Rhegmatogenous retinal detachment(RRD)is a vision-threatening ocular emergency with the potential risk of blindness. Pars plana vitrectomy(PPV)is the treatment of choice for RRD, especially for complex retinal detachments such as posterior pole retinal tears, grade B or higher proliferative vitreoretinopathy, and concomitant choroidal detachment. Although most patients achieve good anatomical restoration after surgery, some patients may still experience postoperative symptoms such as distorted vision, abnormal color perception, and lack of improvement in corrected visual acuity. Epiretinal membranes(ERM), as one of the most common complications after RRD, occur in 4% to 13% of cases, which not only affect the recovery of patients' postoperative vision, but also are frequently associated with visual distortion. In severe cases, a second surgical intervention may be required. In recent years, internal limiting membrane peeling(ILMP)has been introduced as an adjunctive procedure in the treatment of RRD, to facilitate retinal reorientation, reduce postoperative complications, and improve patients' postoperative visual quality and quality of life. However, previous studies on the effects of combined intraoperative ILMP on retinal anatomy and visual function recovery are limited. Therefore, this article reviews the mechanism, clinical application, challenges and research progress of ILMP in RRD, providing a reference for surgical decision making, disease assessment, and prognosis evaluation.

Objective To investigate the needs and gains of eight-year clinical medicine program students during their oncology internships,and provide reference for the reform of clinical teaching in oncology.Methods A ques-tionnaire survey was conducted among 52 students from Peking Union Medical College,Tsinghua University School of Medicine,and Peking Union Medical College"4+4"medical doctor program who underwent internships in the Department of Oncology at Peking Union Medical College from July 2023 to June 2024 in order to examine their basic knowledge of oncology,the courses they are interested in,their preference for teaching methods and the gains from the internships.The exam was conducted before and after the internship.Results All 52 students participated in the survey and examination.Most students were interested in clinical diagnosis and treatment,new drug develop-ment and progress in basic research.All students acknowledged that their ability to solve actual clinical problems had been improved after the internship in oncology,51(98.08%)recognized that their capacity of literature searching and reviewing,integrating the information and reasoning had improved,while 50(96.15%)believed that their capacity to read Computed Tomography(CT)images or perform imaging diagnosis had improved.The number of students who were interested in oncology increased from 41(78.85%)before the internship and up to 47(90.38%)after the training.The average score of the students before internship was 63.88±8.90,and then signif-icantly increased up to 82.94±9.12 afterwards.Conclusions Eight-year program students of clinical medicine are quite interested in oncology,their learning and training outcomes have been further improved through the clinical training during internship.

Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

OBJECTIVE To optimize the preparation process of sinomenine microemulsion and evaluate its pharmacodynamics.METHODS HPLC method for sinomenine content determination was established,and sinomenine microemulsion prescription was in-itially screened by solubility test and pseudo-ternary phase diagram.D-optimal mixing experimental design method was used to optimize sinomenine microemulsion prescription with particle size and drug load as investigation indexes,and its particle size,drug load and sta-bility were evaluated.Transdermal absorption was investigated by transdermal test in vitro,and the anti-inflammatory effect was evalua-ted by ear swelling test.RESULTS With methanol:0.1%phosphoric acid(40 ∶ 60)as the mobile phase,the detection wavelength was 262 nm,and the method was suitable for the determination of sinomenine.The optimal formula of microemulsion was obtained as castor oil(7.0%),PEG40 hydrogenated castor oil/anhydrous ethanol(69.0%),the optimal Km value was 3∶1,and distilled water(24.0%).The average particle size of the microemulsion was 18.76 nm,the PDI was 0.072 and the drug loading was 5.225%.The cumulative permeability of 1.0%sinomenine microemulsion at 12 h was 1.223 4 μg·cm-2,and the steady permeability rate was 0.0649 μg·cm-2·h-1,which was better than sinomenine solution.The inhibitory rate of sinomenine microemulsion was 65.07%,which was similar to dexamethasone.CONCLUSION The preparation of sinomenine microemulsion has the advantages of stable process,high drug loading,good transdermal absorption and anti-inflammatory effect,which can provide reference for the development of sinomenine transdermal drug delivery preparation.

Objective To investigate the effect of peripheral blood bile acids on the cognitive function of schizophrenia patients.Methods Targeted metabolomics was adopted to analyze the total level of primary and secondary serum bile acid metabolites collected from 23 schizophrenia patients and 23 health control individuals.The MATRICS Consensus Cognitive Battery(MCCB)was adopted to evaluate the subjects'cognitive function in five dimensions.Results We found that the schizophrenia patients had impaired cognitive functions in multiple dimensions including speed of processing,working memory,reasoning and problem solving,and visual learning.Compared with the health control group,serum levels of cholic acid(CA)and chenodeoxycholic acid(CDCA)were significantly lower in patients with schizophrenia,while serum level of glycocholic acid(GCA)was significantly higher,and the ratio of deoxycholic acid(DCA)to CA was higher(3.04 vs.1.16).Speed of processing,working memory,reasoning and problem solving,and visual learning abilities were significantly negatively correlated with serum levels of multiple primary bile acids including taurocholic acid(TCA),GCA,glycochenodeoxycholic acid(GCDCA)and taurochenodeoxycholic acid(TCDCA),after adjustments of age,sex,and body mass index.Conclusion The bile acid profile of schizophrenia patients is obvious,and the decrease in neuroprotective bile acids(namely,CA and CDCA)and the up-regulation of cytotoxic bile acid(i.e.,GCA)may impair the cognitive function of schizophrenia patients.

Objective:To explore the benefits of speech training for young persons with tongue cancer after 125Ⅰ radioactive seed implantation. Methods:Fifty young persons bearing a 125Ⅰ radioactive seed implanted to treat tongue cancer were given up to 40min of daily tongue function training beginning on the second day after the operation. Abnormal sounds were corrected in the seven days before their discharge. An online platform assisted further training in the family combined with biofeedback. Daily 20-30 minute sessions were prescribed. Time domain waveforms, speech spectra and energy waterfalls were recorded from the 50 subjects before the experiment and after 1 week of the speech training. Intelligibility (PI) was quantified before the operation and the speech training, and then 1, 2, 4 and 6 months after discharge. Results:After 1 week of speech training abnormal waveforms had disappeared from the time domain waveform diagram. Fricative disturbance areas in the speech spectrum diagram had improved significantly, and the energy distribution in the energy waterfall diagram was balanced, showing a trend typical of normal speech fluctuation. The average PI before the operation (39.92±8.46) increased to (40.32±8.79) before the speech training and to (42.78±8.24) one month after discharge. It then continued to improve to (72.32±5.55) 6 months after discharge.Conclusion:Speech training can significantly improve the speech intelligibility of patients with tongue cancer after 125Ⅰ radioactive seed implantation.

Objective:To observe the characteristics of early changes in choroidal thickness and choroidal microvascular morphology in the macula of patients with systemic lupus erythematosus (SLE) using swept-source optical coherence tomography angiography (OCTA).Methods:A cross-sectional study was conducted.Thirty-seven patients (37 eyes) who were diagnosed with SLE without obvious ocular symptoms in Hebei General Hospital from January 2022 to July 2022 were enrolled in this study as a SLE group.At the same time, 35 normal adults (35 eyes) matched with age and sex were included as a control group.Swept-source OCT was used to perform a 9 mm×9 mm radial scan of the macular region of subjects to obtain the average choroidal thickness of the macular central concave area, the paracentral concave area (1-3 mm), and the pericentral concave area (3-6 mm). OCTA was used to perform a 3 mm×3 mm scan of the macular region and images of retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) blood flow density, choroidal capillary plexus (CC) blood flow density, and microvascular blood flow in the macular region were obtained and binarized using ImageJ software (Phansalkar method) to calculate the choroidal capillary flow void area (FDa) and percentage of flow deficits (FD%). The study protocol followed the Declaration of Helsinki and was approved by the Ethics Committee of Hebei General Hospital (No.202310). Informed consent was obtained from all subjects.Results:The choroidal thickness of the subfoveal region in SLE group was (268.73±81.67)μm, which was significantly higher than (230.14±68.14) μm of control group ( t=2.170, P=0.033). The blood flow density of SCP, DCP and CC in the macular central zone area of SLE group were (16.58±3.90)%, (14.25±3.15)% and (51.80±4.27)%, respectively, which were significantly lower than (20.55±4.41)%, (16.57±3.74)% and (54.33±3.41)% of control group ( t=-4.043, -2.851, -2.763; all at P<0.05). The FDa and FD% in SLE group were 3.43(3.25, 3.56)mm 2 and 38.11%(36.13%, 39.52%), which were greater than 3.25(3.21, 3.32)mm 2 and 36.11%(35.64%, 36.84%) of control group, and the differences were statistically significant ( Z=-3.470, -3.476; both at P<0.05). Conclusions:OCTA can detect an increase in choroidal thickness and a decrease in blood flow density of CC in eyes with SLE without obvious ocular symptoms.

Glaucoma is a chronic neurodegenerative disease of the optic nerve accompanied by apoptosis of the retinal ganglion cells, atrophy and depression of the optic nerve, and visual field loss.However, the mechanism of high intraocular pressure and glaucomatous optic neuropathy has not yet been elucidated.Autophagy is a lysosomal degradative process, which eliminates bulk cytoplasmic constituents.In recent years, a large number of studies have shown autophagy to be closely related to the occurrence and development of glaucoma.These studies examined the stress response of ocular tissues to high intraocular pressure, optic nerve protection, optic disc remodeling, immune regulation, abnormal protein removal and scar regulation.This article summarizes the relationship between autophagy and glaucoma, and pays special attention to the progress of research concerning autophagy in the trabecular meshwork, retinal ganglion cells, exfoliation syndrome, and scarring after glaucoma filtering surgery.It will lay a foundation for a deeper understanding of glaucoma pathogenesis and provide a new idea for diagnosing and treating glaucoma in the future.

Objective:To explore the effect of nursing intervention based on self-efficacy theory on self-efficacy of patients with chronic obstructive pulmonary disease (COPD) .Methods:By the convenient sampling method, a total of 140 COPD patients who were admitted to the First Affiliated Hospital of Zhengzhou University from May 2018 to June 2019 were selected as research objects. According to the random number table method, they were divided into the observation group and the control group, with 70 cases in each group. Patients in the control group were given routine nursing while patients in the observation group were given nursing intervention based on self-efficacy theory on basis of the control group. The self-efficacy score of patients before and after nursing was compared between the two groups.Results:Before the intervention, there was no statistically significant difference in the self-efficacy scores between the two groups ( P>0.05) . After intervention, the self-efficacy scores in all dimensions of the observation group were all higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Nursing intervention based on self-efficacy theory can effectively improve the self-efficacy of COPD patients on the basis of routine treatment and nursing, which is worthy of clinical application.