AIM: To compare the refractive prediction accuracy of 7 intraocular lens(IOL)calculation formulas in the cataract eyes with short axial length(AL)at different corneal curvatures and anterior chamber depth(ACD), and analyze relevant influencing factors contributing to prediction errors.METHODS: A retrospective analysis was performed for 125 patients(125 eyes)with a short AL, who received cataract phacoemulsification at Shenyang He Eye Specialist Hospital from November 2020 to December 2021. According to the keratometry(Km), they were divided into low flat Km group(≤45.5 D), medium and high Km group(45.5 D

Objective To mine adverse drug event(ADE)signals of doxycycline using the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,and provide scientific evidence for clinical medication safety.Methods The data from the FAERS database between the first quarter of 2004 and the first quarter of 2024 were extracted.After data cleaning and standardization,ADE reports with doxycycline as the main suspected drug were screened.The system organ class(SOC)of ADE was performed using MedDRA,and the reporting odds ratio method and Medicines and Healthcare products Regulatory Agency method were used to mine ADE signals.The information component method was also used to evaluate signal strength.Results A total of 43 126 ADE reports with doxycycline as the primary suspected drug were collected,involving 14 642 patients,with a higher proportion of female patients(57.32％).There were 555 related ADE signals involving 26 SOC,with the top 5 SOC being gastrointestinal disorders,skin and subcutaneous tissue disorders,injuries,poisonings,and procedural complications,psychiatric disorders,and infections and infestations.The top 5 ADE signals with the highest signal intensity were Hatch reaction,sclerosing cholangitis,esophageal ulcer,gastrointestinal mucosal necrosis,and gastrointestinal injury.Among the ADE signals with the strongest signal strength not listed in the package insert,the top five were sclerosing cholangitis,nephrogenic diabetes insipidus,minimal change glomerular nephritis,diabetes insipidus and Sixth cranial nerve paralysis.Conclusion In clinical practice,particular attention should be paid to the frequent ADEs caused by doxycycline,as well as those not yet documented in the package insert,which involve multiple SOC such as renal and urinary disorders,hepatobiliary diseases,blood and lymphatic system disorders,and endocrine disorders.Therefore,clinical pharmacists should play a key role in assisting clinicians to develop and implement prevention plans for ADEs,thereby improving the safety of doxycycline in clinical use.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective To evaluate the biochemical indicators,nutritional status,and immune levels of pa-tients with pulmonary aspergillosis(PA)and other pulmonary diseases,and to construct a predictive model for PA so as to improve the diagnostic efficacy of clinical PA.Methods A total of 40 PA patients and 39 pa-tients with other pulmonary diseases who were hospitalized in the hospital from January 2020 to August 2022 were retrospectively analyzed.The expression trends and differences of serum 1,3-β-D Glucan(G test),galac-tomannan test(GM test),biochemical indexes,blood routine indexes and immune cell subsets were analyzed and compared.The receiver operating characteristic(ROC)curve and binary Logistic regression analysis were used to construct the predictive model for PA by the combination of clinical indicators.Results Serum GM test,G test,albumin,hemoglobin,hematocrit,lymphocytes,B lymphocytes,CD44 T lymphocytes and CD4/CD8 ratio displayed significant differences between PA patients and patients with other lung disease(P＜0.05).The levels of GM test in alveolar lavage fluid of PA patients were significantly higher than that in the serum,and the differences were statistically significant(P＜0.05).The ROC curve analysis showed that the GM test,as an independent predictor of PA,had good predictive accuracy[0.85＜area under the curve(AUC)＜0.95].Besides,albumin,natural killev cells,CD4+T lymphocytes and CD4/CD8 ratio had general predictive efficacy(0.70＜AUC＜0.85).The prediction efficacy of G test and B lymphocytes was poor(AUC＜0.70).The Logistic regression analysis showed that the combination of GM test and serum albumin could construct the optimal prediction model,and the prediction formula of the combined model was as fol-lows:Logit(P)=17.781× GM-0.131×albumin+1.394.The prediction accuracy of the combined model was 0.924(95％CI:0.865-0.982),the sensitivity was 87.5％,the specificity was 81.2％,and the cut off value was 17.781×GM-0.131×albumin-1.735.Conclusion This study retrospectively analyzed the differences in various clinical indicators between patients with PA and patients with other pulmonary diseases,and then screen the key clinical indicators as candidate predictors which displayed significantly different ex-pression between the two groups.The optimal prediction model for the diagnosis of PA is constructed by the combination of GM test and serum albumin through ROC curve and Logistic regression analysis.This model may significantly improve the diagnostic efficiency of PA in clinical,and provide the reference for the early di-agnosis and effective treatment of PA patients.

Objective To investigate the effect of inertial sleep-wake pattern on neurological function,cognition,and emotion in patients with acute ischemic stroke on day 90 after disease onset.Methods The patients with acute isch-emic stroke who were admitted to Department of Neurology in the Second Affiliated Hospital of Navy Medical University from April 2021 to April 2023 were analyzed,and they were divided into groups according to the circadian rhythm of inertial sleep-wake before disease onset.Demographic data,location of lesion,risk factors,and 90-day outcome were recorded and compared between groups.Results A total of 51 patients,aged 30 to 68 years,were enrolled in this study,with a mean age of(47.750±9.104)years.There were 40 male patients(78.43%),with a male/female ratio of 3.64∶1.Among the 51 patients,there were 9 patients(17.65%)with definitely evening type,18(35.29%)with mild evening type,22(43.14%)with intermediate type,and 2(3.92%)with mild morning type,and there were no patients with absolute morning type.There were no significant differences in baseline data between groups(P>0.05);the univariate analysis showed significant differences between groups in 90-day Mini-Mental State Examination(MMSE)score(P=0.021)and Hamilton Anxiety Scale(HAMA)score(P=0.008),and comparison between any two groups showed that the differences mainly came from absolute evening type and intermediate type.The Spearman correlation analysis showed that cognitive function(r=0.492,P<0.001)and anxiety(r=-0.428,P=0.002)on day 90 after the onset of acute stroke were signifi-cantly associated with sleep-wake pattern.The multivariate analysis showed that sleep-wake pattern(P=0.018)and MMSE score on day 14 after disease onset(P=0.001)were independent risk factors for cognitive decline on day 90 in acute ischemic stroke,and sleep-wake pattern(P=0.040)and HAMA score on day 14 after disease onset(P<0.001)were independent influencing factors for anxiety disorder on day 90.Conclusion Inertial sleep-wake pattern is an inde-pendent risk factor for the poor short-term prognosis of cognitive and anxiety outcomes in acute ischemic stroke,and it is recommended to adopt active intervention measures.

Objective To investigate the factors influencing the pregnancy outcomes during frozen-thawed embryo transfer(FET)cycles in patients with polycystic ovary syndrome(PCOS).Methods A retrospective analysis was conducted on patients'data from 882 FET cycles.According to the pregnancy outcome,the patients were divided into non-implantation group(Group A),abortion group(Group B1)and live birth group(Group B2).Clinical data and laboratory parameters were compared among the three groups,and ordered Logistic regression analysis was used to study the factors influencing pregnancy outcomes after FET.Patients were also divided into four groups(C1-C4)based on the number of high-quality embryos obtained(0-3,4-6,7-10,≥11),and their clinical data and laboratory parameters were compared.Results The clinical pregnancy rate,live birth rate,and miscar-riage rate in the 882 treatment cycles were 71.09%(627/882),61.68%(544/882),and 13.24%(83/627),respectively.Single-factor analysis showed significant differences in body mass index(BMI),infertility type,hu-man chorionic gonadotropin(hCG)day estradiol(E2)level,number of retrieved oocytes,and number of high-quality embryos among Groups A,B1,and B2(P<0.05).Further multiple Logistic regression analysis revealed that BMI(OR=1.046,95%CI:1.001-1.093,P=0.044)and a history of previous pregnancy(OR=1.417,95%CI:1.030-1.950,P=0.032)were independent risk factors for successful FET in PCOS patients,while an in-creased number of high-quality embryos was an independent protective factor for successful pregnancy.Based on the results of Group B2,compared to Group A,OR=0.920,95%CI:0.880-0.962,P=0.000;compared to Group B1,OR=0.923,95%CI:0.862-0.988,P=0.022.Compared with the other three groups(C1-C3),the total amount of gonadotropin(Gn)in the C4 group was the lowest and the number of oocytes obtained was the high-est(P<0.05).Multiple comparisons showed that Group C4 had lower BMI,follicle-stimulating hormone(FSH),very low-density lipoprotein(vLDL)levels,a higher luteinizing hormone and follicle-stimulating hormone(LH/FSH)ratio compared to Group C1(P<0.05).Group C4 had lower fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR)levels compared to Group C3,and higher high-density lipoprotein-cholesterol(HDL-C)and apolipoprotein A1(Apo A1)levels compared to Groups C2 and C3(P<0.05).Con-clusion BMI,the history of previous pregnancy and the number of high-quality embryos were both independent factors for predicting pregnancy outcomes in PCOS patients undergoing FET cycles.Patients with a higher number of high-quality embryos have a higher clinical pregnancy rate during FET cycles.

Objective To compare the differences in clinical outcomes of ovulation induction with highly purified human menopausal gonadotropin(HP-hMG,Menopur)versus recombinant human follicle stimulating hormone(rFSH,Gonal-F)in normal ovarian responder patients treated with the GnRH-antagonist protocol.Methods Pa-tients treated with the GnRH-antagonist protocol were retrospectively analyzed and divided by gonadotropin(Gn)usage into HP-hMG group and rFSH group.The basic characteristics,ovulation induction method,laboratory inde-xes,and clinical outcomes were compared between the two groups.Results A total of 614 normal ovarian re-sponder patients were enrolled in the study,with 216 in the HP-hMG group and 398 in the rFSH group.There was no significant difference in P levels and LH levels on the hCG trigger day between the two groups.However,the E2 levels on the hCG trigger day were significantly lower in the HP-hMG group(P＜0.001).Moreover,the HP-hMG group had a higher biochemical pregnancy rate(69.23％vs 63.51％)and clinical pregnancy rate(66.67％vs 59.46％)compared to the rFSH group.The incidence of OHSS in the HP-hMG group(2.31％vs 3.02％)showed a decreasing trend compared to the rFSH group.Conclusion Compared to rFSH,HP-hMG offers distinct advanta-ges in reducing the incidence of OHSS and improving pregnancy outcomes in normal ovarian responder patients un-dergoing pituitary suppression with the GnRH-antagonist protocol.

Objective To investigate the clinical effects and pregnancy outcomes of using luteal phase long protocol and GnRH antagonist protocol in patients with polycystic ovary syndrome(PCOS)who have failed their first GnRH antagonist protocol therapy.Methods The clinical data of 163 PCOS patients who underwent IVF/ICSI-ET were retrieved.After the failure of their first GnRH antagonist protocol treatment,they were divided into two groups in the second controlled ovarian hyperstimulation(COH)cycle:Luteal phase long protocol group(n=95)and Gn-RH antagonist protocol group(n=68).A retrospective analysis and comparison of basic clinical data,clinical and laboratory indicators,and pregnancy outcomes between two groups were conducted.Results ① There was no sta-tistically significant difference in basic clinical indicators between two group except LH.② Compared the first and second cycle treatments of patients in the luteal phase long protocol group,the initiation dose of gonadotropin(Gn),total number of Gn days,total Gn usage,estradiol(E2)on the day of hCG injection,number of retrieved eggs,oocyte maturation rate,2PN fertilization rate,2PN cleavage rate,blastocyst formation rate,high-quality blas-tocyst formation rate,and moderate to severe OHSS rate were significantly higher than those in the first GnRH an-tagonist cycle(P＜0.05).The GnRH antagonist protocol group also showed similar improvements.③ The com-parison of the second COH cycle between two groups showed that the total number of Gn days,total Gn usage,and total Gn cost in the luteal phase long protocol group were significantly higher(P＜0.05),while the E2 and LH on the day of hCG injection,and the maturation rate of eggs were significantly lower than those in the GnRH antagonist protocol group(P＜0.05).However,there was no statistically significant difference in the number of retrieved eggs,2PN fertilization,2PN cleavage,blastocyst formation rate,high-quality blastocyst formation rate,and OHSS rate between the two groups;④ The comparison of fresh transplantation cycles for the second COH cycle between the two groups showed that the luteal phase long protocol fresh transplantation rate,implantation rate,clinical preg-nancy rate,and live birth rate were slightly higher than those of the GnRH antagonist protocol group,but the differ-ence was not statistically significant.Comparing the outcomes of pregnancy following the initial frozen-thawed em-bryo transfer(FET)between two groups,the biochemical pregnancy rate and clinical pregnancy rate of the GnRH antagonist protocol group were higher than those of the luteal phase long protocol group(P＜0.05).However,no significant statistical variations were found in implantation rate,live birth rate,neonatal gestational age,and birth weight.Conclusion For PCOS patients who fail the first GnRH antagonist protocol,an appropriate increase in the initiating dose and usage of Gn can achieve satisfactory pregnancy outcomes with both protocols.Compared with change to a luteal phase long protocol,reusing the GnRH antagonist protocol still maintains its long-standing advan-tages,such as shorter total Gn days,lower costs,and better patient compliance.

ObjectiveTo explore the effect of Anmeidan on the sleep quality and serum levels of brain-derived neurotrophic factor （BDNF）， glial fibrillary acidic protein （GFAP）， and irisin in the patients with chronic insomnia. MethodA multicenter， randomized， double-blind， placebo-controlled clinical study was carried out， including 480 patients with chronic insomnia （deficiency syndrome） in Wuhan （Hubei）， Guangzhou （Guangdong）， and Lanzhou （Gansu）. They were randomized into an observation group and a control group at a ratio of 1∶1. The observation group was orally administered with Anmeidan granules at a dose of 11 g， 3 times per day， and the control group with Anmeidan simulant at a dose of 11 g， 3 times per day， Both groups of patients received sleep education after enrollment. After 4 weeks of medication， the Athens insomnia scale （AIS） scores， Spiegel scale scores， and serum levels of BDNF， GFAP， and irisin were compared between the two groups as well as between before and after treatment. ResultA total of 480 adult patients with chronic insomnia were enrolled in this study， with 64 patients falled off. Finally， the 415 patients were included in the analysis， including 213 patients in the observation group and 202 patients in the control group. There was no difference in age or sex between the two groups of patients. Compared with before treatment， the treatment in both groups decreased the AIS and Spiegel scores （P<0.01）. After treatment， the observation group had lower AIS and Spiegel scores than the control group （P<0.01）. The treatment in the observation group slightly lowered the level of BDNF， elevated the level of irisin （P<0.05）， and lowered the level of GFAP （P<0.05） in the serum. After treatment， the observation group showed higher level of irisin （P<0.05） and lower levels of BDNF and GFAP in the serum than the control group. ConclusionAnmeidan may improve the sleep quality of patients with chronic insomnia by elevating the irisin level and lowering the GFAP level in the serum.

Objective:To analyze the application effect of the information platform based on the Internet of Things (IoT) in the screening and management of patients with chronic obstructive pulmonary disease (COPD).Methods:In this cross-sectional study, 151 062 residents who participated in the screening in the districts covered by 33 general hospitals and 289 primary medical institutions within the framework of Henan Provincial Center for COPD Prevention and Treatment from November 2021 to October 2022 were included as the subjects. Spirometer based on the IoT was used to conduct pulmonary function tests for subjects who scored 16 points or more with COPD Screening Questionnaire (COPD-SQ), and the subjects were evaluated and managed through the structured electronic data in the information platform. The distribution characteristics and follow-up of the subjects and COPD patients were described and the application effect of this strategy in patients screening and management was analyzed.Results:A total of 151 062 residents with complete basic information in the information platform completed the questionnaire. High-risk population of COPD accounted for 26.5% (40 042/151 062) of the population who received the questionnaire screening, and more than 50% had respiratory symptoms, such as chronic cough (59.4%), or shortness of breath (77.6%). The proportion of high-risk population increased with age, especially after 50 years old. Compared with non-smokers, the proportion of high-risk group was significantly higher (77.1% vs 16.4%) in the group with smoking index over 600. Biofuel exposure (61.3% vs 22.1%) and family history of respiratory diseases (64.2% vs 22.6%) were associated with an increased proportion of high-risk groups, with statistically significant differences ( P<0.001). 5 268 patients were diagnosed with COPD by pulmonary function tests, and the prevalence of COPD in high-risk groups was 27.8% (5 268/18 965), the prevalence rate of male was 34.0% (3 942/11 588), which was higher than that of female 18.0% (1 326/7 377). 2 950 patients (56.0%) completed at least one follow-up of symptom questionnaire and 510 patients (9.7%) completed more than one follow-up of pulmonary function test. Conclusion:The screening and management strategy of COPD based on the IoT and information technology can improve the efficiency of COPD screening, and improve the status quo of under-diagnosis and discontinuous follow-up of COPD.