OBJECTIVES: To compare the efficacy of toric implantable collamer lens (Toric-ICL) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia correction in patients with moderate to high myopia complicated with astigmatism. METHODS: We retrospectively collected data from 64 patients (aged 18-42 years) with moderate to high myopia complicated with astigmatism (128 eyes) undergoing either Toric-ICL (28 patients/56 eyes) or FS-LASIK (36 patients/72 eyes) at our department between January, 2019 and December, 2020. The changes of uncorrected distance visual acuity (UCVA), spherical equivalent (SE), mean astigmatism correction index (CI), corneal endothelial cell density (ECD) and intraocular pressure (IOP) following the procedures were compared between the two groups. RESULTS: In FS-LASIK group, all the eyes (72/72) achieved an UCVA≥1.0, similar to the rate in Toric-ICL group (55/56 eyes; P=0.2374). The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups [0.43±0.06 D (range: -1.0 to 1.50 D) vs 0.38±0.05 D (range: -0.75 to 1.00 D); P=0.56]. The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group (0.8561 vs 0.7176; P<0.0001), and 88.89% of the eyes in FS-LASIK group and 69.64% in Toric-ICL group had postoperative astigmatism ≤0.50 D. No significant changes were observed in postoperative corneal ECD in FS-LASIK group, whereas ECD decreased significantly after the procedure in Toric-ICL group (P=0.0057). The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP, but the patients receiving FS-LASIK had significantly reduced IOP after the procedure (P<0.001). CONCLUSIONS Although the patients included in Toric-ICL group had higher myopia and astigmatism, Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group. Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
Humans ; Astigmatism/complications* ; Myopia/complications* ; Keratomileusis, Laser In Situ/methods* ; Retrospective Studies ; Adult ; Visual Acuity ; Adolescent ; Young Adult ; Treatment Outcome ; Male ; Lens Implantation, Intraocular/methods* ; Female ; Phakic Intraocular Lenses ; Intraocular Pressure

Objective:Human genetic resources are valuable biological resources with significant importance in medical research, population genetics, and other fields. This paper focuses on ″human genetic resources data management″, analyzing the management practices at National Medical Center Fudan University Zhongshan Hospital, and proposing optimization strategies for current management issued to enhance data security protection and compliance.Methods:Based on case analysis methodology, this study systematically reviewed the hospital′s human genetic resources data management practices. Through statistical correlation analysis, the relationship between resource application quantities and applicants′ research outputs was validated.Results:The findings revealed that basic research dominates human genetic resources applications, primarily focusing on genetic testing, drug trials, and neoadjuvant therapies. Correlation analysis demonstrated a significant positive correlation between the number of human genetic resources applications and applicants′ research outputs, indicating that utilization of human genetic resources was closely related to research productivity.Conclusions:Based on the main issues identified at the hospital management level, optimization measures such as refining management scope, technological innovation empowerment, data standardization, and data interoperability are beneficial for enhancing data security protection and compliance. It is necessary to establish relevant training systems and implementation standards to ensure the safe and effective management of human genetic resources data.

Objective To explore current status of alexithymia in middle-aged and young patients with stroke,and to analyse the influencing factors and summarise the nursing strategies therefore to provide references for nursing interventions.Methods A convenience sampling method was used to select 220 patients who had stroke and admitted to the wards of Neurology and Neurosurgery in our hospital between February and April 2024.The patients were surveyed using a general information questionnaire,the stroke symptom experience scale,the stroke-specific quality of life scale(SSQOL),and the Toronto alexithymia scale-20(TAS-20).Pearson correlation analysis was used to evaluate the relationship between alexithymia,stroke symptom experience and quality of life in middle-aged and young patients with stroke.Multiple linear regression analysis was used to identify the influencing factors of alexithymia.Results A total of 205 middle-aged and young patients with stroke completed the study.The mean score of the TAS-20 was 74.67±19.68,with average subscale scores for difficulty in identifying feelings of 3.45±0.73,difficulty in describing feelings of 3.49±0.74 and externally-oriented thinking of 3.22±0.69.The prevalence of alexithymia was 74.63%.Alexithymia was found positively correlated with stroke symptom experience and negatively correlated with quality of life(all P<0.05).The education,family income and stroke symptom experience were the protective factors for alexithymia,while quality of life was a risk factor(all P<0.05).These factors collectively explained 61.50%of the variance in alexithymia.Conclusion Middle-aged and young patients with stroke have a high level of alexithymia.Patients with higher education,family monthly income≥2,000 yuan,lower quality of life and higher symptom burden are more likely to develop an alexithymia.Nursing staff should seek appropriate methods to guide patients in expressing their emotions in order to prevent the alexithymia.

Objective:Human genetic resources are valuable biological resources with significant importance in medical research, population genetics, and other fields. This paper focuses on ″human genetic resources data management″, analyzing the management practices at National Medical Center Fudan University Zhongshan Hospital, and proposing optimization strategies for current management issued to enhance data security protection and compliance.Methods:Based on case analysis methodology, this study systematically reviewed the hospital′s human genetic resources data management practices. Through statistical correlation analysis, the relationship between resource application quantities and applicants′ research outputs was validated.Results:The findings revealed that basic research dominates human genetic resources applications, primarily focusing on genetic testing, drug trials, and neoadjuvant therapies. Correlation analysis demonstrated a significant positive correlation between the number of human genetic resources applications and applicants′ research outputs, indicating that utilization of human genetic resources was closely related to research productivity.Conclusions:Based on the main issues identified at the hospital management level, optimization measures such as refining management scope, technological innovation empowerment, data standardization, and data interoperability are beneficial for enhancing data security protection and compliance. It is necessary to establish relevant training systems and implementation standards to ensure the safe and effective management of human genetic resources data.

Objective To explore current status of alexithymia in middle-aged and young patients with stroke,and to analyse the influencing factors and summarise the nursing strategies therefore to provide references for nursing interventions.Methods A convenience sampling method was used to select 220 patients who had stroke and admitted to the wards of Neurology and Neurosurgery in our hospital between February and April 2024.The patients were surveyed using a general information questionnaire,the stroke symptom experience scale,the stroke-specific quality of life scale(SSQOL),and the Toronto alexithymia scale-20(TAS-20).Pearson correlation analysis was used to evaluate the relationship between alexithymia,stroke symptom experience and quality of life in middle-aged and young patients with stroke.Multiple linear regression analysis was used to identify the influencing factors of alexithymia.Results A total of 205 middle-aged and young patients with stroke completed the study.The mean score of the TAS-20 was 74.67±19.68,with average subscale scores for difficulty in identifying feelings of 3.45±0.73,difficulty in describing feelings of 3.49±0.74 and externally-oriented thinking of 3.22±0.69.The prevalence of alexithymia was 74.63%.Alexithymia was found positively correlated with stroke symptom experience and negatively correlated with quality of life(all P<0.05).The education,family income and stroke symptom experience were the protective factors for alexithymia,while quality of life was a risk factor(all P<0.05).These factors collectively explained 61.50%of the variance in alexithymia.Conclusion Middle-aged and young patients with stroke have a high level of alexithymia.Patients with higher education,family monthly income≥2,000 yuan,lower quality of life and higher symptom burden are more likely to develop an alexithymia.Nursing staff should seek appropriate methods to guide patients in expressing their emotions in order to prevent the alexithymia.

Objective:To analyze the mutations of globin genes among patients suspected for thalassemia from the Shanghai area.Methods:A total of 4 644 patients diagnosed at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between June 2016 and December 2019 were selected as the study subjects. The patients were tested for common mutations associated with thalassemia gene by Gap-PCR and reverse dot blotting (RDB). Patients were suspected to harbor rare mutations based on the inconsistency between hematological phenotypes and results of common mutation detection, and were further analyzed by Gap-PCR and Sanger sequencing.Results:Among the 4 644 patients, 2 194 (47.24%) were found to carry common thalassemia mutations, among which 701 (15.09%) were α-thalassemia, 1 448 (31.18%) were β-thalassemia, and 45 (0.97%) were both α- and β-thalassemia. Forty six samples were found to harbor rare mutations, which included 17 α-globin gene and 29 β-globin gene mutations. CD77(CCC>ACC) ( HBA2: c. 232C>A) of the α-globin gene, NG_000007.3: g. 70567_71015del449, codon 102(-A) ( HBB: c. 308_308delA) and IVS-Ⅱ-636 (A>G) ( HBB: c. 316-215A>G) of the β-globin gene were previously unreported new types of globin gene mutations. Conclusion:Among the 4 644 patients, the detection rate for common thalassemia mutations was 47.24%, whilst 46 samples were detected with rare gene mutations. The type of gene mutation types were diverse in the Shanghai area. The study has provided more accurate results for genetic diagnosis and counseling.

Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

Objective To research the procedure for creating an animal model of mitral regurgitation by implanting a device through the apical artificial chordae tendineae, and to assess the stability and dependability of the device. Methods Twelve large white swines were employed in the experiments. Through a tiny hole in the apex of the heart, the artificial chordae tendineae of the mitral valve was inserted under the guidance of transcardiac ultrasonography. Before, immediately after, and one and three months after surgery, cardiac ultrasonography signs were noted. Results All models were successfully established. During the operation and the follow-up, no swines died. Immediately after surgery, the mitral valve experienced moderate regurgitation. Compared with preoperation, there was a variable increase in the amount of regurgitation and the values of heart diameters at a 3-month follow-up (P<0.05). Conclusion In off-pump, the technique of pulling the mitral valve leaflets with chordae tendineae implanted transapically under ultrasound guidance can stably and consistently create an animal model of mitral regurgitation.

Developing new therapeutic agents for cancer immunotherapy is highly demanding due to the low response ratio of PD-1/PD-L1 blockade in cancer patients. Here, we discovered that the novel immune checkpoint VISTA is highly expressed on a variety of tumor-infiltrating immune cells, especially myeloid derived suppressor cells (MDSCs) and CD8⁺ T cells. Then, peptide C1 with binding affinity to VISTA was developed by phage displayed bio-panning technique, and its mutant peptide VS3 was obtained by molecular docking based mutation. Peptide VS3 could bind VISTA with high affinity and block its interaction with ligand PSGL-1 under acidic condition, and elicit anti-tumor activity in vivo. The peptide DVS3-Pal was further designed by d-amino acid substitution and fatty acid modification, which exhibited strong proteolytic stability and significant anti-tumor activity through enhancing CD8⁺ T cell function and decreasing MDSCs infiltration. This is the first study to develop peptides to block VISTA/PSGL-1 interaction, which could act as promising candidates for cancer immunotherapy.

Objective:To study the clinical value of the ISBAR communication model based on nursing priorities in nursing ward rounds.Methods:Using a quasi-experiment method, 104 patients who received secondary and tertiary care from April to June 2020 were set as the control group, and 122 patients who received secondary and tertiary care from July to September 2020 were set up as the experimental group, with non-randomized method. The experimental group used the ISBAR communication model based on nursing priorities for nursing ward rounds, and the control group used the traditional method for nursing ward rounds. The abilities of bedside nurses collecting the patients′condition, the bedside nurses′ condition observation and the nurses′ critical thinking were compared between the two groups, and the patients' nursing quality and satisfaction were also compared.Results:The scores of the bedside nurses′ knowledge of the patients′ condition were 81.14±3.09 in the test group and 75.90±2.84 in the control group, with statistically significant difference ( t value was -12.88, P<0.01). The scores of the bedside nurses′ ability in observing patients′ condition were 140.50 (137.00, 144.50) in the experimental group and 135.50 (128.75, 139.00) in the control group, with statistically significant difference ( Z value was -3.399, P<0.01). The scores of the Critical Thinking Disposition Inventory Chinese-version (CTDI-CV) were 309.82±36.33 in the experimental group and 286.86±33.54 in the control group, with statistically significant difference ( t value was -2.177, P<0.05). The scores of patient care quality evaluation were 62.50 (60.00, 64.00) in the experimental group and 59.00 (55.00, 61.50) in the control group, with statistically significant difference ( Z value was -6.47, P<0.01). The patient discharge satisfaction score of the experimental group was 53.00 (48.75, 55.00), and that of the control group was 51.00 (44.00, 54.00), with statistically significant difference ( Z value was -3.56, P<0.01). Conclusions:The application of ISBAR communication model based on nursing priorities in nursing ward rounds had a significant promotion effect on the improvement of nurses' abilities of collecting the patients′ condition, observing patients′ condition, and critical thinking, and can effectively improve nursing care quality and patients′ satisfaction.