reference for developing scientifically grounded fertility preservation programs.