AIM: To explore the correlation between remnant cholesterol(RC)and anterior ischemic optic neuropathy(AION).METHODS: A total of 80 cases of AION patients hospitalized in the department of ophthalmology of Linyi People's Hospital from January 2020 to December 2023 were selected as the observation group, and 80 cases of those who had completed health checkups in Linyi People's Hospital during the same period(without ischemic optic neuropathy and other fundus vasculopathies)were selected as the control group. The general data and biochemical indexes of the two groups were compared to evaluate the correlation between RC and AION.RESULTS: Compared with the control group, the levels of RC, fasting blood glucose(FBG), triglyceride(TG), total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-C)in patients with AION were significantly higher than those in the control group(all P<0.01). Spearman correlation analysis showed that RC was positively correlated with TG, TC, and LDL-C(all P<0.01). Logistic regression analysis showed that RC and FBG were risk factors for the development of AION. The analysis of receiver operating characteristic(ROC)curves showed that the level of RC had a better predictive value for the development of AION compared with FBG.CONCLUSION: RC is associated with the development of AION and is a risk factor for the development of AION. Clinical standardization of the management of people with high RC values can reduce the risk of the development of AION, which is of clinical significance.

Distant cutaneous metastasis of primary lung squamous cell carcinoma is an exceedingly rare event,with scalp metastasis as the initial clinical presentation even rarer.Scalp skin metastases are prone to be misdiagnosed as other scalp disorders,yet their appearance signifies the deterioration and poor prognosis of lung cancer.This case report documents a female patient presenting initially with scalp folliculitis in dermatology,who was subsequently diagnosed with malignant lung tumor through radiological imaging and referred to Department of Thoracic Surgery.Pathological examination of the excised lesion from the scalp revealed distant metastasis of lung cancer.A review of similar cases reported in literature was conducted.This article aims to enhance understanding and awareness of skin metastasis in lung cancer,to emphasize the importance of this condition,and to improve early recognition and precise diagnosis.It is crucial to prevent clinical misdiagnosis and ensure ap-propriate treatment,finally leading to improve the prognosis of the patients.

Host cell residue DNA is one of the most common impurity which can affect the safety of biological products,therefore,domestic and international regulatory agencies have required the limit for host cell residue DNA in different biological products,either at the final product qualification or the appropriate intermediate control stage.The removal effect is verified by monitoring the residue DNA of products in different production stages,which is beneficial for assuring the scientificity and stability of the production process.In order to strengthen the understanding of control strategy about host cell residual DNA,the paper reviews progress in host cell residual DNA in biological products by authors'work experience and other's research,which provides reference for future work.

Objective:To analyze the use of policy tools for rural-oriented tuition-waived medical student training policy and to provide relevant suggestions for the continuous promotion of the policy.Methods:With "rural-oriented tuition-waived medical students" as the key word, the policy texts were collected and screened from government portals. Using ROTHWELL disaggregated method to build the rural order directional medical students training policy analysis framework, applying Excel 2019 software for classification and coding of policy texts.Results:A total of 13 rural-oriented medical student training policy texts were screened and obtained. The X dimension of the policy analysis framework for rural order-oriented medical student training included three policy tools, namely, supply, environment and demand, and the Y dimension included three policy objectives, namely, available, usable, and retained. In X dimension, environmental policy tools were most frequently used. In Y dimension, the "retained" target had the highest frequency of use.Conclusion:There were differences in the frequency of using policy tools for targeted medical student cultivation in different policies. The frequency of using environmental tools is higher, which highlighted the attention of the state to medical and health services. The internal structure of policy tools is unbalanced, so the configuration of supply-oriented policy tools should be optimized, and the construction of demand-oriented policy tools should be emphasized. It is suggested to continuously optimize the combination of policy tools, improve the compatibility between policy tools and rural order-oriented medical student training, and pay attention to the sustainability of policy tools.

AIM: To explore the pharmaceutical effects of tetrahydroxy stilbene glycoside (TSG) on acute liver injury induced by acetaminophen (APAP) using method of non-targeted metabonomics. METHODS: SPF C57BL/6 mice were randomly divided into the group of APAP-induced model and the group of TSG intervention groups (n=15). After intragastric administration of TSG for 7 days, the mice were injected once by APAP via intraperitoneal injection and the livers were taken 6 hours later. RESULTS: H&E staining, MDA and SOD tests showed that the injection of APAP could cause hepatic injury, but TSG could reduce the severity of liver injury. The results of metabolite detection showed that there were significant changes in ABC transporter, choline metabolism, central carbon metabolism, galactose and alanine amino acid metabolism in TSG groups compared with APAP model group. CONCLUSION: TSG protects against acute liver injury induced by APAP, mainly by improving lipid peroxidation and disorder of energy metabolism.

Objective: To investigate the clinical effect of Astragalus injection combined with meropenem in the treatment of severe infection patients and its influence on T lymphocyte subsets and inflammatory factors in peripheral blood. Methods: From January 2016 to December 2018, 80 patients with severe infections in Yiwu Fuyuan Private Hospital were selected and divided into observation group (n=40) and control group (n=40) according to single blind random table method.The observation group was treated with Astragalus injection combined with meropenem, while the control group was treated with meropenem.Both two groups were treated for 10 days.The therapeutic effects, changes of body temperature, heart rate and respiratory rate, changes of T lymphocyte subsets and inflammatory factors in peripheral blood, and negative time of bacterial culture before and after treatment were compared between the two groups. Results: The total effective rate of the observation group (92.50%) was higher than that of the control group (70.00%) (χ²=6.646, P<0.05). After treatment, the levels of CD₃⁺ [(62.38±4.51)%], CD₄⁺ [(40.63±2.15)%] and CD₄⁺ /CD₈⁺ (1.63±0.18) in the observation group were higher than those in the control group [(57.27±3.19)%, (35.47±1.93)% and (1.30±0.21)] (t=5.850, 11.296, 7.546, all P<0.05). After treatment, the levels of CRP [(28.79±8.74)mg/L], PCT [(0.56±0.12)g/L] and TNF-α [(157.93±20.47)pg/mL] in the observation group were lower than those in the control group [(43.71±12.67)mg/L, (1.10±0.23)g/L and (247.16±34.64)pg/mL] (t=13.640, 13.165, 14.026, all P<0.05). The negative turning time of bacterial culture in the observation group [(4.36±1.29)d] was shorter than that in the control group [(7.43±1.57)d] (t=9.493, P<0.05). Conclusion Astragalus membranaceus injection combined with meropenem has significant clinical effect in the treatment of patients with severe infections.It can improve cellular immune function and reduce inflammatory reaction, which is worthy of clinical reference.

BACKGROUND: Few studies have attempted to compare the differences in the prevalence and impact factors of hysterical tendencies (HTs) in adolescents. Thus, the aim of this study was to examine gender differences in the prevalence and impact factors of adolescents' HTs across three eastern Chinese provinces (Anhui, Jiangsu, and Zhejiang). METHODS: A multicenter, school-based, cross-sectional study was conducted in three provinces (Anhui, Jiangsu, and Zhejiang) in China in 2014. The sample included 10,131 middle-school students aged 13-18 years who were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage appraisal procedure was used to determine the adolescents' HTs. We also designed a multicenter, school-based, case control (1329 cases with 2661 control individuals) study to collect data on the common factors affecting this population using a common protocol and questionnaire. RESULTS: An overall positive rate of HTs among adolescents across the three eastern Chinese provinces studied was found at 13.1% (95% confidence interval (CI) 12.5-13.8%), at 14.5% (95% CI 13.3-15.7%) for females, and at 12.2% (95% CI 11.1-13.4%) for males. Gender-stratified, multiple conditional regression analyses revealed that superstitious beliefs pertaining to life, somatotype, teacher-student satisfaction, and family achievement orientation were significantly linked to HTs only in males, while left-behind adolescents, emotional and social adaptation, teacher-student support, family cohesion, and the Hospital Anxiety and Depression Scale - depression scores were significantly associated with female HTs only. The models indicated that of all the independent variables studied, family medical history was the strongest impact factor for both male HTs (adjusted matched odds ratio (amOR) = 2.92, 95% CI = 1.84-4.86) and female HTs (amOR = 2.74, 95% CI = 1.59-4.98). CONCLUSIONS HTs are prevalent among adolescents in the three eastern Chinese provinces studied. Gender differences in the prevalence and impact factors of HTs are significant in adolescents, and HTs seem to affect more females than males. Therefore, sex-specific intervention programs against HTs in adolescents should be considered to reduce HT prevalence in adolescents by modifying influential social, school, and family factors.
Adolescent ; Adolescent Behavior ; psychology ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Histrionic Personality Disorder ; epidemiology ; psychology ; Humans ; Male ; Prevalence ; Risk Factors ; Sex Factors ; Students ; psychology

Objective: To evaluate efficacy of the BiRd regimen, a combination of clarithromycin, lenalidomide, and dexamethasone, in the treatment of patients with relapsed/refractory multiple myeloma (RRMM) . Methods: Patients with RRMM treated with BiRd between September 11, 2013 and August 1, 2016 at six centers were included to evaluate overall survival rate (ORR) , clinical benefit rate (CBR) , progression-free survival (PFS) , overall survival (OS) , as well as adverse events. Results: Of 30 patients with RRMM, 27 patients were evaluable, and ORR and CBR were 51.9% (14/27) and 66.7% (18/27) respectively, including 1 sCR (3.7%) , 3 CR (11.1%) , 3 VGPR (11.1%) , and 7 PR (25.6%) . In 13 patients with prior Rd, ORR and CBR were 38.5% (5/13) and 61.5% (8/13) respectively, of which 5 patients with ≥MR carried high-risk cytogenetic[ (e.g.17p- or t (4;14) ] together with at least one of other adverse-prognostic cytogenetic (e.g.13q- and/or 1q21+) . In 24 patients with prior bortezomib-based therapy, ORR and CBR were 45.8 and 62.5%, respectively. With a median follow-up time of 14.9 (range 1.0-33.8) months, the median PFS and OS were 12.0 (95%CI 11.6-12.4) and 27.6 (95%CI 15.1-40.1) months, respectively. The BiRd regimen was well tolerated. Conclusion The BiRd regimen is an effective and safety protocol for RRMM, including those carrying high-risk cytogenetic markers.

Objective To observe the effect of kinesthetic imagery and visual imagery on upper limb rehabilitation among stroke survivors.Methods Forty-five hemiplegic stroke survivors were randomly assigned into a kinesthetic imagery training group (n=14),a visual imagery training group (n=15) or a control group (n=16).In addition to conventional rehabilitation,patients in the kinesthetic and visual imagery training groups were given 30 minutes of the appropriate imagery training once a day,five days per week for four weeks,while the control group relaxed or received health education for the same time.Before and after the 4-week intervention,the upper limb section of the Fugl-Meyer assessment (FMA-UE) and the modified Barthel index (MBI) were used to evaluate the motor function of the subjects' upper limb and their ability in the activities of daily living respectively.Results Before the intervention,there were no significant differences in the average FMA-UE and MBI scores among the 3 groups.After the intervention there was no significant difference between the average FMA-UE and MBI scores of the two training groups,but both were significantly better than the control group's averages.Conclusion Either kinesthetic or visual imagery training can improve the upper limb function of stroke survivors and their abihty in the activities of daily living.Their effectiveness is not significantly different.

Objective To study the correlation of quantitative electroencephalography (qEEG) parameters with outcomes of adults who sustained coma after cardio-pulmonary resuscitation.Methods The clinical data of coma patients after cardio-pulmonary resuscitation,admitted to our hospital from March 2008 to August 2014 were retrospectively analyzed.Glasgow coma scale (GCS) was performed.EEG was registered and recorded at least once within 7 d of coma after cardio-pulmonary resuscitation:electrodes were placed according to the international 10-20 system,using a 16-channel lay out.The qEEG parameters defined as burst suppression ratio (BSR),brain symmetry index (BSI),[delta+theta]/[alpha+beta] ratio (DTABR) were analyzed at the same time.Follow-up was performed 3 months after onset and the outcomes of these patients were assessed by Glasgow outcome scale (GOS).The correlations of GOS scores with qEEG parameters were analyzed.Results Sixty patients with GCS scores-＜ 8 after cardio-pulmonary resuscitation were included.BSR1 and BSR2 were negatively correlated with GOS scores 3 months after onset (r=-0.723,P=0.000;r=-0.651,P=0.000);DTABR was positively correlated with GOS scores 3 months after onset (r=0.270,P=0.037).BSI and DTABR were not correlated with GCS scores.BSR1 and BSR2 were negatively correlated with GCS scores (r=-0.562,P=0.000;r=-0.429,P=0.001).Conclusion The qEEG parameters are correlated with outcomes after cardio-pulmonary resuscitation.