Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Gut microbiome is an important part of maintaining human homeostasis.In recent years, with the rapid development of sequencing technologies such as 16S rRNA and metagenome, people have a deeper and more comprehensive understanding about microorganisms.Studies in animals and humans have confirmed that the gut microbiome is not only involved in the pathological process of systemic diseases such as immune, metabolic and neurological disorders, but is also closely related to eye diseases.Factors such as host high blood glucose, immune disorders, aging, high intraocular pressure can cause gut microbiota dysbiosis and increase gut-blood barrier permeability.Lipopolysaccharide, peptidoglycan and other pathogen-associated molecular patterns enter the systemic circulation through the damaged gut barrier and eventually reach the retina and uveitis where they participate the immune and inflammatory response process.In addition, gut-derived host immune cells or injury-related molecular patterns may exacerbate the ocular inflammatory cascade.At the same time, metabolites of microbiota, including those induced by diet and environment factors, such as bilirubin, bile acids and short-chain fatty acids, are involved in the progression of retinal diseases via regulating immune T cell balance, miRNA expression and retinal cell inflammatory activation.This article aims to review the domestic and foreign studies on gut microbiome in diabetic retinopathy, uveitis, age-related macular degeneration and glaucoma in recent years, and discuss the possible mechanisms of gut microbiome in eye diseases via the gut-retina axis in order to provide some new ideas for further study and treatment of eye diseases.

Objective To explore the correlation between lumbar spine bone mineral density and the occurrence of large rotator cuff tears. Methods A total of 109 patients with arthroscopic shoulder surgery in the Department of Arthroplasty Surgery in Kunshan Hospital of Traditional Chinese Medicine from January 2018 to October 2023 were selected and divided into large rotator cuff tear group (n=27) and small rotator cuff tear group (n=82) according to the severity of the rotator cuff tears. General materials of patients were collected, and multivariate Logistic regression analysis was used to investigate the correlation between lumbar spine bone mineral density and the occurrence of large rotator cuff tears. Results The large rotator cuff tear group had significant higher age and higher proportion of patients with a history of trauma compared to the small rotator cuff tear group (P < 0.05); additionally, the levels of total cholesterol, albumin, serum magnesium, total hip bone mineral density, and lumbar spine bone mineral density were significantly lower in the large rotator cuff tear group (P < 0.05). The results of multivariate Logistic regression analysis indicated that lumbar spine bone mineral density was associated with the occurrence of large rotator cuff tears. The prevalence of large rotator cuff tears across the four quartile intervals of lumbar spine bone mineral density named as Q1 (< 0.870 g/cm²), Q2 (0.870~ < 0.991 g/cm²), Q3 (0.991~1.137 g/cm²), and Q4 (>1.137 g/cm²) were 48.15%, 29.63%, 18.52% and 3.70% respectively, showing a gradual decreasing trend with significant differences (P < 0.05). Conclusion There is a correlation between lumbar spine bone mineral density and large rotator cuff tears. The lower the bone density of the lumbar spine is, the higher the risk of large rotator cuff tears will be.

Objective:To explore the initial motivation of nursing students to engage in voluntary service for the aged, and to provide scientific basis for the formulation of strategies and measures of voluntary service for the aged.Methods:Totally 25 nursing students volunteers who regularly participated in the volunteer service for the aged in Changsha First Welfare Home were selected by objective sampling method for semi-structured in-depth interviews, and the data were analyzed by Colaizzi phenomenological 7-step analysis method.Results:Four themes of nursing students' initial motivation to participate in voluntary service for the aged were extracted: self-interest motivation, altruistic motivation, affinity motivation and achievement motivation. Among them, self-interest motivation included two sub-themes: enriching college life and life experience, improving one's own ability and gaining professional experience; altruistic motivation included two sub-themes: accompanying and helping the elderly and eliminating loneliness of the elderly; affinity motivation included two sub-themes: establishing emotional sustenance and making up for the lack of emotion; achievement motivation included two sub-themes: facing challenges bravely, acquiring a sense of achievement, serving society and others, and realizing one's own value.Conclusion:Nursing students have a clear initial motivation to participate in the voluntary service for the aged of the aged care facilities, and schools can strengthen the relevant education for students to participate in voluntary service in the training of nursing talents. The voluntary service for the aged can formulate corresponding development strategies and incentives according to the initial motivation of nursing students, so that promote the expansion and stability of the voluntary service for the aged team, and promote the development and improvement of voluntary service for the aged.

AIM: To study the distribution characteristics of steady-state trough concentration (C

Objective:To investigate the discriminant function of optical coherence tomography angiography (OCTA) in the diagnosis of primary open angle glaucoma (POAG) and to evaluate the correlation between vessel density, as measured by OCTA, and visual field mean defect (MD) in patients with POAG.Methods:A case control study was designed.Ninety-five eyes of 54 patients with POAG and ninety-six eyes of 48 healthy subjects in Changsha Aier Eye Hospital were included in this study.The vessel density in the radial peripapillary capillary (RPC) network, the macular vessel density, the ganglion cell complex (GCC) layer thickness, the macular thickness, and the retinal nerve fiber layer thickness were tested for correlation with MD.The aera under the receiver operating characteristic (ROC) curves (AUC), as well as sensitivities at fixed vessel density specificities in the RPC network, and macular regions were analyzed.ROC regression was used to evaluate the effect of covariates on the diagnostic abilities.The study protocol was approved by the Ethics Committee of Changsha Aier Eye Hospital.Written informed consent was obtained from all subjects prior to entering the study cohort.Results:Compared with the normal control group, the macular area and vessel density in the RPC network were significantly decreased in the POAG group ( P<0.001). Also in the POAG group, except for the capillary density inside the disc, all other measurements including the density of superficial capillaries in the macula, the density of deep capillaries in the macula, the density of RPC layers around the optic disc, the average capillary density of the optic disc RPC layer, the capillary density of the optic disc RPC layer (above, below, nasal, and temporal), the thickness of the retinal nerve fiber layer, the thickness of the whole macular layer, and the thickness of the GCC layer of the macula area were positively correlated with the MD value ( r=0.586, 0.352, 0.610, 0.592, 0.598, 0.589, 0.445, 0.587, 0.578, 0.530, 0.609; all at P<0.01). The AUCs of vessel densities ranged from 0.623 to 0.927.The highest diagnostic efficiency was the RPC vessel density (whole image), the AUC value was 0.927. Conclusions:The OCTA parameters have a high diagnostic ability for POAG, except for the capillary density of inside the disc, all other vascular parameters are positively correlated with the MD value.

Objective:To observe the macular vascular density and the area of foveal avascular zone(FAZ) in the follow eyes of monocular retinal vein occlusion (RVO) patients.Methods:Retrospective case-control study. From May to November 2018, 78 follow eyes of 78 monocular RVO patients who were clinically diagnosed in Changsha Aier Eye Hospital were included in the study. Among them, 44 were male and 34 were female. The average age was 53.17±10.12 years. There were 42 patients with central retinal vein occlusion(CRVO group) and 36 patients with branch retinal vein occlusion (BRVO group). Forty-two eyes of 33 gender and age matched healthy volunteers were selected as the control group. Among them, 17 were male (22 eyes) and 16 were female (20 eyes), with the mean age of 53.48±10.84 years. OCT angiography was performed on all eyes in CRVO group, BRVO group and control group. The scanning region in the macular area was 6 mm× 6 mm. Macular vascular density and FAZ area in the superficial and deep retinal capillary plexi were measured.Results:The mean overall vascular density measured in the entire scan was lower in the CRVO group( t=-4.26, -4.93) and BRVO group ( t=-4.79, -4.74) compared with the control group in both the superficial and deep capillary plexus ( P<0.05). The reduce degree of vascular density in the deep capillary plexus (CRVO group:5.51%, BRVO group:4.58%) was higher than that in the superficial plexus (CRVO group:4.13%, BRVO group:3.50%). In the CRVO group, the FAZ area decreased compared with the control group ( t=-3.43, P<0.05). There was no statistically significant difference in the area of FAZ between the BRVO group and the control group ( t=-0.10, P>0.05). Conclusions:The macular vascular density in the follow eyes of monocular RVO patients is lower than that of normal healthy eyes. The reduce degree of vascular density in the deep capillary plexus is higher than that in the superficial plexus. Compared with normal healthy eyes, the FAZ area in the follow eyes of monocular CRVO patients decreased, while it did not change significantly in the follow eyes of monocular BRVO patients.

Polycystic ovary syndrome (PCOS) women often deal with the main characteristics of obesity, obesity is caused by the endocrine disorder, the menstrual cycle changes, etc. The main causes of infertility, easy cause anxiety, women have a negative impact on the quality of life through the fueling weight management of patients with PCOS were reviewed, summarized method, explore new train of thought, for fueling beset with PCOS patients provide better health and weight management method.

Objective To evaluate the efficacy and safety of intravitreal ranibizumab injection combined with triamcinolone acetonide (TA) for macular edema secondary to type Ⅱ optic disc vasculitis.Methods Totally 19 cases(19 eyes) with macular edema secondary to type Ⅱ optic disc vasculitis from January 2013 to December 2015 were injected ranibizumab intravitreally and triamcinolone acetonide 2 weeks later.The visual acuity,intraocular pressure,ocular fundus,OCT,FFA and related complications were observed during the 6 months follow-up period.If the macuiar edema returns during the follow-up period,the eyes would be given ranibizumab and TA again until the macular edema subsided.Results The visual acuity was 0.16 ± 0.09 and the central retinal thickness was (694.88 ± 79.06) μm before treatment.Compared with pretreatment,the visual acuity of all cases were improved in different degree except for one at 1 month,3 months and 6 months (all P ＜ 0.05).Also central retinal thickness were decreased and macular edema were subsided,there were statistical differences (all P ＜0.05).Compared with results at 1 month,the visual acuity and central retinal thickness was no significant different at 3 months and 6 months (all P ＞ 0.05).The intraocular pressure of all cases were normal throughout the follow-up period but one was increased transitorily in the first day after intravitreal rauibizumab injection.FFA examination at 1 month showed retinal hemorrhage and effusion absorbed obviously,besides,the optic disc and macular fluorescein leakage reduced significantly.The macular edema of 1 eye returned at 3 months and subsided after giving ranibizumab and TA again.The average number of injected eyes was 2.11 times.No complications associated with intravitreal injection and drugs were observed during the follow-up period.Conclusion It is effective and safe that intravitreal ranibizumab junction combined with TA for macular edema secondary to type Ⅱ optic disc vasculitis,which not only shorten the period of treatment but also reduce the times of drug injection,surgical trauma and complications.