Obesity is a risk factor and pathological basis for various chronic non-communicable diseases and is an important risk factor leading to human mortality and disability. The harm of obesity to the body includes not only various systemic diseases but also some ocular diseases. Currently, the higher pursuit of life and visual quality has led to increased attention to the etiology and prevention of ocular diseases, and the impact of obesity on ocular diseases has been gradually discovered. This article reviews the impact of obesity on certain ocular diseases to deepen the understanding of obesity's impact on ocular diseases and provide a reference for the prevention and treatment of ocular diseases.

With the rapid development of science and technology and the wide application of electronic products, the number of patients with high myopia is gradually increasing. Meanwhile, owing to the continuous optimization of surgical skils and the continuous advancement in materials of posterior chamber intraocular lens and manufacturing processes, implantable collamer lens(ICL)V4c implantation has gradually become one of the main surgeries for the treatment of high myopia. In the rapid era of social information, people pay more attention to the long-term efficacy after ICL V4c implantation, they not only want clear vision, but also the pursuit of visual comfort and durability. Therefore, this paper will specifically discuss the research progress of the post-implantation efficacy of ICL V4c with at least 2 a of follow-up observation within 3 a, aiming to review the latest research progress on the long-term efficacy of ICL V4c implantation from the three dimensions of visual quality, safety, efficacy and stability and possible surgical complications after ICL V4c implantation.

Objective To observe the effects of different nutritional strategies on the nutritional status,inflammatory markers,and immune function of patients with acute respiratory distress syndrome(ARDS)in the intensive care unit(ICU).Methods A retrospective research method was conducted.A total of 51 ARDS patients admitted to the department of intensive care unit of Yanbian University Affiliated Hospital from March 2018 to March 2021 were selected as the study subjects.According to different nutritional regimens,patients were divided into a short peptide whole protein sequential treatment group(sequential treatment group,25 cases)and a conventional whole protein treatment group(conventional treatment group,26 cases).The differences in nutritional status indicators such as hemoglobin(Hb),prealbumin(PA),total protein(TP),albumin(ALB),inflammatory indicators such as interleukin-6(IL-6),procalcitonin(PCT),and immune function indicators such as CD3+,CD4+,and CD8+ levels were compared among ARDS patients on the 1st,5th,and 8th day of treatment.And the frequency of feeding adverse events was observed during nutritional therapy.Results On the 8th day of treatment,both PA and TP significantly increased in the sequential treatment group,which was significantly higher than that of the conventional treatment group[PA(mg/L):144.04±86.75 vs.87.15±54.88,TP(g/L):57.44±6.18 vs.52.08±6.58],the difference was statistically significant(both P<0.05).From the 5th day of treatment,the ALB in the sequential treatment group was significantly higher than that in the conventional treatment group(g/L:28.84±3.13 vs.27.07±3.05),and continued until the 8th day of treatment(g/L:30.72±4.59 vs.28.30±3.94),with statistically significant differences(both P<0.05).There was no statistically significant difference in lymphocyte count,IL-6,PCT,CD3+,CD4+,and CD8+ between the two groups,both within and between groups(all P>0.05).Both groups had gastric retention to varying degrees and used gastric motility drugs,but there was no statistical difference in the incidence of feeding related adverse events between the two groups(all P>0.05).Conclusion Early use of short peptide whole protein sequential nutrition in ARDS patients is better than simple use of whole protein enteral nutrition in correcting nutritional status,but it has no significant effect on feeding tolerance,inflammation indicators,and immune indicators.

Objective To analyze and discuss the medication rule of professor Ruan Yan in the treatment of children with allergic rhinitis by using data mining method,and to provide reference for the clinical research and patented drugs development for the treatment of children with allergic rhinitis.Methods The outpatient medical records of professor Ruan Yan for the treatment of children with allergic rhinitis were collected.Microsoft Excel 2010 software was used for frequency statistics.SPSS Clementine 12.0 software was used for association rule analysis,cluster analysis and factor analysis to obtain the data.The frequency of use of various drugs and the association rules between drugs were obtained.Then the medication rules in professor Ruan Yan's prescription were analyzed.Results A total of 308 Chinese medicine compounds were included,involving 80 kinds of Chinese medicines,among which relieving drugs and qi-invigorating herbs were high-frequently used.The distribution of traditional Chinese medicine syndrome types was mainly characterized by lung-qi deficiency-cold syndrome and lung-spleen qi deficiency syndrome.The medicinal properties were mainly spicy,warm and sweet,and most of them belonged to the lung,spleen and stomach meridians.Five core prescriptions were extracted by factor analysis.Four drug combinations were obtained by systematic cluster analysis.Conclusion Ventilating lung and opening the orifices,expelling wind and removing cold,strengthening the spleen and replenishing qi are basic therapeutic principles for professor Ruan Yan in the treatment of children with allergic rhinitis.The treatment mainly focused on dispelling evil,ventilating lung and opening the orifices,expelling wind and removing cold during the acute stage of allergic rhinitis.In the remission period,according to the principle of"treating disease must be based on its origin",the treatment should enhance children's physical fitness,tonify lung and strengthen spleen,thereby reducing recurrence.

Methods:Cultured human alveolar epithelial A549 cells were assigned into LPS group and blank control group. LPS group was stimulated with LPS and adenosine triphosphate to induce pyroptosis and inflammation. A549 cells were divided into 4 groups: miR-20a mimics group, mimics-negative control (NC) group, inhibitor group and inhibitor-NC group. MiRNA-20a mimics, mimics-NC, inhibitor, and inhibitor-NC were transfected respectively into A549 cells, and after 24 h, the cells were collected to verify transfection efficiency by qPCR. MiRNA-20a mimics and the constructed TLR4-3'UTR double luciferase reporter plasmid were co-transfected into A549 cells, and luciferase activity was analyzed. MiRNA-20a mimics/inhibitors were transfected into A549 cells, and then the cells were stimulated by LPS for 8 h followed by adenosine triphosphate for 30 min. QPCR, Western Blot and ELISA were used to detect the expression of GSDMD, inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and Signaling molecules (TLR4、NF-κB) in A549 cells at mRNA level and protein level. Immunofluorescence was used to detect the expression of TLR4 in the A549 cells and NF-κB in the nucleus of A549 cells after transfecting with miRNA-20a mimics/inhibitor.Results:The mRNA and protein expression of pyroptosis marker molecule (GSDMD) and inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) in A549 cells stimulated with LPS were significantly higher than those in the blank control group, and the differences were statistically significant ( P<0.05). The expression of miRNA-20 in the mimics group was significantly higher than that in the mimic-NC group ( P<0.05), while the expression of miRNA-20a in the inhibitor group was lower than that in the inhibitor-NC group ( P<0.01). The double luciferase reporter gene experiment showed that the relative fluorescence value of the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics was significantly lower than the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics-NC ( P<0.05). The mRNA and protein levels of pyroptosis marker molecule (GSDMD) , inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and signaling molecules (TLR4, NF-κB) were decreased in the mimics group compared to the mimics-NC group, and increased in inhibitor group compared to inhibitor-NC group. Conclusions:miRNA-20a may inhibit LPS-induced pyroptosis and inflammation of A549 cells via TLR4/NF-κB signal pathway.Objetive:To explore the potential role of miRNA-20a in lipopolysaccharide (LPS) induced pyroptosis and inflamation of human alveolar epithelial A549 cells and its regulation mechanisim.

Objective:In order to improve the staff's ability to deal with public health emergencies, a third-class hospital in Beijing has made efforts to improve the emergency response ability of all staff members to achieve zero infection, and to carry out vocational training and assessment of all staff.Methods:The instructional system design (ISD) model system is used to design the training course. The online learning, electronic examination paper assessment and on-site training of people in the hospital were analyzed by Excel and SPSS 22.0.Results:After training, the average scores of trainees increased from 84 points to 100 points, and the average answering time was shortened from 308 s to 179 s. There were differences in the assessment scores before and after training for personnel with different professional titles, and there were differences in the assessment scores before and after training for personnel between different departments.Conclusion:In case of public health emergency, it is necessary to train and assess the whole staff. The application of ISD model is helpful to make training plan quickly. The application of online learning assessment is the first effective way of emergency training.

Objective: To understand the prevalence and risk factors for functional constipation (FC) among high school students in Chongming District of Shanghai. Methods: A cross sectional study was conducted in Chongming District of Shanghai from March-June 2019. A total of 4 969 adolescents under the age of 18 were recruited high schools, using a stratified random sampling technique. A validated self administered questionnaire on Rome IV criteria for diagnosing FC and predisposing factors was filled by each student in a classroom setting. Results: The prevalence of FC among middle school students in Chongming District of Shanghai was 13.95%. There were no significant differences in the prevalence between males and females, middle and high school groups, and urban and rural areas( P ＞0.05). In senior high schools, students in the graduation year were more likely to suffer from FC(17.36%，130/749) than other students (13.77%，201/1 460)( χ 2=5.01, P =0.03). The prevalence of FC in the key senior high schools(18.23%，115/631) was significantly higher than that in ordinary high schools (13.07%，49/375)( χ 2=7.43, P =0.02). Multivariate Logistic regression analysis showed that frequency of physical exercise, and consumption of spicy foods, proportion of spicy foods in the diet, consumption of vegetables, a lower proportion of vegetables in the diet, drinking water, anorexia, quality of sleep and school type were associated with FC in high school students ( OR=0.11-7.71, P <0.05). Conclusion FC is prevalent among high school students on Chongming District of Shanghai, especially among middle school graduates, and many risk factors were significantly associated with the occurrence of FC.

Objective To screen for malignant tumors and high-risk factors in rural residents over 60 years old， so as to prevent and control the occurrence and development of tumors in the future. Methods The survey was conducted with reference to part of the questionnaire in the "Urban Cancer Early Diagnosis and Treatment Project and Evaluation of High-risk Populations". Clinical examinations included serum tumor marker detection， CT screening for lung cancer， occult blood （+） plus colonoscopy screening for colorectal cancer， and mammography screening. Individuals who were positive in the abovementioned clinical tests were defined as high-risk subjects. Results A total of 271 high-risk subjects （1.91%） were screened out of 14 161. Among the high-risk subjects， 71 cases of malignant tumors （26.19%） were found， with an incidence rate of 501.38 per 10⁵. The top five tumors （63.38% of all diagnosed） were mainly concentrated in lung， upper digestive tract， blood system， urinary system， and rectum-colon. The proportion of malignant tumors detected by positive indicators was 61.54% of blood； 46.15% of carcinoembryonic antigen and carbohydrate antigen 125； 23.08% of alpha-fetoprotein； 16.66% of lung CT； and 3.09% of prostate PSA. The positive indicators in the high-risk subjects were mainly for the tumors in the prostate， lungs， liver， and CEA/CA125. The subjects with positive test indicators had lower average annual income in the last 5 years than the normal subject group （χ²=3.380， P=0.040）. The subjects with positive test indicators had higher proportion in family history of tumors than the normal group （χ²=2.596， P=0.046）. People in thehigh-risk group had a higher proportion than the normal group in suffering from hypertension， liver disease， gastrointestinal disease， respiratory system disease， and surgical treatment. Patients with high-risk tumors were found to have higher proportion than the normal group in showing pre-tumor clinical symptoms in the last 1 year. Study of the tumor-related risk factors found that the high-risk group had a higher proportion of high-fat/high-cholesterol diet， alcohol drinking， passive smoking， and personality depression. Conclusion High tumor risk factors have been identified in this population. It is necessary to strengthen the corresponding intervention and follow-up treatment of precancerous diseases in the future. We recommend the government to conduct tumor screening among high-risk groups to improve cost-effectiveness.

A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians′ understanding of the special clinical characteristics in MM patients.

Objectives:To systematically evaluate effectiveness and safety of early warning and prevention of hospital-acquired venous thromboembolism (HAT) .Methods:Computers were used to search PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, China Biology Medicine disc, CNKI and Wanfang Database. RCTs of early warning and prevention HAT at home and abroad was searched systematically and the retrieval time was from the establishment of databases to June 1, 2020. Two researchers independently screened the literature according to the literature inclusion and exclusion criteria, extracted data and evaluated the risk of bias in the study. RevMan 5.3 software was used to conduct Meta-analysis of the incidences of HAT, pulmonary thromboembolism (PTE) , deep vein thrombosis (DVT) , bleeding and prevention rate of HAT.Results:A total of 8 articles were included. Results of Meta-analysis showed that the incidence of PTE in the early-warning group ( RR=0.69, 95% CI 0.53-0.91, P=0.009) and the prevention rate of HAT ( RR=1.45, 95% CI 1.14-1.84, P < 0.001) were statistically significantly different from those in the non-warning group. However, the incidences of HAT ( RR=0.89, 95% CI 0.68-1.16, P=0.380) , DVT ( RR=0.99, 95% CI 0.76-1.29, P=0.970) and bleeding ( RR=0.95, 95% CI 0.81-1.11, P=0.500) had no statistically significant difference between the two groups. HAT prevention was defined as a subgroup of appropriate prevention. There was no statistically significant difference in the HAT prevention rate of patients between the two groups ( RR=1.01, 95% CI 0.95-1.07, P=0.810) . In the subgroup that did not describe in detail whether prevention was appropriate, the HAT prevention rate in the early-warning group was higher than that in the non-early warning group, and the difference was statistically significant ( RR=2.28, 95% CI 2.09-2.49, P<0.001) . Conclusions:Early warning can reduce the incidence of PTE by increasing the prevention rate of HAT without increasing the incidence of bleeding, but it has no significant effect on the incidences of HAT and DVT. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.