Objective To explore the characteristics and diagnostic significance of ultrasound signs in the diagnosis of acute appendicitis in children.Methods This study focused on 81 children with acute appendicitis and divided them into two groups based on pathological examination results:34 children with severe progressive appendicitis(41.98%)and 47 children with simple appendicitis(58.02%).By analyzing the indirect and direct signs of ultrasound detection,as well as pathological examination data,and using ROC curve analysis to analyze the area under the curve(area under curve,AUC)of ultrasound signs combined,a comprehensive analysis is conducted to score the ultrasound examination results of children.Results The detection rates of wall continuity interruption/low-level clarity,intraluminal fluid accumulation,periappendiceal or abdominal fluid accumulation,periappendiceal hyperechogenicity,cecal and ileal wall thickening in the advanced group were higher than those in the simple group(P<0.05);The scores of indirect,direct,and combined ultrasound signs in the progressive group were higher than those in the simple group(P<0.05);Under the ROC curve,the sensitivity,specificity,positive predictive value,and negative predictive value of combined signs were 98.77%,97.53%,98.77%,and 96.30%,respectively,higher than those of indirect signs and direct signs.The AUC was 0.835,higher than those of indirect signs and direct signs(P<0.05).Conclusion The combined diagnosis of ultrasound examination signs can provide objective evidence for the early diagnosis of acute appendicitis in children,and can also achieve dynamic monitoring of the disease,which is conducive to the formulation of clinical treatment plans.

Objective To prepare a nano drug(PFOB@Lip-MMC)with liposome as the carrier,liquid perfluorooc-tyl bromide(PFOB)as core and mitomycin C(MMC)loading on the liposome shell and study its inhibitory effect on the proliferation of human pterygium fibroblasts(HPFs).Methods The thin film dispersion-hydration ultrasonic method was used to prepare PFOB@Lip-MMC and detect its physical and chemical properties.Cell Counting Kit-8,Cam-PI cell viability staining and flow cytometry were employed to detect the impact of different concentrations of PFOB@Lip-MMC on the via-bility of HPFs.DiI fluorescence labeled PFOB@Lip-MMC was used to observe the permeability of the nano drug to HPFs under a laser confocal microscope.After establishing HPF inflammatory cell models,they were divided into the control group(with sterile phosphate-buffered saline solution added),PFOB@Lip group(with PFOB@Lip added),MMC group(with MMC added),PFOB@Lip-MMC group(with PFOB@Lip-MMC added)and normal group(with fresh culture medi-um added)according to the experimental requirements.After co-incubation for 24 h,flow cytometer was used to detect the apoptosis rate of inflammatory cells,and the gene expression levels of interleukin(IL)-1β,prostaglandin E2(PGE2),tumor necrosis factor(TNF)-α and vascular endothelial growth factor(VEGF)in cells were analyzed by PCR.Results The average particle size and Zeta potential of PFOB@Lip-MMC were(103.45±2.17)nm and(27.34±1.03)mV,respec-tively,and its entrapped efficiency and drug loading rate were(72.85±3.28)％and(34.27±2.04)％,respectively.The sustained-release MMC of drug-loaded nanospheres reached(78.34±2.92)％in vitro in a 24-hour ocular surface environ-ment.The biological safety of PFOB@Lip-MMC significantly improved compared to MMC.In terms of the DiI fluorescence labeled PFOB@Lip-MMC,after co-incubation with inflammatory HPFs for 2 h,DiI fluorescence labeling was diffusely dis-tributed in the cytoplasm of inflammatory HPFs.The apoptosis rate of inflammatory HPFs in the PFOB@Lip-MMC group[(77.23±4.93)％]was significantly higher than that in the MMC group[(51.62±3.28)％].The PCR examination results showed that the gene transcription levels of IL-1 β,PGE2,TNF-α and VEGF in other groups were significantly reduced com-pared to the control group and PFOB@Lip group,with the most significant decrease in the PFOB@Lip-MMC group(all P＜0.05).Conclusion In this study,a novel nano drug(PFOB@LIP-MMC)that inhibited the proliferation of HPFs was successfully synthesized,and its cytotoxicity was significantly reduced compared to the original drugs.It has good bio-compatibility and anti-inflammatory effects,providing a new treatment approach for reducing the recurrence rate after pte-rygium surgery.

Objective To evaluate the relationship between diabetic nephropathy(DN)and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM)based on imaging and clinical testing data.Methods Totally 600 T2DM patients who visited the First People's Hospital of Ziyang from March 2021 to December 2022 were included.The fundus photography and fundus fluorescein angiography were performed on all these patients and their age,gender,T2DM duration,cardiovascular diseases,cerebrovascular disease,hypertension,smoking history,drinking history,body mass in-dex,systolic blood pressure,diastolic blood pressure and other clinical data were collected.The levels of fasting blood glu-cose(FPG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipo-protein cholesterol(LDL-C),glycosylated hemoglobin(HbA1c),24 h urinary albumin(UAlb),urinary albumin to creati-nine ratio(ACR),serum creatinine(Scr)and blood urea nitrogen(BUN)were measured.Logistic regression was used to analyze the risk factors associated with DR.DR staging was performed according to fundus images,and the convolutional neural network(CNN)algorithm was used as an image analysis method to explore the correlation between DR and DN based on emission computed tomography(ECT)and clinical testing data.Results The average lesion area rates of DR and DN detected by the CNN in the non-DR,mild-non-proliferative DR(NPDR),moderate-NPDR,severe-NPDR and pro-liferative DR(PDR)groups were higher than those obtained by the traditional algorithm(TCM).As DR worsened,the Scr,BUN,24 h UAlb and ACR gradually increased.Besides,the incidence of DN in the non-DR,mild-NPDR,moderate-NPDR,severe-NPDR and PDR groups was 1.67％,8.83％,16.16％,22.16％and 30.83％,respectively.Logistic regression analysis showed that the duration of T2DM,smoking history,HbA1c,TC,TG,HDL-C,LDL-C,24 h UAlb,Scr,BUN,ACR and glomerular filtration rate(GFR)were independent risk factors for DR.Renal dynamic ECT analysis demonstrated that with the aggravation of DR,renal blood flow perfusion gradually decreased,resulting in diminished renal filtration.Conclusion The application of CCN in the early stage DR and DN image analysis of T2DM patients will improve the diag-nosis accuracy of DR and DN lesion area.The DN is worsening as the aggravation of DR.

Objective To acquire,evaluate and integrate the best evidence of perioperative exercise interventions in patients with liver cancer and provide evidence-based references for clinical medical staff.Methods Following the"6S"Evidence Resource Pyramid model,literatures in perioperative exercise interventions published between January 2010 and June 2022 were retrieved from various databases,including BMJ Best Practice,UpToDate,Guidelines International Network,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Medlive,Cochrane Library,JBI,Web of Science,PubMed,Embase,CINAHL,CNKI,SinoMed,Wanfang Data,American Cancer Society,American College of Sports Medicine and International Liver Cancer Association from January 2010 to June 2022.Two researchers evaluated the quality of the retrieved literatures and extracted evidences that met the inclusion criteria.Results A total of 22 articles were included,yielding 26 pieces of evidence across seven themes:the necessity of exercise,evaluation before exercise,preoperative exercise program,postoperative exercise program,exercise monitoring,health education and effect evaluation.Conclusions This study provides a summary of the best evidence regarding perioperative exercise interventions in the patients with liver cancer.The findings offer valuable references for clinical healthcare providers to deliver evidence-based care for the patients with liver cancer.

The access evaluation of new medical technology is an important part of the preclinical application of medical technology and plays a vital role in ensuring the quality and safety of medical services.However,in the con-crete practice of access evaluation,there are still some problems such as imperfect access theoretical framework,imperfect evaluation index system.With the strategic support of health policies,laws,and regulations,the theory and method of HB-HTA are used for reference,core elements such as assessment subject,assessment object,and assessment content are comprehensively considered,the index system is designed from the dimensions of tech-nical characteristics,safety,effectiveness,economy and applicability,and the access evaluation framework of im-ported medical new technologies is constructed.To offer a theoretical framework and evidence-based basis for medi-cal facility medical technology access management.

AIM: To prepare a nanodrug MMC-ATS-@PLGA using polylactic acid hydroxyacetic acid copolymer(PLGA)as a carrier and mitomycin C(MMC)loaded on PLGA, and to analyse the biological safety and treatment effect of this nanodrug on inhibiting the proliferation of filtering bleb scarring after glaucoma surgery in vivo.METHODS: The thin-film dispersion hydration ultrasonic method was used to prepare the MMC-ATS-@PLGA, and its physical and chemical properties were detected. The effect of MMC-ATS@PLGA on rabbit corneas was analysed through corneal fluorescence staining and HE staining, and tear film rupture time(BUT), Schirmer test and intraocular pressure data were collected to analyse ocular surface biosafety. A slit lamp was used to observe and calculate the filtration bubble size, and the tissue morphological changes were analysed by conjunctival HE staining. In addition, immunohistochemistry and Elisa were used to compare the anti-inflammatory effects of Flumiolone Eye Drops(FML), MMC, and MMC-ATS-@PLGA nanoparticles on inhibiting the formation of filtering bleb scarring after glaucoma surgery from multiple perspectives via comparative proteomic analysis.RESULTS: The average particle size and zeta potential of MMC-ATS-@PLGA were 128.78±2.54 nm and 36.49±4.25 mV, respectively, with an encapsulation efficiency and a drug loading rate of(78.49±2.75)% and(30.86±1.84)%, respectively. At 33°C(the ocular surface temperature), the cumulative release rate of the MMC-ATS-@PLGA nanoparticles reached(76.58±2.68)% after 600 min. Moreover, corneal fluorescence staining, HE, BUT, Schirmer, and intraocular pressure results showed that MMC-ATS-@PLGA had good biocompatibility with the ocular surface of rabbits. At 3 wk after surgery, the area of filtering blebs in the MMC-ATS-@PLGA group was significantly larger than that in the FML group and MMC group, and the filtering blebs in the control group had basically disappeared. Pathological tissue analysis of the conjunctiva in the filtering blebs area of the eyes of the rabbits revealed that compared with that in the normal group, the morphology of the collagen fibres in the MMC-ATS-@PLGA group was relatively regular, the fibres were arranged neatly, and the tissue morphology was similar to that of the normal group. Immunohistochemistry and Elisa confirmed that compared with those in the normal group, the expression levels of α-SMA, CTGF, and type Ⅲ collagen fibre antibodies were significantly increased in the control group. After FML, MMC, or MMC-ATS-@PLGA treatment for 3 wk, the expression of inflammatory factors gradually decreased. Among the groups, the MMC-ATS-@PLGA group showed the most significant decrease(P<0.05).CONCLUSION: This study successfully synthesized a nanomedicine(MMC-ATS-@PLGA)that inhibits scar proliferation after glaucoma filtration surgery. The drug had stable physicochemical properties, good biocompatibility, and better anti-inflammatory effects by inhibiting the expression of α-SMA, CTGF, and type Ⅲ collagen fibres, which can prevent the formation of scarring in the filtering blebs area, thereby improving the success rate of glaucoma filtering surgery.

OBJECTIVE To study effects of Jinshui Liujun decoction(JLD) on pulmonary water metabolism and TNF-α/NF-κB signaling pathway in asthmatic mice. METHODS After 1 week of acclimatization, 10 mice were randomly selected by body weight as a blank control group, and the rest of the mice were sensitized by intraperitoneal and subcutaneous injections of ovalbumin sensitizing solution on the 1st, 8th, and 15th day of the experiment. On the 22nd day, they were randomly divided into model control group, positive control group and JLD low, medium and high dose(4.1, 8.2, 16.4 g·kg−1) group, and replicated the asthma mouse model by inhaling nebulized excitation solution(1% ovalbumin) once every other day for 2 consecutive weeks, and at the same time, were given atomized excitation solution(1% ovalbumin) every other day for two weeks to replicate the asthmatic mouse model, and were given the test drug by gavage daily. The effects of JLD on the behavior, lung wet-dry weight ratio, AQP1, AQP5, TNF-α, NF-κB, and NF-κB mRNA expression in asthmatic mice were observed. RESULTS JLD reduced the number of animals with asthma attacks, alleviated asthma symptoms, decreased the lung index and lung wet-to-dry weight ratio, increased the expression level of AQP1 and AQP5 in lung tissues, reduced the content of TNF-α in bronchoalveolar lavage fluid and lung tissues, and down-regulated the expression level of NF-κB and its genes in lung tissues(P<0.05 or P<0.01). CONCLUSION JLD has an anti-asthma effect and its mechanism of action is partially due to its inhibition of the TNF-α/NF-κB signaling pathway, upregulation of AQP1 and AQP5, and improvement of pulmonary water metabolism.

Objective To systematically evaluate the efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma.Methods This study was conducted according to PRISMA guidelines,with a PROSPERO registration number of CRD42023488398.PubMed,Embase,Web of Science,the Cochrane Library,CNKI,Wanfang Data,VIP,and CBM were searched for Chinese and English articles on three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma published up to March 2023.After quality assessment and data extraction of the studies included,RevMan 5.4 software was used to perform the meta-analysis.Results A total of 11 studies were included,with 972 patients in total,among whom 447 underwent ablation assisted by three-dimensional visualization technology(3D group)and 525 underwent ablation assisted by traditional two-dimensional imaging technology(2D group).The meta-analysis showed that compared with the 2D group,the 3D group had significantly higher success rate of first-time ablation treatment(odds ratio[OR]=5.43,95%confidence interval[CI]:2.64—11.18,P<0.001),technical efficiency(OR=6.15,95%CI:3.23—11.70,P<0.001),and complete ablation rate(OR=2.50,95%CI:1.08—5.78,P=0.03),as well as significantly lower incidence rate of major complications(OR=0.45,95%CI:0.24—0.87,P=0.02),local recurrence rate(OR=0.35,95%CI:0.17—0.72,P=0.004),and local tumor progression rate(OR=0.29,95%CI:0.16—0.50,P<0.001),while there was no significant difference in the incidence rate of mild complications between the two groups(P>0.05).Conclusion Three-dimensional visualization technology is safe and feasible in assisting ablation therapy for hepatocellular carcinoma and can improve ablation rate and reduce the incidence rate of serious complications,local recurrence rate,and local tumor progression rate,thereby showing an important application value in clinical practice.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

OBJECTIVE To establish characteristic chromatogram of Yao medicine Kadsura longipedunculata and the method for the content determination of its main component anwulignan， and evaluate the anti-inflammatory activity of anwulignan. METHODS HPLC method was performed with acetonitrile-0.5% phosphoric acid solution as the mobile phase for gradient elution. The characteristic chromatogram of K. longipedunculata was established and similarity was evaluated by Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）. The content of anwulignan in K. longipedunculata was determined. Lipopolysaccharide induced RAW264.7 macrophages were selected as inflammatory cell model to investigate the effects of anwulignan on the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β） and IL-6. RESULTS The similarities of characteristic chromatogram for 10 batches of K. longipedunculata ranged 0.901-0.994， and 9 common peaks were determined； 3 components were identified， such as changnan schisantherin E， kadsulactone A， anwulignan. The contents of anwulignan were （0.72±0.05）-（1.21±0.03） mg/g（n＝3）. Anwulignan of 0.125-0.5 μg/mL greatly decreased the levels of TNF-α， IL-1β and IL-6 in the supernatant of inflammatory model cells （P＜0.05 or P＜0.01）. CONCLUSIONS HPLC characteristic chromatogram of K. longipedunculata and the method for the content determination of anwulignan are all established， and anwulignan may be the active ingredient of anti-inflammatory effect in K. longipedunculata.