Amblyopia is a common visual development disorder and is the main cause of monocular vision impairment in children and adults. Photobiomodulation(PBM), a non-invasive treatment method, has gradually gained attention in the field of ophthalmology. This paper begins with the macroscopic manifestation of light on the animal model of amblyopia. Additionally, it discusses the pathological changes of the amblyopic retina and the human eye's central nervous system, as well as the influence and mechanism of PBM on the visual perception and processing system and its chemical effect on the visual system through dopamine and melatonin. It examines its mechanism of action, current clinical application status, and future development direction in order to provide new ideas and theoretical foundation for amblyopia treatment.

Objective:To construct and test the reliability and validity of an assessment scale for self-management of patients with dry eye, so as to help patients establish dry eye related health behaviors.Methods:Based on the knowledge attitude and practice theory, the initial scale was constructed on the basis of literature review and qualitative interview, and revised through Delphi expert consultation and expert argumentation. After the preliminary investigation, 211 dry eye patients treated in the dry eye nursing outpatient department of Beijing Tongren Hospital from August 2023 to January 2024 were selected by convenience sampling method for questionnaire investigation to test the reliability and validity of the scale.Results:Among 211 dry eye patients, there were 58 males and 153 females, aged (39.31 ± 12.81) years old. The scale of self-management of patients with dry eye included 27 items in 3 dimensions: knowledge, attitude and behavior. The authority coefficient of the two rounds of expert consultation was 0.86, and the Kendall coordination index increased from 0.175 to 0.223 (both P < 0.01). The cumulative variance contribution rates of the three dimensions were 41.843%, 54.219% and 44.273%, respectively. The Cronbach α coefficient of the scale was 0.787, and the Spearman-Brown coefficient was 0.641. Conclusions:The scale of self-management of patients with dry eye has good reliability and validity and can be used in the assessment of dry eye patients to provide a reference basis for targeted guidance and intervention.

Objective:To determine the risk factors for permanent nerve damage (PND) after aortic arch surgery in patients with acute type A aortic dissection (AAAD).Methods:This was a retrospective case-control study. The medical records from patients of both sexes with AAAD, aged > 18 yr, of American Society of Anesthesiologists Physical Status classification IV, who underwent aortic arch surgery in the Second Hospital of Hebei Medical University from December 2018 to December 2023, were collected. The patients were divided into non-PND group and PND group according to whether PND occurred after operation. The preoperative data of patients were collected, including age, gender, body mass index; comorbidities (hypertension, coronary heart disease, diabetes mellitus), history of smoking, history of stroke, and history of cardiovascular surgeries; syncope at onset, preoperative low SpO 2, preoperative low systolic blood pressure, and preoperative low diastolic blood pressure. The intraoperative data included surgical procedure (total aortic arch replacement or half aortic arch replacement), selective antegrade cerebral perfusion during operation, cardiopulmonary bypass (CPB) time, aortic cross-clamp time, post-parallel time, moderate hypothermia circulatory arrest time, nasopharyngeal temperature and rectal temperature during circulatory arrest, and BIS value during circulatory arrest; blood pressure during cardiopulmonary bypass and after restoration of heart beat; the incidence of dysfunction after recovery of heart beat and difficulty in hemostasis after termination of CPB. The aforementioned indicators were analyzed for difference, and the indicators with P<0.05 were included in the multivariate logistic regression analysis. Results:A total of 292 patients were ultimately included, among which 73 developed postoperative PND, resulting in an incidence of 25.0%. The results of multivariate logistic regression analysis showed that age ≥62 yr ( OR=3.783, 95% confidence interval [ CI] 1.513-10.346, P=0.006), preoperative hypertension ( OR=2.230, 95% CI 1.118-4.715, P=0.028), syncope at onset ( OR=3.001, 95% CI 1.343-6.710, P=0.007), BIS value > 14 during circulatory arrest ( OR=2.439, 95% CI 1.249-4.755, P=0.009) and difficult hemostasis after termination of CPB ( OR=3.465, 95% CI 1.758-6.882, P<0.001) were risk factors for PND after surgery. Conclusions:Age ≥ 62 yr, history of hypertension, syncope at onset, BIS value greater than 14 during circulatory arrest and difficulty in hemostasis after termination of CPB are risk factors for PND after aortic arch surgery in patients with AAAD.

Humans ; Mutation/genetics* ; HIV Infections/drug therapy* ; Drug Resistance ; Treatment Failure ; China ; Drug Resistance, Viral/genetics*

OBJECTIVE: To analyze a child with 11β hydroxylase deficiency (11β-OHD) due to CYP11B2/CYP11B1 chimeric gene. METHODS: Clinical data of the child who was admitted to Henan Children's Hospital on August 24, 2020 were retrospectively analyzed. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. RT-PCR and Long-PCR were carried out to verify the presence of chimeric gene. RESULTS: The patient, a 5-year-old male, had featured premature development of secondary sex characteristics and accelerated growth, and was diagnosed with 21 hydroxylase deficiency (21-OHD). WES revealed that he has harbored a heterozygous c.1385T>C (p.L462P) variant of the CYP11B1 gene, in addition to a 37.02 kb deletion on 8q24.3. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.1385T>C (p.L462P) was rated as a likely pathogenic variant (PM2_Supporting+PP3_Moderate+PM3+PP4). The results of RT-PCR and Long-PCR suggested that CYP11B1 and CYP11B2 genes have recombined to form a CYP11B2 exon 1~7/CYP11B1 exon 7~9 chimeric gene. The patient was diagnosed as 11β-OHD and effectively treated with hydrocortisone and triptorelin. A healthy fetus was delivered following genetic counseling and prenatal diagnosis. CONCLUSION 11β-OHD may be misdiagnosed as 21-OHD due to the potential CYP11B2/CYP11B1 chimeric gene, which will require multiple methods for the detection.
Child, Preschool ; Humans ; Male ; Adrenal Hyperplasia, Congenital/genetics* ; Cytochrome P-450 CYP11B2/genetics* ; Exons ; Retrospective Studies ; Steroid 11-beta-Hydroxylase/genetics*

Objective:To construct an evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room and provide a reference for objectively assessing the nursing quality in ophthalmological Daytime Operation Room.Methods:From January to August 2020, the evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room was constructed by literature retrieval, semi-structured interviews, Delphi's expert correspondence inquiries, and hierarchical analysis based on Donabedian's structure-process-outcome model.Results:The effective response rates of the questionnaires for the two rounds of expert correspondence inquiries were 100.0%; the expert authority coefficients were 0.851 and 0.858; and the expert coordination coefficients were 0.098-0.264. The evaluation indicator system of nursing quality in ophthalmological daytime operation room finally constructed included 3 primary indicators, 11 secondary indicators, and 57 tertiary indicators.Conclusions:The evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room constructed in this study is highly scientific and reliable, which can comprehensively and objectively assess and continuously improve the nursing quality of Ophthalmological Daytime Operation Room.

Objective To establish the implant-mandible model with different design parameters, observe stress distributions on the implant and surrounding bone, and analyze the influence of different design parameters on dental implant of the mandible. Methods Eight implant models were designed based on structural characteristic parameters (implant diameter, thread depth, height of abutment through gingiva, thread shape), and assembly of the mandibular model was performed respectively. The models were applied with static 150 N vertical and oblique 45° loads, so as to analyze peak von Mises stress of the implant and bone tissues and explore the structural parameter variables of implant most sensitive to peak von Mises stress. Results The peak stress of the mandible was larger under inclined load than that under vertical load. Implant diameter was the key factor affecting the peak von Mises stress of cortical bone, while thread depth was the key factor affecting the peak von Mises stress of cancellous bone. The peak von Mises stress was also affected by the height of abutment through gingiva, but the effect was not as significant as thread depth and implant diameter. Thread shape had little effect on the peak von Mises stress of the mandible. Conclusions Different implant design parameters can affect the peak stress of different tissues of the mandible, so it is necessary to carefully consider the selection of implant parameters for personalized implants. This study can provide theoretical guidance for structural parameter design of oral implants and provide references for accurate prediction of oral implants.

Objective To analyze stress distributions on mandible bone and periodontal ligaments during acceleration of orthodontic tooth movement by mechanical vibration, and investigate the mechanism of static-vibration coupled loading to accelerate orthodontic tooth movement. MethodsThe finite element model including tooth, periodontal ligament, cancellous bone and cortical bone was established by Mimics，SolidWorks，Geomagic and ANSYS Workbench software. Conventional static orthodontic force and low-magnitude high-frequency mechanical vibration loads were applied to the finite element model for dynamic analysis. ResultsThe compression and tension zones of alveolar bone and periodontal tissues were identified based on Y-normal stress distribution of alveolar bone and periodontal tissues, which was periodic with the same frequency as the applied low-magnitude high-frequency vibration. The von Mises stress of alveolar bone and periodontal tissues also showed periodic changes, but the compression and tension zones of alveolar bone and periodontal tissues could not be identified based on von Mises stress distribution of alveolar bone and periodontal tissues. Conclusions In the field of orthodontics, Y-normal stress is a reasonable mechanical stimulus, and static-vibration coupled loading is an effective method for accelerating orthodontic treatment. The research findings can provide guidance for low-magnitude high-frequency mechanical vibration to accelerate orthodontic tooth movement.

Objective: To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers. Methods: Seventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese med-icine clinician. Of the participants, we included healthy participants with normal weight (NW, n =23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group. Results: After comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups. Conclusion: Participants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.

Objective:To investigate the optimal cut-off of sequential screening for Down syndrome (DS) with a cost-effectiveness analysis.Methods:A theoretical model, covering 1 000 000 singleton pregnancies, was established with the parameters from published articles and on-the-spot investigation. Two screening strategies were involved and both required conventional second-trimester serum triple screening first. For the next step, strategyⅠ was followed by cell-free fetal DNA (cffDNA) testing if the cut-offs were higher than 1/300 (Ⅰ-1) or 1/1 000 (Ⅰ-2), and if cffDNA testing indicated high risk, prenatal diagnostic testing would be performed. While strategy Ⅱ was followed by prenatal diagnostic testing in high-risk populations with cut-offs higher than 1/10 (Ⅱ-1), 1/50 (Ⅱ-2), 1/100 (Ⅱ-3), 1/150 (Ⅱ-4), 1/200 (Ⅱ-5), 1/250 (Ⅱ-6) or 1/300 (Ⅱ-7), or cffDNA testing for those with intermediate risks. The primary outcome was an incremental cost analysis on the baseline and alternative assumptions. The strategy was defined as "appropriate" when the incremental cost was less than the cost of raising one DS child. The secondary outcomes included total cost, cost-effectiveness analysis, cost-benefit analysis, and screening efficiency.Results:(1) More DS cases and less survived miss-diagnosed cases were detected by strategy Ⅱthan strategyⅠ (Ⅰ-1: 1 921, Ⅰ-2: 2 199 vs Ⅱ-1 to Ⅱ-7: 2 202-2 212; Ⅰ-1: 312; Ⅰ-2: 100 vs Ⅱ-1 to Ⅱ-7: 98-90). The total prenatal diagnosis cases and the number of case requring prenatal diagnosis for detecting one DS case were the lowest in strategy Ⅰ-1 group (2 081; 1.1, 2 081/1 921) and were the highest in Strategy Ⅱ-7 group (82 385; 37.2, 82 385/2 212). (2) Strategy Ⅰ-1 was the most cost-effective approach with the lowest total cost (￥928.896 million) and cost-effectiveness (￥237 000), and the highest benefit/cost ratio (4.90), followed by strategy Ⅱ-7 (￥957.380 million, ￥371 000 and 3.11). The most costly strategy was Ⅰ-2 (￥1 040.883 million, ￥404 000 and 2.85). (3) Setting strategyⅠ-1 as the baseline, strategyⅠ-2 had the highest incremental cost (￥1.580 million). The incremental cost of strategy Ⅱ ranged from ￥1.535 million (Ⅱ-1) to ￥1.259 million (Ⅱ-7), close to or less than the cost of raising a DS child (￥1.52 million). (4) The cost of cffDNA was a major factor in decision-making based on sensitivity analysis. When the price went down to ￥1 075, the incremental cost of strategy Ⅱ-1 was the lowest (￥757 000). If it further lowered to ￥697, strategy Ⅰ-2 was optimal (lower than ￥523 000). (5) The sensitivity analysis also suggested that the acceptance rate of cffDNA testing had no influence on the incremental cost-related findings (incremental cost: in strategy Ⅱ-7 was least and less than costs for one Down Syndrome patient). When the acceptance rate of prenatal diagnostic testing was lower than 80%, the incremental cost of strategy Ⅱ-7 (￥1.669 million) was the lowest, which was higher than raising a DS child.Conclusions:cffDNA testing in high-risk populations (strategyⅠ-1) could significantly reduce unnecessary diagnostic tests and is appropriate in total cost, cost-effectiveness and cost-benefit analysis, but misses more DS livebirths. Implementing prenatal diagnostic testing among pregnancies with risk cut-offs higher than 1/300 (strategy Ⅱ-7) could improve screening efficiency and reduce incremental costs, but require more cases to be tested. The cost of cffDNA testing is the most important influencing factor. On the premise of achieving substantial screening efficiency, strategy Ⅱ-1 and Ⅰ-2 are optimal with the lowest incremental costs if cffDNA testing cost drops to ￥1 075 and ￥697, respectively. Lower acceptance of prenatal diagnostic testing is accompanied by less detected DS cases and increased incremental costs than the baseline, which is not conducive to the prevention of birth defects.