Objective To investigate the effects of probiotic treatment combined with knowledge attitude and practice(KAP)model management on the recovery and quality of life of patients with severe acute pancreatitis.Methods Patients with severe acute pancreatitis from June 2020 to June 2023 in Quzhou People's Hospital were selected.The patients were divided into the control group,the probiotics group and the KAP combination group.All groups received symptomatic treatment.The control group was given routine nursing,the probiotic group was given daily oral administration of probiotic granules,and the KAP combination group was managed by KAP model on the basis of probiotic treatment,including targeted intervention in the dimensions of disease knowledge,behavior and belief.The APACHE Ⅱ scores,quality of life scale QOL-C30 scores,serum inflammatory factors C-reactive protein(CRP)and procalcitonin(PCT)levels were compared before and after treatment in three groups.Results A total of 108 patients were included,with 36 cases in each group.The CRP and PCT decreased significantly after treatment in three groups(P＜0.05).The reduction ranges of the probiotics group and the KAP group were significantly higher than that of the control group(P＜0.05).The self-management ability was significantly increased in all three groups after treatment compared to before treatment(P＜0.05),and the increase was significantly greater in the KAP combination treatment group than in the probiotic and control groups(P＜0.05).The APACHEⅡ scores decreased significantly and QOL-C30 scores increased significantly after treatment in the probiotics group and the KAP group(P＜0.05).Conclusion Probiotic treatment could significantly improve the inflammatory status,clinical symptoms and quality of life of patients with severe acute pancreatitis.The KAP model management could further enhance the effect of probiotic treatment,effectively improve patients'organism recovery ability and quality of life.

Objective To investigate the Oncomelania hupensis snails spread and its spatio-temporal clustering characteristics in Suzhou City, Jiangsu Province from 2016 to 2023, so as to provide insights into precision control of O. hupensis snails in the City. Methods O. hupensis snail surveillance data in Suzhou City from 2016 to 2023 were collected, and the areas of O. hupensis snail spread and areas of emerging and re-emerging snail habitats were retrieved. The spatial distribution characteristics and clustering types and locations of environments with O. hupensis snail spread were investigated using global and local spatial auto correlation analyses with the software ArcGIS 10.7, and the clustering and cluster areas of O. hupensis snail spread were identified in Suzhou City using spatio-temporal scans with the software SaTScan 10.0.2. Results O. hupensis snail spread covered an area of 677 171 m² in Suzhou City from 2016 to 2023, including 376 230 m² emerging snail habitats and 300 941 m² re-emerging snail habitats. Global spatial autocorrelation analysis showed overall clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023 (Moran’s I = 0.066, P = 0.007), and there were spatial clustering of areas with O. hupensis snail spread in 2019 (Moran’s I = 0.086, P = 0.001) and 2021 (Moran’s I = 0.045, P = 0.003). Local spatial autocorrelation analysis showed clusters of O. hupensis snail spread in Suzhou City from 2016 to 2023, with high-high clusters in Guangfu Township and Dongzhu Street, and the high-high clusters of O. hupensis snail spread were mainly distributed in southwestern Suzhou City. Spatio-temporal scans identified two clusters of areas with O. hupensis snail spread and areas of re-emerging snail habitats in Suzhou City from 2016 to 2023, with large clustering areas found in Guangfu Township, Dongzhu Street, Tong’an Township and Wangting Township [relative risk (RR) = 22.34, log likelihood ratio (LLR) = 163 295.32, P < 0.001] and small clustering areas in Xukou Township, Mudu Township and Xiangshan Street (RR = 2.73, LLR = 921.92, P < 0.001). Conclusions There was spatial clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023. Improved quality of O. hupensis snail control and intensified management of environments at a high risk of O. hupensis snail spread are recommended in Suzhou City.

Bone metastasis-caused pain （BMP） is a common complication of cancer， and the incidence has been on the rise with the increase in the overall prevalence of cancer， threatening the survival and quality of life of patients. BMP is a kind of special pain with the characteristics of inflammatory pain and neuropathic pain， but is different from the two. Therefore， its pathogenesis is very complicated， and it is of great significance to understand the pathogenesis. The currently available studies mainly focused on osteoclast activation， changes in the bone microenvironment， glial cell activation， spinal cord neuron activation， and miRNA dysregulation. Modern therapies include the three-step analgesics， bisphosphonates， palliative radiotherapy， and interventional therapy for bone metastases， which show definite efficacy in short term. However， the long-term effect is unsatisfactory due to the adverse reactions， addiction， and drug resistance. Studies have shown that traditional Chinese medicine （TCM） has definite curative effect on BMP， which is safe， enhances efficacy， reduces toxicity， and boosts immunity. Moreover， it exerts the effect through multiple components， multiple targets， and multiple pathways. As a result， it has unique advantages in the prevention and treatment of BMP and has become a research focus. This paper summarizes the research on the pathogenesis of BMP， the intervention of TCM （compound Chinese medicine prescriptions， Chinese medicinals， and monomers from Chinese medicinals）， and the mechanisms of TCM， such as inhibiting osteoclast activation， glial cell activation， and spinal cord neuron activation， regulating pain mediators and abnormal expression of microRNA， and anti-tumor， which is expected to further clarify the pathogenesis of BMP and provide ideas and methods for the effective prevention and treatment of BMP with TCM.

Objective:To evaluate the safety and efficacy of bortezomib plus highdose melphalan (L-phenylalanine nitrogen mustard) (Bor-HDM) pretreatment regimen for multiple myeloma (MM) with autologous hematopoietic stem cell transplantation (ASCT).Methods:From August 2008 to December 2021, the relevant clinical data were retrospectively reviewed for 58 MM patients undergoing MM transplantation.The conditioning regimens were Bor-HDM (n=36) and HDM (n=22). Non-hematopoietic adverse reactions, hematopoietic reconstruction time, remission rate post-ASCT and minimal negative rate of residual disease (MRD) on flow cytometry within 3 months post-ASCT and survivals were analyzed.Results:In Bor-HDM and HDM groups, median time of neutrophil engraftment was 12(8-30) and 11(8-29) day and median time of platelet reconstitution 16(8-33) and 16(7-32) day respectively.There was no significant inter-group difference ( P=0.890, P=0.638). In Bor-HDM group, the most common non-hematological adverse reactions were nausea (n=21, 58.0%) and diarrhea (n=11, 30.6%). There was no transplant-related death.Complete remission (CR) rate was (25/36, 69.4%) versus (9/22, 40.9%). The inter-group difference was statistically significant ( P=0.032). Median follow-up period was 29.0(2.0-91.0) vs. 20.5(5.0-114.0) month, 3-year progression-free survival(PFS)62.1% vs. 39.7% and 3-year overall survival(OS) 83.8% vs. 62.5%.There were relapse (n=10 vs.10) and death (n=6 vs. 7). Median PFS in Bor-HDM and HDM groups was non-attained and 27 months( P=0.047) and median OS time non-attained and 40 months respectively ( P=0.282). Multivariate analysis revealed that CR was an independent risk factor for PFS ( HR=28.896, 95% CI: 6.130-136.198, P<0.001). Non-CR was an independent risk factor for OS ( HR=3.843, 95% CI: 1.334-11.071, P=0.013; HR=28.595, 95% CI: 6.273-130.355, P<0.001). Conclusions:Bor-HDM pretreatment regimen of ASCT is both safe and efficacious for MM patients.

Objective To understand the current situation of patients with advanced schistosomiasis in Suzhou, and to provide a basis for scientific management, medical assistance, and improvement of patients' quality of life. Methods Questionnaire survey, physical examination and B-ultrasound examination were performed on the registered patients with advanced schistosomiasis. The diagnosis and classification were carried out according to the “Schistosomiasis Control Manual”. The epidemiological and clinical characteristics, disease classification, and medical and financial assistance of all existing patients were analyzed. Results There were 2 420 cases of advanced schistosomiasis in Suzhou. Their distribution was highly correlated with the cumulative area of oncomelania snails and the cumulative number of schistosomiasis patients in each district (county) (r=0.949, P<0.01; r=0.946, P<0.01). There were 845 males and 1 575 females. The highest proportion of male patients was found in Suzhou Industrial Park and the lowest in Kunshan (χ²=26.591, P<0.001). The average age of patients was (76.80±7.55) years old, and the age of female patients were higher that of male patients (F=72.01, P<0.001). The splenomegaly type was the most common (2 165), ascites type was the second (198), colonic proliferative type was the third (55), and pygmy type was the least (2). A total of 895 patients were cured and 1 337 patients were improved, while 188 patients were not cured. The condition of advanced schistosomiasis patients with different clinical types was different (χ² =226.034, P<0.001), and the condition of patients with ascites was the worst. 1 438 patients' labor level was reduced, and 540 patients lost their labor ability, while only 442 patients were normal. Age increase (β=0.012，P<0.001), clinical classification being ascites type (β=0.346，P<0.001) and need for treatment (β=0.298，P<0.001) were risk factors for the loss of labor ability in patients with late schistosomiasis. The stable condition of the disease (β= -0.089，P=0.001) was a protective factor. Conclusion There are a large number of advanced schistosomiasis cases in Suzhou, and the epidemiological characteristics of advanced schistosomiasis patients in different districts (cities) are different. The relief work of advanced schistosomiasis in Suzhou should focus on the historical heavy epidemic areas, strengthen the nursing care of the elderly patients, and pay attention to the quality of life of patients with ascites. It is also important to strengthen the follow-up nursing of patients with splenomegaly to avoid turning into ascites. All districts and counties should be guided by the characteristics of local patients and formulate targeted scientific management methods and rescue policies to improve the quality of life of patients.

Paclitaxel is the first-line chemotherapy drug for a variety of cancers. However， the paclitaxel resistance greatly reduced the efficacy in the later treatment stage， which seriously increased the mortality and recurrence rate of cancer and limited the clinical application of paclitaxel. At present， Chinese medicine compound prescription， proprietary Chinese medicine， and Chinese medicine injection are widely used as the adjuvant chemotherapy drugs for the treatment of cancer in clinic. Chinese medicine has shown unique advantages in improving the efficacy of chemotherapy drugs and the prognosis of chemotherapy， and reducing the toxic and side effects. However， the specific mechanism and effective monomer composition of Chinese medicine for reversing the resistance of chemotherapy drugs are unclear， and the application of Chinese medicine in different types of cancer is also limited， which are worthy of further exploration. This review summarized the composition of Chinese medicine monomer with synergistic antitumor effect combined with paclitaxel in recent years. The specific mechanism and pharmacological activities of Chinese medicine monomer reversing paclitaxel resistance were classified. This review found that through acting on the membrane transport protein， Chinese medicine monomer promoted the accumulation of paclitaxel in tumor cells， inhibited the expressions of protein and metabolic enzyme related to multidrug resistance and the metabolism of paclitaxel， and regulated the levels of apoptosis genes and factors and apoptosis-related pathways to promote the inhibitory effect of paclitaxel on cell proliferation. Chinese medicine monomer also significantly improved paclitaxel chemotherapy sensitivity by regulating the expression levels of micro ribonucleic acid （microRNA） and long non-coding ribonucleic acid RNA （lncRNA）， inhibiting the characteristics of tumor stem cells and tumor metabolic reprogramming， improving tumor microenvironment， and triggering tumor cell death autophagy and oxidative stress response. This review provides a theoretical basis for clarifying the specific anti-tumor mechanism of Chinese medicine monomer combined with paclitaxel， which is of great significance for the development of new Chinese medicine and the clinical research of the drugs combined with paclitaxel， and has certain value for the application of Chinese medicine combined with other chemotherapy drugs.

Objective:To investigate the method and application experience of nasolabial subcutaneous pedicled flap in the repair of skin defect after resection of nasolabial mass.Methods:From December 2016 to December 2020, a total of 58 patients (43 cases of nevus, 12 cases of seborrheic keratosis and 3 cases of keratinacanthoma) were admitted to the Facial Neck Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences, including 24 males and 34 females. They ranged from 17 to 55 years old, with an average age of 33 years. The minimum facial tumor area was 0.8 cm×0.8 cmand the maximum was 2.2 cm×2.0 cm. A local skin flap with a subcutaneous pedicle was designed preoperatively in the nasolabial groove area, and the subcutaneous pedicle was transferred to the defect area through subcutaneous tunnel or by disconnecting the surrounding tissue. The tumor was removed and the skin defect was closed at one stage. Postoperative complications were summarized and patient＇s satisfaction was investigated.Results:Follow-up period ranged from 6 to 48 months. All the 58 patients had primary healing of the transfer incisions, and all the flaps survived. The blood supply of the flaps was good, and the scar of the operative area was smooth. After resection of peri-lip mass, there was 1 case with obvious scar in the donor area of nasolabial groove, and the overall satisfaction rate was 98.3%.Conclusions:The application of nasolabial subcutaneous pedicled skin flap to repair the skin defect after resection of nasolabial tumor has the advantages of preventing the pulling deformation of the organ, it can be completed in one stage and repair the facial skin defect from a distant position. In addition, the thickness and color of the skin flap are similar to the defect site, and the scar of the donor site is not obvious, and so the appearance and function of the surgery can be satisfied.

Objective:To explore the application value of wide detector multi-slice spiral CT target scanning technique in the preoperative evaluation of pancreatic cancer.Methods:The clinical data of 22 patients with pancreatic cancer who underwent pancreatic arterial contrast enhanced CT scanning and were diagnosed by pathology in the First Affiliated Hospital of Naval Medical University from September 2019 to October 2019 were analyzed retrospectively. The CT phantom experiment was carried out on the international standard phantom CATPHON500. By changing the scanning radiation dose, scanning mode and scanning field of view, the spatial resolution and density resolution of the image were compared and analyzed. The target scan technical parameters obtained from the experiment were applied to the late arterial phase of MDCT enhanced scan in 22 patients with pancreatic cancer. Executive current, volume scanning mode and small scanning field were used for scanning. The attenuation value (CT value) and noise value (SD value) of pancreatic cancer tissue and normal pancreatic tissue were measured at different phases, the attenuation difference and contrast signal-to-noise ratio (CNR) of the two tissues were calculated, the contrast difference between the two tissues was evaluated, and the CT values of celiac trunk, renal artery and vein, superior mesenteric artery and vein, splenic vein and portal vein were measured, and the display of tumor tissue and peripancreatic important vessels was evaluated.Results:In the phantom experiment, under the condition of the same radiation dose, the image quality of the volume scan mode was better than that of the spiral scan mode (1%@4 mm versus 1%@9 mm at 5 mGy and 1%@2 mm versus 1%@6 mm at 25 mGy). In comparison between pancreatic tumor and pancreatic tissue, the enhancement process of pancreatic tumor tissue was increased at first and then decreased, while that of pancreatic tumor tissue was slightly enhanced. The attenuation difference between pancreatic tissue and tumor tissue and CNR also increased at first and then decreased, reaching the maximum at the late arterial stage [(91.96±29.29)HU, 8.60±5.71]. The differences between each phase were statistically significant ( F values were 47.20 and 19.80 respectively, all P values <0.05). The evaluation of vascular variation and invasion showed that a better arterial phase image could be obtained on the late arterial target scan images, while taking into account the display of splenic vein, mesenteric vein and portal vein. Conclusions:The wide detector MDCT target scanning technique can improve the spatial resolution and density resolution of the image, greatly improve the contrast between tumor tissue and peripancreatic tissue and blood vessels, and provide more accurate tumor staging and resectability evaluation information for preoperative evaluation of pancreatic cancer.

Objective: To investigate visual acuity of pupils of grade 4-6 in Liaoning Province in 2019 and to analyze its influencing factors, and to provide the scientific basis for myopia prevention and intervention. Methods: A total of 16 716 students of grade 4-6 in 14 cities of Liaoning Province were selected by multi-stage stratified random cluster sampling, and the long-range visual acuity and refraction was evaluated and a questionnaire survey was conducted. Logistic regression analysis was used to analyze the in-fluencing factors of myopia in primary school students. Results: The myopic rate of grade 4-6 pupils in Liaoning Province was 49.17%. Multiple Logistic regression analysis found that the main factors affecting vision included urban and rural division, sex, recess, restriction of electronic products usage from parents, and heredity(OR=0.93, 1.29, 0.90, 0.82, 3.12, 1.61, 1.64, P<0.05). Among them, rural areas, outdoor activity during recess and restriction of electronic product usage from parents was associated with lower risk of myopia, in contrast, being girl and parental myopia was associated with higher risk of myopia. Conclusion The incidence of myopia among primary school students in Liaoning Province is relatively high, exterting high pressure on prevention and control. In order to prevent myopia in primary school students, Composite interventions should be developed including change students’ lear-ning style, eliminate unhealthy living habits and targeted propaganda and education.

Objective:To investigate the regulatory effects of sphingosine kinase-2 (SphK2) on the function of activated astrocytes and the progression of experimental autoimmune encephalomyelitis (EAE) in mice.Methods:Primary mouse astrocytes were isolated from wild-type (WT) C57BL/6 mice and sphk2 gene knock-out ( sphk2 -/-) mice and stimulated in vitro with interleukin 17 (IL-17). Real-time PCR was used to measure the expression of inflammatory cytokines and chemokines at mRNA levels. Western blot and immunofluorescence were used to detect the expression of glial fibrillary acidic protein (GFAP) and the phosphorylation of signal transducer and activator of transcription 3 (p-STAT3). An EAE mouse model was constructed using myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55) polypeptide. Western blot was used to detect the expression of GFAP and p-STAT3 at protein level and real-time PCR was used to detect the expression of inflammatory cytokines and chemokines at mRNA level in spinal cords. Hematoxylin-Eosin (HE) and Luxol fast blue (LFB) staining were used to observe the changes in inflammatory cell infiltration and demyelination in spinal cords. Results:Compared with the WT group, the phosphorylation of STAT3 was obviously reduced in in vitro activated mouse astrocytes of sphk2 -/- mice, and the expression of inflammatory cytokines and chemokines including monocyte chemotactic protein 1 (MCP-1), TNF-α and IL-6 at mRNA level was also significantly decreased. Compared with the WT EAE group, changes in the above-mentioned cytokines and relative proteins in sphk2 -/- EAE mice in vivo were similar to those in vitro. Moreover, inflammatory cell infiltration and demyelination were significantly reduced in spinal cords of sphk2 -/- EAE mice. However, no significant difference in in vitro or in vivo GFAP expression was observed between WT and sphk2 -/- mice. Conclusions:SphK2 might regulate the function of reactive astrocytes through STAT3 molecular pathway, thereby regulating the production of inflammatory cytokines and chemokines and participating in the pathological process of EAE.