Polypoid choroidal vasculopathy(PCV)is associated with poor visual prognosis in its natural course and is more prevalent in Asian populations. Despite advancements in optical coherence tomography(OCT)and OCT angiography(OCTA)that have significantly improved morphological diagnostic capabilities, imaging biomarkers are limited by temporal resolution constraints and fail to elucidate molecular mechanisms underlying vascular angiogenesis, inflammation, genetic factors, and extracellular matrix(ECM)remodeling. This review synthesizes current research on molecular biomarkers associated with PCV, focusing on its core pathological mechanisms. These biomarkers provide crucial insights into disease pathogenesis to inform precision prevention, dynamic disease monitoring, and therapeutic response prediction. Furthermore, this article proposes the integration of multi-omics data(genomics, proteomics, and radiomics)to establish a multimodal hierarchical diagnostic-therapeutic model. This framework will guide risk stratification, real-time disease assessment, and personalized treatment strategies, advancing the development of a precision medicine framework for PCV management.

Circadian rhythm disruption is a universal phenomenon that is associated with a combination of internal and external factors, with internal factors referring to disturbances in the intrinsic regulatory mechanisms of sleep-wake behavior, and external factors including changes in sleep habits, severe sleep deprivation, shift work, social jet lag, prolonged exposure to nighttime light, and late nighttime eating. Shift work, as a common occupational factor, can lead to disruption of the central/ peripheral biological clock which regulates the expression of almost the entire genome, and the disruption of the biological clock can lead to genetic variants, hormonal secretion abnormalities, insulin resistance, oxidative stress, and systemic inflammation, which are risk factors for obesity. In the context of rapid advancement of global economy and industrialization, the prevalence of simple obesity in the traditional cognitive category is increasing in a linear trend, while the incidence of abdominal obesity, which is closely related to metabolic disorders, is also showing an increasing trend. In recent years, the mechanism of circadian rhythm disorder and obesity associated with shift work has attracted much attention, and this article summarized the latest research progress, aiming to provide a basis for the prevention and treatment of obesity caused by circadian rhythm disruption due to shift work.

Objective To investigate the knowledge,attitude and behavior of pediatric ICU nurses on preventing unplanned extubation(UEX).Methods The pre-test paper was prepared by the combination of literature review and expert consultation.The convenience sampling method was used to select 237 pediatric ICU nurses from four tertiary hospitals(including one children's hospital and three general hospitals)to con-duct a survey.The project analysis and reliability and validity test of the pre-test questionnaire were carried out to form a formal questionnaire.Results The questionnaire included 41 items,including 13 items of knowl-edge dimension,nine items of attitude dimension and 19 items of behavior dimension.The average content va-lidity index of knowledge,attitude and behavior dimensions was 0.921,0.996 and 0.998,respectively,and the content validity index of each item was 0.852-1.000.The Cronbach's α coefficients of knowledge,behavior and attitude were 0.911,0.946 and 0.944 respectively,and the total Cronbach's α coefficient of the question-naire was 0.953.The split-half reliability of knowledge,behavior and attitude dimensions was 0.710,0.931 and 0.859,and the total split-half reliability of the questionnaire was 0.695.Conclusion The questionnaire of knowledge,attitude and behavior of pediatric ICU nurses in preventing tracheal intubation UEX has good reli-ability and validity,and can be used as an evaluation tool for pediatric ICU nurses'cognition and behavior compliance in preventing tracheal intubation UEX.

Objective To investigate the impact and mechanism of Liraglutide on autophagy and apoptosis of human podocyte induced by high glucose.Methods Human podocytes were cultured in vitro,and grouped into normal control group(NC group),high glucose group(HG group),25 nmol/L Liraglutide group(HG+Lir 25 group),50 nmol/L Liraglutide group(HG+Lir 50 group),Liraglutide+LY294002 group(HG+Lir+LY294002 group),and Liraglutide+3-MA group(HG+Lir+3-MA group).The podocyte activity was detected by CCK-8.The apoptosis rate and morphology of podocytes were detected by flow cytometry and Hoechst 33342 staining.The expression of autophagic body and autophagic marker LC3 protein in podocyteswas observed by transmission electron microscopy and immunofluorescence staining.Western blot was applied to detect the expression of apoptosis,autophagy and phosphoinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR)pathway related proteins in podocytes.Results Compared with NC group,the activity of podocytes and the expression of Bcl-2,Bcl-2/Bax,LC3 Ⅱ/LC3 Ⅰ,p-PI3K/PI3K,p-Akt/Akt proteins in HG group were decreased(P＜0.05),while the apoptosis rate and the expression of Bax,p62,p-mTOR/mTOR proteins were increased in HG group(P＜0.05).There were many podocytes with pyknotic nuclei,the number of autophagic bodies and the number of green fluorescent spots of LC3 protein were decreased in HG group.Compared with HG group,the activity of podocyte increased,and the expression of Bcl-2,Bcl-2/Bax,LC3 Ⅱ/LC3 Ⅰ,p-PI3K/PI3K,p-Akt/Akt protein increased(P＜0.05),while the apoptosis rate and the expression of Bax,p62,p-mTOR/mTOR protein decreased(P＜0.05)in HG+Lir 25 group and HG+Lir 50 group.The number of podocytes with karyopyknosis was reduced,the number of autophagosomes and the number of green fluorescent spots of LC3 protein were increased in HG+Lir 25 group and HG+Lir 50 group,and the above changes indexes were more obvious in the HG+Lir 50 group group.Compared with HG+Lir 50 group,PI3K/Akt/mTOR pathway could be regulated,and reduce the improvement of Liraglutide on podocyte viability,apoptosis and autophagy induced by high glucose in HG+Lir+LY294002 group and HG+Lir+3-MA group.Conclusion Liraglutide may promote the autophagy of human podocyte induced by high glucose and inhibit its apoptosis through PI3K/Akt/mTOR pathway.

Objective:To develop a self-directed learning feedback system for patients with post-stroke dysphagia (PSD) and analyze its effectiveness.Methods:From November 2022 to July 2023, convenience sampling was used to select 108 PSD patients from the Neurological Disease Center of Taiyuan Central Hospital as the research subject. The patients were divided into a control group and an experimental group using a random number table method, with 54 cases in each group. The control group received routine nursing upon discharge, while the experimental group was treated intervention measures through the self-directed learning feedback system. The self-efficacy, quality of life, swallowing function, and psychological status of two groups of patients were compared before intervention and one and three months after intervention, respectively.Results:A total of 52 patients in the experimental group and 50 patients in the control group completed the study. Repeated measures analysis of variance showed that the self-efficacy and quality of life scores of both groups improved with the extension of intervention time, and the self-efficacy and quality of life scores of the experimental group were higher than those of the control group at one and three months after intervention, with statistical differences ( P<0.01). After one and three months of intervention, the severity scores of dysphagia in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.01). As the intervention time extended, the psychological status scores of the experimental group were lower than those of the control group at different time periods, and the differences were statistically significant ( P<0.05) . Conclusions:The application of self-directed learning feedback system in the rehabilitation of PSD patients at home can improve their self-efficacy, quality of life and swallowing function, and relieve negative emotions, which is worthy of further promotion.

Objective To investigate the clinical efficacy of dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar.Methods A total of 86 patients with depressed acne scar admitted to the Second Affiliated Hospital of Nanchang University from February 2022 to August 2023 were selected and divided into dot matrix group and combined group according to random number table method,with 43 cases in each group.The patients in dot matrix group were treated with dot matrix laser,and the patients in combined group were treated with dot matrix laser combined with subcutaneous separation.The visual analogue scale(VAS)score,echelle d'evaluation clinique des cicatrices d'acne(ECCA)score,pigmentation area,scar area,treatment satisfaction and adverse reactions were compared between two groups.Results There was no significant difference in VAS scores between two groups after the first treatment and the second treatment(P>0.05).Three months after treatment,the ECCA score of combined group was significantly lower than that of dot matrix group,and the pigmentation area and scar area were significantly smaller than those of dot matrix group(P<0.05).The total satisfaction of patients in combined group was significantly higher than that in dot matrix group(χ2=4.746,P=0.029).There was no significant difference in the occurrence of adverse reactions between two groups(χ2=0.453,P=0.501).Conclusion Dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar can effectively promote scar repair,reduce skin pigmentation area and scar area,and do not increase pain,with good safety and high patient satisfaction.

OBJECTIVE: To assess the diagnostic value of whole exome sequencing (WES) for patients with intellectual disability (ID) or global developmental delay (GDD). METHODS: 134 individuals with ID or GDD who presented at Chenzhou First People's Hospital between May 2018 and December 2021 were selected as the study subjects. WES was carried out on peripheral blood samples of the patients and their parents, and candidate variants were verified by Sanger sequencing, copy number variation sequencing (CNV-seq) and co-segregation analysis. The pathogenicity of the variants was predicted based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). RESULTS: A total of 46 pathogenic single nucleotide variants (SNVs) and small insertion/deletion (InDel) variants, 11 pathogenic genomic copy number variants (CNVs), and 1 uniparental diploidy (UPD) were detected, which yielded an overall detection rate of 43.28% (58/134). The 46 pathogenic SNV/InDel have involved 62 mutation sites in 40 genes, among which MECP2 was the most frequent (n = 4). The 11 pathogenic CNVs have included 10 deletions and 1 duplication, which have ranged from 0.76 to 15.02 Mb. A loss of heterozygosity (LOH) region of approximately 15.62 Mb was detected in 15q11.2q12 region in a patient, which was validated as paternal UPD based on the result of trio-WES. The patient was ultimately diagnosed as Angelman syndrome. CONCLUSION WES can detect not only SNV/InDel, but also CNV and LOH. By integrating family data, WES can accurately determine the origin of the variants and provide a useful tool for uncovering the genetic etiology of patients with ID or GDD.
Humans ; Exome Sequencing ; Intellectual Disability/genetics* ; DNA Copy Number Variations ; Mutation ; Loss of Heterozygosity

Botulinum toxin is a potent protein toxin produced by Clostridium botulinum. It acts directly on the brain nerve nucleus and peripheral neuromuscular junction, blocking the release of acetylcholine and thereby affecting nerve impulse transmission, ultimately leading to muscle paralysis. Mild cases may present with ocular muscle involvement, whereas severe cases may involve dysphagia, general paralysis, respiratory depression, and even death. This article reports on a patient who experienced severe poisoning symptoms after using type A botulinum toxin obtained through informal channels. The patient was treated with antitoxin on the 13th day after symptoms onset and achieved a significant improvement in their condition.

Botulinum toxin is a potent protein toxin produced by Clostridium botulinum. It acts directly on the brain nerve nucleus and peripheral neuromuscular junction, blocking the release of acetylcholine and thereby affecting nerve impulse transmission, ultimately leading to muscle paralysis. Mild cases may present with ocular muscle involvement, whereas severe cases may involve dysphagia, general paralysis, respiratory depression, and even death. This article reports on a patient who experienced severe poisoning symptoms after using type A botulinum toxin obtained through informal channels. The patient was treated with antitoxin on the 13th day after symptoms onset and achieved a significant improvement in their condition.

Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.