AIM:To systematically evaluate the changes in retinal and choroidal thickness in patients with internal carotid artery stenosis by using optical coherence tomography(OCT)through Meta-analysis.METHODS: Literatures on the measurement of retinal and choroidal structure in patients with internal carotid artery stenosis by using OCT from CNKI, VIP, WF, PubMed, the Cochrane Library, SinoMed, and Embase databases were searched for relevant studies. The retrieval time was from the establishment of the databases to January 2024. In addition, quality of the included literatures was assessed by the Newtle-Ottawa scale(NOS), and RevMan 5.4.1 and Stata 16.0 were used for statistical analysis.RESULTS: A total of 17 articles(including 18 studies)were included, and the Meta-analysis results showed that, patients with internal carotid artery stenosis had significantly thinner peripapillary retinal nerve fiber layer(pRNFL), ganglion cell complex(GCC), center macular thickness(CMT), and subfoveal choroidal thickness(SFCT)than the healthy control group(age matched normal population). The pRNFL and SFCT of the ipsilateral eye in patients with internal carotid artery stenosis become thinner compared with the contralateral eye.CONCLUSION:To a certain extent, the morphological structure of the retina and choroid can be altered by stenosis of the internal carotid artery. OCT can non-invasively detect the microstructural changes of the retina and choroid in patients with internal carotid artery stenosis, and can be used for the evaluation of internal carotid artery stenosis.

AIM: To explore retinal microvascular changes in migraine patients using meta-analysis.METHODS: The National Library of Medicine PubMed, Embase, and Cochrane Library were searched to find relevant studies, and the search period was from the creation of database to June 2023. Two investigators independently screened the literatures, extracted data, and evaluated the quality of included studies using the NOS scale. STATA15.0 was used for Meta-analysis and publication bias evaluation, sensitivity analysis was performed for results with large heterogeneity, and the funnel plot and Egger were used to assess the publication bias of the literature.RESULTS:A total of 12 studies, including 217 patients(252 eyes)with migraine with aura(MA), 283 patients(388 eyes)with migraine without aura(MO), and 374 healthy individuals(479 eyes), were included in this Meta-analysis. Several optical coherence tomography angiography(OCTA)indicators, including foveal avascular zone(FAZ)macular or optic disc perfusion density were compared and analyzed. The Meta-analysis results showed that compared with healthy controls, patients with MA had a significant increase in FAZ area and perimeter, a significant decrease in perfusion density of the macular deep capillary plexus(mDCP)except for the fovea, and a significant decrease in perfusion density of the radial peripapillary capillaries(RPC)around the optic disc; the FAZ parameters were significantly increased in MO, while the differences in perfusion density of the macular superficial capillary plexus(mSCP), mDCP and RPC were not statistically significant, except for the perfusion density in the parafovea mDCP.CONCLUSIONS: Both MA and MO patients had an enlarged FAZ area, patients with MA had a significant decrease in mDCP perfusion density, and migraine patients had some degree of retinal ischemia.

In the early stage of diabetes retinopathy(DR),the change in the molecular level is often earlier than chan-ges in retinal microvessels.Under the chronic high-glucose environment,oxidative stress,epigenetic changes and other mechanisms cause retinal mitochondrial DNA(mtDNA)damage,affect the transcription process of mtDNA coding genes,and damage the electronic transport chain,leading to a vicious cycle of free radicals,which accelerates the apoptosis of retinal capillary pericytes and endothelial cells,leads to retinal microcirculation dysfunction,and cause DR.This paper will review the epigenetic changes,oxidative stress,damage to replication and repair system,gene mutation and other aspects,in order to elaborate on the research progress of retinal mtDNA damage in the pathogenesis of DR.

Objective : To explore the independent risk factors affecting the prognosis，and to construct a nomogram model predicting overall of patients with rectal cancer at T1 and T2 stage． Methods : Retrospective analysis was made on the data of 353 patients diagnosed as rectal cancer，who received the radical rectal resection．The collect- ed data were as follows : age，body mass index (BMI) ，carcinoembryonic antigen ( CEA) ，tumor size，histological type，T stage，N stage，tumor location and number of lymph nodes detected，which were used to perform Kaplan- Meier curve and Log-rank test for univariate analysis and Cox regression for multivariate analysis．The nomogram model was established to predict the overall survival of patients. Results : Age≥60 years，Mucinous adenocarcino- ma，poorly differentiation ，T2 stage ，lymph node metastasis ，BMI ≥25 kg / m2 ，CEA ≥5 μg / L and number of lymph nodes detected ＜12 were associated with overall survival of patients with rectal cancer at T1 and T2 stage (all P＜0. 05) ．Cox regression showed that age≥60 years，T2 stage，mucinous adenocarcinoma，lymph node me- tastasis，CEA≥5 μg / L，BMI ≥25 kg / m2 and lymph node detection number ＜12 were independent risk factors. Based on the above independent risk factors，the nomogram model was constructed，and the predicted curve was in good agreement with the actual survival curve ( C-index = 0. 779) ． Conclusion Age≥60 years，T2 stage，mucin- ous adenocarcinoma，lymph node metastasis，CEA≥5 μg / L，BMI≥25 kg / m2 and the number of lymph nodes de- tected ＜12 are independent risk factors ，and the nomogram established in this study can effectively predict the prognosis of patients with rectal cancer at T1 and T2 stage.

Objective : To investigate the effect of ginsenoside Rg1 (GRg1) on human retinal microvascular endothelial cells (HRMECs) glycolysis by regulating pyruvate kinase M2 ( PKM2) expression. Methods : HRMECs were cultured in vitro and divided into normal control (NC) group, high glucose (HG) group, high glucose + ginsenoside Rg1 (HG + GRg1) group, high glucose + ginsenoside Rg1 + low expression PKM2 ( HG + GRg1 + si-PKM2) group, and high glucose + ginsenoside Rg1 + overexpression PKM2 (HG + GRg1 + OE⁃PKM2) group. si-PKM2 and OE⁃PKM2 were transfected into HRMECs cells by cell transfection. The expression of PKM2 mRNA in HRMECs was detected by qRT⁃PCR. The expression levels of related proteins in HRMECs were detected by Western blot. The number of lumen formation in vitro was observed under an inverted microscope to quantify the angiogenesis ability. Cell culture medium of each group was collected, and glucose intake, lactate production and adenosine triphosphate(ATP)content were detected by glucose detection kit, lactate detection kit and ATP detection kit,re spectively. Results : HG induced HRMECs significantly increased the number of blood vessel formation, glycolysis and PKM2 expression, while GRg1 treatment significantly reduced the number of blood vessel formation, glycolysis and PKM2 expression; transfection of si⁃PKM2 assisted the inhibitory effect of GRg1 on glycolysis and angiogenesis while transfection of OE⁃PKM2 interfered with the function of GRg1 . Conclusion GRg1 inhibits angiogenesis by inhibiting PKM2 to reduce glycolysis of HRMECs.

Objective:To observe the effect of electroacupuncture(EA)combined with oriented conductive bio-protein hydrogel(OCBH)on the recovery of nerve function in rats with complete spinal cord injury(SCI)and to explore its effect and mechanism on the formation and changes of glial scars.Methods:A total of 72 female Sprague-Dawley rats were randomly divided into groups according to the treatment received.A rat model of complete SCI was constructed using a spinal cord transection.Behavioral assessments,hematoxylin-eosin(H&E)staining,immunofluorescence staining,and Western blotting were performed at a fixed period after the operation.Results:The material group and the material+EA group obtained better results in the behavioral as-sessments(all P＜.05)and the H&E staining.In the immunofluorescence staining and Western blotting,the GFAP protein was expressed more and denser in the material group and the material+EA group than in the model group,and the density of the GFAP expression in the material+EA group was lower at week 12 than in the material group(all P＜.05).The expression of complement C3 in the model,material,and material+EA groups decreased in turn.Some inflammatory factors and the NF-kB signaling pathway showed similar results in the Western blotting(all P＜.05).The expression of the GDNF protein in the material+EA group was significantly higher than that in the model group and the material group(both P＜.01).Conclusion:EA combined with OCBH can promote the recovery of motor functions after SCI by facili-tating the formation of glial scars in the early stage,preventing the further spread of an inflammatory response that would affect the activation of A1/A2 astrocytes and change the morphology of glial scars at the spinal cord-material interface in its late stage.

Objective:To construct a systematic, standardized, scientific and effective evaluation index system for standardized training of newly recruited nurses.Methods:By the literature review, applying the Delphi method and purpose sampling to conduct two rounds of expert consultations to 17 nursing experts from 5 medical units and 1 nursing school from October 2019 to April 2020 to construct the evaluation index system for standardized training of newly recruited nurses.Results:The recovery rates of the two rounds of expert consultation questionnaires were all 100%, and the expert authority coefficient was 0.92. The final evaluation index system for standardized training of newly recruited nurses included 4 first-level indicators (professional literacy, theoretical knowledge, nursing operation skills, and core competency of the post) , 17 second-level indicators, and 52 third-level indicators.Conclusions:The evaluation index system for standardized training of newly recruited nurses established in this study is systematic, scientific and effective, which can provide a reference for standardized training and evaluation of newly recruited nurses, and provide a theoretical basis and practical guidance for improving the training effect and quality.

Objective:To explore the application value of contrast-enhanced ultrasound with SonoLiver software including quantitative analysis and dynamic vascular pattern (DVP) in the intraoperative diagnosis of glioma.Methods:SonoLiver software was used to analyze the contrast-enhanced ultrasound (CEUS) process of 252 cases with different grades of gliomas in General Hospital of Southern Theatre Command of PLA from 2006 to 2016. Among them, 144 were in the low-grade gliomas (LGG) group and 108 were in the high-grade gliomas (HGG) group. The quantitative parameters included maximum intensity (IMAX), time to peak (TTP) and mean transit time (mTT). The images of each CEUS were obtained, and the microvessel density (MVD) of corresponding pathology was compared, so as to analyze their correlations and characteristics.Results:There were significant differences in IMAX, TTP and mTT between the CEUS parameters of gliomas with different grades. IMAX in HGG group was significantly higher than that in LGG group( P<0.001), while TTP was shorter ( P=0.017) and mTT was longer( P=0.030). By correlation analysis between MVD and the CEUS parameters, MVD was positively correlated with IMAX ( r s=0.736, P<0.001) and mTT( r s=0.184, P=0.003), but negatively correlated with TTP( r s=-0.186, P=0.003). Compared with DVP images, the tumor areas of LGG group were mainly warm and black colors with small spots of cool-colored areas, and most of the surrounding areas were more obvious black areas. In HGG group, the tumor areas were mainly warm colors. Most of which were scattered in patchy cold colors areas, and the surrounding black areas were less ( P<0.05). There were significant differences in differentiating gliomas boundary before and after using DVP technique ( P<0.05). After using DVP, the boundary of glioma was clearer and more discernible. The discernibility of HGG group was up to 99%, and that of LGG group reached 97%. Conclusions:SonoLiver software can effectively and quantitatively analyze the CEUS parameters of gliomas with different grades, and its DVP images can directly reflect the contrast perfusion characteristics of gliomas, providing a new way to distinguish the boundary of gliomas and a new imaging method for the differential diagnosis of high and low grades of gliomas.

Objective To investigate the protective effect of dexamethasone on hearing loss induced by canalwall-down mastoidectomy.Methods A total of 76 patients (76 ears) were randomized to dexamethasone group and non dexamethasone group with 38 patients in each group.For dexamethasone group,gelfoam soaked with dexamethasone (5 mg/ml) was topically applied to the round window niche at the end of the surgery,and dexamethasone was administrated intravenously at the dosage of 5 mg/50 kg immediately after the surgery.While for non-dexamethasone group,dexamctbasone was not used.The pure-tone audiograms were performed before mastoidectomy and 90 days after the surgery.Absolute bearing change was defined as the difference in hearing thresholds in decibels before and after the surgery.Results The changes of bone conduction thresholds in dexamethasone group were 8.3± 3.9 dB at 6 kHz,11.3±5.2 dB at 8 kHz,and 10.1±7.2 dB for HPTA (4-6-8 kHz high tone average).As in non-dexamethasone group,the changes of bone conduction thresholds were 13.7±4.6 dB at 6 kHz,25.1±5.4 dB at 8 kHz,19.3±9.7 dB for HPTA.There were significant differences in the changes of bone conduction thresholds between dexamethasone and non dexamethasone groups at frequencies of 6 kHz (P=0.039),8 kHz (P=0.007) and HPTA (P=0.009).Conclusion The results demonstrated that application of dexamethasone significantly reduced sensorineural high frequencies (6 kHz and 8 kHz) hearing loss after canal-wall down mastoidectomy,thus the use of dexamethasone is recommended.

Objective To study the protective effects of salvia miltiorrhiza on acute acoustic trauma (AAT) showed by temporary threshold shifts (TTS) induced by impulse noise.Methods A total of 62 male soldiers from a boot camp were randomly divided into the experimental group and the control group,each with 31 persons.The experimental group was treated with salvia miltiorrhiza,and the control group with placebo.Salvia miltiorrhiza was taken orally at the dosage of 780 mg each time,three times a day for 3 consecutive days before the live fire training and 1 day after the live fire training.The pure tone thresholds of right ears of these two groups were measured and compared 72 hours before live fire training and 6 hours after the live fire training.Results The puretone averages at 0.5,1 and 2 kHz of the right ears of the experimental group and the control group before live fire training were 16.32±6.12 dB and 16.21±5.42 dB,respectively,and the averages at 4,6 and 8 kHz were 14.22±5.16 dB and 14.89±5.38 dB,respectively.There were no significant differences between the 2 groups(P＞0.05).The PTAs of the right ears of the experimental group and the control group 6 hours after live fire training were 21.88±5.71 dB and 21.66±6.62 dB,respectively(P＞0.05),while the HPTAs were 25.89 ± 7.97 dB and 39.75 ± 7.84 dB,respectively(P＜0.01).There were significant differences in TTS between the two groups at 4,6 and 8 kHz(P＜ 0.01).Conclusion Salvia miltiorrhiza can reduce TTS at high frequencies induced by AAT.It has a potential preventive effect on AAT.