Objective To compile the"expert consensus on preventive and management of exposure keratopathy"(hereinafter referred to as"consensus"),aiming to standardize and promote the prevention of exposure keratopathy(EK)in medical institutions at different levels.Methods The evidence-based methods were used to retrieve,evaluate and summarize evidence in this field according to the level of evidence,and relevant recommendations and research conclusions were extracted,and the first draft of consensus was formed.After 2 rounds of Delphi expert letters and expert meetings,combined with evidence and expert opinions,the consensus content is written,adjusted and modified,and recommendations were made.Results 58 experts were invited to participate in the consultation.The expert positive coefficient was 100％;the expert judgment basis of the 2 rounds were 0.940 and 0.936;the degree of familiarity of the 2 rounds were 0.779 and 0.797;the coefficient of authority of the 2 rounds were 0.859 and 0.866.The Kendall W coefficients of the 2 rounds of inquiry were 0.099 and 0.117,and the difference was statistically significant(P＜0.05).The consensus includes 5 aspects of EK:risk factors,assessments,protection measures,symptom management and training and management.Conclusion The consensus was based on the existing evidence and clinical practical requirements and recommendations of experts in the field.Consensus can provide guidance for clinical nursing staff in prevention,nursing and management of EK effectively.

Objective:To investigate the incidence of hearing loss among helicopter flying personnel, and to analyze the contributing factors.Methods:Basic data of 443 male helicopter flying personnel who received physical examinations at Beidaihe Rehabilitation and Recuperation Center of PLA between March and June 2024 was collected. The hearing threshold levels were measured at 8 frequencies: 250, 500, 1 000, 2 000, 3 000, 4 000, 6 000 and 8 000 Hz. Routine blood tests and blood biochemical tests were performed. Based on the results of pure-tone audiometry, the participants were divided into 2 groups: the hearing loss group (hearing threshold ≤20 dB HL) and the normal hearing group (hearing threshold >20 dB HL). The basic data, routine blood results, and blood biochemical indicators were compared between the 2 groups before the contributors to hearing loss were analyzed.Results:A total of 443 helicopter flying personnel were included in the study, with 82 cases (18.51%) in the hearing loss group and 361 cases (81.49%) in the normal hearing group. There were significant differences in age and pulse between the flying personnel in the 2 groups ( t=2.13, 2.78, P=0.034, 0.006). Among the blood routine indicators, only the mean platelet volume (MPV) was significantly different ( t=2.26, P=0.025). Among the blood biochemical indicators, only homocysteine (HCY) revealed statistically significant difference ( Z=2.30, P=0.021). The determinants of hearing loss in helicopter flying personnel were age ( OR=1.046, 95% CI: 1.060-1.361), pulse ( OR=1.201, 95% CI: 1.060-1.361), MPV ( OR=1.365, 95% CI: 1.016-1.834) and HCY ( OR=1.065, 95% CI: 1.033-1.097). Conclusions:Age, pulse, the MPV and HCY levels can all contribute to hearing loss, and the MPV and HCY can serve as potential biomarkers for hearing loss in helicopter flying personnel. Potential hearing loss should be detected early and personalized interventions should be implemented. Noise exposure should be monitored more rigorously to reduce the risk of occupational hearing loss for helicopter flying personnel and ensure flight safety.

Objective This study preliminarily investigated the potential mechanisms of the Huoxue Tongluo prescription(HXTLP)in treating spinal cord injury(SCI)through a combination of network pharmacology,molecular docking technology,and in vivo experimental verification.Methods The traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP)were utilized to select the active ingredients,targets of action were obtained from Swiss target prediction database,and an"active ingredients-targets"network was constructed.SCI-related targets were obtained by accessing online mendelian inheritance in man(OMIM)and human gene database(GeneCards),and a protein interaction network of the common targets of HXTLP and SCI was established based on the search tool for the retrieval of interacting genes/protein(STRING)database.The Metascape database was used in KEGG pathway enrichment and GO analyses of the common targets.Molecular docking of active ingredients and key targets was performed through Autodock 1.5.7 software,and the results were visualized with Pymol 2.4.0 software.Finally,the effect of HXTLP on SCI was verified by animal experiments.Results A total of 184 intersection targets were obtained,and the key targets were serine/threonine kinase(AKT1),signal transducer and activator of transcription 3(STAT3),heat shock protein 90 kDa alpha,class A member 1(HSP90AA1),phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3CA),phosphoinositide-3-kinase regulatory subunit 1(PIK3R1),harvey ras(HRAS),estrogen receptor 1(ESR1),mitogen-activated protein kinase 1(MAPK1),and epidermal growth factor receptor(EGFR).Molecular docking result showed strong binding abilities between the core active components and key targets.In the animal experiments,the behavioral scores of mice in the HXTLP group increased(P＜0.05),the motor function of hind limbs was improved,and the histological morphology of the injured area was more complete compared with those of the model group.Western Blot result revealed that HXTLP effectively inhibited the key target protein(HSP90AA1)and the expression of phospho-STAT3(P-STAT3)and promoted the expression of phospho-phosphatidylinositol-3-kinase(P-PI3K)and phospho-AKT1(P-AKT1).Conclusions This study verified that HXTLP has multi-component,multi-target,and multi-pathway synergistic effects in the treatment of SCI and has provided experimental and theoretical bases for further clinical medication research for SCI.

Objective This study preliminarily investigated the potential mechanisms of the Huoxue Tongluo prescription(HXTLP)in treating spinal cord injury(SCI)through a combination of network pharmacology,molecular docking technology,and in vivo experimental verification.Methods The traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP)were utilized to select the active ingredients,targets of action were obtained from Swiss target prediction database,and an"active ingredients-targets"network was constructed.SCI-related targets were obtained by accessing online mendelian inheritance in man(OMIM)and human gene database(GeneCards),and a protein interaction network of the common targets of HXTLP and SCI was established based on the search tool for the retrieval of interacting genes/protein(STRING)database.The Metascape database was used in KEGG pathway enrichment and GO analyses of the common targets.Molecular docking of active ingredients and key targets was performed through Autodock 1.5.7 software,and the results were visualized with Pymol 2.4.0 software.Finally,the effect of HXTLP on SCI was verified by animal experiments.Results A total of 184 intersection targets were obtained,and the key targets were serine/threonine kinase(AKT1),signal transducer and activator of transcription 3(STAT3),heat shock protein 90 kDa alpha,class A member 1(HSP90AA1),phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3CA),phosphoinositide-3-kinase regulatory subunit 1(PIK3R1),harvey ras(HRAS),estrogen receptor 1(ESR1),mitogen-activated protein kinase 1(MAPK1),and epidermal growth factor receptor(EGFR).Molecular docking result showed strong binding abilities between the core active components and key targets.In the animal experiments,the behavioral scores of mice in the HXTLP group increased(P＜0.05),the motor function of hind limbs was improved,and the histological morphology of the injured area was more complete compared with those of the model group.Western Blot result revealed that HXTLP effectively inhibited the key target protein(HSP90AA1)and the expression of phospho-STAT3(P-STAT3)and promoted the expression of phospho-phosphatidylinositol-3-kinase(P-PI3K)and phospho-AKT1(P-AKT1).Conclusions This study verified that HXTLP has multi-component,multi-target,and multi-pathway synergistic effects in the treatment of SCI and has provided experimental and theoretical bases for further clinical medication research for SCI.

Objective To compile the"expert consensus on preventive and management of exposure keratopathy"(hereinafter referred to as"consensus"),aiming to standardize and promote the prevention of exposure keratopathy(EK)in medical institutions at different levels.Methods The evidence-based methods were used to retrieve,evaluate and summarize evidence in this field according to the level of evidence,and relevant recommendations and research conclusions were extracted,and the first draft of consensus was formed.After 2 rounds of Delphi expert letters and expert meetings,combined with evidence and expert opinions,the consensus content is written,adjusted and modified,and recommendations were made.Results 58 experts were invited to participate in the consultation.The expert positive coefficient was 100％;the expert judgment basis of the 2 rounds were 0.940 and 0.936;the degree of familiarity of the 2 rounds were 0.779 and 0.797;the coefficient of authority of the 2 rounds were 0.859 and 0.866.The Kendall W coefficients of the 2 rounds of inquiry were 0.099 and 0.117,and the difference was statistically significant(P＜0.05).The consensus includes 5 aspects of EK:risk factors,assessments,protection measures,symptom management and training and management.Conclusion The consensus was based on the existing evidence and clinical practical requirements and recommendations of experts in the field.Consensus can provide guidance for clinical nursing staff in prevention,nursing and management of EK effectively.

Objective:To investigate the incidence of hearing loss among helicopter flying personnel, and to analyze the contributing factors.Methods:Basic data of 443 male helicopter flying personnel who received physical examinations at Beidaihe Rehabilitation and Recuperation Center of PLA between March and June 2024 was collected. The hearing threshold levels were measured at 8 frequencies: 250, 500, 1 000, 2 000, 3 000, 4 000, 6 000 and 8 000 Hz. Routine blood tests and blood biochemical tests were performed. Based on the results of pure-tone audiometry, the participants were divided into 2 groups: the hearing loss group (hearing threshold ≤20 dB HL) and the normal hearing group (hearing threshold >20 dB HL). The basic data, routine blood results, and blood biochemical indicators were compared between the 2 groups before the contributors to hearing loss were analyzed.Results:A total of 443 helicopter flying personnel were included in the study, with 82 cases (18.51%) in the hearing loss group and 361 cases (81.49%) in the normal hearing group. There were significant differences in age and pulse between the flying personnel in the 2 groups ( t=2.13, 2.78, P=0.034, 0.006). Among the blood routine indicators, only the mean platelet volume (MPV) was significantly different ( t=2.26, P=0.025). Among the blood biochemical indicators, only homocysteine (HCY) revealed statistically significant difference ( Z=2.30, P=0.021). The determinants of hearing loss in helicopter flying personnel were age ( OR=1.046, 95% CI: 1.060-1.361), pulse ( OR=1.201, 95% CI: 1.060-1.361), MPV ( OR=1.365, 95% CI: 1.016-1.834) and HCY ( OR=1.065, 95% CI: 1.033-1.097). Conclusions:Age, pulse, the MPV and HCY levels can all contribute to hearing loss, and the MPV and HCY can serve as potential biomarkers for hearing loss in helicopter flying personnel. Potential hearing loss should be detected early and personalized interventions should be implemented. Noise exposure should be monitored more rigorously to reduce the risk of occupational hearing loss for helicopter flying personnel and ensure flight safety.

Objective:To explore the significance and interpretation of low-depth whole-genome copy number variation sequencing (CNV-seq) in prenatal diagnosis in detecting DMD gene variations in fetuses without a family history of genetic diseases, and to investigate the results of family testing. Methods:Retrospectively collected case data of 16 fetuses with DMD gene deletions or duplications detected by low-depth whole-genome CNV-seq from December 2019 to August 2023 at the First Affiliated Hospital of Zhengzhou University. Amniotic fluid or chorionic villus samples and peripheral blood from family members were collected for all 16 cases, and genomic DNA was extracted. The fetal chromosomal copy number variations were detected using CNV-seq technology and the DMD gene deletions or duplications were verified by multiplex ligation-dependent probe amplification (MLPA), followed by family validation to trace the source of variation. The pathogenicity of the DMD gene deletion or duplication fragments was analyzed based on online Mendelian genetics databases and family validation results. Results:All 16 cases denied a family history of monogenic diseases. The indications for CNV-seq prenatal diagnosis were high-risk Down syndrome screening in nine cases, advanced maternal age in two cases, abnormal fetal ultrasound in three cases, and non-invasive prenatal DNA testing suggesting X chromosome abnormalities in two cases. CNV-seq results indicated nine cases of DMD gene duplication variations and seven cases of DMD gene deletion variations. MLPA validation confirmed results consistent with CNV-seq detection. Family analysis showed that three cases were de novo variations, 12 cases were inherited from the mother, one case had a mother with normal peripheral blood testing but a sister carrying the same variation, suggesting a high possibility of the mother being a carrier of gonadal mosaic. The likelihood of pathogenic variation was high in seven cases of deletion; nine cases were duplication variations, four of which were located within the DMD gene and could potentially disrupt the gene, leading to disease, while the other five variations were located in the 5' untranslated region or 3' untranslated region, considered benign variations. Conclusions:Low-depth whole-genome CNV-seq can effectively detect large deletion and duplication variations of the DMD gene in fetuses without a family history, preventing the birth of children with de novo variations. However, the pathogenicity of fetuses with large DMD gene duplications should be assessed based on family validation. When the duplication region includes the 5' untranslated region or 3' untranslated region of the DMD gene, it is more likely to be a polymorphic variation.

Objective To compare the clinical efficacy of three different therapies,including transjugular intrahepatic portosystemic shunt(TIPS)treatment,endoscopic treatment and medication treatment,combined with transhepatic arterial chemoembolization(TACE)in treating primary liver cancer complicated by portal hypertension and upper gastrointestinal bleeding.Methods A total of 105 patients with primary liver cancer associated with portal hypertension and upper gastrointestinal bleeding,who were admitted to the No.980 Hospital of PLA Joint Logistics Support Forces of China to receive treatment between January 2014 and June 2020,were enrolled in this study.According to the therapeutic scheme,the patients were divided into TIPS+TACE group(TIPS group,n=25),endoscopy+TACE group(endoscopy group,n=30),and medication+TACE group(medication group,n=50).The clinical efficacy,recurrence rate of bleeding,incidence of hepatic encephalopathy,and survival rate were compared between each other among the three groups.Results The differences in the postoperative 6-month,12-month and 24-month recurrence rates of bleeding between each other among the three groups were statistically significant(all P＜0.05).In TIPS group,the portal vein pressure decreased from preoperative(38.47±9.35)mmHg(1 mmHg=0.133 kPa)to postoperative(25.24±5.68)mmHg,the difference was statistically significant(P＜0.05).After treatment,the hemoglobin level in the three groups showed varying degrees of elevation,which in the TIPS group and endoscopy group were better than that in the medication group,the differences were statistically significant(P＜0.05).In all three groups,the differences in the recurrence rate of bleeding between postoperative 6-month value,12-month value and 24-month value were statistically significant(all P＜0.05).The postoperative 6-month,12-month and 24-month recurrence rates of bleeding in the TIPS group were lower than those in the endoscopy group and the medication group,and the differences were statistically significant(P＜0.05).The postoperative 12-month and 24-month recurrence rates of bleeding in the TIPS group were lower than those in the endoscopy group,and the differences were statistically significant(P＜0.05).The postoperative 12-month and 24-month recurrence rates of bleeding in the endoscopy group were lower than those in the medication group(P＜0.05),and the difference in the postoperative 6-month recurrence rate of bleeding between the two groups was not statistically significant(P＞0.05).The postoperative 6-month and 12-month incidences of hepatic encephalopathy in the TIPS group were higher than those in the endoscopy group and the medication group,the differences were statistically significant(P＜0.05),while the differences in the postoperative 6-month and 12-month incidences of hepatic encephalopathy between the endoscopy group and the medication group were not statistically significant(P＞0.05),and the differences in the postoperative 24-month incidence of hepatic encephalopathy between each other among the three groups were not statistically significant(P＞0.05).No statistically significant difference in the 6-month mortality existed between TIPS group and endoscopy group(P＞0.05),and the 6-month mortality of both TIPS group and endoscopy group was remarkably lower than that of the medication group(P＜0.05).The postoperative 12-month mortality and 24-month mortality in TIPS group were lower than those in the endoscopy group and the medication group,and the differences were statistically significant(P＜0.05),but the differences in the postoperative 12-month mortality and 24-month mortality between the endoscopy group and the medication group were not statistically significant(P＞0.05).Conclusion For primary liver cancer associated with portal hypertension and upper gastrointestinal bleeding,TIPS combined with TACE can effectively control tumor progression and prolong survival.(J Intervent Radiol,2024,32:33-37)

Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

Humans ; Diabetic Neuropathies/diagnostic imaging* ; Diabetes Mellitus, Type 2 ; Ultrasonography ; Diabetic Foot/diagnostic imaging*