Objective To investigate the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)flap filling preserving subretinal fluid(SRF)in treatment of macular hole retinal detachment(MHRD)in patients with high myopia.Methods A retrospective case study was conducted.Thirty patients with high myopia MHRD(total of 32 eyes)with posterior staphyloma and chorioretinal atrophy from department of ophthalmology,Union Hospital,Tongji Medical Col-lege,Huazhong University of Science and Technology between August 2020 and June 2023 were included in the study.The mean axial length was(30.32±1.71)mm.All patients underwent PPV,SRF preservation,and macular hole(MH)nasal flap creation(utilizing the optic disc as a support to fix the detached retina).The ILM flap was inverted to fill MH,and the surgery ended with silicone oil tamponade.The patients were observed for SRF absorption,retinal reattachment,MH closure,and visual acuity changes in the follow-up.Results OCT examination within 1 week after the operation showed that 25 eyes had MH closure and SRF absorption,6 eyes had MH closure with residual SRF,and 1 eye had MH non-closure.During the follow-up period,residual SRF in 7 eyes was fully absorbed within 1 year(5 cases),18 months(1 case),and 21 months(1 case)after the operation.All 32 eyes had retinal reattachment after a single silicone oil removal,and the retinal reattachment rate was 100％.Among the 32 eyes,90.62％(29/32)had MH type Ⅰ closure,including 22 eyes with U-shaped closure,5 eyes with V-shaped closure,and 2 eyes with W-shaped transformation into U-shaped scar closure;9.38％(3/32)had MH type Ⅱ(W-shaped)closure.There was an im-provement in the postoperative best-corrected visual acuity(BCVA,logMAR)from(1.90±0.34)to(1.14±0.37),with a statis-tically significant difference(t=11.11,P＜0.01).Conclusion In the presence of residual SRF,the ILM flap inversion filling technique achieves MH closure successfully.The combination of PPV,SRF preservation,ILM flap filling,and silicone oil tam-ponade provides a preferred treatment for highly myopic MHRD with long eye axis and posterior staphyloma.

The update of multi-omics technology is a key means to promote the rapid development of accurate health model in the whole life cycle.It can formulate dynamic and accurate nursing measures and provide massive data information from the perspective of nursing biology of health and disease.At present,clinical nursing research faces many challenges such as insufficient application and transformation ability of multi-omics technology.This paper introduces the multi-omics technology,reviews the application status of multi-omics technology in cancer nursing,maternal and child nursing,chronic metabolic disease nursing and symptom management,and puts forward the cross integration and prospect of multi-omics technology and nursing research,so as to strengthen the information mining ability of nurses at different levels of health and disease,and provide an important basis for accelerating the clinical transformation of precision nursing.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

The aims of tooth restoration of endodontically treated teeth are to protect the remaining dental tissue; restore coronal morphology, functions and aesthetics; prevent bacterial microleakage and ensure periodontal healthy; prevent fracture of the restorations and reduce the wear from antagonist teeth. This article reviews the preservation and minimally invasive restoration of endodontically treated teeth. The results of the literature review show that tooth fracture resistance decreases after root canal treatment, the amount of remaining tooth tissue is an important factor affecting the success of root canal treatment, and the neck is the stress concentration area of tooth tissue, the traditional full crown and postcore crown have a certain amount of abrasion on the healthy neck teeth tissue, which will further reduce the bending resistance of the teeth and may cause the teeth to fracture. With the development of bonding technology, composite resin materials and ceramic materials, there are fewer molar tissues removed when resin, inlay, onlay, overlay and inlay crown are used to repair tooth defects, which can better preserve the remaining tooth tissues, especially the neck tooth tissues. After root canal treatment, only the pulp cavity of the tooth can be directly repaired by resin. When the marginal ridge is absent, minimally invasive restoration methods, such as inlay, onlay, and inlay crown, can be selected according to the number of marginal ridges removed and the thickness of the remaining dental tissue.

Objective: To construct the evaluation index of follow-up assessments on TCM (traditional Chinese medicine) health management of female. Methods: The evaluation indicators and score criteria were extracted for the efficacy evaluation of diseases and syndromes related to irregular menstruation in The criteria of diagnosis and therapeutic effect of diseases and syndromes in Traditional Chinese Medicine and Guidelines of clinical research of new drugs of Traditional Chinese Medicine; The health behaviors related to the onset of irregular menstruation diseases, such as diet, emotion, exercise, etc. were collected to build index of health behavior of irregular menstruation. Results: A comprehensive index system of follow-up assessments on TCM health management of female composed of disease curative effect, syndrome curative effect and health behavior score was constructed. Conclusion: The evaluation index system helps to dynamically track the effectiveness of interventions and management, and helps users to adjust the intervention plan and avoid the unhealthy behaviors.

To compare the efficacy and safety of cetuximab biweekly regimen with those of standard weekly regimen as a first-line therapy of KRAS/RAS wild-type metastatic colorectal cancer. Methods: Patients who received weekly or biweekly administra-tion of cetuximab plus FOLFOX/XELOX as a first-line therapy from July 2010 to December 2017 in Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively screened for eligibility. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and frequencies of adverse events (AEs) between the two groups were compared. Results: Of 152 eligible patients, 55 were in the biweekly group and 43 were in the weekly group. The biweekly group had significantly higher ORR than the weekly group (76.3% vs. 54.8%, P=0.025). Median PFS in the biweekly and weekly groups were 10.3 and 8.8 months, respectively (P=0.288), and the median OS were 33.5 and 27.4 months, respectively (P=0.563). The two groups showed no significant difference in PFS and OS. For overall AEs, the biweekly group presented significantly more stomatitis (32.7% vs. 14.0% , P=0.032) and tended to show substantially more acne-like rash (80.0% vs. 62.8%, P=0.058) and leukopenia and/or neutropenia (72.7% vs. 55.8%, P=0.081). The frequency of 3/4 grade acne-like rash in the biweekly and weekly groups were 18.2% and 7.0%, respectively (P=0.105). The frequency of all grade 3/4 AEs between the two groups showed no significant difference (P>0.05). Conclusions: Biweekly regimen of cetuximab plus FOLFOX/XE-LOX had similar efficacy and higher ORR compared with those of standard weekly regimen. Cetuximab administered biweekly may be an optional choice in clinical practice, with close attention paid to increased frequency of certain AEs.

Objective:To explore the effects and possible mechanism of liraglutide on hypoxia and high glucose-induced oxidative stress injury in cardiomyocytes. Methods:The neonatal rat cardiomyocytes were separated and cultured in vitro. The hypoxia and high glucose-induced injury model was established in neonatal rat cardiomyocytes. The cells were divided into six groups:the normal control group, liraglutide control group, hypoxia and high glucose model group, liraglutide treatment group, GLP-1R antagonist group and hyperosmotic control group. The metabolic ability of the cells was detected by MTT assay, the activities of LDH and CK-MB were detected by colorimetric method,SOD activity and MDA content were determined by xanthine oxidase method and thiobarbituric acid method,ROS level was measured by chemiluminescence method. The mRNA and protein expression of adaptor protein p66Shc was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. Results:Compared with those in the normal control group, the cells in hypoxia and high glucose model group had poorly metabolic ability,the content of LDH, CK-MB, MDA and ROS increased (P < 0.01), the activity of SOD decreased (P <0.01), and the expression of adaptor protein p66Shc greatly increased(P <0.01). After the treatment with liraglutide,the above mentioned parameters were all improved(P < 0.01). Exendin(9-39),an antagonist of GLP-1R,attenuated the protective effect of liraglutide. Conclusion:Liraglutide has a protective effect on cardiomyocytes by down-regulating adaptor protein p66Shc expression and reducing ROS formation.

The addition of HER2-targeted therapy has markedly improved the survival and prognosis of patients with advanced gastric cancer. Inhibiting the HER2 signaling pathway has become the backbone treatment for advanced HER2-positive gastric cancer in the first-line setting. TOGA trial established trastuzumab in combination with cisplatin and 5-flurouracil as the standard first-line treat-ment. In the post-TOGA era, combinations of trastuzumab with other chemotherapy agents were proven to be effective as both the second-line treatment and the conversion treatment. Such combinations are promising in the neoadjuvant treatment for locally ad-vanced gastric cancer. Research focuses on the development of novel anti-HER2 agents in combination with agents targeting against other signal pathways. Real-time monitoring of the gene expression profile is the key to discovering the mechanism of trastuzumab re-sistance. The preliminary results of existing clinical trials have shown potential to overcome resistance to trastuzumab. In this review, we summarized the treatment advancement for HER2 positive gastric cancer and the direction for future development, thereby provid-ing guidance on clinical practice.

Objective To explore the effect of continuous aspiration of subglottic secretion at different negative pressure levels on mechanical ventilation. Methods Toally 142 patients were randomized by way of lottery into the control group (n=70) and the experiment group ( n = 72 ): the control group received continuous negative pressure aspiration of subglottic secretion at a negative pressure of 60 mmHg while the experiment group did 30~40 mmHg for grade I of the sticky secretion , 40~60 mmHg for gradeⅡ~Ⅲof the sticky secretion, respectively. The two groups were compared in terms of the rate of ventilator associated pneumonia (VAP), airway mucosal injury and cough. Result There was no significant difference in the rate of ventilator associated pneumonia (P>0.05), but the rates of airway mucosal injury and cough were lower in the experiment group than those of the control group (P < 0.05). Conclusion It is reasonable to choose different negative pressure levels based on stickiness of the secretions for mechanical ventilation, for it can prevent the ventilator associated pneumonia and airway mucosal injury.

Growth year is one of the important factors for the quality of Polygala tenufolia. In this study, primary metabolites and secondary metabolites were compared in 1, 2 and 3 years old P. tenufolia cultivated in Shaanxi Heyang. The samples were subjected to ultra-high performance liquid chromatography (UPLC)-quadrupole time-of-flight mass spectrometry (Q-TOF MS) and nuclear magnetic resonance (NMR) analysis, and the obtained data were analyzed using principal component analysis (PCA) and other statistical analysis methods. In addition, content and correlation of different metabolites were also calculated. The results showed no significance between main component contents in 2 year-old and 3 year-old P. Tenufolia, but 1 year-old was statistically different. The contents of primary metabolites, such as fructose, sucrose, and choline increased as time goes on, while glycine and raffinose decreased. The contents of secondary metabolites, such as onjisaponin Fg, polygalasaponin XXVIII, polygalasaponin XXXII increased, while polygalaxanthone III and parts of oligosaccharide multi-ester including tenuifoliose A, tenuifoliose C, tenuifoliose C2 and tenuifoliose H decreased with the extension of the growth years. Growth years has important impact on the quality of P. tenuifolia and the existing growing years of commodity P. tenuifolia have its scientific evidence. This study supplied a new method for the quality evaluation of Chinese medicinal materials.