AIM: To evaluate the effects of 3% diquafosol ophthalmic solution(DQS)on the ocular surface and tear film in adolescents with mild dry eye syndrome during the early stage of wearing orthokeratology lenses.METHODS: Prospective study. Totally 60 myopic adolescents(120 eyes)with mild dry eye syndrome who were fitted with orthokeratology lenses for the first time in our hospital from January 2023 to September 2023 were enrolled in this study. They were randomly divided into control group and observation group. Both groups wore the same brand of orthokeratology lenses for 8-9 h a day and 7 d a week. In the control group(30 cases, 60 eyes), the patients were treated by routine eyelid cleaning and warm compresses from the day of fitting. In addition to the control group's treatment, patients in the observation group(30 cases, 60 eyes)were given DQS 6 times a day for 3 mo, and follow-up for 6 mo after discontinuation of DQS. According to the follow-up requirements of orthokeratology lens, uncorrected visual acuity(UCVA), corneal curvature, corneal topography, and corneal fluorescein staining were rechecked. The ocular surface disease index(OSDI)scores, tear meniscus height(TMH)of lower eyelid, non-invasive tear film break-up time [first and average, NIBUT(f)and NIBUT(av)] and corneal fluorescein staining were measured at baseline, 1, 2 and 3 mo after treatment, and 3 and 6 mo after DQS discontinuation.RESULTS: All patients completed follow-up. The NIBUT(f), NIBUT(av)and TMH of lower eyelid in the observation group were higher than those in the control group at 2 and 3 mo after treatment and at 3 and 6 mo after discontinuation of DQ3(all P<0.05). The OSDI scores for both groups decreased significantly at 2 mo after treatment(all P<0.05). At 3 mo after treatment and 3 and 6 mo after discontinuation of DQS, the OSDI scores in the observation group was significantly lower than the control group(all P<0.01). There was no significant difference of corneal fluorescein staining between the two groups(P=0.731).CONCLUSION: The combination of DQS with eyelid hygiene and warm compresses shows better efficacy in enhancing the stability of the tear film for adolescents with mild dry eye syndrome while wearing orthokeratology lenses.

By sorting out the differences and connections between family doctor teams and specialized disease teams, role competency and mutual collaboration, and introducing the learning health system (LHS) mechanism, a comprehensive operating system for community general practice learning organizations based on LHS was constructed, focusing on five single disease types. The system includes a combination of general and specialized medicine that links three levels of medical institutions, thereby opening up the business cooperation process between professionals in different institutions, and establishing a sustainable collaboration mechanism. This allows medical institutions at three levels to continuously tap the potential of their disciplines, achieve their own ability growth and feel higher work value, and also bring better health solutions to residents, guided by the common goal of "health centered, patient centered".

AIM: To assess the accuracy of predicting intraocular lens(IOL)power after myopic refractive surgery using the Pentacam system's true net power(TNP)in the 3 mm zone combined with the SRK/T formula [i.e. TNP 3 mm(SRK/T)].METHODS: Retrospective study. This study enrolled 35 cases(50 eyes)of patients undergoing cataract surgery after laser assisted in situ keratomileusis(LASIK)or photorefractive keratectomy(PRK)from July 2019 to December 2021. Preoperatively, IOL power of 50 eyes, 34 eyes and 41 eyes was calculated by TNP 3 mm(SRK/T), Barrett True-K and Olsen 2 formulas, respectively, with at least 2 formulas used to calculate IOL power for each patient. The actual diopter was recorded 3 mo postoperatively. Prediction errors(PE)of IOL power were compared among the three calculation methods, and the proportion of eyes with PE within ±0.5 D and ±1.0 D was analyzed.RESULTS: The PE at 3 mo postoperatively for TNP 3 mm(SRK/T), Barrett True-K, and Olsen 2 was -0.02±0.63, -0.54±0.80, and 0.25±0.80 D, respectively(P<0.001). The proportions of PE within ±0.5 D were 66%(33/50), 44%(15/34)and 37%(15/41), respectively(P<0.05); the proportions of PE within ±1.0 D were 88%(44/50), 71%(24/34)and 80%(33/41), respectively(P>0.05).CONCLUSION: The Pentacam TNP 3 mm(SRK/T)method is simple to operate and provides accurate calculation of IOL power after corneal refractive surgery.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective:To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on the childhood Epstein-Barr virus(EBV)-positive lymphoproliferative diseases(EBV + LPD). Methods:The clinical features, treatment course, and prognosis of 9 children with EBV + LPD who underwent allo-HSCT in Children′s Hospital Affiliated to Zhengzhou University from July 2019 to July 2022 were analyzed retrospectively. Results:All the 9 children underwent histopathological examination, including 6 patients with EBV-positive T-cell lymphoproliferative disease (EBV + T-LPD), 1 with pulmonary lymphomatoid granuloma, and 2 with systemic EBV-positive T-cell lymphoma.There were 6 males and 3 females, with the median age of 5.8 (1.5-13.0) years.At the initial diagnosis, plasma and peripheral EBV-DNA copy at the initial diagnosis was (5.67-865.00)×10 2/mL, and (5.13-1 250.00)×10 2/mL, respectively.The EBV-DNA load of cerebrospinal fluid increased to (5.18-291.00)×10 2/mL in 3 cases.The whole exon sequencing data showed no abnormality in 3 cases, pulmonary lymphomatoid granuloma with the IL2RG mutation in 1 case and EBV + T-LPD with a hemizygous mutation in the SH2D1A gene as the pathogenic mutation in 1 case.Pathogenic mutations were not detected in the remaining 4 cases.The course of disease before transplantation was 5.4(3.0-10.0) months.Disease status before transplantation was as follows: all 3 cases of lymphomas had partial regression; 2 cases of EBV + T-LPD had active disease; and 4 cases had no active disease.Among the donors, there were 5 cases of half-matched relatives, 2 cases of full-matched siblings and 2 cases of unrelated full-matched donors.The median number of mononuclear cells in peripheral blood and/or bone marrow hematopoietic stem cell was 6.60(3.64-12.18)×10 8/kg, while the median implantation time of neutrophils was 18(9-23) days.One month after the transfusion of hematopoietic stem cells, plasma EBV-DNA copy was negative in all cases, and peripheral EBV-DNA copy was negative in 7 cases.The copy number in the other 2 cases was 10 2/mL.At the 3-month evaluation, plasma and peripheral EBV-DNA copy were negative in all cases.In addition, 3 cases of lymphomas achieved radiographic complete remission, and 6 cases of EBV + T-LPD were inactive.All transplant-related complications were effectively controlled after medication.Following the median follow-up of 24 (11-42) months, all patients had disease-free survival.Serious impact on the quality of life due to graft versus host disease was not reported. Conclusions:allo-HSCT is an effective treatment of childhood EBV + LPD, which is able to control transplant-related complications.Children with EBV + LPD can achieve long-term disease-free survival through transplantation.

Objective To explore the functional status and influencing factors of physical fitness of children with intellectual and developmental disabilities enrolled in special education, and to establish framework of physical fitness for analysis of physical fitness and exercise intervention using International Classification of Functioning, Disability and Health (ICF). Methods Based on the ICF apporach, we analyzed the functional status and physical fitness characteristics and influencing factors of students in special education schools, and developed a function-based physical fitness intervention program for children with intellectual and developmental disabilities with reference to the requirements of WHO Guidelines on Physical Activity and Sedentary Behavior (2020). Results A systematic analysis of the overall functional status of children with intellectual and developmental disabilities based on ICF, especially intellectual functions, activities and environmental factors related to intellectual disability, was conducted and discussed in the context of related motor functions and physical fitness. A physical activity program was developed based on the ICF and with reference to WHO Guidelines on Physical Activity and Sedentary Behavior (Children and Adolescents), and related adaptive support strategies were proposed. Conclusion The overall functional status of children with intellectual and developmental disabilities has been analyzed in body functioning (both intellectual and motor), activity and participation, and environmental factors. Based on WHO Guidelines on Physical Activity and Sedentary Behavior and the ICF framework, a physical activity program for physical fitness with adaptive and supportive teaching and training methods, has been developed for children with intellectual and developmental disabilities.

Aim To investigate the effects of astragalus polysaccharide (APS) on depressive behaviors, hippocampal damage and Nrf2-ARE signaling pathway in rats. Methods Wistar rats were randomly divided into control group, depression group, APS low dose group and APS high dose group. Rats (except the control group) underwent chronic unpredictable mild stress (CUMS) for 28 days. The depressive behaviors were assessed by tail suspension test, forced swim test and sucrose preference test. The histopathological changes of the hippocampus were valuated by HE staining. Levels of nuclear factor erythroid 2-related factor 2 (Nrf2) protein and Nrf2 mRNA were measured. The hippocampal levels of oxidative stress were evaluated. Results Compared with the control group, the depression group showed significant depressive behaviors and hippocampal damage. The depression group had higher levels of Nrf2 and MDA, but lower levels of HO-1, SOD, CAT and GSH-Px than the control group. However, APS does-dependently attenuated the hippocampal damage and depressive behaviors, increased hippocampal levels of Nrf2, HO-1, SOD, CAT and GSH-Px, but decreased hippocampal levels of MDA in rats. Conclusions APS can attenuate CUMS-induced hippocampal damage and depressive behaviors in rats, and the effects may be associated with the activation of Nrf2-ARE signaling pathway.

Objective:To apply the best evidence of non-drug management of chemotherapy induced nausea and vomiting (CINV) in clinical practice, and evaluate the effect of practice.Methods:After searching domestic and foreign databases, 14 articles were finally included, including 3 systematic reviews, 3 evidence summaries and 8 guidelines. According to the evidence-based continuous quality improvement model of Joanna Briggs Institute (JBI) Evidence-based Nursing and Health Care Center, we conducted the review before and after evidence application, obstacle factors, available resources and strategy analysis, and evaluation of the effect of evidence application. From March to May 2020, convenience sampling was used to select 52 inpatients with gynecological chemotherapy in the Affiliated Hospital of Qingdao University and 26 clinical nurses as subjects for baseline review. From June to August 2020, 42 inpatients with gynecological chemotherapy and 26 clinical nurses (same as before) were selected for re-review.Results:The management process, nursing routine, nursing path, and risk assessment and follow-up form for CINV were improved, and an evidence-based education video was produced. After application of the evidence, the compliance of nurses' review indicators improved, and the differences were statistically significant ( P<0.05) . The scores of nurses on the non-drug management evidence-based knowledge questionnaire for gynecological CINV increased, and the difference was statistically significant ( P<0.05) . The incidence of acute CINV decreased, and the difference was statistically significant ( P<0.05) . The incidence of delayed CINV decreased, and the difference was not statistically significant ( P> 0.05) . Conclusions:The development of the evidence-based practice project promotes the improvement of related processes, routines, and paths, enriches the forms and content of CINV non-drug antiemetic education, standardized nurses' behavior, improves nurses' compliance with evidence-based practice, and reduces the incidence of acute nausea and vomiting in patients.

Objective To investigate the expression level of hypoxia-inducible factor-lot (HIF-1ot) in gastric cancer and its relationship with clinicopathological characteristics and prognosis of patients with gastric cancer.Methods From March 3,2011 to September 28,2012,49 patients with gastric adenocarcinoma tissue chips were selected from pathology department of our hospital.They were matched with paracancerous tissues.The expression levels of HIF-1α were measured by immunohistochemistry method in gastric cancer tissues and paracancerous tissues chips.Kaplan-Meier was used to evaluate the progression-free survival (PFS) and overall survival (OS),and the Cox proportional hazards model was used to analyze whether HIF-1α was a prognostic factor.Results The high expression rate of HIF-1α protein in gastric cancer was significantly higher than that in paired para-carcinoma group (42.9％ vs.4.1％,x2 =20.509,P ＜ 0.001).The expression of HIF-1 α protein was related to TNM stage (x2 =4.601,P =0.032),vascular invasion (x2 =6.766,P =0.009) and degree of differentiation (x2 =7.969,P =0.005).Compared with patients with low expression of HIF-1α,the median PFS (16.2 months vs.27.3 months) and median OS (34.8 months vs.43.8 months) were shorter in the patients with high expression of HIF-1 α,and the differences were statistically significant (median PFS:x2 =4.661,P =0.002;median OS:x2 =6.903,P =0.009).The results of single factor analysis showed that overexpre-ssion of HIF-1α was correlated with PFS and OS (PFS:HR =4.461,95％ CI:1.969-10.802,P ＜0.001;OS:HR =3.109,95％CI:1.274-7.588,P =0.013).The results of Cox multivariate analysis showed that overexpression of HIF-1α was the independent risk factor that affected the survival and prognosis of patients with gastric cancer (PFS:HR =4.747,95％ CI:2.175-10.230,P ＜0.001;OS:HR =3.171,95％ CI:1.358-7.404,P =0.008).Conclusion The high expression rate of HIF-1α protein in gastric cancer tissues is significantly higher than that in paracancerous tissues.The expression of HIF-1α is associated with TNM stage,vascular invasion,degree of differentiation in patients with gastric cancer.The high expression of HIF-1α is associa-ted with the shorter median OS and PFS.The high expression of HIF-1α is an independent risk factor for the survival and prognosis of patients with gastric cancer,which is expected to be an independent marker of poor prognosis.

Adult ; Female ; Genetic Predisposition to Disease ; Humans ; Mutation, Missense ; genetics ; Spectrin ; genetics ; Spinocerebellar Ataxias ; etiology ; genetics ; Young Adult