ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

BACKGROUND:The stemness index may be associated with the prognosis and immune infiltration of sarcoma,but the specific regulatory mechanism and characteristic genes have yet to be fully elucidated. OBJECTIVE:To investigate the correlation between stem cells and prognosis as well as immune infiltration in sarcoma employing the gene stemness index model and to identify the ferroptosis signature genes associated with sarcoma stem cells. METHODS:The sarcoma RNA sequencing data and related clinical information were obtained from the Cancer Genome Atlas(TCGA).The sarcoma RNA sequencing data were grouped using the sarcoma stemness index.Survival data were used to analyze prognosis between groups.Differentially expressed genes were obtained for pathway enrichment and immune infiltration analysis.Ferroptosis-related differential genes were used to construct a protein interaction network and analyze prognostic correlation.Rhabdomyosarcoma cell lines were cultured and divided into adherent cell group and stem cell group.The adherent cell group received no intervention,while the stem cell group was treated with serum-free culture to enrich stem cells in rhabdomyosarcoma cells.qRT-PCR was used to evaluate stemness markers,ferroptosis-related genes,and mRNA expression of ferroptosis-related markers in the cells. RESULTS AND CONCLUSION:(1)Patients were divided into high and low stemness index groups based on the median stemness index.The progression-free survival of patients in the high stemness index group was lower than that in the low stemness index group by disease risk prediction,suggesting poor prognosis.(2)According to GO and KEGG analysis,the groups with high and low stemness indices differed from one another.There were differences in immune infiltration between the high and low stemness index groups.Nine of the 23 ferroptosis-related genes in the differential genes have the potential to establish a highly correlated network of protein interactions.Patients with high expression of IDO1,IFNG,and AQP5 have a better prognosis,while those with high expression of CA9 have a poor prognosis.(3)The qRT-PCR results demonstrated a significant upregulation of stem cell-related markers NANOG,SOX2,and OCT4 mRNA expressions in the stem cell group compared to the adherent cell group(P<0.05).Compared to the adherent cell group,the stem cell group exhibited decreased mRNA expression level of ferroptosis-related marker SLC7A11(P<0.05)while showing increased levels of ACSL4,GPX4,FTH1,and COX2(P<0.05).Compared to the adherent cell group,the stem cell group displayed decreased mRNA expression level of differentially expressed gene CA9 alongside elevated levels of IDO1,IFNG,and AQP5(P<0.05).Stem cells were strongly associated with sarcoma survival and ferroptosis by bioinformatics analysis and experimental verification.Sarcoma stem cells have aberrant expression of CA9,IDO1,IFNG,and AQP5,which may serve as new targets for sarcoma therapy as well as diagnostic indicators.

The coagulation factors in cryoprecipitate are mainly coagulation factor Ⅷ, fibrinogen, von Willebrand factor (VWF), and coagulation factor ⅩⅢ. This article provides different treatment dosages and plans for different patients with rare coagulation disorders based on their actual conditions referring to international and domestic guidelines and consensus. In order to achieve precise infusion for cryoprecipitate, it is necessary to avoid poor treatment effects caused by insufficient doses, as well as waste of blood components and the risk of thrombosis caused by excessive infusion.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Objective To investigate the geographical distribution and seasonal fluctuations of visceral leishmaniasis vectors sandflies in Henan Province in 2023, so as to provide insights into the prevention and control of visceral leishmaniasis vectors. Methods A total of 23 counties (districts) were sampled from 18 cities of Henan Province from May to September, 2023 as sandfly surveillance sites, and sandflies were captured using human capture and light trapping methods. Following morphological identification, the changes in the sandfly density were calculated at different months and in different breeding habitats. Results A total of 406 light traps were set at sandfly surveillance sites in Henan Province from May to September, 2023, and a total of 3 137 female sandlies were captured, with an average density of 7.73 sandlies/(light·night). A total of 1 494 Phlebotomus chinensis sandflies were captured, including 1 222 female sandflies, with an average density of 3.01 sandflies/(light·night), and the highest density of P. chinensis was found in Gongyi City [17.00 sandflies/(light·night)]. A total of 5 544 sandflies were captured using the human capture method, including 230 P. chinensis, and the density of P. chinensis appeared a unimodal distribution, with a peak in early July [5.81 sandflies/(light·night)]. Among different breeding habitats, the highest P. chinensis density was detected in pigpens [4.50 sandflies/(light·night)]. Conclusions P. chinensis was predominantly distributed in hilly areas of northern and central-western Henan Province in 2023, and the sandfly density appeared a unimodal distribution. Intensified monitoring of visceral leishmaniasis vectors is recommended.

Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. Results Finally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. Conclusion Bronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.

Objective:To evaluate the effects of different interaction modes on the rehabilitation outcomes of stroke patients, and to provide reference for caregivers to choose the best interaction mode according to the rehabilitation goals.Methods:Computerized search of Web of Science, PubMed, Cochrane Library, EMbase, CNKI, Wanfang Database, VIP Database, and China Biomedical Literature Database for randomized controlled trials (RCTs) of interaction modes to improve rehabilitation outcomes of stroke patients was performed from the year of database construction to January 8, 2024. Two researchers independently screened the literature according to inclusion and exclusion criteria, evaluated the risk of bias in the included studies, and extracted data from them. Stata16.0 was used for a network meta-analysis.Results:A total of 22 articles were included that met the inclusion and exclusion criteria, involving 2 404 patients and 5 interaction modes, namely Cox health behavior interaction mode, doctor-patient interaction mode, King interaction compliance mode, dual track interaction mode, and online interaction mode. The results of the network Meta-analysis showed that in terms of improving self-care ability, the King interaction model [ SMD(95% CI)=0.25(0.05-0.45)], the network interaction model [ SMD(95% CI)=0.27(0.07-0.48)], and the Cox health behavior interaction model [ SMD(95% CI)=0.37(0.07-0.67)] were all superior to conventional nursing (all P<0.05). In terms of improving motor function, except for the dual track interactive mode, all other modes were superior to conventional nursing ( SMD values were -0.52--0.30, all P<0.05). There was no statistically significant difference in the application effects of different modes in improving the quality of life (all P>0.05). The ranking results of the area under the cumulative ranking probability curve (SUCRA) for improving self-care ability, motor fuction and quality of life were Cox health behavior interaction mode (SUCRA=83.7%), doctor-patient interaction mode (SUCRA=89.5%) and King interaction standard mode (SUCRA=78.2%). Conclusions:The Cox health behavior interaction model can improve the self-care ability of stroke patients, the doctor-patient interaction model can improve the motor function of stroke patients, and the King interaction standard model may have more advantages in improving the quality of life of stroke patients. It is suggested to combine the advantages of the three to maximize the rehabilitation effect of stroke patients.

Objective To investigate the effect of onset-to-needle time(ONT)on early neurological deterioration(END)in patients with acute ischemic stroke(AIS).Methods From June 2020 to June 2023,AIS patients receiving intravenous thrombolysis treatment in the Neurology Department of Seventh People's Hospital of Zhengzhou were continuously enrolled.Patients were divided into the END group(n=96)and non-END group(n=293)based on whether their NIHSS score increased by ≥4 points compared to baseline after 24 h.Baseline and clinical data of the two groups were collected,and relevant influencing factors were analyzed through univariate analysis,multivariate analysis,and subgroup analysis.A logistic regression model predicting the occurrence of END in acute stroke patients was constructed,and the model's predictive ability was evaluated by ROC curves.Results The results of the univariate analysis showed that there were statistically significant differences in age,total cholesterol,low-density lipoprotein cholesterol(LDL-C),lipoprotein-associated phospholipase A2(Lp-PLA2),white blood cell count,activated partial thromboplastin time(APTT),and ONT between the END group and non-END group(all P＜0.05).Additionally,there were statistically significant differences in the distribution of cardiac history,infarct location,and TOAST classification between the two groups(all P＜0.05).The results of the multivariable logistic analysis showed that age(OR=1.095,95％CI:1.029-1.165,P=0.004),LDL-C(OR=2.779,95％CI:1.355-5.694,P=0.005),Lp-PLA2(OR=1.007,95％CI:1.001-1.014,P=0.047),complete anterior circulation infarction(compared to lacunar infarction as control,OR=8.045,95％CI:5.175-12.503,P=0.024),cardioembolic stroke(compared to small vessel occlusion patients as control,OR=12.794,95％CI:8.411-19.462,P=0.002),and ONT(OR=1.014,95％CI:1.001-1.026,P=0.029)were independent risk factors for END in patients with AIS.Subgroup analysis based on the NIHSS score at admission showed that for moderate and severe subgroups,each additional minute of ONT increased the risk of END by 1.4％(95％CI:1.001-1.027,P=0.032)and 2.9％(95％CI:1.008-1.050,P=0.006),respectively.A predictive model was established based on the Logistic analysis results,and a nomogram predicting the risk of END outcome was created.The area under the ROC curve was calculated to be 0.922(95％CI:0.859-0.984,P＜0.001),indicating good predictive performance.Conclusions In clinical practice,patients with high-risk factors such as age,LDL-C,Lp-PLA2,TOAST classification,and infarct location should be given more attention.Timely thrombolytic therapy should be initiated,and patients'families should promptly seek medical assistance.Additionally,optimizing the diagnostic and treatment process,reducing ONT,and minimizing the occurrence of END in patients are crucial.

Objective To develop an expert consensus on subcutaneous injection for allergen-specific immunotherapy.Methods Relevant domestic and intemational literature was reviewed,and nursing experts who had experiences in subcutaneous injection of allergen-specific immunotherapy were interviewed to form the initial draft of the consensus.A total of 85 experts from 42 hospitals nationwide were invited to participate in discussions.2 rounds of expert consultations,adjustments,revisions,and improvements were made to the initial draft,and an online meeting was held to form the final version of the consensus.The content approved by more than 75％of the expert group is adopted,or it will be discussed or deleted.Results The expert consensus includes operational standards for subcutaneous injection of allergen-specific immunotherapy,identification and management of adverse reactions,and health education.Conclusion The consensus demonstrates strong scientific rigor and practicality,providing guidance for nursing practices in the field of clinical allergology.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.