AIM:To investigate the effect of peripheral defocus design rigid gas permeable contact lenses(defocus RGPCL)in controlling myopia progression in children aged 6-12 y with high myopia, and to compare the outcomes with traditional single-vision RGPCL and single-vision spectacles.METHODS:This prospective cohort study enrolled children aged 6-12 y with high myopia who visited the Ophthalmology and Optometry Center of Xi'an No.1 Hospital between January 2022 and January 2023. Based on parental preference, participants were divided into three groups: defocused RGPCL group, single-vision RGPCL group, and single-vision spectacles group. The axial length(AL)and cycloplegic spherical equivalent(SE)refraction were compared at baseline, 0.5, 1, 1.5, and 2 y after lens wear. Additionally, AL and SE delay rates were calculated for each group.RESULTS: This study enrolled a total of 90 children with high myopia(180 eyes), with no participants lost to follow-up. Participants were allocated into three groups based on parental preference. Thirty children(60 eyes)were assigned to the peripheral defocus RGPCL group, consisting of 12 boys and 18 girls with a mean age of 9.96±1.56 y; 30 children(60 eyes)to the single-vision RGPCL group, including 15 boys and 15 girls with a mean age of 9.40±1.52 y; and 30 children(60 eyes)to the single-vision spectacles group, with 14 boys and 16 girls and a mean age of 9.80±1.37 y. At 0.5, 1, 1.5, and 2 y lens fitting, AL and SE increased significantly in all three groups(all P<0.05), with the growth rates in the defocused RGPCL group being significantly lower than those in the single-vision RGPCL and single-vision spectacles groups(all P<0.05). At 2 y lens fitting, the AL elongation was 0.22±0.24 mm and the mean SE progression was 0.70±0.70 D in the peripheral defocus RGPCL group; 0.49±0.38 mm and 1.34±0.60 D in the single-vision RGPCL group; and 0.50±0.21 mm and 1.72±0.47 D in the single-vision spectacles group. Using the single-vision spectacles group as the control, the AL delay rate and SE delay rate at 2 y lens fitting were 56.0% and 59.3%, respectively, in the defocused RGPCL group.CONCLUSION:For children with high myopia aged 6-12 y, defocus RGPCLs can effectively and significantly delay AL elongation and SE progression, demonstrating markedly superior control efficacy compared to single-vision RGPCL or single-vision spectacles. Defocused RGPCL can serve as an effective optical intervention for high myopia children.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

OBJECTIVE To understand the current status of standard precautions knowledge,behaviors of the pri-mary health care workers and analyze the influencing factors so as to provide bases for improving the standard pre-caution behaviors of the primary health care workers.METHODS A total of 1320 primary health care workers from a district of Luoyang were recruited as the research subjects.In Dec.2024,a cross-sectional survey was conducted by using self-designed questionnaires on standard precautions knowledge,behavior scales,and Health Belief Mod-el(HBM)scales.The survey data were treated with statistical description,reliability and validity tests and struc-tural equation model(SEM)fitting.RESULTS A total of 1205 valid questionnaires were recovered,with an effec-tive recovery rate 91.29％(1205/1320).Among the primary health care workers,45.64％mastered standard pre-cautions knowledge,and 62.99％could implement standard precautions behaviors.There was significant differ-ence in the score of standard precautions knowledge among the health care workers of different genders and age(P＜0.05);the significant differences in standard precautions behavior scores were observed among the health care workers of different genders,professional titles,work regions,and unit natures(P＜0.05).After the Knowledge-Attitude-Behavior(KAB)theory was integrated with the Health Belief Model,the knowledge,per-ceived severity,perceived benefits,perceived barriers,cues to action and self-efficacy had direct impacts on stand-ard precautions behaviors during the implementation process of standard precautions,with direct effect values 0.054,0.112,0.276,-0.062,0.223 and 0.213,respectively.CONCLUSIONS The awareness rate of standard pre-cautions and the implementation level of related behaviors are relatively low among the primary health care work-ers.The standard precautions behaviors can be remarkable improved by designing reasonable training programs to improve medical staff's knowledge,perceived severity,perceived benefits,cues to action and self-efficacy,while by reducing perceived barriers.

ObjectiveTo study on the different therapeutic effects and potential mechanisms of Rhei Radix et Rhizoma（RH） before and after steaming with wine on constipation model mice. MethodsFifty-four male ICR mice were randomly divided into control group， model group， lactulose group（1.5 mg·kg^-1）， high， medium and low dose groups of RH and RH steaming with wine（PRH）（8， 4， 1 g·kg^-1）. Except for the control group， the constipation model was replicated by gavage of loperamide hydrochloride（6 mg·kg^-1） in the other groups. After 2 weeks of modeling， each administration group was gavaged with the corresponding dose of drug solution， and the control and model groups were given an equal volume of normal saline， 1 time/d for 2 consecutive weeks. After administration， the feces were collected for 16S rRNA sequencing， the levels of gastrin（GAS）， motilin（MTL）， interleukin-6（IL-6）， γ-interferon（IFN-γ） in the colonic tissue were detected by enzyme-linked immunosorbent assay（ELISA）， the histopathological changes of colon were observed by hematoxylin-eosin（HE） staining， flow cytometry was used to detect the proportion changes of CD4⁺， CD8⁺ and regulatory T cell（Treg） in peripheral blood. ResultsCompared with the control group， the model group showed significantly decrease in fecal number in 24 h， fecal quality and fecal water rate（P<0.01）， the colon was seen to have necrotic shedding of mucosal epithelium， localized intestinal glands in the lamina propria were degenerated， necrotic and atrophied， a few lymphocytes were seen to infiltrate in the necrotic area in a scattered manner， the contents of GAS and MTL， the proportions of CD4⁺， CD8⁺ and Treg were significantly reduced（P<0.01）， the contents of IL-6 and IFN-γ were significantly elevated（P<0.05， P<0.01）. Compared with the model group， the fecal number in 24 h， fecal quality and fecal water rate of high-dose groups of RH and PRH were significantly increased（P<0.05， P<0.01）， the pathological damage of the colon was alleviated to varying degrees， the contents of GAS， MTL， IL-6 and IFN-γ were significantly regressed（P<0.05， P<0.01）， and the proportions of CD4⁺ and CD8⁺ were significantly increased（P<0.01）， although the proportion of Treg showed an upward trend， there was no significant difference. In addition， the results of intestinal flora showed that the number of amplicon sequence variant（ASV） and Alpha diversity were decreased in the model group compared with the control group， and there was a significant difference in Beta diversity， with a decrease in the relative abundance of Lactobacillus and an increase in the relative abundances of Bacillus and Helicobacter. Compared with the model group， the ASV number and Alpha diversity were increased in the high-dose groups of RH and PRH， and there was a trend of regression of Beta diversity to the control group， the relative abundance of Lactobacillus increased， and the relative abundances of Bacillus and Helicobacter decreased. ConclusionRH and PRH can improve dysbacteriosis， promote immune system activation， inhibit the release of inflammatory factors for enhancing the gastrointestinal function， which may be one of the potential mechanisms of their therapeutic effect on constipation.

OBJECTIVE To standardize the management of patients’ self-carried medicines dispensed by Pharmacy Intravenous Admixture Services （PIVAS） of our hospital， improve the quality of medical care， and ensure the safety of patients’ medication. METHODS Based on evidence-based methodology， the research literature of domestic medical institutions on the management of patients’ self-carried medicines was systematically searched and analyzed， and the data on the use of patients’ self- carried medicines in our hospital from February to April 2023 were extracted based on our hospital’s information system. A fishbone diagram of the difficulties in constructing patients’ self-carried medicines within PIVAS of our hospital was drawn through brainstorming， thereby establishing a refined whole-process management system for patients’ self-carried medicines in PIVAS. The effectiveness of the system was evaluated through the indicators， including dispensing volume， error rate， and so on. RESULTS & CONCLUSIONS A total of 15 papers were included， covering descriptive studies on the reasons for the use of patients’ self- carried medicines， current status of their use， management system， management methods， management suggestions. There were 12 clinical departments in our hospital with a high proportion of patients using self-carried medicines， among which the pediatric neurology department had the most use of patients’ self-carried medicines， accounting for 10.65%. In terms of dosage form， injectable drugs accounted for 13.68%， all of anticancer drug were uniformly dispensed by our hospital’s PIVAS. PIVAS in our hospital had successfully constructed the management system for dispensing patients’ self-carried medicines， which included the processes of drug reception and preservation， medical document retention， doctor’s order review， drug placement， dispensing， review and transportation. After the implementation of the system， from May 2023 to October 2024， our hospital’s PIVAS dispensed 654 bags of patients’ self-carried medicines in total，with a monthly average of 36 bags. Zero error management 5）；was realized for all patients’ self-carried medicines. The system operates stably and effectively， thereby ensuring the high-quality dispensing of patients’ self-carried medicines in PIVAS of our hospital.

INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Objective:To explore the correlation between serum γ-glutamyl transpeptidase (γ-GGT), albumin/globulin ratio (AGR), miR-208a levels and cardiac function classification and prognosis in patients with chronic heart failure (CHF).Methods:A total of 150 CHF patients who were diagnosed in the Affiliated Hospital of Yan′an University from May 2020 to May 2023 and followed up for at least 1 year were retrospectively selected as the CHF group. Eighty healthy volunteers recruited from the physical examination center were selected as the control group. The serum levels of γ-GGT, AGR and miR-208a were compared between the two groups. Subgroup analysis was conducted according to the New York Heart Association (NYHA) classification of CHF patients and whether major adverse cardiovascular events (MACE) occurred during 1-year follow-up. Multivariate logistic regression analysis was used to screen the influencing factors of prognosis in CHF patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index for adverse prognosis of patients.Results:The serum levels of γ-GGT and miR-208a in the CHF group were significantly higher than those in the control group (all P<0.05), while the AGR level was lower than that in the control group ( P<0.05). The serum levels of γ-GGT and miR-208a in patients with NYHA class Ⅳ were significantly higher than those in patients with class Ⅱ and Ⅲ (all P<0.05), and the AGR level was lower than that in patients with class Ⅱ and Ⅲ (all P<0.05); the serum levels of γ-GGT and miR-208a in patients with NYHA class Ⅲ were significantly higher than those in patients with class Ⅱ (all P<0.05). The serum levels of γ-GGT and miR-208a in the MACE group were significantly higher than those in the non-MACE group (all P<0.05), while the AGR level was lower than that in the non-MACE group ( P<0.05). Prolonged CHF course, NYHA classification ≥class Ⅲ, decreased left ventricular ejection fraction (LVEF), complicated with atrial fibrillation, increased γ-GGT, decreased AGR and increased miR-208a were independent risk factors for adverse prognosis of CHF patients (all P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of γ-GGT, AGR, miR-208a alone and in combination for predicting adverse prognosis of CHF patients were 0.631(95% CI: 0.531-0.731), 0.704(95% CI: 0.602-0.805), 0.753(95% CI: 0.657-0.849) and 0.879(95% CI: 0.818-0.941), respectively. Conclusions:Serum γ-GGT, AGR and miR-208a are closely related to NYHA classification and adverse prognosis of CHF patients. The combined application of the three indicators has important reference significance for predicting the adverse prognosis of patients.

Objective:To explore the correlation between serum γ-glutamyl transpeptidase (γ-GGT), albumin/globulin ratio (AGR), miR-208a levels and cardiac function classification and prognosis in patients with chronic heart failure (CHF).Methods:A total of 150 CHF patients who were diagnosed in the Affiliated Hospital of Yan′an University from May 2020 to May 2023 and followed up for at least 1 year were retrospectively selected as the CHF group. Eighty healthy volunteers recruited from the physical examination center were selected as the control group. The serum levels of γ-GGT, AGR and miR-208a were compared between the two groups. Subgroup analysis was conducted according to the New York Heart Association (NYHA) classification of CHF patients and whether major adverse cardiovascular events (MACE) occurred during 1-year follow-up. Multivariate logistic regression analysis was used to screen the influencing factors of prognosis in CHF patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index for adverse prognosis of patients.Results:The serum levels of γ-GGT and miR-208a in the CHF group were significantly higher than those in the control group (all P<0.05), while the AGR level was lower than that in the control group ( P<0.05). The serum levels of γ-GGT and miR-208a in patients with NYHA class Ⅳ were significantly higher than those in patients with class Ⅱ and Ⅲ (all P<0.05), and the AGR level was lower than that in patients with class Ⅱ and Ⅲ (all P<0.05); the serum levels of γ-GGT and miR-208a in patients with NYHA class Ⅲ were significantly higher than those in patients with class Ⅱ (all P<0.05). The serum levels of γ-GGT and miR-208a in the MACE group were significantly higher than those in the non-MACE group (all P<0.05), while the AGR level was lower than that in the non-MACE group ( P<0.05). Prolonged CHF course, NYHA classification ≥class Ⅲ, decreased left ventricular ejection fraction (LVEF), complicated with atrial fibrillation, increased γ-GGT, decreased AGR and increased miR-208a were independent risk factors for adverse prognosis of CHF patients (all P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of γ-GGT, AGR, miR-208a alone and in combination for predicting adverse prognosis of CHF patients were 0.631(95% CI: 0.531-0.731), 0.704(95% CI: 0.602-0.805), 0.753(95% CI: 0.657-0.849) and 0.879(95% CI: 0.818-0.941), respectively. Conclusions:Serum γ-GGT, AGR and miR-208a are closely related to NYHA classification and adverse prognosis of CHF patients. The combined application of the three indicators has important reference significance for predicting the adverse prognosis of patients.

OBJECTIVE To understand the current status of standard precautions knowledge,behaviors of the pri-mary health care workers and analyze the influencing factors so as to provide bases for improving the standard pre-caution behaviors of the primary health care workers.METHODS A total of 1320 primary health care workers from a district of Luoyang were recruited as the research subjects.In Dec.2024,a cross-sectional survey was conducted by using self-designed questionnaires on standard precautions knowledge,behavior scales,and Health Belief Mod-el(HBM)scales.The survey data were treated with statistical description,reliability and validity tests and struc-tural equation model(SEM)fitting.RESULTS A total of 1205 valid questionnaires were recovered,with an effec-tive recovery rate 91.29％(1205/1320).Among the primary health care workers,45.64％mastered standard pre-cautions knowledge,and 62.99％could implement standard precautions behaviors.There was significant differ-ence in the score of standard precautions knowledge among the health care workers of different genders and age(P＜0.05);the significant differences in standard precautions behavior scores were observed among the health care workers of different genders,professional titles,work regions,and unit natures(P＜0.05).After the Knowledge-Attitude-Behavior(KAB)theory was integrated with the Health Belief Model,the knowledge,per-ceived severity,perceived benefits,perceived barriers,cues to action and self-efficacy had direct impacts on stand-ard precautions behaviors during the implementation process of standard precautions,with direct effect values 0.054,0.112,0.276,-0.062,0.223 and 0.213,respectively.CONCLUSIONS The awareness rate of standard pre-cautions and the implementation level of related behaviors are relatively low among the primary health care work-ers.The standard precautions behaviors can be remarkable improved by designing reasonable training programs to improve medical staff's knowledge,perceived severity,perceived benefits,cues to action and self-efficacy,while by reducing perceived barriers.

Objective To explore the relationship between serum Krüppel-like factor 5(KLF5)and actinin-4 with prognosis of hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE).Methods From March 2015 to March 2020,130 HCC patients admitted into the Second Affiliated Hospital were collected as study subjects and divided into HCC group and 86 patients with liver cirrhosis were collected as control group.After 3 years of postoperative follow-up,HCC patients were sub-divided into survival group(n=38)and mortality group(n=92)based on their survival outcomes.ELISA was applied to detect the level of serum KLF5 and actinin-4 in each group and analyzed the correlation between serum KLF5 and actinin-4 levels.Cox regression was applied to analyze the risk factors affecting the prognostic mortality of HCC patients;Receiver operating char-acteristic curve(ROC)was plotted to evaluate the predictive value of serum KLF5 and actinin-4 levels for the prognostic mortality of HCC patients.Results The serum level of KLF5 and actinin-4 in the mortality group was significantly higher than those in the survival group(P＜0.05);There was a positive correlation between serum level of KLF5 and actinin-4 in HCC patients(P＜0.001);Low differentiation,staging(CNLC)stage IIIa of China liver cancer staging(CNLC),vascular invasion and elevated level of KLF5 and actinin-4 were risk factors for prognostic mortality in HCC patients(P＜0.05);The area under the curve(AUC)of serum KLF5 and acti-nin-4 alone and in combination for predicting mortality in HCC patients was 0.835,0.866,and 0.936,respec-tively,showing a high level of combined predicting function(Zcombination-KLF5=2.792,P=0.005,Zcombi-nation-actinin-4=2.014,P=0.044).Conclusions Serum level of KLF5 and actinin-4 l found in HCC patients has a high predictive value for prognosis.