OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine （TCM） for diabetes retinopathy （DR） based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th， 2024. According to the inclusion and exclusion criteria， literature screening was conducted. After extracting relevant information from the included literature， the GRADE system was used to evaluate the quality level of the evidence body in the included studies， and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included， encompassing 135 outcome indexes. Among these， 19 indicators （14.1%） were of high quality， 87 （64.4%） were of medium quality， 26 （19.3%） were of low quality， and 3 （2.2%） were of very low quality. Overall， the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine， calcium dobesilate or placebo， TCM had significant advantages in improving overall efficacy， reducing bleeding spot area， reducing macular foveal thickness， and increasing visual improvement rate. In addition，the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings， TCM demonstrates good clinical efficacy in the treatment of DR.

Diabetic retinal neurodegeneration is a serious complication of diabetes mellitus, manifested by apoptosis and gliosis, and its pathogenesis is closely related to the oxidative stress induced by high glucose levels. The increase in blood glucose in the body leads to excessive production of reactive oxygen species and the downregulation of antioxidant defense signaling pathways, which leads to oxidative stress in the body, which in turn induces apoptosis, mitochondrial damage and autophagy, resulting in diabetic retinal neurodegeneration. Antioxidant stress therapy with gene therapy, flavonoids, recombinant Ad-β-catenin carriers, and autophagy inducers to exert neuroprotective effects. In the future, more clinical trials are needed to explore the effective dosage and side effects of drugs, and to develop new drugs and treatment strategies for oxidative stress to prevent and treat diabetic retinal neurodegeneration and protect retinal nerve function.

Objective:To understand the status quo of emotional intelligence, emotional labor, and humanistic caring ability of medical staff, and to clarify their internal relationship.Methods:Convenience sampling was used to select 713 medical staff from a grade A tertiary hospital in Chengdu, Sichuan Province, China. Emotional Intelligence Scale, Humanistic Caring Scale, and Emotional Labor Scale were used to measure the emotional intelligence, humanistic caring ability, and emotional labor of medical staff. SPSS 22.0 software was used to establish a database for statistical description and analysis. Process 3.2 software was used to analyze the mediating effect.Results:In humanistic caring ability, the average score of comprehension dimension was the highest (75.62±8.20) and the average score of patience dimension was the lowest (58.53±5.01). In emotional labor, the average score of the deep action dimension was the highest (23.39±3.85) and the average score of the surface action dimension was the lowest (17.73±3.18). In emotional intelligence, the average score of self-emotion evaluation dimension was the highest (21.76±3.30) and the average score of other-emotion evaluation dimension was the lowest (20.07±3.71). Positive correlations were found between humanistic caring ability and emotional intelligence, between humanistic caring ability and emotional labor, and between emotional intelligence and emotional labor ( P<0.01). Humanistic caring ability had a partial mediating effect between emotional intelligence and emotional labor. Humanistic caring ability had direct and indirect effects on emotional labor, and the effect sizes were 0.279 and 0.029, respectively. Conclusion:Emotional intelligence has a direct positive predictive effect on emotional labor, humanistic caring ability as an intermediary variable indirectly and positively predicts emotional labor. Humanistic caring ability plays a partial mediating role between emotional intelligence and emotional labor. Attention should be paid to the emotional labor of medical staff, and the emotional labor of medical staff should be improved through targeted training on emotional intelligence and humanistic caring ability. These efforts will improve the current situation and establish a harmonious doctor-patient relationship.

There are a variety of post-transcriptional modifications in mRNA, which regulate the stability, splicing, translation, transport and other processes of mRNA, followed by affecting cell development, body immunity, learning and cognition and other important physiological functions. m⁶A modification is one of the most abundant post-transcriptional modifications widely existing in mRNA, regulating the metabolic activities of RNA and affecting gene expression. m⁶A modified homeostasis is critical for the development and maintenance of the nervous system. In recent years, m⁶A modification has been found in neurodegenerative diseases, mental diseases and brain tumors. This review summarizes the role of m⁶A methylation modification in the development, function and related diseases of the central nervous system in recent years, providing potential clinical therapeutic targets for neurological diseases.
Methylation ; Central Nervous System/metabolism* ; RNA, Messenger/metabolism* ; RNA

ObjectiveTo study the brain network during balance control tasks in older adults. MethodsFrom January to April, 2022, 22 healthy young adults and 20 healthy older adults were recruited from the Fifth Affiliated Hospital of Guangzhou Medical University and communities. They were asked to finish standing tasks on the plantar pressure plate with eyes opening and closing, while the functional connectivities (FC) of prefrontal cortex (PFC) and primary motor cortex (PMC) were measured with functional near-infrared spectroscopy. ResultsCompared with the young adults, the area of the ellipse (Z = -2.884, P < 0.01) and the maximum swing (Z = -2.481, P < 0.05) increased in the older adults as eyes closing. During the standing task, the intra-FC of left (t = 2.978, P < 0.01) and right (Z = -3.123, P < 0.01) PFC decreased in the older adults, and the inter-FC of right PMC to left PFC (t = 2.087, P < 0.05) and right PFC to left PFC (t = 3.471, P < 0.001) decreased, too. ConclusionThe FC of PFC decreased in healthy older adults during balance control tasks, which may be a indicator for aging brain.

Humans ; Aminoquinolines/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation/genetics* ; Standard of Care

Objective:To summarize the best evidence on exercise for the prevention and treatment of diabetic foot.Methods:A bibliometric approach was used. Systematic searches were carried out to retrieve all the publicly published evidences till July 2022 on exercise for the prevention and treatment of diabetic foot, including guidelines, evidence summary, recommended practices, expert consensus, systematic review, and original research, from foreign language databases including BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Practice Database, Cochrane Library, Embase, PubMed, Guideline International Network, National Guideline Clearinghouse, Chinese databases including China National Knowledge Infrastructure, Wanfang Database, VIP Database, China Biology Medicine disc, China Clinical Guidelines Library, and the official websites of relevant academic organizations including National Institute for Health and Care Excellence of the United Kingdom, Registered Nurses' Association of Ontario of Canada, the International Working Group on the Diabetic Foot, International Diabetes Federation, American College of Sports Medicine, American Diabetes Association, and Chinese Diabetes Society. The literature was screened and evaluated for the quality, from which the evidences were extracted and evaluated to summarize the best evidences.Results:Nine guidelines, three expert consensuses, one evidence summary (with two systematic reviews being traced), two systematic reviews, 6 randomized controlled trials were retrieved and included, with good quality of literature. Totally 33 pieces of best evidences on exercise for the prevention and treatment of diabetic foot were summarized from the aspects of appropriate exercise prevention of diabetic foot, exercise therapy of diabetic foot, precautions for exercise, health education, and establishment of a multidisciplinary limb salvage team.Conclusions:Totally 33 pieces of best evidences on exercise for the prevention and treatment of diabetic foot were summarized from 5 aspects, providing decision-making basis for clinical guidance on exercise practice for patients with diabetic foot.

Objective: To compare the clinical efficacy and patient satisfaction of 755 nm semiconductor laser for hair removal during different stages of auricular reconstruction. Methods: From July 2016 to September 2018, 86 patients who had ear reconstruction underwent 755 nm semiconductor laser for auricle hair removal in plastic surgery department of Tongji hospital affiliated to Tongji medical college of Huazhong university of science and technology. There were 39 males and 47 females with an average age 12 years old(from 6 to 28 years old). 28 cases were left ear, 58 cases were right ear. With random grouping, 40 patients underwent auricle hair removal treatment after posterior ear tissue expander implantation (post-operation of stage Ⅰ depilation group) and 46 patients underwent treatment after auricular reconstruction (post-operation of stage Ⅱ depilation group). Auricle hair removal treatments(pulse width 10-20 ms, wave length 755 nm, spot size 10 mm×15 mm, energy density 4-8 J/cm²) were respectively started at different intervention time. Each treatment time were 5-10 minutes. The end of the treatment was slight redness or edema of the local hairy follicle. The treatment was repeated every 4 weeks with a total of 5 times. The number of adverse reactions was recorded as while as the hair density, hair clearance rate and patient satisfaction before treatment and 6 months after the 5th depilation. Results: Patients in both groups successfully were completed the treatment and were followed up to about 6 months (23 to 25 weeks) after the last depilation treatment. There were only 2 cases with scratch in skin preparation and 2 cases with blisters in the postoperative of stage Ⅱ group. None of the other patients had adverse reactions. Hair density after treatment (27.63±7.75 bar/cm²) was less than before treatment (84.55±13.68 bar/cm²) in post-operation of stage Ⅰ depilation group. Hair density after treatment was 40.52±5.92 bar/cm² in post-operation of stage Ⅱ depilation group, less than before treatment (74.78±11.19 bar/cm²). The differences were statistically significant (both P<0.001). After hair removal, the hair density of post-treatment in the post-operation of stage Ⅰ depilation group was less than the post-operation of stage Ⅱ depilation group. The difference was statistically significant (P=0.000). The hair clearance rate of the post-operation of stage Ⅰ (67.32%) was higher than the post-operation of stage Ⅱ(45.81%). The difference was statistically significant (P<0.001). Patients’ satisfaction was 87.5% in the post-operation of stage Ⅰ and 69.5% in the post-operation of stage Ⅱ. The former was superior to the latter. Conclusions Auricle hair removal with semiconductor 755 nm laserstarted at stage Ⅰ that posterior ear tissue expander was implanted has more favorable clinical efficacy, and higher patient’s satisfaction rate.

OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.

Objective:To explore therapeutic effect of neuromuscular electrical stimulation combined swallowing training in dysphagia after stroke.Methods: A total of 86 stroke patients during recovery period were selected.According to random number table, they were randomly and equally divided into pure training group (received swallowing training based on rehabilitation treatment and nursing care) and combined training group (received neuromuscular electrical stimulation based on routine training group).Therapeutic effects, scores of video fluorography (VFG) and swallowing quality of life (SWAL-QOL) questionnaire before and after treatment were compared between two groups.Results: After treatment, total effective rate of combined training group was significantly higher than that of pure training group (95.35% vs.69.77%, P=0.006).Compared with pure training group after treatment, there was significant rise in VFG score [(5.74±1.86) scores vs.(6.88±2.32) scores], and significant reduction in SWAL-QOL score [(762.66±27.22) scores vs.(648.22±29.62) scores] in combined training group, P=0.025, 0.001 respectively.Conclusion: Compared with swallowing training alone, neuromuscular electrical stimulation combined swallowing training possesses better therapeutic effects, which is better for recovery of swallowing function.