Objective To study and compare the myopia control effects of orthokeratology(OK)lenses with a small treatment zone and peripheral defocus spectacle lenses in children aged 8-12 years.Methods A prospective study was made on 120 myopic children(120 myopic eyes were all right eyes)aged 8-12 years who visited the Optometry Clinic of the First Affiliated Hospital of Baotou Medical College between September 2022 and April 2023.The patients were randomly divided into a single vision lens(SVL)group,a highly aspherical lenslets(HAL)group,a 6.2 mm-BOZD OK group and a 5.0 mm-BOZD OK group,with 30 cases(30 eyes)in each group.After 12 months of follow-up,the spherical equivalent(SE),axial length(AL),cylinder diopter and their variations were compared among the four groups at different time points before and after treatment.Results There were no significant differences in SE and AL among the four groups be-fore and 3 months after treatment(all P＞0.05).After 6 months of treatment,there were no statistically significant differ-ences in SE among the four groups(P＞0.05),but significant differences were observed in AL among the four groups(P＜0.05).Pairwise comparisons revealed that the AL in the 5.0 mm-BOZD OK group was significantly lower than that in the SVL group(P＜0.05).There was no significant difference between each two of the other groups(all P＞0.05).After 12 months of treatment,significant differences in SE and AL were observed among the four groups(all P＜0.05).Pairwise comparisons revealed that compared with the SVL group,the HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups ex-hibited a statistically significant increase in SE and decrease in AL(all P＜0.05).However,there was no significant differ-ence in SE and AL among HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups(all P＞0.05).After 12 months of treat-ment,there were significant differences in the changes of SE and AL among the four groups(all P＜0.05).The changes of SE and AL in HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups were significantly less than those in the SVL group(all P＜0.05).The changes of SE and AL in the 5.0 mm-BOZD OK group were significantly less than those in HAL and 6.2 mm-BOZD OK groups(all P＜0.05).There was no significant difference in the changes of SE and AL between HAL and 6.2 mm-BOZD OK groups(both P＞0.05).There were no significant differences in cylinder diopter among the four groups be-fore and 12 months after treatment.In the SVL group,there was no significant difference in cylinder diopter before and 12 months after treatment.The cylinder diopters of HAL,6.2 mm-BOZD OK and 5.0 mm-BOZD OK groups were significantly decreased 12 months after treatment,compared with those before treatment.Conclusion HAL,6.2 mm-BOZD OK len-ses and 5.0 mm-BOZD OK lenses can effectively control the progression of myopia in children aged 8-12 years.Among them,5.0 mm-BOZD OK lenses exhibit the most significant control effect,while HAL and 6.2 mm-BOZD OK lenses have similar myopia control effects.

Objective : To investigate the expression and clinical significance of kynurenine-3-monooxygenase (KMO) in peripheral blood mononuclear cells ( PBMC ) ，synovial tissue ，and fibroblastic-like synovial cells (FLS) of rheumatoid arthritis (RA) patients． Methods : Peripheral blood samples from 25 healthy control ( HC) individuals and 25 patients diagnosed with RA were collected ，and real-time fluorescence quantitative PCR and Western blot were used to detect KMO gene and protein expression in PBMC of RA and HC groups，and to analyze the correlation between the expression level of the KMO gene in the PBMC of the RA patients and the indexes of the laboratory tests．Meanwhile，immunohistochemistry and immunofluorescence were used to detect KMO expression in synovial tissue and FLS in RA and HC groups． Results : ① KMO gene and protein expression in PBMC of RA group were higher than that of HC group，and the difference was statistically significant (P＜0. 001) ．② The level of KMO gene expression in PBMC of RA group was positively correlated with disease activity index 28 score，blood sedimentation，and rheumatoid factor (rs = 0. 417，P = 0. 038 ; r = 0. 545，P = 0. 005 ; rs = 0. 433，P = 0. 031) ， and had no correlation with C-reactive protein and anti-cyclic citrullinated polypeptide antibody．③ KMO expres- sion in synovial tissue of RA group was higher than that of HC group，and the difference was statistically significant (P＜0. 01) ; KMO expression in FLS of synovial tissue of RA group was higher than that of HC group，and the difference was statistically significant (P ＜0. 001) ． Conclusion KMO expression increases in PBMC ，synovial tissue and FLS of RA patients，and the level of KMO gene expression is correlated with the disease activity of RA patients，suggesting that KMO may promote the course of RA．

Objective:To explore the configurational factors influencing the professional commitment of Master of Nursing Specialist (MNS) students and identify effective paths to enhance their professional commitment.Methods:A convenience sample of MNS students from six hospitals in Jiangsu Province, Shanghai City, and Anhui Province was surveyed between December 2023 and October 2024. Data were collected using a general information questionnaire, the Nurses' Professional Commitment Scale (NPCS), the Connor-Davidson Resilience Scale (CD-RISC-10), the Multidimentional Perceived Social Support (MSPSS), and the Vocational Outcome Expectation Scale (VOE-R). Fuzzy-set Qualitative Comparative Analysis (fsQCA) was used to explore the configurational influences on professional commitment.Results:A total of 332 questionnaires were distributed, and 302 valid responses were obtained (effective response rate: 90.1%). The mean NPCS score among respondents was (89.30±22.42), indicating a upper-middle level of professional commitment. The fsQCA results revealed that the frequency of night shift rotation was a necessary condition affecting professional commitment. A total of three distinct configurations (paths) were identified that can enhance the professional commitment of MNS students.Conclusions:The professional commitment of MNS students is influenced by multiple interacting factors. It is recommended that hospitals, universities, and nursing educators develop targeted interventions based on these identified configurations to improve professional commitment.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective:To explore the configurational factors influencing the professional commitment of Master of Nursing Specialist (MNS) students and identify effective paths to enhance their professional commitment.Methods:A convenience sample of MNS students from six hospitals in Jiangsu Province, Shanghai City, and Anhui Province was surveyed between December 2023 and October 2024. Data were collected using a general information questionnaire, the Nurses' Professional Commitment Scale (NPCS), the Connor-Davidson Resilience Scale (CD-RISC-10), the Multidimentional Perceived Social Support (MSPSS), and the Vocational Outcome Expectation Scale (VOE-R). Fuzzy-set Qualitative Comparative Analysis (fsQCA) was used to explore the configurational influences on professional commitment.Results:A total of 332 questionnaires were distributed, and 302 valid responses were obtained (effective response rate: 90.1%). The mean NPCS score among respondents was (89.30±22.42), indicating a upper-middle level of professional commitment. The fsQCA results revealed that the frequency of night shift rotation was a necessary condition affecting professional commitment. A total of three distinct configurations (paths) were identified that can enhance the professional commitment of MNS students.Conclusions:The professional commitment of MNS students is influenced by multiple interacting factors. It is recommended that hospitals, universities, and nursing educators develop targeted interventions based on these identified configurations to improve professional commitment.

Objective To study and compare the myopia control effects of orthokeratology(OK)lenses with a small treatment zone and peripheral defocus spectacle lenses in children aged 8-12 years.Methods A prospective study was made on 120 myopic children(120 myopic eyes were all right eyes)aged 8-12 years who visited the Optometry Clinic of the First Affiliated Hospital of Baotou Medical College between September 2022 and April 2023.The patients were randomly divided into a single vision lens(SVL)group,a highly aspherical lenslets(HAL)group,a 6.2 mm-BOZD OK group and a 5.0 mm-BOZD OK group,with 30 cases(30 eyes)in each group.After 12 months of follow-up,the spherical equivalent(SE),axial length(AL),cylinder diopter and their variations were compared among the four groups at different time points before and after treatment.Results There were no significant differences in SE and AL among the four groups be-fore and 3 months after treatment(all P＞0.05).After 6 months of treatment,there were no statistically significant differ-ences in SE among the four groups(P＞0.05),but significant differences were observed in AL among the four groups(P＜0.05).Pairwise comparisons revealed that the AL in the 5.0 mm-BOZD OK group was significantly lower than that in the SVL group(P＜0.05).There was no significant difference between each two of the other groups(all P＞0.05).After 12 months of treatment,significant differences in SE and AL were observed among the four groups(all P＜0.05).Pairwise comparisons revealed that compared with the SVL group,the HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups ex-hibited a statistically significant increase in SE and decrease in AL(all P＜0.05).However,there was no significant differ-ence in SE and AL among HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups(all P＞0.05).After 12 months of treat-ment,there were significant differences in the changes of SE and AL among the four groups(all P＜0.05).The changes of SE and AL in HAL,6.2 mm-BOZD OK,and 5.0 mm-BOZD OK groups were significantly less than those in the SVL group(all P＜0.05).The changes of SE and AL in the 5.0 mm-BOZD OK group were significantly less than those in HAL and 6.2 mm-BOZD OK groups(all P＜0.05).There was no significant difference in the changes of SE and AL between HAL and 6.2 mm-BOZD OK groups(both P＞0.05).There were no significant differences in cylinder diopter among the four groups be-fore and 12 months after treatment.In the SVL group,there was no significant difference in cylinder diopter before and 12 months after treatment.The cylinder diopters of HAL,6.2 mm-BOZD OK and 5.0 mm-BOZD OK groups were significantly decreased 12 months after treatment,compared with those before treatment.Conclusion HAL,6.2 mm-BOZD OK len-ses and 5.0 mm-BOZD OK lenses can effectively control the progression of myopia in children aged 8-12 years.Among them,5.0 mm-BOZD OK lenses exhibit the most significant control effect,while HAL and 6.2 mm-BOZD OK lenses have similar myopia control effects.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective To provide an animal model for studying the effect of TDO2 on the function of macrophages on the occurrence and development of diseases by constructing macrophage-specific tryptophan,2,3-dioxygenase(TDO2)gene knockout mice.Methods TDO2flox/flox Lyz2-iCre+mice were constructed based on Cre/LoxP sys-tem.The genotypes of mice were identified by PCR amplification and agarose gel electrophoresis.Western blot and immunofluorescence were used to verify the effect of TDO2 knockdown in mouse macrophages.The spontaneous le-sions in major tissues and organ were observed by HE stainings.Results The results of genotype identification showed that the mice with only one band at 407 bp or 408 bp for the flox amplification product and one band at 543 bp for the Cre amplification product were TDO2flox/flox Lyz2-iCre+mice.Western blot results showed that TDO2 ex-pression in bone marrow-derived macrophages(BMDMs)of TDO2flox/flox Lyz2-iCre+mice decreased compared with TD02flox/flox mice(P＜0.01).Immunofluorescence results showed that TDO2 expression in peritoneal macrophages and BMDMs of TDO2flox/flox Lyz2-iCre+mice decreased compared with TDO2flox/flox mice.HE staining showed no sig-nificant differences in cell morphology in the liver,brain,kidney and spleen tissues of TDO2flox/flox Lyz2-iCre+mice compared to TDO2flox/f1ox mice.Conclusion TDO2flox/flox Lyz2-iCre+mice is successfully constructed,providing a more precise experimental animal model for subsequent in-depth study of the role and mechanism of TDO2-regulated macrophage activation in disease.

Objective To explore the effects of Huoxue Jiedu Formula on the expression of the apoptosis-related factors B-cell lymphoma-2(Bcl-2)and survivin in submaxillary gland cells in mice with Sj?gren syndrome(SS).Methods Using 15 healthy C57BL/6J female mice as the blank control group.Seventy-five of non-obese diabetes mellitus female mice were classified as SS model.They were randomly assigned to the model group,total glucosides of paeony capsule group(TGP group,0.233 g/kg),Huoxue Jiedu Formula low-(15.925 g/kg),middle-(31.850 g/kg),and high-dose(62.335 g/kg)groups,with 15 mice in each group.The blank control and model groups received distilled water by gavage,and the other groups received respective drug doses by gavage once a day for 8 consecutive weeks.After 1,2,4,6,and 8 weeks of gavage,the salivary secretion volume of the mice was measured.The submaxillary gland index was calculated.Pathological changes in the submaxillary gland of mice were observed by hematoxylin-eosin staining.The expression of apoptosis-related factors Bcl-2 and survivin was detected by Western blotting and real-time fluorescence PCR.Results There was statistical significance in salivary secretion volume from aspects of between-group,time-point,and interaction effects(P<0.05).After 8 weeks of treatment,compared to the blank control group,salivary secretion volume,submaxillary gland index,and protein and mRNA expressions of Bcl-2 and survivin in the model group were decreased,while the pathological score grading increased(P<0.05).Compared to the model group,the TGP group and the Huoxue Jiedu Formula low-,medium-,and high-dose groups showed an increase in saliva secretion after 8 weeks of treatment and an increase in submaxillary gland index,Bcl-2,and survivin mRNA expression levels,and a decrease in pathological score levels.The protein expressions of Bcl-2 and survivin in the Huoxue Jiedu Formula medium-and high-dose groups were increased(P<0.05).Compared to the TGP group,salivary secretion volume and submaxillary gland index in the Huoxue Jiedu Formula low-dose group were lower at weeks 4 and 6,while the pathological score grading was higher(P<0.05).The pathological score grading in the Huoxue Jiedu Formula high-dose group was lower.The protein and mRNA expressions of Bcl-2 in the Huoxue Jiedu Formula low-and medium-dose groups were lower(P<0.05).Conclusion Huoxue Jiedu Formula may relieve the submaxillary gland lesions and increase the salivary secretion volume of the submaxillary gland in SS model mice by regulating the expressions of apoptosis-related factors such as Bcl-2 and survivin in the submaxillary gland.

Objective:To explore the ventilation strategy of using pressure controlled ventilation-volume guaranteed (PCV-VG) mode combined with personalized positive end expiratory pressure (PEEP) during surgery, and its impact on oxygenation function and incidence of postoperative pulmonary complications (PPCs) in patients undergoing brain tumor surgery.Methods:Sixty patients who underwent elective brain tumor surgery at the Linyi People′s Hospital from January 2023 to June 2023 were selected. The patients were randomly divided into PCV-VG ventilation mode group (T group) and volume controlled ventilation (VCV) mode group (C group) using a random number table method, with 30 patients in each group. One patient was excluded from group T due to changes in the condition, and 29 patients were actually included. Group T adopted PCV-VG ventilation mode and searched for the maximum dynamic lung compliance (Cdyn) by titrating PEEP. The PEEP corresponding to the maximum Cdyn value was the optimal PEEP, which was maintained until the end of mechanical ventilation. Group C adopted a ventilation mode of VCV plus 5 cmH 2O fixed value PEEP. All patients underwent arterial blood gas analysis before anesthesia induction (T 1), 15 minutes after setting ventilation mode (T 2), and 15 minutes after extubation (T 3), recording arterial oxygen partial pressure (PaO 2), carbon dioxide partial pressure (PaCO 2), lactate (Lac), and blood glucose (Glu), and calculating oxygenation index (PaO 2/FiO 2). The levels of white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were recorded before and 72 hours after surgery. The incidence of postoperative PPCs at 72 hours was observed. Results:There was a statistically significant difference in the grouping effect and time effect of PaO 2 and PaCO 2 between group C and group T (all P<0.05), while there was no statistically significant difference in the interaction effect (all P>0.05); The differences in grouping effects, time effects, and interaction effects of PaO 2/FiO 2 between group C and group T were statistically significant (all P<0.05); The average value of the optimized PEEP obtained by T-group titration was 7.48 cmH 2O, corresponding to an average platform pressure (Pplat) of 14.90 cmH 2O, and an average value of 53.37 ml/cmH 2O corresponding to the maximum Cdyn value. Compared with the Pplat and Cdyn corresponding to the fixed value of 5 cmH 2O PEEP in Group C, the Pplat corresponding to the optimized PEEP in Group T was lower than that in Group C ( P<0.05), and the Cdyn was higher than that in group C ( P<0.05). The CRP level and incidence of PPCs in group T after 72 hours of surgery were significantly lower than those in group C (all P<0.05). Conclusions:Compared with VCV, the ventilation mode of PCV-VG combined with personalized PEEP can improve intraoperative lung ventilation and oxygenation function in patients with brain tumors, reduce the occurrence of pulmonary inflammation 72 hours after surgery, and lower the incidence of PPCs.