Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.

Objective:To systematically review the teaching effect of problem-based learning (PBL) combined with evidence-based medicine (EBM) teaching mode on the standardized residency training.Methods:CNKI, Wanfang database, VIP database, SinoMed, Embase, PubMed and Web of SCI databases were searched, and the randomized controlled trial (RCT) studies of the application of EBM combined with PBL teaching in standardized residency training were collected. The retrieval time was from the establishment to 1st July, 2018. Two investigators independently extracted data and assessed the quality of the studies. After assessing the risk of bias of included studies, Meta-analysis was performed on RevMan 5.3.Results:In total, 4 studies were included in the review. Narrative assessment was adopted, because outcome indicators of these study were varied and the quality of the literatures could not meet the requirement of Meta-analysis. Our study suggested that the residents who were in PBL combined with EBM teaching mode group got higher scores in the standardized residency training, compared with those in the lecture-based learning (LBL) teaching mode group, especially in case analysis score, total score of examination, improvement of clinical thinking ability, communication and expression ability, organization and cooperation ability, etc.Conclusion:The current evidence suggests that the application of EBM combined with PBL teaching mode has a positive effect on the standardized residency training. Compared with the traditional LBL teaching, EBM can improve students' ability. However, limited by the quantity and quality of included studies, the above conclusions still need to be verified by more studies with larger samples and higher quality.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine

Objective To explore the efficacy and safety of pemetrexed combined with platinum in the treatment of patients with advanced non-squamous non-small cell lung cancer.Methods A total of 74 patients with advanced non-squamous non-small cell lung cancer were collected,35 cases in the control group were treated with cisplatin,and 39 cases in observation group was treated with pemetrexed combined with cisplatin.After two cycles of treatment,therapeutic effect,toxic reaction and complications were compared between two groups.Results The partial remission rate of the observation group was 38.5％,which was significantly higher than 20.0％ of the control group,and the rate of progress was 7.7％,which was significantly lower than 17.1％ of the control group.The adverse reactions and complications such as nausea and vomiting,abdominal pain,diarrhea,alopecia,neurotoxicity,thrombocytopenia,leukocyte reduction and liver function damage showed no significant differences between two groups.Conclusion Pemetrexed combined with cisplatin can significantly improve the clinical efficacy of chemotherapy in patients with non-squamous cell lung cancer without increasing the adverse effects of chemotherapy.

Objective To explore the efficacy and safety of pemetrexed combined with platinum in the treatment of patients with advanced non-squamous non-small cell lung cancer.Methods A total of 74 patients with advanced non-squamous non-small cell lung cancer were collected,35 cases in the control group were treated with cisplatin,and 39 cases in observation group was treated with pemetrexed combined with cisplatin.After two cycles of treatment,therapeutic effect,toxic reaction and complications were compared between two groups.Results The partial remission rate of the observation group was 38.5％,which was significantly higher than 20.0％ of the control group,and the rate of progress was 7.7％,which was significantly lower than 17.1％ of the control group.The adverse reactions and complications such as nausea and vomiting,abdominal pain,diarrhea,alopecia,neurotoxicity,thrombocytopenia,leukocyte reduction and liver function damage showed no significant differences between two groups.Conclusion Pemetrexed combined with cisplatin can significantly improve the clinical efficacy of chemotherapy in patients with non-squamous cell lung cancer without increasing the adverse effects of chemotherapy.

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y-type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time.Methods The clinical data of a total of 16 patients,who received inverted Y-type metal airway stent implantation under local anesthesia,were retrospectively analyzed.Routine gradual guide wire exchange method with a harder one was used in 6 patients (routine group),while in 10 patients (modification group) a modified technique of exchanging guide wire,i.e.inserting two hard wires at one time,was employed.Technical success rate and operation time were used as the main observation indexes.Results Under local anesthesia,the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients.The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the performance of implantation of inverted Ytype metal airway stent under local anesthesia to treat malignant carina stenosis,the use of modified technique of guide wire insertion,i.e.inserting two hard wires at one time,can effectively shorten the operation time.

It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.

China ; Humans ; Liver Neoplasms ; surgery

Objective To investigate DSA- estimated hepatic arterial hemodynamics of hepatocellular carcinoma (HCC) determined shortly after transcatheter arterial chemoembolization (TACE) plus sorafenib treatment. Methods The clinical data of thirty HCC patients treated with TACE were retrospectively analyzed. The patients were divided into study group (n = 13) and control group (n = 17). Patients in the study group received additional oral administration of 400mg sorafenib twice a day one week before or two weeks after TACE procedure, while patients in the control group received TACE only. The initial DSA images as well as the images obtained at three months after TACE were analyzed. With the help of Photoshop software, the grey gradient of the tumor staining was measured on the series dynamic DSA images, based on which the time- density curve of the tumor was drawn. The peak density value (PV), the time to reach the peak (TP) and the slope of the upslope (SU) were determined, and the results were compared between the two groups. Results Photoshop software was used to measure the grey density values of the tumor staining on DSA images. In the study group, the post- treatment PV was smaller than the pre- treatment one, which were (38.0 ± 14.6) and (46.7 ± 18.4) respectively, the difference between the two groups was statistically significant (P = 0.040). The post- treatment PV of the study group was also smaller than that of the post -treatment PV of the control group (54.4 ± 19.8), and the difference between the two was also statistically significant (P = 0.011). No significant differences in TP values and SU values existed between the two groups as well as between the pre - treatment and post - treatment ones in each group. Conclusion After TACE.