The sirtuin 1(SIRT1)is an important NAD+-dependent deacetylase that has attracted much attention in ophthalmic research in recent years. This is because the expression of SIRT1 in ocular tissues and its function are inextricably linked to the pathogenesis and progression of many ocular diseases, including dry eye, glaucoma, cataract and diabetic retinopathy. Through in-depth investigations, we have found that SIRT1, as a key regulatory protein, has a profound impact on the pathophysiological processes of ocular diseases through a variety of mechanisms, such as regulating apoptotic programs, modulating oxidative stress, mediating inflammatory responses and maintaining normal mitochondrial function. These findings indicate that SIRT1 plays an important protective role in ocular diseases. The aim of this article is to comprehensively review the latest research findings on SIRT1 in ophthalmic diseases in recent years, and hopes to provide new ideas and methods for the prevention and treatment of ophthalmic diseases by thoroughly analyzing the mechanism of action of SIRT1.

Objective To systematically evaluate the experiences of drug self-management in elderly patients with multiple chronic illnesses,so as to provide references for the development of personalized drug self-management intervention programs.Methods Qualitative research on drug self-management experiences of elderly patients with multiple chronic diseases was retrieved from PubMed,Cochrane Library,Embase,CINAHL,Web of Science,Scopus,CNKI,Wanfang,VIP and SinoMed.The retrieval time limit is from the establishment of the databases to November 2023.The qualitative research quality evaluation criteria of the Joanna Briggs Institute Evidence-based Health Care Center in Australia was used to evaluate quality of studies.The results were integrated by meta-integration method.Results A total of 9 studies were included,and 33 research results were extracted,and 4 integrated results and 12 categories were synthesized.The integration results included the objective dilemmas and challenges of drug self-management,the low level of drug literacy,willingness to engage in positive behavior attempts,need of multi-party assistance.Conclusion The objective dilemmas of drug self-management and low level of drug literacy in elderly patients with multimorbidity will seriously affect their health outcomes.Medical staffs should pay attention to the different experiences of patients in the process of drug self-management,identify the needs of patients,formulate targeted intervention support strategies,and improve the level of drug self-management in elderly patients.

Objective:To explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge.Methods:This study was a retrospective cohort study that included 268 children with bacterial meningitis who were discharged from the infectious medicine ward of Beijing Children′s Hospital from September 2018 to September 2023. The children were managed with a multidisciplinary collaborative comprehensive healthcare management model after discharge. Outpatient data at 1 month and 6, 12 and 24 months after discharge were collected, including (height, weight, body mass index, nutritional feeding status, hearing and vision screening results, Gesell developmental assessment results and intervention guidance services. The follow-up interval or frequency was dynamically adjusted or increased according to the child′s situation. The paired sample t-test and chi square test were applied to compare the differences in Gesell developmental quotient (DQ) and developmental delay rate between the first and last assessments to preliminarily explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge. Results:All the 268 children completed their first assessment one month after discharge, and 37 children were found to have abnormal physical growth, mainly obesity (28 children), and another 9 children were malnutrition. Nutritional intervention and feeding guidance services were provided to all the 37 children, and as of the last follow-up, 20 children′s physical growth evaluations had turned normal. A total of 188 children completed at least 2 developmental assessments, with an interval of (14.2±9.4) months between the first and last assessments (range: 3.1-49.5 months). The DQ values of in the energy region of adaptability, gross motor skills, fine motor skills, language, and personal social skills at the last assessment were significantly higher than those at the first assessment [(91.93±13.28) vs (80.73±15.96) points, (91.69±12.96) vs (78.31±16.58) points, (89.32±16.11) vs (80.68±15.63) points, (90.10±16.65) vs (82.04±18.43) points, (92.01±14.05) vs (77.82±17.42) points]; moreover, the rates of developmental delay in each energy region were significantly lower than those at the initial assessment (9.6% vs 35.1%, 9.6% vs 42.0%, 18.1% vs 33.0%, 13.3% vs 31.9%, 9.6% vs 42.0%) (all P<0.05). Among the 200 children who completed the hearing screening, 18 were found with hearing abnormalities, and 2 were diagnosed with hearing loss in the Otolaryngology Department. Among 217 children who completed vision screening, 23 had abnormalities, and 5 were diagnosed with ophthalmic abnormalities in Ophthalmology Department (2 with strabismus, 2 with refractive errors, and 1 with optic nerve injury). Two children were found to have autism-like behavior during monitoring, and were referred to a developmental behavior clinic to be diagnosed with autism spectrum disorder and were given early diagnosis and intervention guidance. Conclusion:The comprehensive healthcare management model for children with bacterial meningitis after discharge can integrate clinical and healthcare resources, which is beneficial for improving the prognosis and enhancing the quality of life for children with special health status.

Objective:To explore the properties of gelatin-polyethylene glycol hydrogel loaded with silver nanoparticle (AgNP) Chlorella (hereinafter referred to as the composite hydrogel) and its effects on healing of infected full-thickness skin defect wounds in mice. Methods:The research was an experimental research. The simple gelatin-polyethylene glycol hydrogel (hereinafter referred to as the simple hydrogel) and the composite hydrogel were prepared, and the appearance and injectability of the two hydrogels were observed at 55 and 37 ℃, and under the irradiation of 808 nm near-infrared light, respectively. An electronic universal testing machine was employed to assess the tensile and compressive stress-strain properties of both types of hydrogels at room temperature. Additionally, the cyclic compressive stress-strain properties of the composite hydrogel were examined at 80% of the maximum compressive stress. Staphylococcus aureus or Escherichia coli solution was added to phosphate buffer solution (PBS), simple hydrogel, and composite hydrogel, respectively. The part of composite hydrogel containing Staphylococcus aureus or Escherichia coli solution was irradiated with near-infrared light for 5 minutes. After each sample was incubated for 6 h, the dilution plating method was used to detect and calculate the mortality rates of the two bacteria at 24 h of culture ( n=5). The discarded foreskin tissue was taken from a 6-year-old healthy boy admitted to the Department of Urology of the First Affiliated Hospital of Naval Medical University for circumcision. Primary human fibroblasts (HFbs) were isolated using the enzyme extraction method, routinely cultured to the 3 rd to 6 th passages for subsequent cellular experiments. Composite hydrogel extracts with final mass concentrations of 100.0, 50.0, 25.0, 12.5, and 0 mg/mL were respectively prepared and used to culture HFbs, and the cell proliferation after 24 h of culture was detected using a cell counting kit 8 ( n=3). A total of twenty 6-8 weeks old C57BL/6J female mice were utilized, and a full-thickness skin defect was surgically created on the back of each mouse. The wounds were infected with Staphylococcus aureus solution. The infected mice were divided into blank control group, simple hydrogel group, composite hydrogel group, and combined treatment group according to the random number table, and the wounds were treated with PBS, simple hydrogel, composite hydrogel, and composite hydrogel+light irradiation (under the irradiation of 808 nm near-infrared light for 5 min), respectively, with 5 mice in each group. On post injury day (PID) 0 (immediately after the first wound treatment), 3, 7, and 14, an overall assessment of wound exudation and healing were conducted, and the wound healing rates on PID 7 and 14 were calculated ( n=5). On PID 14, hematoxylin-eosin staining was performed to observe histopathological changes in the mouse wound. Results:Both simple hydrogel and composite hydrogel were in a solution state at 55 ℃ and transition to a gel state when cooling to 37 ℃. After the two hydrogels were irradiated by near-infrared light, only the composite hydrogel reheated up and returned to the solution state again with injectability. The maximum tensile stress of the composite hydrogel was up to 301.42 kPa, with a corresponding strain of 87.19%; the maximum compressive stress was up to 413.79 kPa, with a corresponding strain of 91.67%, which was similar to the tensile and compressive properties of the simple hydrogel. After 10 compression cycles, the maximum compressive stress of the composite hydrogel still reached 84.1% of the first compressive stress. After 24 h of culture, the mortality rate of Staphylococcus aureus treated with simple hydrogel was significantly higher than that treated with PBS ( P<0.05); the mortality rates of Escherichia coli and Staphylococcus aureus treated with composite hydrogel alone were significantly higher than those treated with simple hydrogel ( P<0.05); the mortality rates of Escherichia coli and Staphylococcus aureus treated with composite hydrogel+light irradiation were significantly higher than those treated with composite hydrogel alone ( P<0.05). After 24 h of culture, compared with that cultured in composite hydrogel immersion solution with final mass concentration of 0 mg/mL, the proliferation activity of HFbs cultured in composite hydrogel immersion solution with final mass concentrations of 25.0 and 50.0 mg/mL was significantly enhanced ( P<0.05), while the proliferation activity of HFbs cultured in composite hydrogel immersion solution with final mass concentration of 100 mg/mL was significantly decreased ( P<0.05). On PID 0 and 3, more purulent secretions were seen in the wounds of mice in blank control group and simple hydrogel group, while only a small amount of exudate was observed in the wounds of mice in composite hydrogel group, and no obvious infection was observed in the wounds of mice in combined treatment group. On PID 7 and 14, the wound healing rates of mice in simple hydrogel group were significantly higher than those in blank control group ( P<0.05); the wound healing rates of mice in composite hydrogel group were significantly higher than those in simple hydrogel group ( P<0.05); the wound healing rates in combined treatment group were significantly higher than those in composite hydrogel group ( P<0.05). On PID 14, the wounds of mice in blank control group exhibited a high infiltration of inflammatory cells with no new epithelial layer observed; the wounds of mice in simple hydrogel group displayed a short length of newly formed epithelium with a small amount of inflammatory cells; the wounds of mice in composite hydrogel group exhibited continuous formation of new epithelium and a large amount of immature granulation tissue; the wounds of mice in combined treatment group showed continuous epithelialization with less immature granulation tissue. Conclusions:The prepared composite hydrogel exhibits excellent thermosensitivity, photothermal properties, and injectability, as well as excellent mechanical properties, antibacterial properties, and biocompatibility, and can promote the healing of infected full-thickness skin defect wounds in mice.

Objective:To explore the real experience and needs of successful aging among urban elderly people who participated in intergenerational raising.Methods:This study was a qualitative study. From February to April 2023, purposive sampling was used to select 10 elderly individuals from Fanjingjiayuan Community in Changqing District, Jinan City who participated in intergenerational raising as the research subject. Semi-structured interviews and face-to-face nonverbal behavior observation methods were used to collect data, while Colaizzi's 7-step analysis method was used to summarize, analyze the data and extract themes.Results:A total of three themes and 10 sub-themes were extracted, namely positive psychological feelings (self-realization, obtaining emotional support, health benefits), negative psychological feelings (intergenerational raising pressure, decreased life satisfaction, mental stress, physical and mental exhaustion), and the need to promote successful aging (family support, community support, policy support) .Conclusions:Urban elderly people who participate in intergenerational raising have both negative and positive psychological experiences. Families and society should pay attention to the psychological feelings of participating in intergenerational raising of elderly people in urban communities, so as to promote successful aging of the elderly people.

Objective To analyze the prevalence trend of chronic hepatitis C and liver function impairment in Taixi area from 2018 to 2021, and to provide theoretical basis for preventing liver function impairment in hepatitis C patients in Taixi area. Methods The data of hepatitis C cases reported in Taixi were downloaded from the infectious disease reporting Information management system of Chinese Center for Disease Control and Prevention, and the epidemiological characteristics of hepatitis C were analyzed by descriptive epidemiological methods. The clinical data including gender, age, place of residence, smoking history, drinking history, therapeutic drugs, genotyping and other clinical data were collected from HIS system of the hospital. Patients were divided into liver function injury group and control group according to whether they had liver function injury. Univariate analysis and logistic regression were used to analyze the factors of liver function injury in hepatitis C patients in Taixi area. Results Among the 550 cases reported from 2018 to 2021, there were no deaths, including 292 males and 258 females. The male cases were more than the female cases, and the average age was (53.47±5.74) years old. There was no significant difference in the composition of male and female cases among different age groups (χ²=1.472,P>0.05). From 2018 to 2021, the proportion of patients aged 40 to 59 was significantly higher than that of patients aged 20 to 39 and ≥60. The occupation composition was mainly farmers, accounting for 44.36% (244/550), and 287 cases (52.18%) lived mainly in rural areas. From 2018 to 2021, 129 (23.45%) of 550 patients with hepatitis C had liver function injury. ALT, AST and GGT values in the liver function injury group were significantly higher than those in the control group (P<0.05). The ALB value of liver function injury group was significantly lower than that of control group (P<0.05). There were statistically significant differences between the two groups in mean age, drinking history, diabetes mellitus, genotyping, HCV-RNA viral load, CD4+CD25+Treg (P<0.05). CD4+CD25+Treg>5%, genotype 1b and high load of HCV-RNA were independent risk factors for liver function impairment in hepatitis C patients in Taixi area (P<0.05). Conclusion The incidence of hepatitis C was high in Taixi area from 2018 to 2021, and patients with CD4+CD25+Treg<5%, genotype 1b and high load of HCV-RNA had a high risk of liver function impairment. Therefore, active treatment should be carried out to reduce the occurrence of liver function injury.

Objective To systematically evaluate the rehabilitation experience of patients after total knee arthroplasty,and to provide references for improving the effect of rehabilitation treatment and formulating related clinical nursing strategies.Methods We searched PubMed,Web of Science,the Cochrane Library,Embase,CINAHL,Scopus,ProQuest,CNKI,Wanfang database,VIP database and Chinese biomedical literature database.A qualitative study on the experiences,feelings,and needs of patients undergoing rehabilitation after total knee arthroplasty was retrieved from the database until April 2023.The quality of literature was evaluated using the Quality Evaluation Criteria of Evidence-Based Health Care Center(2016)of Joanna Briggs Institute in Australia,and the results were summarized and integrated by the aggregation integration method.Results A total of 25 studies were included;82 topics were summarized into 12 categories;4 integrated results were finally formed:rehabilitation treatment was faced with multiple difficulties,and patients lost confidence and needed professional guidance and supervision;unsatisfactory experience in rehabilitation;the perception of the benefits of rehabilitation therapy and the encouragement of medical staff,and firm faith in rehabilitation;seeking understanding and social support can promote the effect of rehabilitation therapy.Conclusion Healthcare professionals should pay attention to and reflect on the challenges and unsatisfactory experiences that patients may face during rehabilitation,and provide them with professional guidance and supervision,as well as personalized rehabilitation treatment.

Objective:To seek any differential effect of combining repeated transcranial magnetic stimulation (rTMS) with a modified version of constraint-induced movement therapy (mCIMT) on the walking ability of stroke survivors.Methods:Seventy-five stroke survivors were randomly divided into a sham rTMS group, an rTMS group and a combined group, each of 25. In addition to 40 minutes of routine rehabilitation daily, including balance training, transfer training, muscle strength training, and proprioceptive training five times a week for 4 weeks, the sham rTMS group and rTMS group received sham or genuine rTMS. The combined group received 20 minutes of rTMS followed by mCIMT training 30 minutes later. The treatment was performed once a day, 5 days a week for 4 weeks. Before and after the treatment, all groups were evaluated using the Fugl-Meyer lower extremity assessment, the Berg balance scale, a 10-metre walk test and the modified Barthel index.Results:Significant improvement was observed in the average scores of all three groups in all of the assessments. The combined group′s averages were, however, significantly better than those of the other two groups.Conclusion:Supplementing mCIMT with rTMS can better improve the walking and other abilities in the activities of daily living of stroke survivors.

Objective: To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI. Methods: A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale. Results: Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05). Conclusion The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Objective To investigate the therapeutic effect of modulated medium frequency current therapy (MMFCT) combined with infrared therapy on patients of acute facial neuritis. Methods A total of forty-six patients with acute facial neuritis were divided into two groups (observation group and control group) randomly and medially. Every patient received medication. Meanwhile, observation group received MMFCT and infrared therapy. Before the treatment, and after two and four weeks of treatment, Portmann scale were used to evaluate the autonomic movements of the facial expression muscles on both sides. After 4 weeks of treatment, the outcome was evaluated by House-Brackmann facial nerve grading system. Results There were no significant differences in Portmann scales before treatment between two groups. Portmann scales were higher in observation group than those of control group after two and four weeks of treatment (P<0.05). With the duration of treatment, Portmann scales were increased successively in two groups. The significant difference was found in multiple comparisons between groups. After 4 weeks of treatment, the efficacy was significant in the observation group, compared with control group, the difference was significant (P<0.05). Conclusion Modulated medium frequency current therapy combined with infrared therapy have a better effect than isolated medication.