AIM: To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses.METHODS: Myopic children aged 8-12 years, deemed suitable and willing to wear orthokeratology lenses, were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD. Data collection included changes in higher-order aberrations, relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d, 1 wk, 1, and 3 mo. The correlation of increase in corneal higher-order aberrations with refractive power was analyzed.RESULTS: The increases in total higher-order aberrations, spherical aberrations and coma aberrations varied over time following lens wear(all P<0.001), and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P>0.05). A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients, which varied over time(Ftime=40.179, Ptime<0.001; Fgroup=11.948, Pgroup=0.001; Finteraction=3.262, Pinteraction=0.03). A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462, Ptime<0.001; Fgroup=13.094, Pgroup<0.001; Finteraction=1.372, Pinteraction=0.25). There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048, Pgroup=0.83; Finteraction=1.208, Pinteraction=0.31); however, relative refractive power changed over time(Ftime=40.030, Ptime<0.001). The difference in treatment zone diameter between the two groups was statistically significant, with changes over time(Ftime=11.212, Ptime<0.001; Fgroup=74.073, Pgroup<0.001; Finteraction=0.312, Pinteraction=0.82). The total higher-order aberrations, spherical aberrations, and coma aberrations in 4, 5 and 6 mm range showed a positive correlation with relative refractive power values(all P<0.001). Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3, 6 and 12 mo(Ftime=185.398, Ptime<0.001; Fgroup=5.618, Pgroup=0.02; Finteraction=2.315, Pinteraction=0.11).CONCLUSION: Orthokeratology lenses leaded to elevated higher-order aberrations. Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters. The corneal total higher-order aberration was positively correlated with relative refractive power. Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective In the theories of pulse disgnosis in traditional Chinese medicine(TCM),it is em-phasized that pulse manifestations at the radial artery within the wrist(called Cunkou)signi-fy the physiological and pathological conditions of different internal organs in the human body.However,different opinions exist among researchers about the objectiveness of the pulse diagnosis technique.Some researchers mentioned that no significant differences were observed in pulse manifestations at various Cunkou areas,hence there might be some diffi-culty in evaluating the status of different organs through checking pulse manifestations at Cunkou.This research aims to analyze the pulse response at Cunkou from the aspect of the characteristics of tactile sensing,thus to give a preliminary explanation to the above question. Methods This research utilized the Weber-Fechner law to model the tactile sensing as a dy-namic low-pass signal filter with varying bandwidths under different compression levels dur-ing pulse diagnosis.The model was applied to analyzing the clinical data collected previously by our group.The arterial pressures measured invasively with equipment from 14 patients with aorta coarctation were processed to simulate different pulse manifestations at Cun,Guan,and Chi positions of Cunkou when different compression levels were applied. Results Due to the characteristics of tactile sensing,significant variations were observed in pulse manifestations at different pulse-depths under the application of changing compres-sion levels;while no such changes in pulse manifestations were observed from the employ-ment of transducer only,without tactile sensing involved.The results explained why different understandings on pulse manifestations were formed between direct pulse-taking technique in TCM and modern sphygmography using transducers.The features of pulse manifestations at Cunkou,using direct pulse-taking technique but at different depths,superficial,middle,and deep positions,respectively,predicted by the developed tactile sensing model were in line with those described in TCM pulse theories. Conclusion Based on the developed tactile sensing model,this study preliminarily explains the phenomenon that pulse manifestation at Cunkou changes in response to the compression force applied during TCM pulse-taking.Integrating the tactile sensing model with the study of TCM pulse diagnosis opens a new chapter for visualizing and quantitatively interpreting pulse manifestations.This not only expands the scope of pulse diagnosis study effectively,but also provide a scientific basis for further technical upgrading and optimization of existing pulse di-agnosis equipment.

Objective To investigate the effects of sodium-glucose cotransporter 2 inhibitor combined with Lepidium seed on cardiac,digestive,and pulmonary function in patients with heart failure complicated by pulmonary infection.Methods A total of 168 patients with heart failure and lung infection admitted to Zigui County Hospital of Traditional Chinese Medicine from August 2017 to March 2019 were selected as the research objects.They were divided into observation group and control group according to different treatment methods(84 patients per group).The control group received sodium-glucose cotransporter 2 inhibitor combined with ceftazidime,while the observation group was treated with Lepidium seed on the basis of control group for 30 days.Nutritional status[prealbumin(PA),albumin(ALB),red blood cell count(RBC),body mass index(BMI)],immune function[cytoplasmic domains(CD3,CD4,CD8),immunoglobulins(IgG,IgM)],inflammatory cytokines[interleukins(IL-8,IL-10,IL-17),tumor necrosis factor-α(TNF-α)],intestinal flora(Enterococcus,Escherichia coli,Lactobacillus,Bifidobacterium,Saccharomycetes,Digestion),and cardiopulmonary function[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),heart rate(HR),maximum oxygen consumption(VO2max),maximum exercise load(Wmax),maximum oxygen pulse,anaerobic threshold(AT),forced expiratory volume in one second/forced lung volume ratio(FEV1/FVC),FEV1 and maximal voluntary ventilation(MVV)]were compared between the two groups before and after treatment.Results After treatment,PA,ALB,RBC,BMI,CD3,CD4,CD8,IgG and IgM,Lactobacillus,Bifidobacterium,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,MVV all increased significantly compared to before treatment.IL-8,IL-17,TNF-α,Enterococcus,Escherichia coli,PaCO2,and heart rate were significantly reduced compared to before treatment.The levels of PA,ALB,RBC,BMI,CD3,IgG,IgM,IL-10,Bifidobacterium,Lactobacillus,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,and MVV in the observation group were significantly higher than those in the control group after treatment[PA(mg/L):259.69±20.73 vs.217.69±20.73,ALB(g/L):41.46±4.58 vs.36.56±3.73,RBC(×1012/L):4.52±0.24 vs.4.21±0.31,BMI(kg/m2):22.37±2.73 vs.19.66±2.24,CD3:0.63±0.08 vs.0.56±0.08,IgG(g/L):21.85±3.68 vs.15.72±4.36,IgM(g/L):4.68±1.68 vs.3.73±1.67,IL-10(ng/L):65.28±7.23 vs.50.23±6.14,Bifidobacterium(CFU/kg):83.5±8.6 vs.78.5±8.3,Lactobacillus(CFU/kg):62.1±6.5 vs.53.5±6.0,PaO2(mmHg,1 mmHg≈0.133 kPa):98.36±1.75 vs.91.95±2.95,VO2max(L/min):1.71±0.35 vs.1.22±0.39,Wmax(W):127.49±19.54 vs.97.49±15.37,maximum oxygen pulse(L/time):11.27±2.42 vs.9.46±2.79,AT:(50.49±7.48)%vs.(41.35±6.67)%,FEV1/FVC:(75.68±5.86)%vs.(65.48±8.54)%,FEV1:(82.44±5.73)%vs.(73.57±7.75)%,MVV(L/min):74.86±10.64 vs.64.63±9.68,all P<0.05].CD4,CD8,IL-8,IL-17,TNF-α.Enterococcus,Escherichia coli,PaCO2,and heart rate levels were significantly lower than those in the control group[CD4:0.32±0.06 vs.0.39±0.05,CD8:0.28±0.06 vs.0.34±0.05,IL-8(ng/L):16.64±2.63 vs.26.35±4.13,IL-17(ng/L):112.38±30.16 vs.207.75±42.23,TNF-α(ng/L):45.27±10.23 vs.61.26±14.29,Enterococcus(CFU/kg):63.6±5.6 vs.69.5±6.8,Escherichia coli(CFU/kg):65.8±6.4 vs.70.5±7.0,PaCO2(mmHg):41.84±4.45 vs.56.18±5.37,heart rate(bpm):75.96±11.57 vs.91.57±12.68,all P<0.05].Conclusions Treatment with Lepidium seed combined with sodium-glucose cotransporter 2 inhibitor improved cardiopulmonary function,reduced inflammation,enhanced nutrition,and normalized gut flora in heart failure patients with lung infections.Our findings support integrating this combination into clinical guidelines for optimized management of these critically ill patients.

A 31-year-old man sought medical evaluation for a 2-year history of edema and proteinuria, with prior pathology suggesting atypical membranous nephropathy (MN). Despite treatment with a combination of steroids, calcineurin inhibitors, and four courses of rituximab (1 g, intravenous injection), the patient′s nephrotic syndrome showed no relief (24 h urine protein peaked at 31.18 g/d), indicating refractory nephrotic syndrome. Later in the disease course, a sudden surge of creatinine level (322.5 μmol/L) prompted a renal biopsy, which revealed concurrent acute interstitial nephritis. Further treatment involving steroids, cyclophosphamide, and a fifth rituximab infusion (1 g, intravenous injection) resulted in improvement in renal function (serum creatinine: 322.5?147 μmol/L), but the MN failed to achieve partial relief. Subsequent treatment with the novel humanized CD20 monoclonal antibody obinutuzumab (1 g, intravenous injection) was initiated. In the latest follow-up, anti-phospholipase-A2-receptor antibody (PLA2R) antibody were negative, B cells were eliminated, serum albumin was 36 g/L, urine protein-to-creatinine ratio was 4 810 mg/g, and serum creatinine was 162 μmol/L. This case underscores the potential efficacy of obinutuzumab in refractory MN. For advanced MN cases, prompt identification of the cause of acute kidney injury is crucial, emphasizing the need for targeted interventions to potentially stall renal function decline.

BACKGROUND/OBJECTIVES: The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers. SUBJECTS/METHODS: This cross-sectional study included 1,255 eligible participants in the ‘H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project’ among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus. RESULTS: The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01–1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22–6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04–3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables. CONCLUSION In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.

Objective To understand the relationship between air pollutants and digestive system cancers, and to provide a reference for future research and prevention and control of digestive system cancer. Methods All relevant literature published in English between 1970-2022 was searched through the databases of PubMed, web of science and Embase, and meta-analysis was used to explore the effects of specific air pollutants on digestive system cancers. Results PM_2.5 was able to increase the risk of incidence or mortality of total digestive cancers by 11% (1.05 to 1.17). For specific cancers, PM_2.5 was only associated with an increased risk of liver cancer in this study, with a combined RR (95% CI) of 1.31 (1.19 to 1.46), while there was no statistically significant association with other specific digestive cancers ( P>0.05）. NO2 increased the risk of incidence or mortality of total digestive cancers by 3% (1.00 to 1.07). Conclusion For specific digestive system cancers, PM_2.5 has the most pronounced effect on liver cancer. More evidence is needed to support the relationship between NO₂ and cancer. Currently, it has been observed that NO2 has a negative effect on overall digestive cancers. This study provides insights for the prevention and control of digestive system cancer in countries and regions with high PM_2.5 and NO₂ concentrations.

Objective : To explore the regulatory effects of ResolvinD1 (RVD1) on autophagy and apoptosis of cardiomyocytes in aging rats , and the effects of RVD1 on mitochondria⁃associated endoplasmic reticulum membranes (MAMs) of myocardial tissue . Methods : Thirty 18⁃month⁃old SD rats were randomly divided into model group , low⁃dose RVD1 group and high⁃dose RVD1 group , with 10 rats in each group , and another 10 6 ⁃month⁃old SD rats were selected as control group . The low⁃dose RVD1 group and high⁃dose RVD1 group were injected with 50 ng/ml and 100 ng/ml RVD1 through the tail vein , respectively , control group and model group were injected with the same amount of phosphate buffered saline (PBS) for 21 days . The β ⁃galactosidase activity of rat myocardial tissue was determined by p ⁃nitrophenol method , the histopathological changes of rat myocardial tissue were detected by hematoxylin⁃eosin (HE) staining , and the collagen deposition in rat myocardial tissue was observed by Masson staining , apoptosis of rat myocardial cells was detected by dUTP in situ end labeling mediated by terminal deoxynucleotide transferase(TUNEL) , the expression of autophagy marker microtubule⁃associated protein 3 (LC3) was detecotide transferase(TUNEL) , the expression of autophagy marker microtubule⁃associated protein 3 (LC3) was detected by immunohistochemical S ⁃P method , the ratio of LC3 ⁃ Ⅱ/LC3 ⁃ Ⅰ and the expression of Beclin⁃1 , p62 in rat myocardial tissue were determined by Western blot , the structure of MAMs in rat myocardial tissue was observed by transmission electron microscopy , the expression levels of glucose⁃regulatory protein 75 (GRP75) , volt⁃dependent anion channel 1 (VDAC1) and mitochondrial fusion protein 2 (Mfn2) in rat myocardial tissue were determined by Western blot . Results : Compared with model group , β ⁃galactosidase activity of myocardial tissue decreased in low⁃dose RVD1 group and high⁃dose RVD1 group (P < 0. 05) , myocardial fiber breakage and myocardial cell damag were significantly alleviated , collagen fiber deposition was significantly reduced , and the proportion of TUNEL positive cells in myocardial tissue decreased (P < 0. 05) , the positive rate of LC3 protein increased (P < 0. 05) , the ratio of LC3 ⁃ Ⅱ/LC3 ⁃ Ⅰ increased , the relative expression level of Beclin⁃1 protein was up⁃regulated and the relative expression level of p62 protein was down⁃regulated ( P < 0. 05) , the structure of MAMs was tighter , and the percentage of MAMs in mitochondrial circumference also increased (P < 0. 05) , the relative protein expressions of GRP75 , VDAC1 and Mfn2 were up⁃regulated (P < 0. 05) . Compared with low⁃dose RVD1 group , β ⁃galactosidase activity in high⁃dose RVD1 group further decreased ( P < 0. 05) , no obvious damage was observed in myocardial tissue , collagen fiber deposition was further decreased , the proportion of TUNEL positive cells in myocardial tissue decreased (P < 0. 05 ) , and the positive rate of LC3 protein increased ( P < 0. 05 ) , LC3 ⁃ Ⅱ/LC3 ⁃ Ⅰ ratio increased , Beclin⁃1 relative expression level was up⁃regulated and p62 relative expression level was down⁃regulated (P < 0. 05) , the structure of MAMs was more compact , and their percentage in mitochondrial circumference further increased (P < 0. 05 ) , the relative expressions of GRP75 , VDAC1 and Mfn2 were further up⁃regulated ( P <0. 05) . Conclusion RVD1 can activate autophagy , alleviate myocardial apoptosis and collagen fiber deposition, and promote mitochondria⁃associated endoplasmic reticulum membranes in aging rats .

A lung diffusion function detection system is designed. Firstly, the controllable collection of air, test gas source and calibration gas source was based on single-breath method measurement principle. Secondly, pulmonary diffusing capacity for carbon monoxide (D_lCO) was calculated by gas concentration measured by the non-dispersive infrared sensor to measure, the gas flow measured by the differential pressure sensor, and the temperature, humidity and atmospheric pressure sensors to test and evaluate the quantitative detection and evaluation of lung diffusion function. Moreover, a preliminary verification of the lung diffusion function detection system was implemented, and the results showed that the error of the lung carbon monoxide diffusion and the alveolar volume did not exceed 5%. Therefore, the system has high accuracy and is of great value for early screening and accurate assessment of COPD.
Carbon Monoxide ; Lung ; Pulmonary Diffusing Capacity/methods*

Objeetive: To understand the recurrence of tuberculosis patients in Yunnan Province and its influencing factors,so as to provide scientific basis for the prevention and control of tuberculosis. Methods: Through the tuberculosis management information system, the data of successful treatment of tuberculosis cases in Yunnan Province in 2013 and the data of recurrent tuberculosis cases in Yunnan Province in 2014-2018 were collected. The recurrence rate,recurrence proportion and recurrence time of tuberculosis were analyzed, and the influencing factors of tuberculosis recurrence were analyzed by Cox multi factor proportional risk model. Results : A total of 9787 cases of tuberculosis were investigated. 385 cases recurred in 5 years, accounting for 3.94%. The recurrence rate was 0.73/100 person years. The recurrence interval [M （QR）] was 35.12 （28.57） months. The following are the risk factors for pulmonary tuberculosis recurrence：male（HR=1.297,95%CI：1.031~1.631）,secondary tuberculosis(HR=2.000,95%CI：1.088~3.676) in the 40-59 age group（HR=1.618,95%CI：1.036-2.528）, the retreatment（HR=1.566,95%CI：1.040-2.356）,positive of sputum culture（HR=4.048,95%CI：1.795-9.129）and sputum?smear positive（HR=1.569,95%CI：1.266-1.945）, cavitary pulmonary tuberculosis（ HR=1.382,95%CI：1.112-1.716）. Conclusion The recurrence rate of tuberculosis is low in Yunnnan province, and the risk of pulmonary tuberculosis recurrence is high in male, in the 40-59 age group,retreatment,positive of sputum culture only and sputum smear positive,patients with cavitary tuberculosis.