Objective:To investigate the outcome of epicanthoplasty combined with double eyelidplasty in different aesthetic forms of double eyelids (inner type and outer type) using Z-epicanthoplasty and inverted L method.Methods:The clinical data of patients with single eyelids and epicanthus were retrospectively analyzed from November 2021 to October 2022 in Gaoxin Hospital of the First Affiliated Hospital of Nanchang University. Patients were divided into inner type group and outer type group based on their aesthetic requirements for inner double eyelids. Both groups underwent Z-epicanthoplasty or inverted L method for epicanthus correction. Postoperative follow-up was conducted to observe the incision healing, complications, and postoperative effects of the two groups. The correction effects [ineffective, effective, and markedly effective, with the effective rate calculated as (the number of markedly effective cases + the number of effective cases)/total number of cases × 100%], scar scores, and patient satisfaction scores were collected for more than 12 months after surgery. Independent sample t-test was used for the scar scores and patient satisfaction scores, and chi-square test was used for the epicanthus correction effects. P<0.05 indicated a statistically significant difference. Results:A total of 76 patients were included. Among them, 41 patients in the inner type group (4 males and 37 females, with an average age of 22.3 years, ranging from 18 to 28 years) underwent 19 cases of Z-epicanthoplasty and 22 cases of inverted L method; 35 patients in the outer type group (3 males and 32 females, with an average age of 24.2 years, ranging from 19 to 30 years) underwent 20 cases of Z-epicanthoplasty and 15 cases of inverted L method. After 12 to 16 months of follow-up, with an average of 14 months, all incisions in both groups healed in the first stage, with no significant scar hyperplasia or other complications. Most of the double eyelid shapes are natural after the surgery, and the correction of epicanthus is obvious. Comparison of the treatment efficacy between Z-epicanthoplasty and inverted L method showed no significant difference [94.87% (37/39) vs. 94.59% (35/37), P>0.05]. In the inner type group, the postoperative scar score of the inverted L method was lower than that of the Z-epicanthoplasty [(6.81±0.66) vs. (7.31±0.88)], and the satisfaction score was better than that of the Z-epicanthoplasty [(0.86±0.63) vs. (1.73±0.65)], with statistically significant differences (both P<0.05). In the outer type group, the scar score of the inverted L method was higher than that of the Z-epicanthoplasty [(7.66±0.89) vs. (7.00±0.64)], and the satisfaction score was worse than that of the Z-epicanthoplasty [(1.80±0.86) vs. (1.00±0.56)], with statistically significant differences (both P<0.05). Conclusion:For patients requiring inner type aesthetic form of medial double eyelids, inverted L method can achieve less postoperative scars and higher postoperative satisfaction compared with Z-epicanthoplasty. For patients requiring "outer type" aesthetic form, Z-epicanthoplasty can achieve less postoperative scars and higher postoperative satisfaction compared with inverted L method.

Objective:To investigate the outcome of epicanthoplasty combined with double eyelidplasty in different aesthetic forms of double eyelids (inner type and outer type) using Z-epicanthoplasty and inverted L method.Methods:The clinical data of patients with single eyelids and epicanthus were retrospectively analyzed from November 2021 to October 2022 in Gaoxin Hospital of the First Affiliated Hospital of Nanchang University. Patients were divided into inner type group and outer type group based on their aesthetic requirements for inner double eyelids. Both groups underwent Z-epicanthoplasty or inverted L method for epicanthus correction. Postoperative follow-up was conducted to observe the incision healing, complications, and postoperative effects of the two groups. The correction effects [ineffective, effective, and markedly effective, with the effective rate calculated as (the number of markedly effective cases + the number of effective cases)/total number of cases × 100%], scar scores, and patient satisfaction scores were collected for more than 12 months after surgery. Independent sample t-test was used for the scar scores and patient satisfaction scores, and chi-square test was used for the epicanthus correction effects. P<0.05 indicated a statistically significant difference. Results:A total of 76 patients were included. Among them, 41 patients in the inner type group (4 males and 37 females, with an average age of 22.3 years, ranging from 18 to 28 years) underwent 19 cases of Z-epicanthoplasty and 22 cases of inverted L method; 35 patients in the outer type group (3 males and 32 females, with an average age of 24.2 years, ranging from 19 to 30 years) underwent 20 cases of Z-epicanthoplasty and 15 cases of inverted L method. After 12 to 16 months of follow-up, with an average of 14 months, all incisions in both groups healed in the first stage, with no significant scar hyperplasia or other complications. Most of the double eyelid shapes are natural after the surgery, and the correction of epicanthus is obvious. Comparison of the treatment efficacy between Z-epicanthoplasty and inverted L method showed no significant difference [94.87% (37/39) vs. 94.59% (35/37), P>0.05]. In the inner type group, the postoperative scar score of the inverted L method was lower than that of the Z-epicanthoplasty [(6.81±0.66) vs. (7.31±0.88)], and the satisfaction score was better than that of the Z-epicanthoplasty [(0.86±0.63) vs. (1.73±0.65)], with statistically significant differences (both P<0.05). In the outer type group, the scar score of the inverted L method was higher than that of the Z-epicanthoplasty [(7.66±0.89) vs. (7.00±0.64)], and the satisfaction score was worse than that of the Z-epicanthoplasty [(1.80±0.86) vs. (1.00±0.56)], with statistically significant differences (both P<0.05). Conclusion:For patients requiring inner type aesthetic form of medial double eyelids, inverted L method can achieve less postoperative scars and higher postoperative satisfaction compared with Z-epicanthoplasty. For patients requiring "outer type" aesthetic form, Z-epicanthoplasty can achieve less postoperative scars and higher postoperative satisfaction compared with inverted L method.

Objective To construct and validate a Nomogram prediction model for overall survival (OS) in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer. Methods The clinical, pathological, and follow-up data of middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer in the Affiliated Hospital of Yangzhou University, Northern Jiangsu People's Hospital, and Yangzhou City Hospital of Traditional Chinese Medicine from March 1, 2012 to December 1, 2022 were retrospectively analyzed. Based on univariate and multivariate Cox regression analyses, the independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer were identified, and a Nomogram prediction model was further constructed and validated. The diagnostic performance of the model was evaluated by the receiver operating characteristic (ROC) curve and calibration curve, and the clinical effect of the model was assessed by decision curve analysis (DCA). Results A total of 382 patients were included. A total of 282 cases were as training sets and 100 cases were as validation sets. Univariate and multivariate Cox regression analyses indicated that family history of gastric cancer, vascular invasion, nerve invasion, T stage, and N stage were independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer (P < 0.05). A prognostic Nomogram was constructed based on these variables, and the concordance index of the model in the training and validation sets was 0.667 (95% CI, 0.601 to 0.726) and 0.708 (95%CI, 0.622 to 0.766) respectively. The ROC curve indicated that the model had good predictive accuracy. The calibration curve showed that the predicted value of the model was in good agreement with the actual value. DCA demonstrated that the model had good clinical application and potential values. Conclusion The Nomogram model for 1-, 3- and 5-year OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer constructed based on real-world big data in this study has an ideal predictive effect, which can help clinicians effectively assess patients' prognosis.

With the recent ongoing autumn/winter 2022 COVID-19 wave and the adjustment of public health control measures, there have been widespread SARS-CoV-2 infections in Chinese mainland. Here we have analyzed 369 viral genomes from recently diagnosed COVID-19 patients in Shanghai, identifying a large number of sublineages of the SARS-CoV-2 Omicron family. Phylogenetic analysis, coupled with contact history tracing, revealed simultaneous community transmission of two Omicron sublineages dominating the infections in some areas of China (BA.5.2 mainly in Guangzhou and Shanghai, and BF.7 mainly in Beijing) and two highly infectious sublineages recently imported from abroad (XBB and BQ.1). Publicly available data from August 31 to November 29, 2022 indicated an overall severe/critical case rate of 0.035% nationwide, while analysis of 5706 symptomatic patients treated at the Shanghai Public Health Center between September 1 and December 26, 2022 showed that 20 cases (0.35%) without comorbidities progressed into severe/critical conditions and 153 cases (2.68%) with COVID-19-exacerbated comorbidities progressed into severe/critical conditions. These observations shall alert healthcare providers to place more resources for the treatment of severe/critical cases. Furthermore, mathematical modeling predicts this autumn/winter wave might pass through major cities in China by the end of the year, whereas some middle and western provinces and rural areas would be hit by the upcoming infection wave in mid-to-late January 2023, and the duration and magnitude of upcoming outbreak could be dramatically enhanced by the extensive travels during the Spring Festival (January 21, 2023). Altogether, these preliminary data highlight the needs to allocate resources to early diagnosis and effective treatment of severe cases and the protection of vulnerable population, especially in the rural areas, to ensure the country's smooth exit from the ongoing pandemic and accelerate socio-economic recovery.

Background: Peste des petits ruminants (PPR), caused by the PPR virus (PPRV), is an acute and fatal contagious disease that mainly infects goats, sheep, and other artiodactyls.Peripheral blood mononuclear cells (PBMCs) are considered the primary innate immune cells. Objectives: PBMCs derived from goats were infected with PPRV and analyzed to detect the relationship between PPRV replication and apoptosis or the inflammatory response. Methods: Quantitative real-time polymerase chain reaction was used to identify PPRV replication and cytokines expression. Flow cytometry was conducted to detect apoptosis and the differentiation of CD4+ and CD8+T cells after PPRV infection. Results: PPRV stimulated the differentiation of CD4+ and CD8+ T cells. In addition, PPRV induced apoptosis in goat PBMCs. Furthermore, apoptosis and the inflammatory response induced by PPRV could be suppressed by Z-VAD-FMK and Z-YVAD-FMK, respectively.Moreover, the virus titer of PPRV was attenuated by inhibiting caspase-1-dependent apoptosis and inflammation. Conclusions This study showed that apoptosis and the inflammatory response play an essential role in PPR viral replication in vitro, providing a new mechanism related to the cell host response.

Objective: To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students. Methods: From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students. Results: The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8 %, which was statistically significant among middle school students in different grades, self perceived family economic status, the number of friends and sleep patterns ( χ 2=42.69, 29.15, 46.02, 93.99, P <0.05). After adjusting for grade, self perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type ( OR =2.84) and negatively associated with morning type ( OR =0.61)( P ＜0.05). Conclusion Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.

OBJECTIVE To eval uate the effectiveness ，safety and economy of deferasir ox for the treatment of iron overload in thalassemia with rapid health technology assessment ，and to provide evidence-based basis for rational clinical use. METHODS Retrieved from Chinese and English database/website as PubMed ，Embase，Cochrane Library ，NHS EED ，CADTH，CNKI and Wanfang database ，health technology assessment （HTA），systematic evaluation/meta-analysis and pharmacological studies about deferasirox versus deferoxamine/deferiprone for the treatment of iron overload in thalassemia were collected from the inception to June 2021. Based on literature screening and data extraction ，the quality of literature about HTA reports ，systematic evaluation/ Meta-analysis and pharmacoeconomic research were evaluated with HTA checklist ，A Measurement Tool to As sess Systematic Reviews，standard scale of economic evaluation report. The effectiveness and safety results were described quantitatively ，and the economic evaluation results were described qualitatively. RESULTS One HTA report ，five systematic evaluation/meta-analysis and five pharmacoeconomic studies were selected from 1 569 literature. Included HTA reports ， systematic evaluation/meta-analysis，pharmacoeconomic studies were high in quality. Most studies reported that 30 mg/（kg·d） deferasirox was E-mail：aydgs@126.com better than deferoxamine in reducing the levels of s erum ferritin and liver iron overload ；ADR induced by deferasirox were mainly gastrointestinal irritation symptoms ，skin itching ，joint pain，transaminase elevation ，etc.，which generally did not affect subsequent treatment. There was no statistical significance in severe ADR between deferoxamine group and deferasirox group [RR ＝0.96，95％CI（0.85，1.08），P＝0.52]. Compared with deferoxamine，deferasirox had higher cost-effectiveness ；but deferasirox was less likely to be cost-effective than deferiprone. CONCLUSIONS Deferasirox has good effectiveness and safety for iron overload in thalassemia ，and has good economic advantages in Britain and Iran ，compared with deferoxamine.

Objective:To evaluate the intervention effect of various drugs on glutathione (GSH) and superoxide dismutase (SOD) enzyme activity of rats kidney with acute nickel carbonyl poisoning.Methods:In January 2019, The 250 SPF male SD rats were randomly divided into normal control group ( n=10) , poisoned group ( n=40) and treatment groups ( n=200) according to the random number table method. And the treatment groups were divided into methylprednisolone group (20 mg/kg) , DDC group (100 mg/kg) , sodium selenite group (10 μmol/kg) , Shenfu huiyang decoction group (0.25 ml) and methylprednisolone combined with DDC group (100 mg/kg) , with 40 mice in each group. Except for the normal control group, rats in the other groups were exposed to nickel carbonyl for 30 min, at 4 h and 30 h after exposure, the rats in each treatment group were intraperitoneally injected with corresponding drugs, and kidney tissues were collected 3 d and 7 d after administration, with 10 mice in each group. The activities of GSH and SOD in kidney were measured by enzyme-linked immunosorbent assay, and using electron microscopy observe ultrastructure changes. Results:Compared to the control group, the activities of GSH and SOD enzyme of poisoned group were significantly decreased at 3 d or 7 d after 4 h or 30 h exposure, and the difference was statistically significant ( P=0.000, 0.031, 0.001, 0.033) , the epithelial nuclei of proximal convoluted tubules were pyknosis and lysosome hyperplasia in the cytoplasm. And compared to poisoned group, the activities of GSH and SOD enzyme of methylprednisolone+DDC group were significantly increased at treatment with 7 d after 4 h exposure, the difference was statistically significant ( P=0.022, 0.000) , and the activities of GSH and SOD enzyme of methylprednisolone and enzyme of methylprednisolone+DDC group were significantly higher at 7 days than at 3 days, the difference was statistically significant ( P=0.020, 0.017, 0.018, 0.033) . The results of electron microscopy showed that the cell nuclei and cytoplasmic organelles of proximal convolute tubule were almost restored to normal tissue level of both methylprednisolone group and methylprednisolone+DDC group. Conclusion:The methylprednisolone and methylprednisolone+DDC have obvious repair effect on renal enzyme activity level of rats with acute nickel carbonyl poisoning, and the treatment effect is better for a long time of medication.

Objective:To evaluate the intervention effect of various drugs on glutathione (GSH) and superoxide dismutase (SOD) enzyme activity of rats kidney with acute nickel carbonyl poisoning.Methods:In January 2019, The 250 SPF male SD rats were randomly divided into normal control group ( n=10) , poisoned group ( n=40) and treatment groups ( n=200) according to the random number table method. And the treatment groups were divided into methylprednisolone group (20 mg/kg) , DDC group (100 mg/kg) , sodium selenite group (10 μmol/kg) , Shenfu huiyang decoction group (0.25 ml) and methylprednisolone combined with DDC group (100 mg/kg) , with 40 mice in each group. Except for the normal control group, rats in the other groups were exposed to nickel carbonyl for 30 min, at 4 h and 30 h after exposure, the rats in each treatment group were intraperitoneally injected with corresponding drugs, and kidney tissues were collected 3 d and 7 d after administration, with 10 mice in each group. The activities of GSH and SOD in kidney were measured by enzyme-linked immunosorbent assay, and using electron microscopy observe ultrastructure changes. Results:Compared to the control group, the activities of GSH and SOD enzyme of poisoned group were significantly decreased at 3 d or 7 d after 4 h or 30 h exposure, and the difference was statistically significant ( P=0.000, 0.031, 0.001, 0.033) , the epithelial nuclei of proximal convoluted tubules were pyknosis and lysosome hyperplasia in the cytoplasm. And compared to poisoned group, the activities of GSH and SOD enzyme of methylprednisolone+DDC group were significantly increased at treatment with 7 d after 4 h exposure, the difference was statistically significant ( P=0.022, 0.000) , and the activities of GSH and SOD enzyme of methylprednisolone and enzyme of methylprednisolone+DDC group were significantly higher at 7 days than at 3 days, the difference was statistically significant ( P=0.020, 0.017, 0.018, 0.033) . The results of electron microscopy showed that the cell nuclei and cytoplasmic organelles of proximal convolute tubule were almost restored to normal tissue level of both methylprednisolone group and methylprednisolone+DDC group. Conclusion:The methylprednisolone and methylprednisolone+DDC have obvious repair effect on renal enzyme activity level of rats with acute nickel carbonyl poisoning, and the treatment effect is better for a long time of medication.

Background: Peste des petits ruminants (PPR) is an infectious disease caused by the peste des petits ruminants virus (PPRV) that mainly produces respiratory symptoms in affected animals, resulting in great losses in the world's agriculture industry every year. Singledomain variable heavy chain (VHH) antibody fragments, also referred to as nanobodies, have high expression yields and other advantages including ease of purification and high solubility. Objectives: The purpose of this study is to obtain a single-domain antibody with good reactivity and high specificity against PPRV. Methods: A VHH cDNA library was established by immunizing camels with PPRV vaccine, and the capacity and diversity of the library were examined. Four PPRV VHHs were selected, and the biological activity and antigen-binding capacity of the four VHHs were identified by western blot, indirect immunofluorescence, and enzyme-linked immunosorbent assay (ELISA) analyses. ELISA was used to identify whether the four VHHs were specific for PPRV, and VHH neutralization tests were carried out. ELISA and western blot analyses were used to identify which PPRV protein was targeted by VHH2. Results: The PPRV cDNA library was constructed successfully. The library capacity was greater than 2.0 × 106 cfu/mL, and the inserted fragment size was approximately 400 bp to 2000 bp. The average length of the cDNA library fragment was about 1000 bp, and the recombination rate was approximately 100%. Four single-domain antibody sequences were selected, and proteins expressed in the supernatant were obtained. The four VHHs were shown to have biological activity, close affinity to PPRV, and no cross-reaction with common sheep diseases. All four VHHs had neutralization activity, and VHH2 was specific to the PPRV M protein. Conclusions The results of this preliminary research of PPRV VHHs showed that four screened VHH antibodies could be useful in future applications. This study provided new materials for inclusion in PPRV research.