Objective To compare the difference in binocular visual function after implantation of different types of intraocular lenses(IOL).Methods A total of 63 patients(126 eyes)with age-related cataract who underwent phacoe-mulsification combined with IOL implantation in Yantai Affiliated Hospital of Binzhou Medical University from October 2021 to June 2023 were collected.Among them,22 patients(44 eyes)were implanted with monofocal IOL in both eyes(mono-focal group),21 patients(42 eyes)were implanted with monofocal and multifocal IOL in both eyes,respectively(mixed group),and 20 patients(40 eyes)were implanted with multifocal IOL in both eyes(multifocal group).Another 22 patients(44 eyes)with physiological presbyopia were selected from the medical examination center of the same hospital during the same period as the control group.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),defocus curve,amplitude of accommodation(AMP),positive relative accommodation(PRA),negative relative accommo-dation(NRA),binocular cross-cylinder(BCC),accommodative convergence/accommodation ratio(AC/A),rupture point at the near point of convergence(NPC),near-far distance positive fusional vergence(PFV)and negative fusional vergence(NFV)rupture points,and near-far distance stereopsis of patients in the four groups were recorded and compared during the 3-month follow-up.Results After three months of follow-up,there was no significant difference in UDVA among the four groups(P＞0.05),while the UNVA of patients in the multifocal group and the mixed group was better than that in the control group and the monofocal group(all P＜0.05).The defocus curves of patients in the mixed group and the multifocal group were bimodal.There were statistically significant differences in AMP,NRA,PRA,and BCC among the four groups(all P＜0.05).There was no statistically significant difference in the AC/A ratio and far-distance NFV and PFV rupture points among the four groups(all P＞0.05).There were statistically significant differences in NPC rupture point and near-distance NFV and PFV rupture points among the four groups(all P＜0.05).There was no statistically significant difference in the proportion of patients with normal far-distance stereopsis among the four groups(P＞0.05).The proportion of pa-tients with normal near-distance stereopsis in the mixed group was significantly lower than that in the other three groups(all P＜0.05).Conclusion Multifocal IOL can effectively improve postoperative UDVA and UNVA in cataract patients.Binocular implantation of multifocal IOL is beneficial to the reconstruction of binocular visual function in far-and near-dis-tance conditions after cataract surgery.The mixed implantation of monofocal and multifocal IOL affects the recovery of near-distance binocular stereopsis in the short term.

OBJECTIVE: To investigate the effect of lateral prone position ventilation in patients with acute respiratory distress syndrome (ARDS). METHODS: A prospective control study was conducted. A total of 75 patients with moderate to severe ARDS admitted to the department of critical care medicine of Jingxian Hospital in Anhui province from January 2020 to December 2022 were selected as the research objects. According to the envelope method, the patients were divided into the lateral prone position ventilation group (38 cases) and the traditional prone position ventilation (PPV) group (37 cases), using lateral prone position ventilation and traditional PPV, respectively. The mechanical ventilation parameters were set according to the ARDS treatment guidelines and lung protective ventilation requirements in both groups, and the time of prone position for the first 3 times was not less than 16 hours per day. General data of patients were recorded, including heart rate (HR), mean arterial pressure (MAP), airway resistance and lung static compliance (Cst) before prone position (T0), 1 hour (T1), 4 hours (T2), 8 hours (T3), and before the end of prone position (T4), oxygenation index (PaO₂/FiO₂) before the first prone position (t0) and 12 hours (t1), 24 hours (t2), 48 hours (t3), and 72 hours (t4) after the intensive care unit (ICU) admission, as well as the incidence of pressure injury (PI) and vomiting, tracheal intubation time, and mechanical ventilation time. Repeated measures analysis of variance was used to compare the effects of different prone positions on patients before and after the prone position. RESULTS: There were no significant differences in age, gender, body mass index (BMI), acute physiology and chronic health evaluation II (APACHE II), underlying diseases, HR, MAP, pH value, PaO₂/FiO₂, blood lactic acid (Lac), arterial blood pressure of carbon dioxide (PaCO₂) and other general information between the two groups. The HR (intergroup effect: F = 0.845, P = 0.361; time effect: F = 1.373, P = 0.247; interaction: F = 0.245, P = 0.894), MAP (intergroup effect: F = 1.519, P = 0.222; time effect: F = 0.169, P = 0.954; interaction: F = 0.449, P = 0.773) and airway resistance (intergroup effect: F = 0.252, P = 0.617; time effect: F = 0.578, P = 0.679; interaction: F = 1.467, P = 0.212) of T0-T4 between two groups showed no significant difference. The Cst of T0-T4 between the two groups showed no significant difference in the intergroup effect (F = 0.311, P = 0.579) and the interaction (F = 0.364, P = 0.834), while the difference in the time effect was statistically significant (F = 120.546, P < 0.001). The PaO₂/FiO₂ of t0-t4 between the two groups showed no significant difference in the intergroup effect (F = 0.104, P = 0.748) and the interaction (F = 0.147, P = 0.964), while the difference in the time effect was statistically significant (F = 17.638, P < 0.001). The group factors and time factors were tested separately, and there were no significant differences in the HR, MAP, airway resistance, Cst, PaO₂/FiO₂ between the two groups at different time points (all P > 0.05). The Cst at T1-T4 and PaO₂/FiO₂ at t1-t4 in the two groups were significantly higher than those at T0/t0 (all P < 0.05). There were no significant differences in the tracheal intubation time [days: 6.75 (5.78, 8.33) vs. 7.00 (6.30, 8.45)] and mechanical ventilation time [days: 8.30 (6.70, 9.20) vs. 7.40 (6.80, 8.75)] between the lateral prone position ventilation group and the traditional PPV group (both P > 0.05). However, the incidences of PI [7.9% (3/38) vs. 27.0% (10/37)] and vomiting [10.5% (4/38) vs. 29.7% (11/37)] in the lateral prone position ventilation group were significantly lower than those in the traditional PPV group (both P < 0.05). CONCLUSIONS Both lateral prone position ventilation and traditional PPV can improve Cst and oxygenation in patients with moderate to severe ARDS. The two types of prone position have little influence on HR, MAP and airway resistance of patients, and there is no difference in the influence on tracheal intubation time and mechanical ventilation time of patients. However, the lateral prone position ventilation mode can reduce the incidence of PI and vomiting, and is worthy of clinical promotion and application.
Humans ; Respiration, Artificial ; Prone Position ; Prospective Studies ; Lung ; Respiratory Distress Syndrome/therapy* ; Respiration ; Vomiting

Non-small cell lung cancer(NSCLC) is one of the most common malignancies worldwide. Not only the complex molecular components but also the cellular heterogeneity in NSCLC tissues pose a great barrier for its clinical treatment. Recent years has witnessed the widespread application of single-cell sequencing in the studies regarding tumor heterogeneity. However, the disadvantages of single-cell sequencing technology itself could not be neglected. Spatial transcriptome(ST) technology allows in situ transcriptome sequencing of tissues to achieve high-throughput transcriptomic information of tissue cells with their spatial information available. In other words, ST makes it possible to acquire cellular composition and gene expression patterns without breaking intercellular communication network, which distinguishes itself from conventional single-cell sequencing, since mechanical separation and enzymatic digestion of tissue cells into single-cell suspension used to be inevitable during the performance of single-cell sequencing. To gain new insights into the spatial heterogeneity of NSCLC, we reviewed and summarized the latest progress in ST technology which has been applied to tumor sample analysis, especially to the field of NSCLC.

Objective: Network pharmacology combines drug and disease targets with biological information networks based on the integrity and systematicness of the interactions between drugs and disease targets. This study aims to explore the molecular basis of Hanshi Zufei formula for treatment of COVID-19 based on network pharmacology and molecular docking techniques. Methods: Using TCMSP, the chemical constituents and molecular targets of Atractylodis Rhizoma, Citri Reticulatae Pericarpium, Magnoliae Officinalis Cortex, Pogostemonis Herba, Tsaoko Fructus, Ephedrae Herba, Notopterygii Rhizoma et Radix, Zingiberis Rhizoma Recens, and Arecae Semen were investigated. The predicted targets of novel coronavirus were screened using the NCBI and GeneCards databases. To further screen the drug-disease core targets network, the corresponding target proteins were queried using multiple databases (Biogrid, DIP, and HPRD), a protein interaction network graph was constructed, and the network topology was analyzed. The molecular docking studies were also performed between the network's top 15 compounds and the coronavirus (SARS-CoV-2) 3CL hydrolytic enzyme and angiotensin conversion enzyme II (ACE2). Results: The herb-active ingredient-target network contained nine drugs, 86 compounds, and 49 drug-disease targets. Gene ontology (GO) enrichment analysis resulted in 1566 GO items (P < 0.05), among which 1438 were biological process items, 35 were cell composition items, and 93 were molecular function items. Fourteen signal pathways were obtained by enrichment screening of the KEGG pathway database (P < 0.05). The molecular docking results showed that the affinity of the core active compounds with the SARS-CoV-2 3CL hydrolase was better than for the other compounds. Conclusion: Several core compounds can regulate multiple signaling pathways by binding with 3CL hydrolase and ACE2, which might contribute to the treatment of COVID-19.

Objective:To study the safety, validity and practicability of the modified trans-cricothyroid needle electrode method for neurmonitoring during thyroidectomy.Methods:115 patients from the Department of Thyroid Surgery in Peking University Shenzhen Hospital scheduled for thyroid surgery were recruited into the group. Two paired needle electrodes were obliquely inserted into the cricothyroid membrane from the angle between the rectus cricothyroid muscle and the inferior margin of thyroid cartilage. The function of recurrent laryngeal nerve (RLN) was localized, exposed and evaluated by standard four-step method (V1-R1-R2-V2) . The vocal cord movement was evaluated by electronic laryngoscope before and after operation, and t-test was used to compare the difference of EMG signal amplitude before and after operation.Results:A total of 130 RLN from 115 patients were recorded effective electromyographic (EMG) signals, including 12 cases of giant goiter with tracheal compression stenosis; 13 cases had repeated adjustments of the position of tracheal intubation electrode during operation, but EMG signals were not satisfactory; 15 cases were with of accidental findings during operation and requiring neurmonitoring, but tracheal intubation electrodes were not used in advance. 75 cases were volunteers. The signals of 3 RLN were lost during operation. On the second day after operation, electronic laryngoscope showed that 2 cases had normal vocal cord movement and 1 case had vocal cord paralysis and no recovery for 6 months follow-up. The EMG signals of other 127 nerves were V1/R1=1857±1718μV/2347±2323μV, V2/R2=1924±1705μV/2450±2345μV. There was no significant difference in EMG signals between pre-operation and post-operation ( t=0.31/0.35, P=0.755/0.725) . The electronic laryngoscope showed normal vocal cord movement before and after operation. During the operation, 2 patients had a little bleeding at the needle electrode insertion point, which stopped after 5 minutes of compression. No electro-acupuncture breakage, infection or local hematoma occurred. Conclusions:The modified trans-cricothyroid needle electrode method had been proved to be safe and feasible for evaluating the function of recurrent laryngeal nerve in thyroid surgery. Besides of unaffected by tracheal conditions, it has good stability, simple implantation and low cost. In thyroid surgery, it can be used as a useful supplement to endotracheal intubation electrode.

OBJECTIVE：To establish the fingerprint of ethanol extract and acetone extract from Anemarrhena asphodeloides and its different processed products ，and to investigate the spectrum-effect relationship between the fingerprint and the antioxidant activity. METHODS ：HPLC method and HPLC-ELSD method were adopted. The determination was performed on Thermo BDS Hypersil C 18 column with mobile phase consisted of acetonitrile- 0.2％ acetic acid at the flow rate of 1.0 mL/min. The column temperature was 30 ℃，and the detection wavelength was set at 258 nm. The sample size was 10 μL. The determination was performed on XDB-C 18 columnwith mobile phase consisted of acetonitrile-0.1％ acetic acid （gradient elution ）at the flow rate of 0.9 mL/min. The column temperature was 30 ℃ . The temperature of atomizer was 40 ℃ and the flow rare of N 2 was 1.6 mL/min. The sample size was 10 μL. Using mangiferin and timosaponin B Ⅱ as reference ，Fingerprint Similarity Eva- com luation System of TCM Chromatogram （2004A edition ）was adopted to draw the fingerprint of ethanol extract and acetoneextract from 20 batches of A. asphodeloides and its different processed products to confirm common peaks. Using scave nging rate of 1，1-diphenyl-2-trinitrophenylhydrazine（DPPH）radical as index，antioxidant activities of ethanol extract and acetone extract from 20 batches of A. asphodeloides and its processed products were investigated. Using scavenging rate of DPPH radical as dependent variable ，common peak area as independent variable ，PLSR was used to analyze the spectrum-effect relationship of ethanol extract and acetone extract from A. asphodeloides with antioxidantion activity. RESULTS ：Eight peaks （M1-M8）were identified in the fingerprints of ethanol extracts from 20 batches of processed A. asphodeloides . Mangiferin （chromatogram peak M 7）was identified with similarity of 0.389-1.000；seven comon peaks （S1-S7）and timosaponin B Ⅱ（peak S 5）were identified in the fingerprint of acetone extract ，and the similarity was 0.044-0.999. DPPH radical scavenging rate of ethanol extract from 20 batches of A. asphodeloides and its processed products was 21.23％- 81.39％，and A. asphodeloides was significantly lower than salt-processed A. asphodeloides with salt wine-processed A. asphodeloides （P＜0.001）；and that of acetone extract was 49.73％-83.78％，and A. asphodeloides was significantly higher than stir-baked A. asphodeloides with salt ，wine or fire （P＜0.001）. The standardized regression coefficients of peaks M 2-M7 in the spectrum of ethanol extract from A. asphodeloides were all greater than 0，which was positively correlated with antioxidant activity. Only the variable importance projection （VIP）value of peak M 7 was greater than 1，which had an important contribution. The standardized regression coefficients of peaks S 4-S7 in the acetone extract spectrum of A. asphodeloides were greater than 0，and were positively correlated with antioxidant activity. The order of VIP values was peak S 5＞S6＞S4，and the VIP values were all greater than 1. CONCLUSIONS：The fingerprint of the different processed products A. asphodeloides and its antioxidant activity spectral effect relationship were successfully established ；mangiferin（peak M 7）may be the main antioxidant substance of ethanol extract from A. asphodeloides . Timosaponin B Ⅱ（peak S 5），peak S 6 and peak S 4 may be the main antioxidant substance in acetone extract from A. asphodeloides .

Objective To analyze the disease constitution,accuracy of clinical and pathological diagnoses of skin biopsy samples in Peking Union Medical College Hospital.Methods A total of 29987 patients subjected to skin biopsy were collected from Department of Dermatology,Peking Union Medical College Hospital from June 2010 to November 2018,and clinical and histopathological diagnoses of these skin biopsy samples were analyzed retrospectively.Results According to the results of histopathological diagnosis,confirmed diagnoses of these patients could be classified into 33 categories and 242 kinds.Common disease categories included epidermal tumors (2931 cases,9.77％),connective tissue diseases (2809 cases,9.37％),melanocytic tumors (2078 cases,6.93％),erythematous scaly pustular dermatoses (1376 cases,4.59％),lichenoid dermatoses (1291cases,4.31％),allergic or eczematous skin diseases (1282 cases,4.28％)and infectious skin diseases (1156 cases,3.86％).Common skin diseases included scleroderma (1887 cases,6.29％),pigmented nevus (1755 cases,5.85％),seborrheic keratosis (1136 cases,3.79％),eczema (1089 cases,3.63％),psoriasis (881 cases,2.94％),lichen planus (867 cases,2.89％),lupus erythematosus (638 cases,2.13％),pemphigus (549 cases,1.83％),and basal cell carcinoma (501 cases,1.67％).Poor consistency was observed between clinical diagnosis and histopathological diagnosis of lichen planus,bullous pemphigoid,granuloma annulare and hypereosinophilic dermatitis.Conclusions Common disease categories of the skin biopsy samples in Peking Union Medical College Hospital were epidermal tumors,connective tissue diseases,melanocytic tumors,erythematous scaly pustular dermatoses,lichenoid dermatoses,and allergic or eczematous skin diseases.Poor consistency was observed between clinical and pathological diagnosis in some skin diseases,and understanding of these diseases should be improved.

In the past ten years, the research and application of microbiome has continued to increase. The microbiome has gradually become the research focus in the fields of life science, environmental science, and medicine. Meanwhile, many countries and organizations around the world are launching their own microbiome projects and conducting a multi-faceted layout, striving to gain a strategic position in this promising field. In addition, whether it is scientific research or industrial applications, there has been a climax of research and a wave of investment and financing, accordingly, products and services related to the microbiome are constantly emerging. However, due to the rapid development of microbiome sequencing and analysis related technologies and methods, the research and application from various countries have not yet unified on the standards of technology, programs, and data. Domestic industry participants also have insufficient understanding of the microbiome. New methods, technologies, and theories have not yet been fully accepted and used. In addition, some of the existing standards and guidelines are too general with poor practicality. This not only causes obstacles in the integration of scientific research data and waste of resources, but also gives related companies unfair competition opportunity. More importantly, China still lacks national standards related to the microbiome, and the national microbiome project is still in the process of preparation. In this context, the experts and practitioners of the microbiome worked together and developed the consensus of experts. It can not only guide domestic scientific research and industrial institutions to regulate the production, learning and research of the microbiome, the application can also provide reference technical basis for the relevant national functional departments, protect the scale and standardized corporate company's interests, strengthen industry self-discipline, avoid unregulated enterprises from disrupting the market, and ultimately promote the benign development of microbiome-related industries.
China ; Consensus ; Humans ; Industry ; Microbiota

Objective: To improve the clinician′s recognition of Gerstmann-Sträussler-Scheinker syndrome (GSS). Methods: The detailed clinical information, neuropsychological examination, cerebrospinal fluid examination, imaging characteristics, electroencephalogram examination and gene detection were analyzed in a case of GSS similar to Creutzfeldt-Jakob disease (CJD) in symptomatology. The differences between the two different prion diseases were compared in combination with the literature review. Results: The patient is a 62-year-old woman, with cerebellar ataxia as the first symptom, followed by rapid dementia, accompanied by pyramidal and extrapyramidal signs. Magnetic resonance imaging showed hyper-intense signal in diffusion weighted imaging in caudatum and cortical ribboning, and protein 14-3-3 was negative. PRNP gene analysis showed P102L gene mutation. Conclusions The typical clinical manifestation of GSS is hereditary ataxia followed by cognitive decline of varying severity. Detection of PRNP plays an important role in the diagnosis of GSS.

OBJECTIVE： To establish a method for simultaneous determination of spinosin and jujuboside A in the seads of Ziziphus jujuba， and to investigate its quality grading standard. METHODS： HPLC-ELSD method was adopted. The separation was carried out on Inertsil ODS-SP column with mobile phase consisted of acetonitrile-water （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， the temperature of drift tube was 90 ℃， the flow of carrier gas was 2.9 L/min and injection volume was 20 μL. The thickness， width， length and 100-grain quality of the medicinal materials were used as indicators to investigate the appearance traits. SPSS 22.0 software was used to analyze the correlation of the contents of spinosin and jujuboside A， its appearance traits with the quality constant of TCM， and establish a quality classification standard for the seads of Z. jujuba. RESULTS： The linear range of spinosin and jujuboside A were 1.03-6.18 μg/mL （r＝0.999 7）， 1.05-6.30 μg/mL （r＝0.999 8）； the limits of quantitation were 0.171， 0.174 μg/mL， respectively； the limits of detection were 0.052， 0.053 μg/mL， respectively. RSDs of precision， stability and reproducibility tests were all lower 2％. The recoveries were 99.01％-102.97％ （RSD＝1.39％， n＝6）， 97.94％-101.03％ （RSD＝1.13％， n＝6）， respectively. Correlation analysis results showed that the length， width， 100-grain quality spinosin content and jujuboside A content of the medicinal materials were positively correlated with the quality constant of TCM. The results of quality classification for 30 batches of medicinal materials showed that S1-S4 and S7-S12 were first-class products； S5， S6， S13-S17 and S20-S30 were second-class products； S18 and S19 were third-class products. CONCLUSIONS： Established content determination method is simple， precision， accurate and stable， and can be used for simultaneous determination of spinosin and jujuboside A in the seads of Z. jujuba. Established quality grading standard of the seads of Z. jujuba can be used to evaluate the quality.