Amblyopia is a common visual development disorder and is the main cause of monocular vision impairment in children and adults. Photobiomodulation(PBM), a non-invasive treatment method, has gradually gained attention in the field of ophthalmology. This paper begins with the macroscopic manifestation of light on the animal model of amblyopia. Additionally, it discusses the pathological changes of the amblyopic retina and the human eye's central nervous system, as well as the influence and mechanism of PBM on the visual perception and processing system and its chemical effect on the visual system through dopamine and melatonin. It examines its mechanism of action, current clinical application status, and future development direction in order to provide new ideas and theoretical foundation for amblyopia treatment.

OBJECTIVE To investigate the effect and mechanism of acute exposure to sodium cyanide(NaCN)on brain nerve damage induced by closed hypoxia in mice.METHODS ① Mice were randomly divided into hypoxia+NaCN 0(hypoxia control group),2.56,3.8,and 5.1 mg·kg-1 groups.After ip adminis-tration of different concentrations of NaCN,the mice were immediately placed into a closed hypoxic tank and the hypoxia survival time was observed.②Mice were divided into normal control,NaCN 3.8 mg·kg-1,hypoxia(30 and 60 min)and NaCN 3.8 mg·kg-1+hypoxia(30 and 60 min)groups.After grouping,the pH,oxygen saturation(sO2),oxygen tension(pO2)and carbon dioxide partial pressure(pCO2)of arterial blood of mice were detected using an arterial blood gas analyzer.The cortical cerebral blood flow of mice was detected using a laser speckle imager.The dry and wet brain tissue were weighed separately,and the brain moisture content was calculated.The kit was used to detect the activity of total superoxide dismutase(T-SOD)and the content of malondialdehyde(MDA)in the hippocampus.TUNEL staining was used to detect the apoptosis rate of cells in the hippocampus.HE staining was used to detect path-ological changes in the hippocampus.RESULTS ①Compared with the hypoxic control group,the sur-vival time of mice in the hypoxic+NaCN groups was significantly prolonged(P<0.01).②Compared with the normal control group,the hypoxia 30 min group showed upregulation of arterial blood p CO2(P<0.05),downregulation of p O2(P<0.05).The hypoxia 60 min group showed upregulation of arterial blood p CO2(P<0.05)and downregulation of cortical cerebral blood flow(P<0.05).In the NaCN 3.8 mg·kg-1 group,arterial blood p O2 and s O2 were significantly downregulated(P<0.05),so was cortical cerebral blood flow(P<0.01),but MDA content and T-SOD activity were significantly upregulated(P<0.01),and the brain moisture content was increased(P<0.01).Compared with the hypoxia 30 min group,s O2 and p O2 of arterial blood in the NaCN+hypoxia 30 min group were significantly upregulated(P<0.05),while p CO2 was significantly downregulated(P<0.05).Compared with the hypoxia group at corresponding time points,the NaCN+hypoxia 30 or 60 min groups showed significant downregulation of cerebral blood flow(P<0.01),significant upregulation of MDA content and T-SOD activity(P<0.01),and signifi-cant upregulation of brain moisture content(P<0.01).HE staining results showed that the NaCN 3.8 mg·kg-1 group and the NaCN+hypoxia group(30 or 60 min)showed significant cell swelling and vacuolization in cells in the hippocampal tissue,a decrease in the number of neurons,nuclear pyknosis and deep staining.TUNEL fluorescence results showed that the NaCN 3.8 mg·kg-1 group significantly increased the apop-tosis rate of the mouse hippocampus compared with the normal control group(P<0.05).The NaCN+ hypoxia 30 and 60 min groups significantly increased the apoptosis rate of the mouse hippocampus compared with the hypoxia group at corresponding time points(P<0.05).CONCLUSION NaCN can exacerbate hypoxia induced decrease in cerebral blood flow,oxidative stress in brain tissue,and neuro-nal apoptosis in mice,thereby reducing oxygen consumption in closed hypoxic tanks and prolonging their survival time.The mechanism is related to reduced utility of cell oxygen,delaying CO2 accumulation and increasing free oxygen in vivo.

Standardization is the universal language of the world, and standardization of traditional Chinese medicine (TCM) is essential for its communication in China and globally. However, the principles and methods of TCM acupuncture standardization have been unclear and inadequate in the early stages. Based on an investigative approach to understanding the current status, identifying problems, and finding solutions, our team has established basic principles of TCM acupuncture that embody Chinese wisdom, evaluated the international strategic environment systematically, proposed the principle of “importance of harmony and exercise of impartiality”, and established basic working principles. A series of methods for TCM acupuncture standard development and evaluation have been constructed, including general standards for the revision of TCM acupuncture standards, the first TCM acupuncture clinical research management specification, a shared full chain technology platform, a data center, and an evaluation research base for TCM acupuncture clinical research. Evaluation criteria for ancient literature and expert experience, a recommendation method for the “three main and three auxiliaries” TCM guideline for prevention were established, and quantifiable assessment methods of TCM standard applicability were proposed. These findings provide methodological guidance for TCM acupuncture standardization.

Objective:To compare the correlation and differences between invasive blood pressure(IBP)and noninvasive blood pressure(NBP)monitoring at three different levels of systolic blood pressure(SBP), diastolic blood pressure(DBP)and mean arterial pressure(MAP)in elderly hypertensive patients with atherosclerosis of the extremities during perioperative anesthesia.Methods:156 elderly patients were prospectively admitted to the Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, for peripheral vascular stenosis interventions between December 2018 and December 2021.Their IBP and NBP were measured simultaneously during the perioperative anesthesia period.Then the correlation and consistency between IBP and NBP were analyzed via the Pearson correlation coefficient, Bland-Altman plots, and the receiver operating characteristic curve(ROC curve).Results:A total of 156 elderly patients were enrolled, including 108 men(69.2%)and 48 women(30.8%), with a mean age of 72.2±7.6.Pearson correlation analysis revealed that there was a significant positive correlation between IBP and NBP.The correlation coefficient was 0.993 for invasive systolic blood pressure(ISBP)and non-invasive systolic blood pressure(NSBP), 0.808 for invasive diastolic blood pressure(IDBP)and non-invasive diastolic blood pressure(NDBP), and 0.853 for invasive mean arterial pressure(IMAP)and non-invasive mean arterial pressure(NMAP)( P<0.001 for all). Bland-Altman analysis showed that the mean deviation of ISBP and NSBP was(20.3±6.5)mmHg(95% CI: 19.18-21.38)(1 mmHg=0.133 kPa), the mean deviation of IDBP and NDBP was(3.8±9.7)mmHg(95% CI: 2.13-5.41), and the mean deviation of IMAP and NMAP was(12.7±11.0)mmHg(95% CI: 10.83-14.55). The correlation coefficient of ISBP-NSBP deviation with ISBP was 0.856, the correlation coefficient of IDBP-NDBP deviation with IDBP was 0.206, and the correlation coefficient of IMAP-NMAP deviation with IMAP was 0.583( P<0.05 for all). When ISBP≥137 mmHg, the sensitivity of an ISBP-NSBP deviation ≥20 mmHg was 96.3%, the specificity was 96.4%, and the area under the ROC curve was 0.970(95% CI: 0.934-1.000). When ISBP≥158 mmHg, the sensitivity and specificity of a predicted ISBP-NSBP deviation≥25 mmHg were 97.4% and 78.8%, respectively, and the area under the ROC curve was 0.876(95% CI: 0.820-0.933); When ISBP≥208 mmHg, the sensitivity and specificity of a predicted ISBP-NSBP deviation≥30 mmHg were 100% and 98.5%, respectively, and the area under the ROC curve was 0.985(95% CI: 0.964-1.000). Conclusions:There is a good agreement between IBP and NBP in elderly hypertensive patients with peripheral atherosclerosis during perioperative anesthesia.The magnitude of the deviation between the two is significantly and positively correlated with the level of blood pressure, suggesting that we should appropriately choose the method of blood pressure measurement in the perioperative period to correctly evaluate the blood pressure of these elderly patients.

With the development of patient-centered medical model,patient values and preferences have become a hot research topic.This paper starts from the concept of patients'values and preferences,analyzes the important importance of patients'values and preferences;Based on the published literature,the importance of patients'values and preferences in the development of acupuncture clinical guidelines,the positive role in doctor-patient co-decision,the value of patients'cognition and value promotion in acupuncture"Deqi"were sorted out,and the influencing factors of patients'values and preferences and acupuncture compliance were summarized.According to the influencing factors,the corresponding solutions were proposed to help patients establish correct values,and thus improve patients'acupuncture compliance.

Objective To observe the ultrasonic manifestations and outcomes of fetal congenital kidney anomalies(CKA)during the second trimester of pregnancy.Methods Data of 223 singleton fetuses with CKA detected with ultrasound during the second trimester of pregnancy were retrospectively analyzed.The ultrasonic manifestations of fetal CKA during the second trimester of pregnancy were observed,and the changes till the third trimester of pregnancy were analyzed.Results Among 223 CKA fetuses,simple renal pelvis separation was detected in 142 fetuses,while simple double renal pelvis malformation in was found in 41,polycystic kidney disease in 11,absent kidneys in 7,simple renal cysts and ectopic kidneys each in 6,smaller kidneys in 4,horseshoe kidneys and unilateral renal pelvis separation complicated with contralateral double renal pelvis malformation each in 2,unilateral renal cyst swelling complicated with contralateral double renal pelvis malformation and unilateral renal double renal pelvis malformation complicated with renal pelvis separation was noticed each in 1 fetus.Abnormalities such as renal pelvis separation,renal pelvis malformation,renal cysts and smaller kidney changed during the third trimester of pregnancy,while polycystic kidney disease,absent kidney,ectopic kidney and horseshoe kidney not significantly changed.Conclusion Fetal CKA had various types being able to change dynamically with the development of pregnancy,among which renal pelvis separation was the most common type.

Objective To observe the ultrasonic manifestations and genetic abnormalities in the second trimester of pregnancy of fetal congenital kidney anomalies(CKA).Methods Totally 14 singleton pregnancy women with CKA fetus detected with prenatal ultrasound and proved by genetic examination who underwent prenatal ultrasound in the second trimester of pregnancy were enrolled.The ultrasonic manifestations and genetic abnormalities in the second trimester of pregnancy were observed.Results Among 14 fetuses,simple renal abnormalities were detected in 10,while renal abnormalities complicated with extrarenal abnormalities were noticed in 4 fetuses with prenatal ultrasound in the second trimester of pregnancy,presented as enhanced renal echoes,renal pelvis separation and ectopic kidney,etc.Genetic examination showed chromosomal karyotype abnormalities in 4 fetuses,chromosomal copy number abnormalities in 8 fetuses,and genetic mutations in 2 fetuses.Conclusion The ultrasonic manifestations in the second trimester of pregnancy of fetal CKA included enhanced renal echo,renal pelvis separation and ectopic kidney,etc.Severe chromosomal or genetic abnormalities could exist even when the relative manifestations were not obvious.

Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Female ; Humans ; Killer Cells, Natural ; Pregnancy ; Pregnancy Complications

Objective:To investigate the clinical features and treatment status of immune-related myositis (IRM) caused by immune checkpoint inhibitors (ICIs) in order to improve the diagnosis and treatment rate of the disease.Methods:Two cases of IRM combined with the diagnosis and treatment were described and the literature about IRM in the past 10 years was reviewed, and the clinical data of 59 patients were analyzed.Results:IRM was more common in males, with a total of 47 (79.7%). IRM usually occurred after 45 days of medication or after two doses. The clinical manifestations were mainly myalgia and muscle weakness, which were more common in the limbs. The initial symptoms were ptosis and diplopia. Fifty patients (84.7%) had serum creatine kinase (CK) levels higher than twice the upper limit of normal (UNL). In immunological examinations, 18 patients were found to be positive for anti-rhabdoid muscle antibody (AsM-Ab), while most of the myositisspecific antibodies (MSAs) and myositis-associated antibodies (MAAs) were negative. Thirty-four patients (75.6%) had abnormal EMG, and most patients showed myogenic injury. Muscle magnetic resonance imaging (MRI) showed muscle edema and inflammation in 8 patients. Muscle biopsies from 18 (45.0%) patients showed varying degrees of necrotic myofibers. Fifty-seven patients (96.6%) discontinued ICIs after developing IRM, 54(91.5%) received cortico-steroids, and 20(33.9%) received other treatments including intravenous immuno-globulin (IVIG), plasma exchange.Conclusion:IRM can occur in the early stage of ICIs treatment. Electro-myography, muscle MRI and muscle biopsy in suspicious cases can improve the diagnosis rate of the disease. Early use of corticoteroid, IVIG and other immunotherapy can effectively alleviate the disease.

Objective:To carry out prenatal screening and diagnosis for a woman with advanced maternal age.Methods:Non-invasive prenatal testing (NIPT) was carried out to determine the risk of fetal chromosome aneuploidy. Aminiocentesis was proceeded for fetal chromosomal karyotyping and copy number variation sequencing (CNV-seq). The fetus was subjected to systematic ultrasound screening in the second trimester.Results:NIPT has indicated there was a loss of fetal sex chromosome. Karotyping of the amniocyte showed a mosaic sex chromosome abnormality 45, X[53]/46, X, + mar[7]. The result of fetal DNA CNV-seq was seq[GRCh37]del(Yq11.1q12) chrY: g. 13 104 553-28 819 361del, seq[GRCh37]del(Yp11.32p11.2) chrY: g. 10 001-9 873 915del (mosaic ratio: 30%). Ultrasonography discovered that the fetus had renal dysplasia and male external genitalia. The karyotypes of the couple were both normal.Conclusion:Multiple genetic tests should be carried out for fetus with a high risk for chromosome aneuploidies signaled by NIPT. It is difficult to predict the post-natal phenotype for fetuses with mosaic sex chromosomal aneuploidies. The couple should be carefully counseled upon genetic counseling.