Objective:To investigate the effects of botulinum toxin A (BTX-A) injection on ocular surface in patients with blepharospasm and dry eye.Methods:In this prospective study, 56 patients (83 eyes) with essential blepharospasm who were treated with BTX-A in the Department of Ophthalmology of Jiaxing Hospital of Traditional Chinese Medicine from April 2020 to January 2022 were included. The patients were divided into blepharospasm with dry eye group (group A, 50 eyes) and simple blepharospasm group (group B, 33 eyes) according to whether they were accompanied by dry eye. The Oculus Keratograph was used to evaluate tear meniscus height (TMH), tear break-up time (BUT), ocular bulbar redness, and corneal fluorescein staining. The OPD-Scan III analyzer was used to measure the corneal surface regularity index. The Ocular Surface Disease Index and meibomian gland analysis were performed to diagnose dry eye before treatment. Paired t-tests and Wilcoxon signed-rank tests were conducted to analyze the data. In patients with unilateral conditions, the ocular surface data of the affected and healthy eyes were compared before treatment. The severity of blepharospasm was evaluated in both groups before treatment and 1 week after treatment. Results:Among the 56 patients, 57.1% (32/56) were diagnosed with dry eye. One week after BTX-A injection treatment, both groups demonstrated varying degrees of improvement in their conditions. In patients with unilateral blepharospasm, pre-treatment ocular surface examinations indicated that the affected eye had a lower tear BUT of (6.67 ± 3.86) seconds and a lower TMH of (0.18 ± 0.07) mm compared with the healthy eye, which showed (10.20 ± 5.95) seconds for BUT and (0.20 ± 0.05) mm for TMH ( t = -3.94, -2.44, both P < 0.05). Additionally, the ocular bulbar redness value was significantly higher in the affected eye [(1.75 ± 0.38)] than in the healthy eye [(1.65 ± 0.47), t = 2.16, P < 0.05]. After treatment, both groups exhibited significant increases in BUT and TMH compared with their pre-treatment values ( t = -6.27, -4.21, -2.56, -3.12, all P < 0.05). Furthermore, both groups showed significant decreases in ocular bulbar redness values compared with pre-treatment values ( t = 3.04, 3.32, both P < 0.05). In group A, the corneal fluorescein staining score post-treatment was significantly lower than the pre-treatment value ( Z = 2.10, P < 0.05). However, in group B, the FL score did not show a significant difference between pre-treatment and post-treatment. ( Z = 0.03, P > 0.05). There were also no significant differences in the surface regularity index between the two groups both before and after treatment ( t = 1.35, 0.65, both P > 0.05). Conclusions:Blepharospasm can affect the stability of the tear film on the ocular surface, and BTX-A injection can help relieve dry eye caused by essential blepharospasm.

Objective To study the effect of Mycobacterium tuberculosis (Mtb) Pro-Pro-Glu-59 (PPE59) protein on the biological function of Mycobacterium smegmatis (Ms) and the regulation of host cell immune response. Methods PPE59 gene fragment was obtained by PCR amplification, cloned into pALACE, constructed into recombinant pALACE-PPE59 vector, and electro-transformed into Ms. Western blot was applied to analyse PPE59 expression and subcellular localization. The survival of Ms_Vec and Ms_PPE59 under low acid (pH=3 and pH=5) conditions and active surface pressure sodium dodecyl sulfate (SDS) conditions and their intracellular survival in macrophages were analyzed. ELISA was used to detect the cytokine (IL-1β, IL-6, IL-12, TNF-α and IL-10) expression levels of Ms_Vec and Ms_PPE59 infected macrophages. Results PPE59 protein localized to the cell wall of Ms can enhance the acid-resistance and anti-SDS effect of Ms, which is conducive to the survival of Ms in macrophages. PPE59 significantly decreased the secretion levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-12 and TNF-α), and promoted the secretion levels of anti-inflammatory cytokine (IL-10). Conclusion PPE59 enhances the survival ability of Ms under low acid and SDS pressure and promotes its intracellular survival by regulating the cytokine secretion levels.
Mycobacterium smegmatis/metabolism* ; Macrophages/metabolism* ; Cytokines/metabolism* ; Mycobacterium tuberculosis/metabolism* ; Bacterial Proteins/metabolism* ; Animals ; Mice ; Antigens, Bacterial/metabolism*

Objective:Investigating the migration pattern of microorganisms in the oil-water phase during the prep-aration of sterile test solutions for drugs by extraction method,providing reference for the pre-treatment of oil-based matrix test samples.Methods:Inoculate 6 strains of test bacteria separately into sterile isopropyl tetradecanoate,simulate the sample preparation process of extraction method,and detect the growth status of microorganisms in oil-water phase;Detect the recovery ratio of each test bacterium in the aqueous phase using the extraction method.Select semi-solid oily matrix samples and prepare the test solution using extraction method.Establish a sterility test method according to Part 1101 of the 2020 edition of the Chinese Pharmacopoeia.Results:After extraction,the recovery ratio of each test bacteria in the water phase is in the range of 0.64-0.89.After the oily matrix sample is extracted,the water phase is taken for microbial test,which effectively solves the problems of filter membrane blockage and difficult antibacterial removal,and is beneficial to the subsequent microbial inspection.Conclusion:The extraction method can improve the accuracy and sensitivity of microbial detection in the prepara-tion of test solutions for oily matrix samples.The applicability test of the established sterile inspection method meets the requirements of the Chinese Pharmacopoeia.

Objective:Investigating the migration pattern of microorganisms in the oil-water phase during the prep-aration of sterile test solutions for drugs by extraction method,providing reference for the pre-treatment of oil-based matrix test samples.Methods:Inoculate 6 strains of test bacteria separately into sterile isopropyl tetradecanoate,simulate the sample preparation process of extraction method,and detect the growth status of microorganisms in oil-water phase;Detect the recovery ratio of each test bacterium in the aqueous phase using the extraction method.Select semi-solid oily matrix samples and prepare the test solution using extraction method.Establish a sterility test method according to Part 1101 of the 2020 edition of the Chinese Pharmacopoeia.Results:After extraction,the recovery ratio of each test bacteria in the water phase is in the range of 0.64-0.89.After the oily matrix sample is extracted,the water phase is taken for microbial test,which effectively solves the problems of filter membrane blockage and difficult antibacterial removal,and is beneficial to the subsequent microbial inspection.Conclusion:The extraction method can improve the accuracy and sensitivity of microbial detection in the prepara-tion of test solutions for oily matrix samples.The applicability test of the established sterile inspection method meets the requirements of the Chinese Pharmacopoeia.

Objective:To investigate the effects of botulinum toxin A (BTX-A) injection on ocular surface in patients with blepharospasm and dry eye.Methods:In this prospective study, 56 patients (83 eyes) with essential blepharospasm who were treated with BTX-A in the Department of Ophthalmology of Jiaxing Hospital of Traditional Chinese Medicine from April 2020 to January 2022 were included. The patients were divided into blepharospasm with dry eye group (group A, 50 eyes) and simple blepharospasm group (group B, 33 eyes) according to whether they were accompanied by dry eye. The Oculus Keratograph was used to evaluate tear meniscus height (TMH), tear break-up time (BUT), ocular bulbar redness, and corneal fluorescein staining. The OPD-Scan III analyzer was used to measure the corneal surface regularity index. The Ocular Surface Disease Index and meibomian gland analysis were performed to diagnose dry eye before treatment. Paired t-tests and Wilcoxon signed-rank tests were conducted to analyze the data. In patients with unilateral conditions, the ocular surface data of the affected and healthy eyes were compared before treatment. The severity of blepharospasm was evaluated in both groups before treatment and 1 week after treatment. Results:Among the 56 patients, 57.1% (32/56) were diagnosed with dry eye. One week after BTX-A injection treatment, both groups demonstrated varying degrees of improvement in their conditions. In patients with unilateral blepharospasm, pre-treatment ocular surface examinations indicated that the affected eye had a lower tear BUT of (6.67 ± 3.86) seconds and a lower TMH of (0.18 ± 0.07) mm compared with the healthy eye, which showed (10.20 ± 5.95) seconds for BUT and (0.20 ± 0.05) mm for TMH ( t = -3.94, -2.44, both P < 0.05). Additionally, the ocular bulbar redness value was significantly higher in the affected eye [(1.75 ± 0.38)] than in the healthy eye [(1.65 ± 0.47), t = 2.16, P < 0.05]. After treatment, both groups exhibited significant increases in BUT and TMH compared with their pre-treatment values ( t = -6.27, -4.21, -2.56, -3.12, all P < 0.05). Furthermore, both groups showed significant decreases in ocular bulbar redness values compared with pre-treatment values ( t = 3.04, 3.32, both P < 0.05). In group A, the corneal fluorescein staining score post-treatment was significantly lower than the pre-treatment value ( Z = 2.10, P < 0.05). However, in group B, the FL score did not show a significant difference between pre-treatment and post-treatment. ( Z = 0.03, P > 0.05). There were also no significant differences in the surface regularity index between the two groups both before and after treatment ( t = 1.35, 0.65, both P > 0.05). Conclusions:Blepharospasm can affect the stability of the tear film on the ocular surface, and BTX-A injection can help relieve dry eye caused by essential blepharospasm.

Objective To evaluate the quality of animal studies into acupuncture for glaucoma using SYRCLE's risk of bias tool,ARRIVE 2.0 guidelines,and the GSPC checklist.Methods Databases from CNKI,VIP,Wanfang,Sinomed,PubMed,Web of Science,Embase and Cochrane Library were searched to find animal research articles on acupuncture for glaucoma.Risk of bias was assessed for the included studies using the SYRCLE's tool,and reporting quality was evaluated using the ARRIVE 2.0 guidelines and GSPC checklist.Statistical analysis was performed by Excel and SPSS software.Results Thirty articles met the inclusion/exclusion criteria and were included in the final analysis.Six of the 10 items of the SYRCLE's tool had a low-risk rate of＜50％,and the non-low-risk items focused on selectivity bias,implementation bias and measurement bias.Twelve of the 22 essential sub-items of the ARRIVE 2.0 guidelines had a low-risk rate of＜50％;9 of the 16 recommended sub-items had a low-risk rate of＜50％;and 12 of the 19 subentries of the GSPC list had a low-risk rate of＜50％.Randomization,blinding,ethical statements,housing and husbandry,animal care and monitoring,and protocol registration were the non-low-risk items in the ARRIVE 2.0 guidelines and GSPC list.Conclusions The quality of the methodology and experimental reporting of animal studies into acupuncture for glaucoma are generally low,and the description of several items is not yet complete,which affects the readers'judgment on whether the result of animal studies can be translated to clinical studies.It is advisable to further promote the use of SYRCLE's tool and reporting guidelines for animal experiments to enhance the design,performance,and reporting of animal experiments;ensure the reproducibility of experiments and result;and provide reliable evidence for the translation of result to the clinic.

Objective: To investigate the association between high normal blood pressure, hypertension and microalbuminuria (MAU), so as to provide the basis for early screening and prevention of renal injury caused by hypertension. Methods: A multi-stage cluster random sampling method was used to select permanent residents aged 18 to 75 years from six provinces including Hebei, Hunan, Sichuan, Heilongjiang, Qinghai and Jiangxi from September to October 2021. Basic information and lifestyle behaviors were collected through questionnaires. Indices including height, weight and blood pressure were measured. Urinary microalbumin and creatinine were measured in 24-hour urine samples. The associations between high normal blood pressure, hypertension, and MAU were analyzed by using a multivariable logistic regression model. Results: A total of 1 982 residents were surveyed, with 996 residents aged <50 years (50.25%) and 986 residents aged ≥50 years (49.75%). There were 958 males (48.34%) and 1 024 females (51.66%). Normal blood pressure was observed in 653 residents (32.95%), high normal blood pressure in 748 (37.74%) and hypertension in 581 (29.31%). MAU was detected in 164 participants, with a detection rate of 8.27%. The detection rates of MAU among residents with normal blood pressure, high normal blood pressure, and hypertension were 2.14%, 8.16% and 15.32%, respectively, and the difference was statistically significant (P<0.05). Multivariable logistic regression analysis showed that after adjusting for gender, age, educational level, smoking, alcohol consumption, regular exercise and body mass index, the residents with high normal blood pressure (OR=3.535, 95%CI: 1.898-6.585) and hypertension (OR=7.232, 95%CI: 3.808-13.732) had higher risks of MAU compared to those with normal blood pressure; the residents with hypertension (OR=1.914, 95%CI: 1.340-2.735) had a higher risk of MAU compared to those with high normal blood pressure. Conclusions High normal blood pressure and hypertension are associated with an increased risk of MAU.

Objective To analyze the differences in static balance plantar pressure characteristics between female adolescent idiopathic scoliosis(AIS)patients with moderate Lenke 3CN and healthy adolescents of the same age,and provide a scientific basis for scoliosis screening,assessment,treatment,and prognosis evaluation.Methods A total of 30 female patients with moderate Lenke 3CN AIS as the AIS group and 30 healthy female adolescents of the same age as the control group were selected,respectively.The plantar pressure data of the subjects were collected,and the characteristics of equilibrium plantar pressure distributions in two groups were comparatively analyzed.Results Regarding the plantar pressure characteristics,the average pressure(P<0.05)and hindfoot pressure(P<0.05)of the left and right foot in the AIS group were significantly greater than those of the control group,the forefoot pressure was significantly lower than that of the control group(P<0.05),and the symmetry index(SI)of both feet was significantly greater than that of the control group(P<0.05).The plantar pressure of the left foot in the AIS group was significantly larger than that of the control group in the medial mid-foot area and 1st toe area(P<0.05),and significantly smaller than that of the control group in the 1st,2nd,3rd,4th and 5th metatarsal areas(P<0.05);the plantar pressure of the right foot in the AIS group was significantly greater than that of the control group in the medial heel area and the1st toe area(P<0.05),and significantly smaller than that of the control group in the lateral mid-foot area,the 3rd,4th,5th metatarsal area and 3rd,4th,5th toe area(P<0.05);and the plantar pressure in the right foot of the AIS group was significantly smaller than that of the control group in the medial heel area and 1st toe area(P<0.05).The plantar pressures at lateral midfoot area,the 3rd,4th,5th metatarsal area and the 3rd,4th,5th toe area of the right foot were significantly larger than those of the control group(P<0.05).Regarding the center of pressure(COP),the length of the COP trajectory,the ellipse area of the 95%confidence interval,the maximum distance of COP left-right movement(COP-X),and the maximum distance of COP anterior-posterior movement(COP-Y)of the AIS group were significantly larger than those of the control group(P<0.05).Conclusions There are significant differences in static balance plantar pressure characteristics between female AIS patients with moderate Lenke 3CN and healthy female adolescents of the same age,with foot pressure favoring the side of the lateral convexity,poorer symmetry and stability of the feet,and weaker balance control.

Objective To reform the teaching content of acupuncture and moxibustion for undergraduate of Nursing College and to evaluate the effectiveness of the teaching reform,so to provide constructive information for optimizing the curriculum.Methods To revise the teaching content of Traditional Chinese Medicine(TCM)acu-puncture course based on the results of previous questionnaires,including reducing boring theoretical knowledge,increasing commonly used acupuncture techniques and clinical case analysis,organizing all undergraduates atten-ding the TCM teaching in the Nursing College of Peking Union Medical College to fill out the"Acupuncture Course Content Questionnaire"in 2023.The content covers four aspects:students'basic cognition of acupuncture and moxibustion before the course,students' learning feedback,students'learning effectiveness after the course and students' suggestions for further optimization of acupuncture and moxibustion course.Results Totally 149 students participated in the questionnaire survey and 73.15%of them were interested in the acupuncture course.There were 62.42%of the students thought that the most difficult part of the course was the"Acupuncture Points",and 71.81%of them complained the most constraining factor to the learning effectiveness was the diffi-culty of memorizing the meridians and acupoints.The most interesting part of the course was"Overview of Acu-puncture Treatment and Acupuncture Treatment of Common Diseases",which accounted for 44.3%of the students.Through the study,88.59%of the students were willing to recommend acupuncture treatment to pa-tients with indications.Students' suggestions for improvement of the acupuncture course was increase of classroom practice or learning by observation of operation videos.Conclusions The reformed acupuncture course highlights the practicability,improves the learning interest and subjective initiative,but the training of practice skill still needs to be strengthened.

China has a large population with accelerating process of population aging.Elderly patients have universal medical needs such as physical function,psychological needs and social needs.Therefore,it is urgent to have a comprehensive understanding of the health status of the elderly population,in order to develop individualized treatment plans for this special group of patients.Comprehensive geriatric assessment(CGA)as the core skill of geriatric medicine is based on four major aspects,including comprehensive medical assessment,physical function assessment,cognitive and emotional assessment,and social and environmental factors assessment.Several domestic and foreign studies have confirmed that CGA score can be used as an independent prognostic factor in elderly B-cell lymphoma patients receiving immunochemotherapy,and can be used to predict the survival outcome of elderly B-cell lymphoma patients.CGA should be promoted and implemented before immunochemotherapy among elderly patients with B-cell lymphoma in China,in the hope to help with the development of accurate treatment strategies and individualized intervention methods for B-cell lymphoma patients over 60 years old in China.