Objective To analyze the changes of vitamin D in children with Henoch-Schonlein purpura(HSP).Methods 130 children with HSP from Kunming Children's Hospital between July 2022-July 2023 were selected as the study subjects and 100 healthy children were selected during the same period as the control group.The blood samples were collected from the children with HSP and the healthy children.The content of vitamin D was measured by Kunming Kingmed Institute for Clinical Laboratory.Results The content of 25(OH)D in children with HSP was lower than that in healthy children,and the difference was statistically significant(P<0.01).The proportion of vitamin D insufficiency in children with HSP was higher than that in healthy children,and the difference was statistically significant(P<0.01).Conclusion The children with HSP are prone to vitamin D insufficiency.Vitamin D supplementation may provide a new method for the treatment of HSP.

The standardized workflow of computer-aided static guided implant surgery includes preoperative exami-nation,data acquisition,guide design,guide fabrication and surgery.Errors may occur at each step,leading to irrevers-ible cumulative effects and thus impacting the accuracy of implant placement.However,clinicians tend to focus on fac-tors causing errors in surgical operations,ignoring the possibility of irreversible errors in nonstandard guided surgery.Based on the clinical practice of domestic experts and research progress at home and abroad,this paper summarizes the sources of errors in guided implant surgery from the perspectives of preoperative inspection,data collection,guide de-signing and manufacturing and describes strategies to resolve errors so as to gain expert consensus.Consensus recom-mendation:1.Preoperative considerations:the appropriate implant guide type should be selected according to the pa-tient's oral condition before surgery,and a retaining screw-assisted support guide should be selected if necessary.2.Da-ta acquisition should be standardized as much as possible,including beam CT and extraoral scanning.CBCT performed with the patient's head fixed and with a small field of view is recommended.For patients with metal prostheses inside the mouth,a registration marker guide should be used,and the ambient temperature and light of the external oral scan-ner should be reasonably controlled.3.Optimization of computer-aided design:it is recommended to select a handle-guided planting system and a closed metal sleeve and to register images by overlapping markers.Properly designing the retaining screws,extending the support structure of the guide plate and increasing the length of the guide section are methods to feasibly reduce the incidence of surgical errors.4.Improving computer-aided production:it is also crucial to set the best printing parameters according to different printing technologies and to choose the most appropriate postpro-cessing procedures.

The concept,connotation and extension,goals and tasks of the discipline of Chinese medicinal materials resource chem-istry have been proposed and developed for 20 years.Looking back at the 20-year construction and development process,continuous exploration and innovative practice have been carried out around the scientific production and effective utilization of traditional Chinese medicinal materials.The theoretical connotation has been further enriched,the research mode has been further improved,and the tech-nical system has been further expanded.A series of research results have been formed and promoted for application,serving the high-quality development of the traditional Chinese medicinal materials industry,and contributing to the improvement of quality,efficiency,and green development of the entire industry chain of Chinese medicinal resources.However,with the rapid growth of Chinese medici-nal materials industry and the continuous expansion and extension of the industry chain,the waste and by-products generated in the production process of Chinese medicinal agriculture and industry are increasing day by day,causing resource waste and environmental pollution,which has become a new major problem facing the development of the industry.This article focuses on the establishment and case analysis of a model for the full industry chain recycling and low-carbon green development of Chinese medicinal materials,as well as the creation of an ecological industry demonstration park for the recycling of Chinese medicinal materials.It showcases the phased a-chievements made in recent years,aiming to provide demonstration and reference for the low-carbon and green transformation of the Chinese medicinal materials industry from a linear economy model to a circular economy model.It provides reference for improving the efficiency of Chinese medicinal materials utilization and creating new quality productivity,and helps promote low-carbon and green de-velopment in the field of Chinese medicinal materials industry.

Objective:To explore the damage of panretinal photocoagulation (PRP) to the subbasal nerve plexus (SNP) and its related mechanisms by comparing SNP changes in wide-field mosaic between before and after PRP treatment in diabetic patients.Methods:A randomized controlled study was conducted.Fifty-seven patients (114 eyes) with type 2 diabetes mellitus and binocular diabetic retinopathy (DR) stage IV to receive PRP treatment in Shanxi Eye Hospital from April to November 2019 were enrolled.The subjects were randomly divided into horizontal-vertical laser group and vertical-horizontal laser group according to a random number table.Twenty-nine eyes from 29 patients were assigned to the horizontal-vertical laser group with the photocoagulation sequence of temporal-nasal-inferior-superior.Twenty-eight eyes from 28 patients were assigned to the vertical-horizontal laser group with the photocoagulation sequence of inferior-superior-temporal-nasal.The severer eyes of each subject were chosen as the treatment eye and the contralateral eyes were chosen as the control eye.Corneal confocal laser scanning microscopy (CCM) was performed before PRP treatment, 1 week after each photocoagulation, and 1 month after the completion of PRP treatment to collect images of the SNP over an area of 2-3 mm around the whorl-like pattern.Captured images at each time were merged into one image by using the Photoshop CC 2017 image processing software, and then the nerve fiber length (NFL) of whorl-like pattern was measured by Neuron J image analysis software.McGill pain questionnaire was used to investigate the pain of patients after each photocoagulation.The NFL changes of SNP at different time points were compared between different eyes and different photocoagulation sequence groups.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanxi Eye Hospital (No.201804b). Written informed consent was obtained from each patient prior to entering the study cohort.Results:After PRP treatment, there were different degrees of neural structure loss of SNP nerve fibers in 11 treatment eyes, but there was no significant change in SNP nerve fibers in the control eyes.There were significant differences in NFL between the treatment eyes and the control eyes at various time points ( Feyes=2.020, P=0.039; Ftime=4.062, P=0.001). In the horizontal-vertical laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the first and second photocoagulation.In the vertical-horizontal laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the third and fourth photocoagulation.There was no significant difference in NFL of treatment eyes between the two groups ( Fgroup=0.099, P=0.754), but there was a significant difference in NFL at various time points before and after treatment ( Ftime=5.231, P<0.001). There were 9 (9/57) patients who complained of pain after PRP, which occurred at the first time of photocoagulation in 7 of them. Conclusions:SNP damage may occur after PRP in patients with DR, and SNP is prone to be damaged on the photocoagulation side when performing horizontal photocoagulation.

Objective To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma.Methods CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software.The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV).Individualized cavity applicators were created by using 3D printer.The applicator was inserted into the patient's nasopharyngeal cavity through oral cavity.The source tube and false source were inserted into the preset pipe of the applicator.CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system.Mter delineating the target volume and organ at risk,treatment plan was optimized.After completing the first treatment,the applicator was removed.Before second treatment in a few days,CT scan was reviewed to confirm whether the position was correct.Results When the applicator was inserted into the nasopharyngeal cavity,it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures.Comparing the location of false source in multiple reviews of CT scan,the error was ≤ 1 mm.No significant discomfort was reported throughout the treatment.In optimized three-dimensional treatment,100％ prescription dose curve included the full rGTV,maximum dose of the brain stem and spinal cord was＜30％ prescription dose.Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week.No tumor recurrence was observed at postoperative 3 months in two cases.Conclusions The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation,accurate location,good repeatability and good patient tolerance.The short-term outcome is effective,whereas its long-term clinical effect and adverse reactions need to be further observed.

Objective To investigate the differences in gene expression profiles of peripheral blood from patients with Keshan disease (KD) and the apoptosis mechanism in KD,to obtain diagnostic markers and establish diagnostic centroids plot for KD.Methods RNA was isolated from ten patients with KD diagnosed according to the clinical criteria for KD in China and ten health controls.The expression profiles were evaluated by Agilent 4 ×44K Whole Human Genome density oligonucleotide microarray analysis.The data were extracted by Agilent Feature Extraction Software t test,Pathway studio analysis and prediction analysis for microarray (PAM) were used to identify differently expressed genes,gene pathways,diagnostic markers and establish diagnostic centroids plot.Results Totally 1 570 up-regulated genes and 1 498 down-regulated genes were identified.Thirty-eight enrichment pathways were also identified,and the highest ranked by Pathway studio analysis was related to apoptosis.Six genes involved in apoptosis pathway were up-regulated in KD included ataxia telangiectasia mutated (ATM),cAMP-dependent protein kinase,protein kinase A (PKA),baculoviral IAP repeat-containing 2 (BIRC2),NLR family,apoptosis inhibitory protein (NAIP),BCL2-1ike 11 (Bim),BCL2-related protein A1 (BCL2A1) and down-regulated were 7 which included caspase 8 (CASP8),BCL2 binding component 3 (BBC3),BCL2--associated athanogene (BAG1),BCL2-associated X protein (BAX),BCL2-1ike 1 (BCL2L1),BCL2-related ovarian killer (BOK),and caspase 6 (CASP6).Forty-two diagnostic markers were obtained through PAM analysis.Conclusions Apoptosis related to genes and pathways might play an important role in the pathogenesis of KD.Forty-two markers could be used as molecular markers for the diagnosis of KD,which is important to the diagnosis of KD.

Objective To evaluate the clinical performance of chemiluminescent immunoassay (CLIA) on anti-nuclear antibody(ANA) specific autoantibodies testing.Methods A multi-center clinical study A total of 811 Sera samples were collected from 6 collaborating hospitals during the period of April to July 2016, and tested with CLIA and line immunoassay (LIA) in parallel for autoantibodies to ribonucleoprotein(RNP), smith antigen(Sm), SSA/Ro60,SSB/La, centromere protein B(CENPB), double-stranded DNA(dsDNA), nucleosome(Nuc), and ribosome P protein(Rib-P).The positive rate,specificity and qualitative coincidence rate for each antibody between CLIA and LIA methods were analyzed.All discrepant samples for systemic lupus erythematosus (SLE) highly specific autoantibodies (including anti-Sm, dsDNA, Nuc and Rib-P) were retested by enzyme linked immunosorbent assay (ELISA) and further analyzed with SLE disease cohort using McNemar test.Results The positive rate and specificity of CLIA and LIA for antibodies to ANA specific antigens were comparable.Excellent qualitative coincidence were found between CLIA and LIA for the detection of anti-RNP, SSA/Ro60, SSB/La and CENPB (Kappa>0.75), while the coincidence rate foranti-Sm, dsDNA, Nuc and Rib-P detection were moderate (0.4

Objective To investigate the application of Computed tomography perfusion imaging (CTP) in superficial temporal artery-middle cerebral artery bypass(STA-MAC) treated moyamoya disease (MMD).Methods The clinical data of 21 patients with MMD who received STA-MAC surgery were collected.CTP was performed before and after the surgery for all the patients included.We routinely delimited the corresponding position as regions of interest (ROI) and obtained value of the cerebral blood flow(CBF),cerebral blood volume(CBV),the mean transittime(MTT),time to peak(TTP).The deviations of rCBF,rCBV,rMTT,rTTP between the affected side and corresponding area were analysed and the paired t test was performed.Results Unobstructed blood flow was observed in all patients received STA-MAC surgery after DSA examination.Increased CBF was observed in 100％ patients and increased CBV in 80.95％ patients,shortened MMT in 80.95 ％ patients,shortened TTP in 85.71％ patients.Difference of CBF,CBV,MTT,r-CBF,rMTT between pre-and post-Operation had statistical significance (P ＜ 0.05).Conclusion CTP is important in elucidating the hemodynamic changes before and after STA-MCA bypass,which indicts a crucial role in evaluating therapeutic effect of surgical treatment for MMD.

Objective To analyze the influence of evidence-based nursing on psychological status and vascular complications in patients with radial artery puncture line PCI surgery.Methods A total of 96 radial artery puncture patients with PCI surgery were randomly divided into control group and observation group,the control group received conventional nursing care and observation group received evidence-based nursing care.The PHQ-9 and GAD-7 score before and after the operation were compared,and the incidences of vascular complications including local hematoma,subcutaneous ecchymosis,upper limb venous thrombosis,vascular occlusion and puncture sites with oozing blood were analyzed.Results After nursing,the PHQ-9 and GAD-7 scores at 24 h before operation in observation group were significantly lower than that in the control group (P ＜ 0.05).At 24 h after operation,the incidence of vascular complications in the observation group was 6.3 ％,which was lower than 29.2％ in control group (P ＜ 0.05).Conclusion Evidence-based nursing care can ease depression and anxiety in some extent,and reduce the incidence of postoperative vascular complications.Hence,it is worthy of further popularization and application in clinic.

Objective To analyze the influence of evidence-based nursing on psychological status and vascular complications in patients with radial artery puncture line PCI surgery.Methods A total of 96 radial artery puncture patients with PCI surgery were randomly divided into control group and observation group,the control group received conventional nursing care and observation group received evidence-based nursing care.The PHQ-9 and GAD-7 score before and after the operation were compared,and the incidences of vascular complications including local hematoma,subcutaneous ecchymosis,upper limb venous thrombosis,vascular occlusion and puncture sites with oozing blood were analyzed.Results After nursing,the PHQ-9 and GAD-7 scores at 24 h before operation in observation group were significantly lower than that in the control group (P ＜ 0.05).At 24 h after operation,the incidence of vascular complications in the observation group was 6.3 ％,which was lower than 29.2％ in control group (P ＜ 0.05).Conclusion Evidence-based nursing care can ease depression and anxiety in some extent,and reduce the incidence of postoperative vascular complications.Hence,it is worthy of further popularization and application in clinic.