Congenital cranial dysinnervation disorders(CCDDs)are a group of diseases with congenital non-progressive developmental abnormalities or absence of one or more cranial nerves, resulting in primary or secondary abnormalities of cranial nerves innervating the extraocular muscles. CCDDs can be sporadic or hereditary, and may be accompanied by systemic abnormalities. In recent years, with the research progress of neuropathology, neuroimaging, and genetics, it has not only been clarified that the cause of eye movement disorder in CCDDs is neurogenic, but also been found the pathogenic genes of CCDDs, including SALL4, HOXA1, KIF21A, PHOX2A, TUBB3, and HOXB1, etc. In this review, the relevant domestic and international literatures on the molecular genetics and neuroscience of CCDDs in recent years are reviewed, aiming to address how the causing gene mutations of CCDDs affect brain neural development and further lead to congenital abnormal cranial nerve innervation, in order to provide references for the clinical and basic research of CCDDs.

Objective To explore the developmental changes in the expression of Rap1B and the effect of monocular form deprivation(MD)during the critical period of visual development on the expression of Rap1B in the mouse superior colliculus(SC).Methods Forty-five SPF-grade healthy male C57BL/6J mice were used in this experimental study.Ex-periment 1:To study the developmental changes of Rap1B expression in the mouse SC,the experimental mice were divided into three groups:the pre-critical period group[postnatal day 18(P18)],the critical period group(P32),and the adult group(P60).The expression levels of Rap1B gene and protein in the left and right SC of mice in each group were detected by quantitative polymerase chain reaction(qPCR)and Western blot,respectively.Experiment 2:To study the effect of MD on the expression levels of Rap1B gene and protein in the SC,the experimental mice were divided into two groups:the right eye MD group(MD models of the right eyes were established at P28 and detected at P32)and the normal control group(NC group,P32).The expression levels of Rap1B gene and protein in the left and right SC of mice in each group were measured by qPCR and Western blot,respectively.Results The expression levels of Rap1B gene and protein were low in the left and right SC of mice in the pre-critical period group;compared with the pre-critical period group,the ex-pression levels of Rap1B gene and protein in the critical period group significantly increased(both P＜0.05);compared with the critical period group,the expression levels of Rap1B gene and protein in the adult group significantly decreased(both P＜0.05).Mice in the right eye MD group showed significantly higher expression levels of Rap1B gene and protein in the left SC(both P＜0.05),while significantly lower expression levels of Rap1B gene and protein in the right SC(both P＜0.05)compared to mice in the NC group.Conclusion The developmental trend of Rap1B gene expression in the mouse SC is consistent with the critical period of visual development,and Rap1B may be involved in the regulatory effect of MD during the critical period on the development of SC.

In order to standardize the clinical diagnosis and treatment of upper airway cough syndrome (UACS) for children in China, Dongzhimen Hospital of Beijing University of Chinese Medicine and Affiliated Hospital of Liaoning University of Traditional Chinese Medicine initiated the development of this Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome based on evidence-based medical evidence. This guideline will process registration, write a plan, and develop relevant processes and writing norms, develop and publish official documents. This plan mainly introduces the scope of the guidelines, the purpose and significance, the composition of the guidelines working group, the management of conflicts of interest, the collection, selection and determination of clinical problems, the retrieval, screening and rating of evidence, and the consensus of recommendations. Registration information: This study has been registered in the international practice guidelines registry platform with the registration code of PREPARE-2023CN087.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Objective To study the effect of TRB3 on gastric cancer cells function by regulating TGF-β1/Smad3/PAI-1 axis.Methods The expression of TRB3 protein in gastric cancer cell lines(AGS,HGC-27,NCI-N87,SNU5 and MKN45)and normal human gastric mucosal cells(GES-1)was detected by Western blot.Knockdown of TRB3 in gastric cancer cell AGS,CCK-8,fluores-cenceactivated cell sorter(FACS),Transwell assay,scratch assay and Western blot were used to detect cell proliferation,apoptosis,in-vasion,migration and the changes of TGF-β1/Smad3/PAI-1 signal pathway proteins.On the basis of knockdown of TRB3,TGF-β1 treated gastric cancer cell AGS,and the above experiments were repeated again.Results Compared with GES-1 cells,the expression of TRB3 protein increased in gastric cancer cell lines.the proliferation ability and the viability of cells(52％±12％,P＜0.001)were decreased;migration ability and cell healing rate(24％±6％,P＜0.001)were decreased;the invasive ability and the number of inva-sive cells(107±23,P＜0.001)were decreased;TGF-β1/Smad3/PAI-1 pathway was inhibited,and the expression of TGF-β1,p-SMAD3 and PAI-1 were decreased;the apoptosis and the proportion of apoptotic cells(17％±3％,P＜0.001)were increased.On the basis of knockdown of TRB3,TGF-β1 was used to treated gastric cancer cells AGS,the cell viability(73％±10％,P＜0.01)was increased;the migration ability and cell healing rate(63％±8％,P＜0.01)were increased;the number of invasive cells(252±20,P＜0.01)was increased;cell apoptosis and the percentage of apoptosis(12％±2％,P＜0.01)was reduced.Conclusion TRB3 pro-motes the development of gastric cancer by activating of TGF-β1/Smad3/PAI-1 signaling pathway.

Objective:To report pediatric endoscopic retrograde cholangiopancreatography (ERCP) intubation techniques and to analyze the influencing factors of pediatric ERCP in China.Methods:Retrospective analysis was performed on 90 cases of pediatric and adult ERCP operations respectively at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to June 2020. The anatomic data, intubation time, and endoscopic intubation measures were reviewed. The anatomic differences in duodenal papilla between the children and adults were analyzed to find the factors affecting ERCP intubation time in children.Results:There were 88 cases of successful infantile intubation with the success rate of 97.8%, and 90 cases of successful adult intubation with the success rate of 100.0%. The intubation time in the pediatric group was 187±67 s, and that in the adult group was 247±86 s with significant difference ( t=5.220, P<0.001). The duodenal diameter of pediatric patients was 3.38±1.57 cm, and that of adult patients was 5.94±1.87 cm with significant difference ( t=9.832, P<0.001). The horizontal distance from the duodenal bulb to the papilla in pediatric patients was 2.44±1.15 cm, which was significantly shorter than 4.22±1.43 cm in adult patients ( t=9.077, P<0.001). Most duodenal papillae in children were hemispherical [flat 26.1% (23/88), hemispherical 51.1% (45/88), cylindrical 22.7% (20/88)], while most of those in the adult patients were cylindrical [flat 9.1% (8/88), hemispherical 23.9% (21/88), cylindrical 67.0% (59/88)]. The factors influencing the intubation time of ERCP in children by univariate analysis included the shape of duodenal papilla, duodenal papilla hardness, visual region, distance from junction of duodenal bulb and descending part to duodenal papilla, distance from duodenal papilla to endoscope, and degree of incising. Conclusion:Shorter and stiffer duodenal papillae in children with normal papilla orientation are associated with shorter intubation time. These indicators are favorable factors for intubation.

Objective:To formulate a blueprint for the care of radiotherapy-induced oral mucositis (RIOM) in patients with nasopharyngeal carcinoma, to implement and observe the effect.Methods:Using the convenient a sampling method, a total of 182 patients with nasopharyngeal carcinoma who underwent radiotherapy and chemotherapy in Cancer Hospital of The University of China Academy of Sciences from July 2019 to June 2020 were selected as the research objects. A total of 91 patients from July to December 2019 were set as the control group and they received conventional radiotherapy care. A total of 91 patients from January to June 2020 were set as the intervention group. On the basis of the control group, the intervention group adopted conventional radiotherapy nursing and implemented the care blueprint based on the action study method. The incidence, severity and pain of RIOM were compared between the two groups.Results:In the 3rd to 5th week of radiotherapy, the incidences of RIOM in the intervention group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . At week 3 and after radiotherapy, the severity of RIOM in the intervention group were less than those in the control group, and the differences were statistically significant ( P <0.05) . At the end of radiotherapy, the degree of oral pain in the intervention group was lighter than that in the control group, and the difference was statistically significant ( P< 0.05) . Conclusions:RIOM care blueprint constructed in this study is scientific and valid. Evidence-based RIOM care blueprint can reduce the incidence and severity of RIOM in nasopharyngeal cancer patients and relieve oral pain, which is worthy of clinical application.

Objective : To explore the effects of two hemostatic agents on the bonding strength of different bonding systems in primary tooth dentin. Methods : Seventy-two retained deciduous teeth were randomly selected. Forty-eight teeth were used to construct the microleakage model, the other 24 teeth were cut along the mesial and distal directions and 48 samples were obtained to construct the shear bond strength model. The two experiments were divided into 2 groups. Group A was the total-etch group: A1 (ViscoStat + Spectrum Bond NT); A2 (ViscoStat Clear + Spectrum Bond NT); and A3 (Non + Spectrum Bond NT); Group B was the self-etch group: B1 (ViscoStat + Single bond Universal Adhesive); B2 (ViscoStat Clear + Single bond Universal Adhesive); and B3 (Non + Single bond Universal Adhesive). Microleakage experiments and shear bond strength experiments were carried out respectively and the morphology of the fracture surface was observed by scanning electron microscopy. Results : There was no significant difference in microleakage among groups A1, A2, and A3 (P > 0.05). There was no significant difference in microleakage among groups B1, B2, and B3 (P > 0.05). There was no significant difference in the shear bond strength among groups A1, A2 and A3 (P > 0.05). The shear bond strength of groups B1 and B2 was significantly lower than that of group B3 (P < 0.05). There was no significant difference between groups B1 and B2 (P > 0.05). Conclusion ViscoStat and ViscoStat Clear had no effect on the marginal integrity of deciduous tooth dentin under the different bonding systems. The two hemostatic agents reduced the shear bonding strength of deciduous tooth dentin under the self-etch adhesive system, but had no effect on the shear bonding strength of deciduous tooth dentin under the total-etch adhesive system.