OBJECTIVE: To observe the efficacy and safety of eye transcutaneous electrical acupoint stimulation (Eye-TEAS) on preventing the progression of pre-myopic to myopia in children aged 6-12 years. METHODS: A total of 170 pre-myopic children aged 6-12 years were randomly divided into an Eye-TEAS group (85 cases, 3 cases dropped out, 2 cases were eliminated) and a placebo Eye-TEAS group (85 cases, 3 cases dropped out, 2 cases were eliminated). The Eye-TEAS group received Eye-TEAS intervention at bilateral Cuanzhu (BL2), Yuyao (EX-HN4), Sizhukong (TE23), Taiyang (EX-HN5), Sibai (ST2), and Jingming (BL1), with continuous wave at a frequency of 4 Hz and a current of 1-2 mA for 30 min per session. The placebo Eye-TEAS group received sham intervention with the same equipment and procedure, but no electrical stimulation. Both groups received intervention once every other day, at least 3 times a week, for a duration of 20 weeks. After intervention and during the 28-week follow-up period after the intervention completion, the changes in axial length (AL), spherical equivalent refraction (SER), and the incidence of myopia were compared between the two groups. Adherence and safety during the intervention period were also evaluated. RESULTS: Compared before intervention, both groups showed an increase in AL after the intervention and during the follow-up (P<0.01). The AL during follow-up was higher than that after the intervention in the two groups (P<0.01). The Eye-TEAS group exhibited a smaller change in AL than the placebo Eye-TEAS group after the intervention and during follow-up (P<0.01, P<0.05). Compared before intervention, both groups showed a decrease in SER after the intervention and during follow-up (P<0.01). The SER during follow-up was lower than that after the intervention in the two groups (P<0.01). The Eye-TEAS group had a higher SER than the placebo Eye-TEAS group after the intervention (P<0.05). The Eye-TEAS group exhibited a smaller change in SER than the placebo Eye-TEAS group after the intervention and during follow-up (P<0.01). The incidence of myopia in the Eye-TEAS group was lower than that in the placebo group during follow-up (20.0% [14/70] vs 34.7% [25/72], P<0.05). Both groups had good adherence, with no adverse events related to the intervention. CONCLUSION Eye-TEAS can delay the progression of pre-myopic to myopia in children, and has a high safety profile.
Humans ; Child ; Male ; Female ; Acupuncture Points ; Myopia/prevention & control* ; Transcutaneous Electric Nerve Stimulation ; Treatment Outcome ; Disease Progression

OBJECTIVE: To reveal the molecular basis of knee osteoarthritis (KOA) with Yang deficiency and blood stasis syndrome by analyzing the gene expression profiles in synovial fluid and blood of KOA patients with this syndrome. METHODS: A total of 80 KOA patients were recruited from October 2022 to June 2024, including 40 cases in the non-Yang deficiency and blood stasis group (27 males and 13 females), with an average age of (61.75±3.45) years old;and 40 cases in the Yang deficiency and blood stasis group (22 males and 18 females), with an average age of (62.00±2.76) years old. The levels of body mass index (BMI), high-density lipoprotein (HDL), low-density lipoprotein (LDL), fibrinogen, total cholesterol, and D-dimer were recorded and summarized. Blood and synovial fluid samples from patients were collected for gene expression profile microarray sequencing, and then PCR and immunohistochemistry were used for clinical verification on the patients' synovial fluid and cartilage samples. RESULTS: Logistic regression analysis showed that compared with KOA patients with non-Yang deficiency and blood stasis syndrome, those with Yang deficiency and blood stasis syndrome had increased BMI, LDL, fibrinogen, total cholesterol, and D-dimer, and decreased HDL, with a clear correlation between the two groups. There were 562 differential genes in the blood, among which 322 were up-regulated and 240 were down-regulated;755 differential genes were found in the synovial fluid, with 350 up-regulated and 405 down-regulated. KEGG signaling pathway analysis of synovial fluid revealed changes in lipid metabolism-related pathways, including cholesterol metabolism, fatty acid metabolism, and PPARG signaling pathway. Analysis of the involved differential genes identified 6 genes in synovial fluid that were closely related to lipid metabolism, namely LRP1, LPL, ACOT6, TM6SF2, DGKK, and PPARG. Subsequently, PCR and immunohistochemical verification were performed using synovial fluid and cartilage samples, and the results were consistent with those of microarray sequencing. CONCLUSION This study explores the clinical and genomic correlation between traditional Chinese medicine syndromes and knee osteoarthritis from the perspective of lipid metabolism, and proves that abnormal lipid metabolism is closely related to KOA with Yang deficiency and blood stasis syndrome from both clinical and basic aspects.
Humans ; Male ; Female ; Middle Aged ; Synovial Fluid/metabolism* ; Osteoarthritis, Knee/metabolism* ; Yang Deficiency/complications* ; Aged

The aim of this study was to investigate the virulence determinants and genetic diversity of foodborne Yersinia enterocolitica from Wenzhou.A total of 71 strains of Yersinia enterocolitica were isolated from food and foodborne diarrhea ca-ses in Wenzhou,and their biotypes,serotypes,and drug resistance were analyzed.On the basis of whole genome sequencing,we assessed virulence gene profiles,and performed multilocus sequence typing(MLST)and core gene multilocus sequence typ-ing(cgMLST).A total of 94.4％(67/71)of isolates belonged to biotype 1A,and the highest proportion had serotype lA/O∶5(29.6％,21/71).The sensitivity rates of the isolates to 14 antibiotics exceeded 95.8％.A total of 16 categories and 126 viru-lence genes were identified,with two strains carrying the pYV plasmid and chromosome-related virulence genes.ST3(31.6％,12/38)was the most widespread MLST type,and cgMLST analysis revealed no dense clusters of genotypes except for strains sharing the same ST.In conclusion,pathogenic strains were identified from foodborne Yersinia enterocolitica in Wenzhou and were found to exhibit high genetic polymorphism.Enhanced regulatory supervision is essential to prevent the outbreak of food-borne diseases caused by Yersinia enterocolitica.

Energy metabolism is fundamental for life.It encompasses the utilization of carbohydrates,lipids,and proteins for internal processes,while aberrant energy metabolism is implicated in many diseases.In the present study,using three-dimensional(3D)printing from polycarbonate via fused deposition modeling,we propose a multi-nuclear radiofrequency(RF)coil design with integrated 1H birdcage and interchangeable X-nuclei(2H,13C,23Na,and 31P)single-loop coils for magnetic resonance imaging(MRI)/magnetic resonance spectroscopy(MRS).The single-loop coil for each nucleus attaches to an arc bracket that slides unrestrictedly along the birdcage coil inner surface,enabling convenient switching among various nuclei and animal handling.Compared to a commercial 1H birdcage coil,the proposed 1H birdcage coil exhibited superior signal-excitation homogeneity and imaging signal-to-noise ratio(SNR).For X-nuclei study,prominent peaks in spectroscopy for phantom solutions showed excellent SNR,and the static and dynamic peaks of in vivo spectroscopy validated the efficacy of the coil design in structural imaging and energy metabolism detection simultaneously.

Objective:To explore the influence factors for futile recanalization following endovascular treatment(EVT)in patients with acute basilar artery occlusion(BAO).Methods:Clinical data of patients with acute BAO,who underwent endovascular treatment within 24 h of onset from January 2017 to November 2022,were retrospectively analyzed.The futile recanalization was defined as modified thrombolysis in cerebral infarction(mTICI)grade≥2b or 3 after successful reperfusion,but the modified Rankin Scale score>2 at 3 months after EVT.Binary logistic regression model was used to analyze the influencing factors of futile recanalization.Results:A total of 471 patients with a median age of 68(57,74)years were included and 68.9%were males,among whom 298(63.27%)experienced futile recanalization.Multivariate analysis revealed that concomitant atrial fibrillation(OR=0.456,95%CI:0.282-0.737,P<0.01),bridging thrombolysis(OR= 0.640,95%CI:0.416-0.985,P<0.05),achieving mTICI grade 3(OR=0.554,95%CI:0.334-0.918,P<0.05),arterial occlusive lesion(AOL)grade 3(OR=0.521,95%CI:0.326-0.834,P<0.01),and early postoperative statin therapy(OR=0.509,95%CI:0.273-0.948,P<0.05)were protective factors for futile recanalization after EVT in acute BAO patients.High baseline National Institutes of Health Stroke Scale(NIHSS)score(OR=1.068,95%CI:1.049-1.087,P<0.01),coexisting hypertension(OR=1.571,95%CI:1.017-2.427,P<0.05),multiple retrieval attempts(OR=1.237,95%CI:1.029-1.488,P<0.05)and postoperative hemorrhagic transformation(OR=8.497,95%CI:2.879-25.076,P<0.01)were risk factors.For trial of ORG 10172 in acute stroke treatment(TOAST)classification,cardiogenic embolism(OR=0.321,95%CI:0.193-0.534,P<0.01)and other types(OR=0.499,95%CI:0.260-0.961,P<0.05)were related to lower incidence of futile recanalization.Conclusions:The incidence of futile recanalization after EVT in patients with acute BAO is high.Bridging venous thrombolysis before operation and an early postoperative statin therapy may reduce the incidence of futile recanalization.

Objective To explore the distribution characteristics and drug resistance of 267 strains of pathogenic bacteria in the intensive care unit.Methods 180 specimens sent for examination from 180 patients admitted to the intensive care unit of Yiwu Central Hospital who developed hospital-acquired infections from January 2021 to November 2023 were collected,and the sites of infection and the sources of specimens of patients with hospital-acquired infections were counted.The distribution characteristics of the patient's protozoa were analyzed,and the drug resistance of major Gram-positive bacteria(Staphylococcus aureus,Staphylococcus epidermidis)and Gram-negative bacteria(Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae)was analyzed in combination with drug sensitivity assessment results.Results Among the 180 patients with hospital-acquired infections,pulmonary and urinary tract infections accounted for a relatively high proportion,and sputum and urine specimens accounted for a relatively high proportion of the samples submitted for examination.180 specimens were cultured for pathogenic bacteria and 267 strains of pathogenic bacteria were detected,of which Gram-positive bacteria accounted for 29.59%,Gram-negative bacteria accounted for 67.04%,and fungi accounted for 3.37%.From 2021 to 2023,the detection rates of Gram-positive bacteria and fungi showed an increasing trend,and Gram-negative bacteria detection rates showed a decreasing trend.Staphylococcus aureus had high sensitivity to linezolid and Staphylococcus epidermidis had high sensitivity to moxifloxacin and linezolid.Escherichia coli and Pseudomonas aeruginosa had high sensitivity to piperacillin/tazobactam,and Klebsiella pneumoniae had high sensitivity to cotrimoxazole,imipenem,and piperacillin/tazobactam.Conclusion The distribution of pathogenic bacteria in patients with hospital-acquired infections admitted to the intensive care unit mainly consisted of Staphylococcus aureus,Staphylococcus epidermidis and Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae,and there were varying degrees of resistance to antimicrobial drugs.The subsequent selection of clinical drugs should be cautious,and antimicrobials with high sensitivity should be prioritized.

Objective To design and construct a syndrome differentiation knowledge graph that integrates TCM facial color diagnosis information;To explore the hidden relationships between the knowledge.Methods The literature data came from ancient classics,textbooks,as well as standard literature related to inspection included in the CNKI,VIP and Wanfang Data from the establishment of the databases to December 31,2022.The clinical data was sourced from 30 elderly individuals who underwent TCM health examinations at the Community Health Service Center in Jiading Industrial Zone,Shanghai in September 2022.Facial image acquisition was performed using TFDA-1 digital tongue and facial diagnostic instrument.By following the steps of knowledge extraction,knowledge fusion and quality assessment to construct a graph,and with the assistance of TCM experts for interpretation,using Access 2019 to integrate qualitative textual data and quantitative objective image digital information,a syndrome differentiation knowledge graph integrating TCM facial diagnosis was designed and completed in the Neo4j graph database.In addition,a method was designed to shift facial diagnosis knowledge from qualitative to quantitative.Results There were a total of 194 nodes under 8 entity term types and 12 entity term labels,as well as 361 relationships under 13 semantic relationships in knowledge graph.The Neo4j graph database provided a visualized TCM facial color diagnosis and differentiation,which could be queried and fed back using Cypher language.Conclusion The knowledge graph constructed based on the theory of TCM facial color diagnosis visually shows the complex correlation between facial color diagnosis and syndrome differentiation diagnosis,with a knowledge representation model that forms qualitative data of image features → semantic relationships → syndrome differentiation diagnosis forms.

Objective This study aims to investigate the effectiveness of hospital-institute integration and collaborative governance between Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences,analyze the specific factors influencing the integration and provide recommendations.Methods Based on the operational status of hospital-institute integration and collaborative governance between Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences,a questionnaire survey was designed.There are a total of 305 participants,who are employees of Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences.Results There is a correlation between"primary factors affecting effectiveness of hospital-institute integration"and"current main problems in the hospital-institute inte-gration",of which determination and understanding of"primary factors affecting effectiveness of hospital-institute integration"are affected by sex,title and education,and that of"current main problems in the hospital-institute integration"by age,position,working years and working years in the hospital;in addition,position also affects the determination and understanding of"actual result and effect of hospital-institute integration on hospital and medicine","evaluation of current advancement of hospital-institu-te integration","role of Hangzhou Institute of Medicine Chinese Academy of Sciences in the hospital-institute integration","un-derstanding related systems and mechanisms of hospital-institute integration".Conclusion Whether they are middle-level cadres or not has an impact on many aspects of the integration of institutions,resulting in difficulties in obtaining information,the need to strengthen incentive measures for some employees,and the need to improve the integration governance system and mechanism.In order to improve the effectiveness of institutional integration and coordinated governance,we propose countermeasures in this paper,such as improving information flows,enhancing employee incentives and strengthening system and mechanism.

The quality control of the surgical pathway for colorectal cancer is closely related to reducing the incidence of postoperative complications, recurrence and metastasis, prolonging survival, and preserving functions. This pathway involves multiple disciplines, stages, and contents: standardizing the diagnosis and treatment process for colorectal cancer is crucial to ensuring medical quality and safety. Strengthening perioperative management is an important essential step for accelerating postoperative recovery and improving patient prognosis. Establishing a standard training program and effective inspection system is guarantee for the quality of colorectal cancer surgery.

OBJECTIVE To establish a ultra-high-performance liquid chromatography-mass spectrum/mass spectrum(UPLC-MS/MS) method for the determination of anlotinib in human plasma and assessment of clinical application. METHODS Zanubrutinib was used as internal standard and the extraction process was performed through protein precipitation method using acetonitrile, followed by separation on an Ultimate XB-C18(100 mm×2.1 mm, 3.0 μm) column using acetonitrile and 10 mmol·L−1 ammonium acetate-0.1% formic acid step-elution gradient. The flow rate was 0.6 mL·min−1 and injection volume was 5 μL. The mass analysis was performed by positive ion electrospray ionization in multiple-reaction monitoring mode, and the mass spectrometer was set at m/z 408.1→339.1 for anlotinib and m/z 472.2→290.1 for internal standard, respectively. The specificity, standard curve and lower limit of quantification, precision and recovery, matrix effect and stability of the method and clinical application were investigated. RESULTS The method was validated over the concentration range of 1.0−100.0 ng·mL−1, with R2=0.998 4. The precision RSD was<9%, the recovery and matrix effect were 104.81%−107.32% and 102.54%−105.26%, respectively, and this method had good stability and was not affected by matrix effect. The method had been used for determined 52 advanced non-small cell lung cancer patients treated with anlotinib. The trough plasma concentration (Ctrough) was measured on day 43 after initiation of anlotinib treatment. Anlotinib Ctrough were higher than lower limit of quantitation (1.0 ng·mL−1) from 52 patients. The plasma concentration of anlotinib Ctrough was (11.38±4.29)ng·mL−1 with 37.66% coefficients of variation, which were shown large inter-patient variability. CONCLUSION This method is high sensitivity, specificity and accurate, and suitable for determination of anlotinib in human plasma.