AIM: To compare the visual quality in patients with low-to-moderate myopia after 0.05 D interval spherical lens optometry-guided small-incision lenticule extraction(SMILE)and conventional 0.25 D interval spherical lens optometry-guided SMILE.METHODS: Retrospective study. A total of 400 cases(400 eyes)with low-to-moderate myopia that underwent SMILE in the ophthalmology department of 989th Hospital of Joint Logistic Support Force from August 2021 to August 2023 were enrolled and the data from the right eyes were collected for analysis. According to the method of optometry test modality, they were divided into 0.05 D group and 0.25 D group, with 200 eyes in each group. The differences were compared between the two groups of patients in intraoperative corneal ablation thickness, uncorrected distance visual acuity(UDVA), high-order corneal aberrations(HOA), spherical aberrations, vertical coma, horizontal coma and trefoil aberrations before and at 1, 3 and 6 mo after surgery. Additionally, the percentage of eyes with residual spherical equivalent(SE)≤±0.25 D, postoperative visual symptoms and scores on the quality of visual(Qov)were compared between the two groups at 6 mo after surgery.RESULTS: The corneal ablation thickness in the 0.05 D group was 92.78±16.56 μm, which was slightly higher than that in the 0.25 D group(83.24±17.33 μm; P<0.001). The UDVA at each postoperative time point in the 0.05 D group was superior to that in the 0.25 D group(all P<0.001). The HOA, spherical aberration, horizontal coma and vertical coma in the two groups at 1, 3 and 6 mo after operation were higher than those before operation(all P<0.05). The spherical aberration in the 0.05 D group at each time point after surgery were higher than those in the 0.25 D group, and vertical coma were lower than those in the 0.25 D group(all P<0.05). At 6 mo postoperatively, the percentage of eyes with residual SE ≤±0.25 D in the 0.05 D group was 97.5%(195 eyes), which was higher than 87.5%(175 eyes)in the 0.25 D group(P<0.05). The most common adverse visual symptoms after SMILE in both groups were hazy vision and glare. The total Qov score in the 0.05 D group was 0.35(0.24, 0.55), which was lower than [0.62(0.32, 0.89)] in the 0.25 D group(P<0.05).CONCLUSION: Compared with conventional 0.25 D interval spherical lens optometry-guided SMILE, the 0.05 D interval spherical lens optometry-guided SMILE for the correction of low-to-moderate myopia has better predictability and can achieve better vision and visual quality.

The current production of Chinese herbal decoction pieces faces several issues including strong subjectivity,unstable quality,low production efficiency,and a lack of intelligent systems.In order to expedite the intelligent transformation and upgrading of Chinese medicine processing,this paper delves deeply into the problems and challenges encountered in establishing a digital and intel-ligent production model for Chinese herbal pieces.Addressing the slow progress in fundamental research on traditional Chinese medi-cine processing mechanisms,the absence of online digital quality characterization techniques,the low level of production equipment in-telligence,and the lack of evaluation standards for high-quality decoction pieces,this paper proposes a"New Quality Productive Forces"formation approach driven by technological innovation.Through interdisciplinary integration methods,the paper explores the mechanisms of Chinese medicine processing in depth,clarifies the correlation between the processing procedures and the"medicinal properties-quality"relationship,and employs bionic sensing and artificial intelligence to achieve a holistic quality characterization of decoction pieces.Additionally,the use of cloud-edge collaborative big data systems is proposed to enhance intelligent upgrades of the production lines.The paper also aims to establish a high-quality decoction piece evaluation system integrating"physical-chemical-bio-logical"multimodal data fusion.This approach aims to steer the Chinese medicine processing towards becoming more efficient,precise,and sustainable,thereby promoting high-quality sustainable development of the Chinese herbal decoction industry and providing both theoretical and practical support for the modernization of traditional Chinese medicine.

AIM: To investigate the early visual quality after 0.05 D interval spherical lens optometry-guided small incision lenticule extraction(SMILE)for the correction of different degrees of myopia.METHODS: Retrospective study. A total of 200 cases(200 eyes)that underwent SMILE at the 989th Hospital of Joint Logistic Support Force from May to September 2023 were selected. The 0.05 D optometry was used to measure diopter. According to the preoperative spherical equivalent(SE), they were divided into low-to-moderate myopic group(>-6.0 D)and high myopic group(≤-6.0 D), with 100 eyes in each group. The total high-order corneal aberration(HOA), spherical aberration, coma and trefoil aberration were compared between the two groups preoperatively and at 6 mo postoperatively, and the quality of vision questionnaire was completed.RESULTS: The HOA, spherical aberration and vertical coma aberration in the two groups at 6 mo after operation were significantly higher than those before operation(all P<0.05). At 6 mo postoperatively, the HOA, spherical aberration and vertical coma aberration in the low-to-moderate myopic group were lower than those in the high myopic group(all P<0.05). The scores of the quality of vision questionnaire, near vision, night vision, night glare and visual fatigue in the low-to-moderate myopic group were all higher than those in the high myopic group(all P<0.05).CONCLUSION: Both low-to-moderate myopia and high myopia after the 0.05 D interval spherical lens optometry-guided SMILE had some visual symptoms, but great visual quality can be obtained after surgery.

ObjectiveTo review the ancient and modern literature of Huanglian Ejiaotang and learn about the historical evolution and clinical application， thereby providing a theoretical basis for the modern application of the classical prescription. MethodLiterature in the Chinese Medical Classics Database was retrieved with "Huanglian Ejiaotang" as the keyword. In China National Knowledge Infrastructure （CNKI） and PubMed， "Huanglian Ejiaotang" in Chinese and English was used as the keyword to retrieve literature. The items and modern clinical application studies related to the prescription， medicine， dosage， syndrome， and treatment of Huanglian Ejiaotang were selected and recorded. The inclusion and exclusion criteria were used to screen out literature. The information about the dynasty， book title， function， and indication was integrated to understand the history， evolution， and clinical application of Huanglian Ejiaotang. ResultFinally， 89 ancient books were included with 111 items. Huanglian Ejiaotang was initially recorded in ZHANG Zhongjing's Treatise on Cold Damage and Miscellaneous Diseases in the Han dynasty. It was composed of five herbs， namely Coptidis Rhizoma， Scutellariae Radix， Paeoniae Radix Alba， Asini Corii Colla， and egg yolk. With the change of historical dynasties， the composition， origin basis， dosage， and preparation method of Huanglian Ejiaotang all changed， but the changes in the processing were not obvious， which was basically consistent with Treatise on Cold Damage and Miscellaneous Diseases. In addition， 48 studies were included to analyze the clinical application of Huanglian Ejiaotang， which was mainly used for insomnia， anxiety， depression， diabetes， and so on. ConclusionAccording to the ancient and modern literature， the origin basis， dosage， processing， decoction， administration， and other content of Huanglian Ejiaotang are consistent with Treatise on Cold Damage and Miscellaneous Diseases. The present clinical application has expanded the usage scale of the ancient record， which promotes the innovation and development of the classic prescription and provides references for later research， development， and accurate application.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease with unknown etiology and limited therapeutic options. Activation of fibroblasts is a prominent feature of pulmonary fibrosis. Here we report that lncRNA DACH1 (dachshund homolog 1) is downregulated in the lungs of IPF patients and in an experimental mouse model of lung fibrosis. LncDACH1 knockout mice develop spontaneous pulmonary fibrosis, whereas overexpression of LncDACH1 attenuated TGF-β1-induced aberrant activation, collagen deposition and differentiation of mouse lung fibroblasts. Similarly, forced expression of LncDACH1 not only prevented bleomycin (BLM)-induced lung fibrosis, but also reversed established lung fibrosis in a BLM model. Mechanistically, LncDACH1 binding to the serine/arginine-rich splicing factor 1 (SRSF1) protein decreases its activity and inhibits the accumulation of Ctnnb1. Enhanced expression of SRSF1 blocked the anti-fibrotic effect of LncDACH1 in lung fibroblasts. Furthermore, loss of LncDACH1 promoted proliferation, differentiation, and extracellular matrix (ECM) deposition in mouse lung fibroblasts, whereas such effects were abolished by silencing of Ctnnb1. In addition, a conserved fragment of LncDACH1 alleviated hyperproliferation, ECM deposition and differentiation of MRC-5 cells driven by TGF-β1. Collectively, LncDACH1 inhibits lung fibrosis by interacting with SRSF1 to suppress CTNNB1 accumulation, suggesting that LncDACH1 might be a potential therapeutic target for pulmonary fibrosis.

Objective:To explore the application effect of micro-video combined with scenario simulation teaching in the training of orthopedic surgery posture placement for intern nursing students, so as to lay a foundation for improving the operation skills of nursing interns.Methods:A total of 86 nursing students in the operating room of Xijing Hospital of Air Force Military Medical University from June 2019 to June 2020 were selected as the research objects. They were divided into the control group ( n=42) and the intervention group ( n=44) according to the time of enrollment. The control group adopted the traditional clinical teaching and learning method, while the intervention group adopted the micro-video combined with scenario simulation teaching method. The effect of intervention was evaluated by theoretical assessment scores, skill operation assessment scores, medical education environmental scores and two-way teaching satisfaction. Results:The theoretical and technical performance assessment scores of the intervention group were higher than those of the control group ( P<0.05) . In addition, the correct rate of surgical positioning in the intervention group increased, while the time required to complete the positioning was reduced ( P<0.05) . In terms of medical education environment scores, students' perception of learning, students' perception of teachers, students' perception of the environment, and students' social self-perception scores and total scores of the intervention group were all higher than those of the control group ( P<0.05) . However, there was no statistically significant difference in academic self-perception of students between the two groups ( P>0.05) . At the same time, the two-way teaching satisfaction of nursing students and teachers in the intervention group was improved ( P<0.05) . Conclusions:The application of micro-video combined with scenario simulation teaching in the training of orthopedic surgical position placement of intern nursing students can effectively improve the teaching quality.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

OBJECTIVE: To develop a cell-based system for the diagnosis of vitamin K-dependent coagulation factor deficiency 1 (VKCFD1). METHODS: In HEK293 cells stably expressing the reporter gene FIX-Gla-PC, the gamma-glutamyl carboxylase (GGCX) gene was knocked out by using CRISPR/Cas9 technology. Enzyme-linked immunosorbent assay (ELISA), DNA sequencing and Western blotting were used to identify the GGCX gene knockout cells. A quickchange point variant method was used to construct the GGCX variant. ELISA was used to assess the influence of GGCX variant on the activity of reporter gene. RESULTS: Two monoclonal cell lines with no reporter activity by ELISA was identified. Edition and knockout of the GGCX gene was confirmed by DNA sequencing and Western blotting. The activity of the reporter gene was recovered by transfection of the wild-type GGCX gene. Thereby two monoclonal cells with GGCX knockout were obtained. By comparing the wild-type and pathogenic GGCX variants, the reporter activity was decreased in the pathogenic variants significantly. CONCLUSION A cell-based system for the detection of GGCX activity was successfully developed, which can be used for the diagnosis of VKCFD1 caused by GGCX variants.

OBJECTIVE: To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou. METHODS: Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. RESULTS: Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups ( CONCLUSIONS Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.
Adult ; Aged ; Albuminuria/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/epidemiology* ; Risk Factors

Objective: To investigate the expression of LIM domain binding 2 (LDB2) in lung cancer tissues and its correlation with sphingosine-1 phosphate receptor 1 (S1PR1). Methods: Lung cancer tissues and the corresponding adjacent tissues from 52 patients in Nantong Tumor Hospital during April 2010 and May 2011 were collected as the experimental group and the control group, respectively. The expression levels of LDB2 and S1PR1 were detected by the real-time PCR (qRT-PCR). The expression results of LDB2 gene were further verified by the Oncomine database, and its correlations with clinicopathological parameters were analyzed. The ROC curve was drawn to evaluate the diagnosis value of LDB2 expression in lung cancer. The correlation of LDB2 expression with the prognosis of lung cancer was analyzed by the “Kaplan-Meier Plotter” database. In addition, the relationship between LDB2 and S1PR1 was also analyzed. Results: The expression levels of LDB2 in lung cancer tissues (0.158 [0.062,0.383]) were significantly lower than that in the adjacent tissues (0.403 [0.261,0.711], U=700.0, P＜ 0.01). A total of 9 eligible studies were retrieved from the Oncomine database, and their expressions of LDB2 were also low (P＜0.01). The expressions of LDB2 in lung cancer tissues were not related to gender, age, smoking history, pathological type, tumor size, TNM staging and lymphatic metastasis (P＞0.05). The results of ROC curve showed that when the area under the ROC curve (AUC ROC ) was 0.741 (95% CI:0.643-0.839) and the cut-off value was 0.247, the sensitivity and specificity of LDB2 in the diagnosis of lung cancer were 80.8% and 61.5%, respectively. The Kaplan-Meier survival analysis showed that the 5-year overall survival time of the patients with low expression of LDB2 was shorter than that of the patients with high expression of LDB2(P＜0.01). In addition, the expression levels of S1PR1 in lung cancer tissues (0.710[0.337,1.523]) were significantly lower than that in the adjacent tissues (1.582[0.913,3.533],U=780.0, P＜0.01), and the expression levels of S1PR1 in lung cancer tissues were positively correlated with that of LDB2(r=0.827,P＜0.01). Conclusion The expressions of LDB2 and S1PR1 in lung cancer tissues are down-regulated, and have a positive correlation, and they may play an important role in the occurrence and development of lung cancer.