The finite element method(FEM)is a widely employed mathematical technique in mechanical research that divides an object into discrete and interacting finite elements. Medically, finite element analysis(FEA)enables the simulation of biomechanical experiments that are challenging to conduct. Orbital surgery poses significant challenges to ophthalmologists due to its inherent difficulty and steep learning curve. FEM enables the simulation and analysis of the mechanical properties of orbital tissue, offering a novel approach for diagnosing and treating orbital-related diseases. With technological advancements, FEM has significantly matured in the diagnosis and treatment of orbital diseases, becoming a popular area of research in orbital biomechanics. This paper reviewed the latest advancements in orbital FEM, encompassing the development of orbital FEA models, simulation of orbital structure, and its application in orbital-related diseases. Additionally, the limitations of FEM and future research directions are also discussed. As a digital tool for auxiliary diagnosis and treatment, orbital FEA will progressively unlock its potential for diagnosing and treating orbital diseases alongside technological advancements.

Congenital entropion, an abnormal condition in which the eyelids roll inward, with the eyelashes losing their normal angulation and tilting toward the eye, especially in the lower eyelids and inner canthus, often occurs in infants and young children. Congenital entropion may lead to corneal epithelial abrasion, inflammation and ulcer, which may affect the function of the eye if not treated in time. Early surgical intervention is helpful to the health of children's eyes. The purpose of surgery is to change the structure of eyelid and weaken the force of entropion, thus improving the symptoms and corneal astigmatism. At present, there are many surgical treatments for congenital entropion. In this paper, the advantages, disadvantages and indications of these treatments are analyzed and summarized, providing a reference for clinical practice.

Objective:To investigate the status quo of psychological contracts and influencing factors among members of the "1+N" family doctor teams in Shenzhen and to explore the impact of psychological contracts on job burnout.Methods:This cross-sectional study was conducted from September 30 to October 31, 2022 among 361 members of 92 family doctor teams from 92 community health service centers which provided family doctor team service in Shenzhen city. A self-designed general information questionnaire, an employee psychological contract questionnaire (including organizational responsibility and personal responsibility dimensions), and a job burnout scale (including emotional exhaustion, depersonalization, and personal accomplishment dimensions) were used in the study. T-tests, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis were used to analyze the influencing factors of psychological contracts and job burnout.Results:Among 361 respondents, there were 299 females (82.8%) and 62 males (17.2%), and a higher proportion of general practitioners (37.5%, 129/361) and nurses (41.8%, 151/361). The total score of psychological contracts among the 361 respondents was (141.6±19.5), with organizational responsibility scoring (70.6±11.2) and personal responsibility scoring (71.0±9.3). On the job burnout scale, emotional exhaustion scored (17.89±6.82), depersonalization scored (6.51±2.54), and personal accomplishment scored (30.95±5.70). General practitioners scored lower in organizational responsibility and personal responsibility compared to other members ( F=7.341,3.119, all P<0.05), and higher in emotional exhaustion and depersonalization ( F=7.637, 2.415, all P<0.05). Members with≤5 years of work experience scored lower in personal responsibility and personal accomplishment ( F=3.656, 4.205, all P<0.05). Correlation analysis showed that scores of organizational responsibility and personal responsibility were negatively correlated with levels of emotional exhaustion and depersonalization ( r=-0.618, -0.526, all P<0.01), ( r=-0.404, -0.393, all P<0.01), and positively correlated with personal accomplishment ( r=0.500, 0.558, all P<0.01). Multiple linear regression analysis indicated that organizational responsibility negatively affected emotional exhaustion and depersonalization ( β=-0.554, -0.274, all P<0.01), and positively affected personal accomplishment ( β=0.172, P<0.05). Personal responsibility positively affected personal accomplishment ( β=0.404, P<0.01). Conclusions:The study demonstrates that general practitioners in family doctor teams in Shenzhen city have lower psychological contract levels and are more prone to emotional exhaustion and depersonalization; members with≤5 years of work experience have lower personal responsibility and accomplishment. The results indicate that enhancing organizational responsibility can reduce job burnout of members in family doctor teams.

ObjectiveTo explore the role of interleukin-6 （IL-6）/signal transducer and activator of transcription 3 （STAT3） pathway in the balance of T helper 17 （Th17）/regulatory T （Treg） cells in ulcerative colitis （UC） with internal dampness-heat accumulation syndrome and the intervention mechanism of Shaoyaotang. MethodA total of 60 SD rats were randomized into blank group （equivalent volume of normal saline）， model group （equivalent volume of normal saline）， western medicine control group （0.42 g·kg^-1 mesalazine）， and low-dose （11.1 g·kg^-1）， medium-dose （22.2 g·kg^-1）， and high-dose （44.4 g·kg^-1） Shaoyaotang groups. UC with internal dampness-heat accumulation syndrome was induced in rats with the compound method except for the blank group. The administration lasted 14 days for each group. At 24 h after the last administration， rats were killed and the spleen and colon tissues were separated. The histopathological changes of colon were observed based on hematoxylin and eosin （HE） staining and the levels of interleukin-17 （IL-17） and transforming growth factor-β₁ （TGF-β₁） in colon tissue were detected by immunohistochemistry （IHC）. Flow cytometry was employed to determine the levels of Th17/Treg cells in the spleen， and Western blot to measure the levels of IL-6 and STAT3 proteins in colon tissue. ResultCompared with the blank group， the model group had lesions such as congestion and erosion， low percentage of spleen Treg cells （P<0.01）， high percentage of Th17 cells （P<0.01）， and high levels of IL-6 and STAT3 proteins in colon tissue （P<0.01）. Compared with the model group， the administration groups showed alleviation of colon injury， high percentage of spleen Treg cells （P<0.05， P<0.01）， low percentage of Th17 cells （P<0.01）， and low levels of IL-6 and STAT3 proteins in colon tissue （P<0.01）. ConclusionShaoyaotang regulates the balance of Th17/Treg by inhibiting the IL-6/STAT3 pathway， thereby relieving the pathological damage of UC rats with internal dampness-heat accumulation syndrome and affecting their immune function.

Phosphatidylinositol-3-kinase (PI3K) inhibitors can increase the sensitivity of tumor cells to Poly ADP-ribose polymerase-1 (PARP-1) inhibitors. Therefore, the simultaneous inhibition of the PARP-1 and PI3K activities are expected to overcome the drug resistance of PARP-1 inhibitors.In our previous work, two compounds XW-1 and WZ-1 with excellent activities against PARP-1 and PI3K were obtained with the limitation to further study due to their poor water solubility.Therefore, XW-1 and WZ-1 were chosen as lead compounds to optimize their solubility by introducing a salt-forming site via a urea group, and 11 novel compounds were designed and synthesized. The structure of all target compounds was confirmed by 1H NMR, 13C NMR, and HRMS.The enzyme activities of the compounds against PARP-1 and PI3K were measured, and the results showed that most of the compounds demonstrated good inhibitory activities against PARP-1 and PI3K.Based on the above result, the inhibitory activities of compounds 8b, 8e, and 8f against MDA-MB-231, MDA-MB-468, HCC1937, HCT116, and olaparib-resistant HCT116R were determined by MTT, respectively.Additionally, the structure-activity relationship was discussed. The results showed that these compounds displayed excellent antiproliferation activity.Among them, compound 8f demonstrated antiproliferation remarkably against all five tumor cells, which was more potent than that of olaparib, and was comparable to that of BKM120.Furthermore, the solubility of hydrochloride salts of compound 8b and 8f was significantly improved compared to the lead compounds.The results of this study will provide a theoretical basis for the further development of PARP-1 and PI3K dual-target inhibitors with good pharmaceutical properties and strong inhibitory activities.

Objective:To systematically analyze the efficacy of nasal endoscopic transsphenoidal decompression and glucocorticoid pulse therapy for traumatic optic neuropathy (TON).Methods:PubMed, Web of Science, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang, China Biomedical and other databases were searched to retrieve clinical studies on endoscopic surgery and hormone therapy for TON since their establishment to November 1, 2020.Two researchers screened the literature and evaluated the quality of the included literatures.The improvement of visual acuity before and after treatment was taken as an effective indicator.RevMan 5.3 statistical software was used for meta-analysis.The sensitivity of the results was analyzed atfer literature exclusion.The publication bias of each study was double checked by funnel plot and Begg test.Results:Eight studies were included, including 7 cohort studies and 1 randomized controlled trial.There was no significant difference between the endoscopic decompression group and glucocorticoid group in the efficiency of visual acuity improvement in the treatment of TON [odds ratio ( OR)=1.65, 95% confidence interval ( CI)∶0.75-3.66, P=0.22], neither in TON patients with residual vision before surgery ( OR=2.17, 95% CI: 0.94-4.98, P=0.07). For nasal endoscopic decompression surgery, early surgery (disease course<7 days) was more effective than late surgery (disease course>7 days) ( OR=4.73, 95% CI: 2.55-8.78, P<0.01). Sensitivity analysis suggested that the results of this literature analysis were not robust.The Begg test showed that there was no literature publication bias. Conclusions:There is no significant difference between nasal endoscopic surgery and glucocorticoid therapy in the treatment of TON.Early endoscopic surgery may help improve visual acuity in patients with residual vision.

Orbital tumors not only damage the appearance of patients, but also damage the visual function, even endanger the life of patients.Orbital tumors can be divided into epidermal ectoderm, neuroectoderm, mesoderm, lymphopoietic system and metastatic tumors according to their origin.Due to the complex structure of orbital tissue, abundant nerve vessels and close connection with visual organs, it is more difficult and risky to treat orbital tumors than other regional tumors.Classic treatments for tumors include surgical resection, chemotherapy, and radiotherapy.Surgery is the main treatment for most orbital tumors.Due to the improvement of technology and equipment, it has been developed in the direction of minimally invasive surgery.For advanced tumors or lymphoid hematopoietic system tumors with extensive invasion, chemotherapy is the main treatment.Due to the improvement of drug delivery methods and protocols, it is developing towards high efficiency and less side effects.Radiotherapy is mostly used for refractory tumors that are difficult to be completely removed by surgery and easy to relapse.Due to the continuous improvement of radiotherapy technology, safe and accurate treatment has been achieved.In addition to the classical treatment methods, targeted treatment of carcinogenic sites at the molecular level has become a hot topic in the treatment of orbital tumors.This paper reviews the current development of orbital tumors in surgical resection, chemotherapy, radiotherapy and targeted therapy.

Intellectual disability (ID) is a group of neurodevelopmental disorders with high heterogeneous in both genotypes and phenotypes and its definitive diagnosis is increasingly dependent ongenome-wide molecular diagnostics.Based on next generation sequencing(NGS), panel sequencing, whole exome sequencing (WES) and even whole genome sequencing are well applied to the molecular diagnosis of ID. Based on these, we recommend WES, especially trio-WES as the preferred detection method. NGS data analysis and reanalysis for ID have clinical significance for diagnosis, and can detect small scale variation and copy number variation in the genome reliably. Therefore, it has the potential to become the next recommended molecular diagnostic toolfor ID.

Objective To explore the dynamic changes and significance of costimulatory molecules CD40 and lymphocyte subsets in peripheral blood of children with eosinophilic gastroenteritis (EG). Methods The CD40 expression and lymphocyte subsets in peripheral blood were detected by flow cytometry (FCM) in 15 children with EG (acute stage and remission stage) and 15 healthy controls. The level of serum interleukin (IL) -4 was detected by enzyme-linked immunosorbent assay (ELISA). The eosinophil (EOS) was count by blood cell analyzer. Results In acute stage, the children with EG had significantly higher expression of CD40, CD3+, CD4+, CD4+/CD8+, and CD19+CD23+ in peripheral blood, higher serum IL-4 level, higher EOS count and lower CD8+ than in remission stage and control group (P all<0.05). There were no differences between remission stage and control group (P>0.05). In acute stage, the expression of CD40 in peripheral blood in children with EG was positively correlated with the expression of CD4+ and IL-4 (P all<0.05). Conclusions CD40 may be involved in the pathogenesis of EG. That the increase of IL-4 secreted by CD4+ T cells that were induced by CD40 results in abnormal increase of EOS may be one of mechanisms of the pathogenesis of EG.

Neurodevelopmental disorders(NDD)is a spectrum of disorders characterized with impaired development of the neuropsychological system and /or functional insufficiency in children.The etiology of NDD is still secure though genetic defects are known to be closely associated with development and prognosis of NDD.Recently, the diagnostic yield of NDD is significantly enhanced along with the application of high-throughput genomic analysis including chromosomal microarray analysis(CMA), target sequencing,and whole exome sequencing(WES)in clinical practice.In view of the high genetic heterogeneity and significant expression variability of NDD, it′s preferred to perform an integrated genetic analysis with multiple molecular diagnostic platforms in a standard workflow for patients with NDD.What′s more,an expert consensus and/or technological guideline for molecular diagnostics of NDD generated from large-scale multi-center studies on cohorts of Chinese patients with NDD is crucial for improvement of healthcare for patients with NDD in China.