AIM: To compare the efficacy and safety of posterior scleral, peripupillary, and intravitreal injections of triamcinolone acetonide(TA)in treating retinal vein occlusion-macular edema(RVO-ME).METHODS: From June 2021 to September 2024, patients with RVO-ME admitted to our hospital were assigned to three groups: group A(posterior scleral injection), group B(peripupillary injection), and group C(intravitreal injection). At 3 mo after treatment, the efficacy, best corrected visual acuity(BCVA LogMAR), central macular thickness(CMT), central retinal artery blood flow parameters, and incidence of complications were compared among the three groups of patients.RESULTS: A total of 93 cases(93 eyes)of RVO-ME were included, with 31 cases(31 eyes)in each group. The mean age in the group A was 50.37±5.71 years old, with 15 males and 16 females, the group B was 48.92±5.36 years old, with 14 males and 17 females, and the group C was 49.66±5.54 years old, with 18 males and 13 females. The overall efficacy rate in the group A(94%)was higher than that in the groups B and C(68% and 74%), and the complication rate(6%)was lower than in the groups B and C(29% and 32%; P<0.05). At 1 and 3 mo after treatment, the BCVA of group A was 0.46±0.06, 0.36±0.04, the end diastolic velocity(EDV)was 11.45±1.79, 13.97±2.28 cm/s, and the peak systolic velocity(PSV)was 2.16±0.31, 2.83±0.42 cm/s; the BCVA of group B was 0.55±0.07, 0.46±0.05, EDV was 9.57±1.38, 12.03±2.14 cm/s, and PSV was 1.93±0.26, 2.41±0.39 cm/s. The BCVA of group C was 0.57±0.09, 0.48±0.06, EDV was 9.39±1.25, 11.91±2.06 cm/s, PSV was 1.87±0.24, 2.35±0.36 cm/s. The BCVA in the group A was better than that of the groups B and C, and EDV and PSV in the group A were greater than those of the groups B and C(all P<0.05); at 1 and 3 mo after treatment, the CMT of patients in the group A was 249.62±29.33 and 141.13±21.59 μm, and resistance index(RI)was 0.71±0.08 and 0.70±0.08, patients in the group B had CMT of 307.13±34.86 and 227.99±28.43 μm, and RI of 0.77±0.09 and 0.76±0.09, while patients in the group C had CMT of 311.42±40.66 and 232.56±31.44 μm, and RI of 0.79±0.11 and 0.78±0.10, with CMT and RI significantly lower in the group A than those in the groups B and C(all P<0.05).CONCLUSION: All three methods improved visual acuity, reduced macular edema, and optimized retinal blood flow parameters. However, posterior scleral injection demonstrated the most significant improvement across all efficacy metrics. In contrast, although peripupillary injection and intravitreal injection demonstrated therapeutic effects, their improvements were relatively limited, and both had a higher incidence of complications. Therefore, posterior scleral injection may represent a superior treatment for RVO-ME.

The contents of Zhang Zhongjing's works Treatise on Exogenous Febrile Disease,the Jade Case Classic of the Golden Cabinet,and Essentials from the Golden Cabinet(collectively known as the three classical medical books of Zhang Zhongjing),as well as Important Formulas Worth A Thousand Gold Pieces and Supplement to"Important Formulas Worth a Thousand Gold Pieces",which were cited in the Arcane Essentials from the Imperial Library(Wai Tai Mi Yao Fang)during comparative proofreading were analyzed.Wai Tai Mi Yao Fang is a book edited and public by the Bureau of Revising Medical Books in Northern Song Dynasty.The contents in the collation records for Wai Tai Mi Yao Fang were compared to the original text of the above five classical medical books proofread in Song Dynasty.The results showed that:(1)the ministers of Song Dynasty which were in charge of the proofreading mainly took the previously-proofread books as references,and widely referenced to the other editions of Wai Tai Mi Yao Fang,which reflected the proofreading principles of the Bureau of Revising Medical Books in Northern Song Dynasty,i.e.,collecting various editions widely and then identifying similarities and differences;(2)the analysis of the collation record in Zhongjing's Treatise on Exogenous Febrile Disease by using comparative proofreading method plus reasoning proofreading method showed that,the medical knowledge of the ministers of Song Dynasty had some limitations;(3)some of the medical terminology used by the ministers of Song Dynasty in their collation record influenced the naming convention of later generations of medical science,for example,making the Piyue Pills be the synonym of the Maziren Wan(Maren Wan).The results indicated that the complexity and uncertainty of the textual content of the popular edition of Wai Tai Mi Yao Fang should deserve the attention,and their influences on the development of later generations'scholarship need further in-depth study.

Sepsis is a systemic inflammatory response syndrome triggered by infection,and the abnormal inflammatory response leads to the damage of intestinal mucosal barrier.The intestinal mucosal barrier consists of four parts,namely biological barrier,chemical barrier,mechanical barrier,and immune barrier.The injured intestinal mucosal barrier is considered as the"initiating organ"of multiple organ dysfunctions in sepsis,with the immune barrier being particularly critical to the progression of sepsis.Berberine(also known as berberine hydrochloride)is an active alkaloid extracted from Berberaceae plants such as Coptidis Rhizoma,and possesses multiple pharmacological actions including antibacterial and anti-inflammatory effects.It has been widely used in the treatment of various diseases,including diarrhea and arrhythmias.This article reviewed the progress in recent research on the protective effects and mechanism of Berberine against sepsis-induced intestinal mucosal immune barrier damage.The recent studies have shown that berberine can modulate intestinal mucosal immune function in sepsis via regulating the TLRs signaling pathway,Notch signaling pathway,and dendritic cell(DC)function,by inducing ferroptosis of macrophages in intestinal mucosa,and by regulating the imbalance of gut microbiota in sepsis patients.The unique advantages of berberine and its promising application prospects in the treatment of sepsis have been demonstrated by its effects on protecting and repairing the intestinal mucosal barrier and on improving the sepsis-induced intestinal mucosal barrier damage.The in-depth research into its therapeutic mechanisms and the exploration of optimized strategies for using berberine to prevent and treat sepsis-induced intestinal mucosal barrier damage are of great significance for enhancing clinical outcomes in sepsis treatment,and will provide new insights and directions for the prevention and treatment of sepsis.

Objective: To perform transient transfection of recombinant human Factor X(rhFX) into HEK293 cells,to optimize transfection parameters,to develop a high-yield in vitro expression system for rhFX production,and to assess the biological activity of expressed rhFX. Methods: The eukaryotic expression vector pcDNA3. 1-EGFP-FX was constructed by inserting the F10 gene into pcDNA3. 1-EGFP and subsequently transfected into HEK293cells to validate the transfection system efficiency. The recombinant expression vector pcDNA3. 1-FX was generated through ligation of the F10 gene fragment with pcDNA3. 1, followed by liposome-mediated transfection into HEK293 cells. The expression of rhFX in the cell supernatant was analyzed by Western blot and sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE). Transfection conditions were systematically optimized,and rhFX concentration was quantified by enzyme-linked immunosorbent assay(ELISA). The coagulation bioactivity of rhFX was evaluated through prothrombin time(PT) assay and chromogenic substrate method. Results: rhFX was successfully expressed in the supernatant of HEK293 cells. rhFX was successfully expressed in the supernatant of HEK293 cells. The highest expression level of rhFX was achieved on the third day after transfection when the cell density was 80% and the ratio of plasmid DNA to polyethyleneimine(PEI) transfection reagent was 1 ∶ 2.Triplicate ELISA measurements demonstrated a maximum rhFX concentration of 5. 20 ng/mL in the supernatant.The prothrombin time(PT) of rhFX-containing supernatant was significantly shorter(P 50) of etoxaban was determined to be 1. 449 nmol/L using the chromogenic substrate method based on rhFX,which was in the same order of magnitude as the reported 0. 78 nmol/L in the literature. Conclusion HEK293cells successfully express biologically active recombinant human Factor X(rhFX) protein,laying a foundation for advancing the development of rhFX-based therapeutics.

On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.

Objective To explore the causal relationship between sleep phenotype and idiopathic normal pressure hydrocephalus(iNPH)using two-sample bidirectional Mendelian randomization.Methods The exposure data including 8 sleep phenotypes used in this study were obtained from GWAS catalog,FinnGenR10 and MRCIEU GWAS.The outcome data for idiopathic normal-pressure hydrocephalus were obtained from FinnGen R10.We used the inverse-variance weighted(IVW)method to perform the principal analyses.Cochrane Q-statistics test was used to assess the heterogeneity and MR Egger-intercept test performed to evaluate the pleiotropy for sensitivity analyses.Results IVW result showed that frequent daytime nap was associated with higher odds of iNPH(OR=3.3393,95 CI%:1.0646-10.4742,P=0.0270).Cochrane Q-statistics test and MR Egger-intercept test showed that the MR analysis had no pleiotropy or heterogeneity(P>0.05).The external validation reproduced this result(OR=2.5660,95 CI%:1.1680-5.6373,P=0.0189;OR=4.0424,95 CI%:1.5709-10.4024,P=0.0038).Reverse Mendelian randomization suggested that iNPH did not have significant impact on sleep phenotype.Conclusion The frequency of daytime naps is causally associated with iNPH,and reducing the frequency of weekly daytime naps can reduce the risk of iNPH in the elderly population.

Objective To explore the causal relationship between sleep phenotype and idiopathic normal pressure hydrocephalus(iNPH)using two-sample bidirectional Mendelian randomization.Methods The exposure data including 8 sleep phenotypes used in this study were obtained from GWAS catalog,FinnGenR10 and MRCIEU GWAS.The outcome data for idiopathic normal-pressure hydrocephalus were obtained from FinnGen R10.We used the inverse-variance weighted(IVW)method to perform the principal analyses.Cochrane Q-statistics test was used to assess the heterogeneity and MR Egger-intercept test performed to evaluate the pleiotropy for sensitivity analyses.Results IVW result showed that frequent daytime nap was associated with higher odds of iNPH(OR=3.3393,95 CI%:1.0646-10.4742,P=0.0270).Cochrane Q-statistics test and MR Egger-intercept test showed that the MR analysis had no pleiotropy or heterogeneity(P>0.05).The external validation reproduced this result(OR=2.5660,95 CI%:1.1680-5.6373,P=0.0189;OR=4.0424,95 CI%:1.5709-10.4024,P=0.0038).Reverse Mendelian randomization suggested that iNPH did not have significant impact on sleep phenotype.Conclusion The frequency of daytime naps is causally associated with iNPH,and reducing the frequency of weekly daytime naps can reduce the risk of iNPH in the elderly population.

Objection:To evaluate the effects of the miniscrew supported removable palatal arch for maxillary molar distalization.Methods:33 patients with mild to moderate crowding teeth and maxillary protrusion were treated with the miniscrew supported remova-ble palatal arch.The lateral cephalograms and dental plaster models were taken at the beginning of the treatment(T0)and at the end of molar distalization(T1).The multicentre variables were measured and compared with statistical software.Results:Cephalometrics showed that the average distance(mm)of the firs molar distalization was 3.6(P＜0.001),molar distal tipping was 6°(P＜0.001)and molar intrusion(mm)was 0.6(P＜0.05).The measurements of right and left molar distalization on plaster models were 4.2 mm(P＜0.001)and 4.0 mm(P＜0.001)respectively,the width of dental arch was increased by 3.1 mm(P＜0.05).The data of distalization of the first molar showed no statistical difference between right and left side on plaster cast and between model and cephalometric meas-urements.On the right side the angle between the mesial-distal tips line and the middle line was increased by 1.6°(P＞0.05),on the left by 4.8°(P＜0.05).Conclusion:The none extraction therapy for mild to moderate crowding teeth and maxillary protrusion can be realized by miniscrew supported removable palatal arch distalization appliance.

Objective To evaluate the molluscicidal effect of spraying different formulations of niclosamide ethanolamine salt with drones against Oncomelania hupensis in ditches. Methods A semi-dry and semi-wet ditch with O. hupensis snails was selected in the second branch field of Jiangbei Farm, Jiangling County, Hubei Province in May 2023, and divided into 4 experimental areas, named groups A1, A2, B1 and B2. Environmental cleaning was performed in groups A1 and B2, and was not conducted in groups A2 or B2. Then, 50% wettable powder of niclosamide ethanolamine salt was sprayed with drones at an effective dose of 2 g/m² in groups A1 and A2, and 5% niclosamide ethanolamine salt granule was sprayed with drones at an effective dose of 2 g/m² in groups B1 and B2. O. hupensis snails were surveyed using the systematic sampling method 1, 3, 5, 7, 14 days after spraying, and the natural mortality and corrected mortality of O. hupensis snails were calculated. Results The occurrence of frames with living snails, mean density of living snails and natural mortality of snails were 97.50% (117/120), 6.30 snails/0.1 m² and 1.18% (9/765) in the test ditch before spraying, respectively. There were significant differences in the mortality of snails among four groups 1, 3, 5, 7 and 14 days after spraying niclosamide formulations with drones (χ² = 17.230, 51.707, 65.184, 204.050 and 34.435, all P values < 0.01). The overall mortality rates of snails were 94.51% (1 051/1 112), 79.44% (908/1 143), 96.54% (977/1 012) and 88.55% (1 021/1 153) in groups A1, A2, B1 and B2 (χ² = 207.773, P < 0.05), respectively. In addition, there was no significant difference in the overall snail mortality between groups A1 and B1 (P > 0.05), and the snail mortality in groups A1 and B1 were both statistically different from that in groups A2 and B2 (all P values < 0.05). Conclusion Both 50% wettlable powder of niclosamide ethanolamine salt and 5% niclosamide ethanolamine salt granule sprayed with drones are active against O. hupensis snails in ditches, and environmental cleaning may improve the molluscicidal effect.

Objective:To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies(IIMs)patients receiving conventional treatment.Methods:Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were in-cluded.The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics,laboratory features,peripheral blood lymphocytes,immunological indicators,and therapeutic drugs.Results:Among the 635 patients included,518 patients finished the follow-up,with an average time of 36.8 months.The total complete clinical response rate of IIMs was 50.0％(259/518).The complete clinical response rate of dermatomyositis(DM),anti-synthetase syn-drome(ASS)and immune-mediated necrotizing myopathy(IMNM)were 53.5％,48.9％and 39.0％,respectively.Fever(P=0.002)and rapid progressive interstitial lung disease(RP-ILD)(P=0.014)were observed much more frequently in non-complete clinical response group than in complete clinical re-sponse group.The aspartate transaminase(AST),lactate dehydrogenase(LDH),D-dimer,erythrocyte sedimentation rate(ESR),C-reaction protein(CRP)and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group.As for the treat-ment,the percentage of glucocorticoid received and intravenous immunoglobin(IVIG)were significantly higher in non-complete clinical response group than in complete clinical response group.Risk factor analysis showed that IMNM subtype(P=0.007),interstitial lung disease(ILD)(P=0.001),eleva-ted AST(P=0.012),elevated serum ferritin(P=0.016)and decreased count of CD4+T cells in peripheral blood(P=0.004)might be the risk factors for IIMs non-complete clinical response.Conclu-sion:The total complete clinical response rate of IIMs is low,especially for IMNM subtype.More effec-tive intervention should be administered to patients with ILD,elevated AST,elevated serum ferritin or decreased count of CD4+T cells at disease onset.