Objective: To analyze the potential categories and influencing factors of the compliance trajectory of orthokeratology lenses (OK lens) in myopic children and adolescents, so as to provide a basis for dynamic and accurate intervention of OK lens compliance in myopic children and adolescents. Methods: From January to June 2024, 310 myopic children and adolescents wearing OK lens were selected as research subjects from the Ophthalmology Medical Center of Cangzhou Central Hospital using a convenient sampling method. Data were collected at four time points: when the glasses were first fitted (T0), 2 weeks after fitting (T1), 1 month later (T2), 3 months later (T3), and 6 months later (T4). The data collection methods included general information questionnaires, compliance surveys for OK lens wearers, the Behavior Rating Inventory of Executive Function-Self-report Version (BRIEF-SR), family support scales, and a self-made questionnaire on myopia control attitudes. A growth mixed model was used to identify the trajectory categories of compliance with OK lens wearing among myopic children and adolescents, and multiple Logistic regression analysis was employed to examine the influencing factors. Results: The compliance with OK lens among myopic children and adolescents were roughly divided into four developmental trajectories: C1 exemplary adherent (58 cases, 18.71%), C2 gradual progressor (130 cases, 41.94%), C3 fluctuating (85 cases, 27.42%), and C4 stubborn low follower (37 cases, 11.94%). Multivariate Logistic regression analysis showed that, with C1 group as the reference, age (C3, OR = 0.74 ), parental education level (C4, OR =0.67), executive function (C2, OR =0.69; C4, OR =0.44), family support (C3, OR =0.75) and myopia control attitude (C2, OR =0.39) were all influencing factors for the compliance trajectory of OK lens; with C2 group as the reference, age (C3, OR = 0.55 ), parental education level (C3, OR =0.34; C4, OR =0.64), executive function (C3, OR =0.77), and family support (C4, OR =0.58) were all influencing factors for the compliance trajectory of OK lens; with C3 group as the reference, age (C4, OR = 0.68 ), and myopia control attitude (C4, OR =0.44) were both influencing factors for the compliance trajectory of OK lens ( P <0.05). Conclusions The compliance of wearing OK lens in children and adolescents with myopia can be roughly divided into four trajectories, and there is group heterogeneity. Dynamic and precise compliance intervention strategies should be given based on different trajectories and influencing factors.

BACKGROUND:The expression efficiency of recombinant adeno-associated virus serotype 9(rAAV9)carrying the macrophage-specific promoter synthetic promoter 146-C1(SP146-C1)and the exogenous gene vascular endothelial growth factor C(VEGFC)in atherosclerosis is uncertain. OBJECTIVE:To investigate the expression efficiency of rAAV9-SP146-C1-VEGFC in atherosclerotic mice and its effect on lymphangiogenesis. METHODS:Thirty ApoE-/-mice were fed high-fat diet for 12 weeks to establish atherosclerosis models and were randomly divided into six groups,five in each group:7-,14-,21-,28-,and 35-day transfection groups and control group.The mice in the transfection groups were transfected with 5.0×1011 vg rAAV9-SP146-C1-VEGFC by caudal vein injection.In the control group,the mice were injected with the same amount of control virus rAAV9-SP146-C1-Scramble.Animals in the first five groups were killed under anesthesia at 7,14,21,28 and 35 days after transfection,respectively,and those in the control group were killed under anesthesia at 7 days.Serum,femur,tibia,heart and aorta tissue samples were collected and retained in each group.The femur and tibia of mice in each group were used to extract bone marrow-derived macrophages.The gene expression of vascular endothelial growth factor C(VEGFC),vascular endothelial growth factor receptor 3(VEGFR3),Podoplanin and lymphatic vessel endothelial hyaluronan receptor-1(LYVE-1)in bone marrow-derived macrophages and the aorta were detected by RT-qPCR.VEGFC protein expression levels in bone marrow-derived macrophages and the aorta were detected by western blot,serum level of VEGFC was detected by ELISA,and VEGFC expression in the aortic sinus and LYVE-1 expression around the aorta and in the myocardium was detected by immunofluorescence. RESULTS AND CONCLUSION:The serum level of VEGFC,the mRNA expression of VEGFC,VEGFR3,Podoplanin,and LYVE-1 in bone marrow-derived macrophages and the aorta,the protein expression of VEGFC in bone marrow-derived macrophages,and the fluorescence intensity of VEGFC in aortic sinus plaques were significantly increased in the 7-day transfection group compared with the control group(P＜0.05,P＜0.01).Serum VEGFC level of mice transfected with rAAV9-SP146-C1-VEGFC gradually increased with time and began to decrease at 28 days.mRNA levels of VEGFC,VEGFR3,Podoplanin and LYVE-1 in mouse aorta and bone marrow-derived macrophages,VEGFC protein level in bone marrow-derived macrophages,VEGFC fluorescence intensity in aortic sinus plaques,LYVE-1 fluorescence intensity around the aortic sinus and in the myocardium gradually increased with time(P＜0.05).In addition,the mRNA level of LYVE-1 in the aorta and the fluorescence intensity of LYVE-1 around the aortic sinus and in the myocardium were the highest at 28 days(P＜0.05),and gradually decreased(P＜0.05).The expression of the other indicators reached the peak at 21 days.To conclude,rAAV9-SP146-C1-VEGFC could effectively transfect bone marrow-derived macrophages and promote lymphatic hyperplasia in atherosclerotic mice.

Objective:To analyze the prognostic value of the coagulation index in stereotactic radio surgery(SRS)for patients with non-small cell lung cancer(NSCLC)and brain metastases(BMS).Methods:We retrospectively analyzed clinical data from 512 patients diagnosed with NSCLC and BMS,who were treated with SRS at Tianjin Huanhu Hospital from October 2015 to September 2018.The overall survival(OS)and progression-free survival(PFS)rates were analyzed.The Cox model was employed to examine prognostic factors.Subsequently,the receiver operating characteristic(ROC)curve was constructed based on multi-factor analysis usin the Cox model.The area under the ROC curve(AUC)was used to assess the prognostic value of coagulation indexes in patients with NSCLC and BMS who underwent SRS.Results:In 1,2,3,and 4 years,PFS rates were 79.9%,69.9%,56.6%,and 43.2%,respectively,and OS rates were 93.4%,83.2%,69.9%,and 57.6%,respectively.Smoking and average fibrinogen(Fib)levels,prothrombin time(PT),and D-dimer(D-D)levels were correlated with a longer PFS(P<0.05).Av-erage activated partial thromboplastin time(APTT),Fib,and D-D levels were correlated with a longer OS(P<0.05).Smoking and mean Fib and D-D levels were significantly correlated with a longer PFS(P<0.05),while The average levels of Fib and D-D are each significantly associated with longer OS rates(P<0.05).The combined detection of Fib and D-D in predicting the prognosis of NSCLC patients with brain metastases undergoing SRS treatment shows a significantly higher AUC compared to the detection of Fib and D-D individually(P<0.05).Conclusions:Co-agulation indexes have a certain correlation with the prognosis of patients with NSCLC and BMS treated with SRS.Furthermore Fib and D-D are independent risk factors for the prognosis of these patients and can be used to assess their outcomes.The combined evaluation of the indexes provides a more ideal prognostic assessment.

ObjectiveTo explore the clinical effect of Tiaoxin formula in the treatment of patients with coronary heart disease and anxiety/depression and its impact on serum levels of 5-hydroxytryptamine （5-HT）， β- thromboglobulin （β-TG） and myeloperoxidase （MPO）. MethodA total of 66 patients with coronary heart disease and anxiety/depression were randomly divided into the Tiaoxin formula group and Deanxit group， 33 cases in each group. Both groups were given fundamental western treatment for coronary heart disease. Additionally， the Deanxit group was treated with flupentixol and melitracen tablets and the Tiaoxin formula group was treated with Tiaoxin Formula. The treatment lasted 8 weeks. Before and after treatment， the changes of clinical efficacy， Patient Health Questionnaire （PHQ-9）， Generalized Anxiety Disorder （GAD-7） scale， Seattle Angina Questionnaire （SAQ）， heart rate variability， and serum 5-HT， β-TG and MPO levels， and incidence of adverse reactions in the two groups were observed. ResultThere was no significant difference in the baseline indexes of patients in the two groups， and thus the two groups were comparable. After treatment for 8 weeks， the total effective rate for traditional Chinese medicine （TCM） syndromes in the Tiaoxin Formula group was 87.88% （29/33） higher than 63.64% （21/33） in the Deanxit group （Z=-2.653， P<0.05）. Compared with those before treatment， the PHQ-9 and GAD-7 scores of the two groups were decreased at week 4 and 8 of treatment （P<0.05）， and there was no statistical difference between two groups. And the SAQ dimension scores of the two groups were increased at week 4 and 8 of treatment （P<0.05）. Compared with the Deanxit group， the Tiaoxin Formula group had elevation in two dimension scores： Physical limitation and angina stability （P<0.05）. Compared with the conditions before treatment， the serum 5-HT level in the two groups were increased， while the β-TG and MPO levels were lowered （P<0.05）， and there was no distinct difference between two groups. In addition， the standard deviation of normal-to-normal intervals （SDNN） and standard deviation of average normal-to-normal intervals （SDANN） of the heart rate variability in the Tiaoxin formula group were elevated after treatment （P<0.05）， which were more significant than those of the Deanxit group （P<0.05）. During the treatment period， the incidence of adverse drug reactions in the Tiaoxin formula group was lower than that in the Deanxit group （P<0.05）， and no adverse events were observed in the two groups. ConclusionTiaoxin formula was effective for the treatment of patients with coronary heart disease accompanied by anxiety and depression， which improved the clinical symptoms， increased serum 5-HT levels， and decreased serum β-TG and MPO levels， and had few adverse reactions and high safety for patients， showing a high clinical value.

Objective:To compare the value of new gastric cancer screening scoring system and serum pepsinogen (PG) combined with gastrin-17 (G-17) (new ABC method) in screening gastric cancer and precancerous lesions.Methods:A total of 576 patients were enrolled after the examination of endoscopy at Endoscopy Center,Department of Gastroenterology,from December 2017 to December 2019. There were 275 males and 301 females with an age of 40-72 (52±10) years. According to the new ABC method and the new gastric cancer screening scoring system, the population was divided into three groups according to age,gender,serum helicobacter pylori antibody test, PG Ⅰ/PG Ⅱ(PGR) and G-17 before endoscopy. The detection rates of gastric cancer and atrophic gastritis by two different methods were analyzed and the value in screening gastric cancer and precancerous lesions were evaluated. Statistical analysis was accomplished by Chi-square test and Gamma coefficient analysis. Results:A total of 576 patients were enrolled. According to the new ABC method, 382 patients were classified into low-risk group, 170 patients into middle-risk group and 24 patients into high-risk group, respectively. In the new ABC method, 1 case of gastric cancer (0.3%) was detected in low-risk group, 8 cases (4.7%) in middle-risk group and 3 cases (12.5%) in high-risk group. As for atrophic gastritis, 89 cases (23.3%) was detected in low-risk group, 94 cases (55.3%) in middle-risk group and 18 cases (75.0%) in high-risk group. According to the new gastric cancer screening scoring system, 336 patients were classified into low-risk group, 205 patients into middle-risk group and 35 patients into high-risk group, respectively. One case of gastric cancer (0.3%) was detected in low-risk group, 6 cases (2.9%) in middle-risk group and 5 cases (14.3%) in high-risk group. As for atrophic gastritis, 41 cases (12.2%) were detected in low-risk group, 134 cases (65.4%) in middle-risk group and 26 cases (74.3%) in high-risk group. In this two methods, the prevalence of gastric cancer increased according to the disease stage ( χ2 =22.509, P<0.01; χ2=24.156, P<0.01); in terms of atrophic gastritis, the detection rate of the new screening scoring system in the low-risk group was significantly lower than that in the new ABC method ( χ2=14.844, P<0.01), but higher in the middle-risk group ( χ2=3.955, P=0.047). Gamma coefficient test showed that there were strong correlations between gastroscopy pathology and classification grade of both methods ( P<0.01). Conclusions:Both methods are suitable for screening gastric cancer and precancerous lesions, and the new scoring system may be more valuable in screening gastric cancer and precancerous lesions.

Objective:To evaluate the new scoring system for gastric cancer screening and risk assessment of gastric precancerous lesions.Methods:A total of 442 patients who underwent endoscopy due to stomach discomfort at the First Hospital of Jiaxing from March 2018 to September 2019 were enrolled. The patients were divided into three groups based on the new scoring system for gastric cancer screening before endoscopy: low-risk group (0-11 points), median-risk group (12-16 points) and high-risk group (17-23 points). The detection rates of gastric cancer and atrophic gastritis in three groups were analyzed. According to the range or degree of atrophy or intestinal metaplasia, patients were divided into five groups of stage 0 to Ⅳ based on the operative link for gastritis assessment (OLGA) or operative link for gastritis intestinal metaplasia (OLGIM). The correlation between the new gastric cancer screening scoring system and OLGA or OLGIM staging system were evaluated.Results:Among 442 patients, 211 were assigned to low-risk group, 207 median-risk group and 24 high-risk group according to the new scoring system. For OLGA staging system, there were 241 cases of stage-0, 105 of stage-Ⅰ, 58 stage-Ⅱ, 27 stage-Ⅲ and 11 stage-Ⅳ. For OLGIM staging system, there were 224 cases of stage-0, 113 stage-Ⅰ, 61 stage-Ⅱ, 31 stage-Ⅲ and 13 stage-Ⅳ. The pepsinogen (PG) Ⅰ and pepsinogen ratio (PGR) levels had differences among different OLGA stages ( F=2.844, P=0.027; F=5.435, P=0.001), and these two variables at Stage-Ⅲ and Ⅳ were significantly lower than three other OLGA stages (all P<0.001). The PGR level had differences among different OLGIM stages ( F=3.887, P=0.008), which was significantly lower at Stage-Ⅳ than at other OLGIM stages (all P<0.001). Gamma coefficient analysis and Kendall′s tau-b analysis showed significant correlations between OLGA/OLGIM staging system and new gastric cancer screening scoring system ( P<0.001). Conclusion:The new scoring system is reliable for gastric cancer screening, and is closely linked with OLGA/OLGIM staging system in the risk assessment of gastric precancerous lesions.

Objective:To observe the functional changes of skeletal muscle in severely burned rats, and to investigate the effects and possible mechanisms of Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) pathway inhibitor in skeletal muscle function.Methods:The experiment research method was applied. One hundred and twenty male Wistar rats of 8-week-old were divided into sham injury group, simple burn group, and burn+JAK/STAT3 inhibitor group according to the random number table, with 40 rats in each group. Rats in simple burn group and burn+JAK/STAT3 inhibitor group were inflicted with 50% total body surface area full-thickness scald on the back and abdomen, and rats in sham injury group were sham injured. Rats in burn+JAK/STAT3 inhibitor group were intraperitoneally injected with JAK/STAT3 inhibitor ruxolitinib. On post injury day (PID) 0 (immediately), 1, 4, 7, and 14, 8 rats in each group were used to measure the specific force generated by extensor digitorum longus in optimal length stimulated with pulse frequency of 20, 40, 60, 80, 100, 120, 140, and 160 Hz using a multichannel electrophysiological instrument, and specific force in fatigue period of extensor digitorum longus in optimal length stimulated with pulse frequency of 50 Hz for 0, 10, 20, 30, 60, 120, 180, 240, and 300 s. On PID 0, 1, 4, 7, and 14, carbonyl compound content of extensor digitorum longus was determined by ultraviolet spectrophotometry, and ATP content of extensor digitorum longus was determined by micrometry. Data were statistically analyzed with analysis of variance for repeated measurement, analysis of variance for factorial design, Bonferroni method, and t test. Results:Compared with those of sham injury group, specific forces of extensor digitorum longus of rats in simple burn group were significantly decreased after being stimulated with all the pulse frequency on PID 0, 1, 7, and all the pulse frequency except for 20 Hz on PID 4, and pulse frequency of 20 and 40 Hz on PID 14 ( P<0.05 or P<0.01). Compared with those of simple burn group, specific forces of extensor digitorum longus of rats in burn+JAK/STAT3 inhibitor group were significantly increased after being stimulated with all the pulse frequency except for 20 Hz on PID 1 and all the pulse frequency on PID 4, 7, and 14 ( P<0.05 or P<0.01). Compared with those of sham injury group, specific forces of extensor digitorum longus of rats in simple burn group were significantly decreased in fatigue period at all the time points post injury and stimulation time points except for 240 s on PID 7 ( P<0.05 or P<0.01). Compared with those of simple burn group, specific forces of extensor digitorum longus of rats in burn+JAK/STAT3 inhibitor group were obviously increased in fatigue period at all the stimulation time points except for 60 and 300 s on PID 1 and 240 s on PID 4, and all the stimulation time points on PID 7 and 14 ( P<0.05 or P<0.01). The carbonyl compound content of extensor digitorum longus of rats in simple burn group on PID 0, 1, 4, 7, and 14 was (0.651±0.155), (0.739±0.194), (0.618±0.086), (0.813±0.162), (0.615±0.115) nmol/mg, which were obviously higher than (0.196±0.019), (0.156±0.004), (0.169±0.023) (0.156±0.027), (0.175±0.008) nmol/mg in sham injury group ( t=7.219, 6.491, 10.938, 9.182, 11.589, P<0.01) and (0.538±0.069), (0.369±0.059), (0.273±0.061), (0.334±0.109), (0.318±0.101) nmol/mg in burn+JAK/STAT3 inhibitor group ( t=2.446, 4.689, 8.355, 5.754, 6.097, P<0.05 or P<0.01). The ATP content in extensor digitorum longus of rats in simple burn group on PID 1, 4, 7, and 14 was obviously lower than that in sham injury group ( t=7.159, 7.591, 7.473, 4.026, P<0.01) and burn+JAK/STAT3 inhibitor group ( t=2.295, 2.575, 2.453, 2.997, P<0.05). Conclusions:After severe burn, the specific force of extensor digitorum longus in rats decreased significantly after being stimulated with different pulse frequencies, and the extensor digitorum longus in rats was prone to fatigue. Blocking the JAK/STAT3 signaling pathway can reduce the oxidative stress of muscle protein and increase ATP content, thereby reducing the muscle strength decline caused by burn injury and improving the muscle strength decline during fatigue period.

Objective:To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection.Methods:Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared.Results:Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant ( P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ 2=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ 2=11.49, P<0.01) . Conclusion:FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.

Objective:To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection.Methods:Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared.Results:Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant ( P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ 2=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ 2=11.49, P<0.01) . Conclusion:FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.

Background: Serum pepsinogens (PGs), as an indicator of gastric mucosal atrophy, reflects the functional and morphological status of gastric mucosa. And OLGA/OLGIM, the staging system of gastritis integrating the severity and topography of gastric mucosal atrophy/intestinal metaplasia, has been gradually accepted and used in gastric cancer screening in recent years. Aims: To investigate the correlation between ABC method [combined assay for serum Helicobacter pylori (Hp) antibody and PGs] and OLGA/OLGIM staging system, as well as the role of PGs test in risk assessment of gastric precancerous lesions. Methods: A total of 331 patients undergoing gastroscopy for upper gastrointestinal symptoms from Jan. 2017 to Jan. 2018 at the First Hospital of Jiaxing were enrolled. According to the results of serum tests and biopsy pathology, these patients were divided into four groups by ABC method and five groups by OLGA/OLGIM staging system, respectively. Hp infection rate, serum levels of PG and PGⅡ, and PG/PGⅡ ratio (PGR) were compared between different OLGA/OLGIM groups, and the correlations between OLGA/OLGIM staging system and ABC method were analyzed. Results: For OLGA/OLGIM staging system, the Hp infection rate was significantly lower in stage-0 and significantly higher in stage- (P<0.05), whereas the PGR decreased with the rising of stage (P<0.05). Only in OLGA groups, the PG level decreased with the rising of stage (P<0.05). Gamma coefficient analysis showed significant correlation between OLGA/OLGIM staging system and ABC method (G=0.589, P<0.05; G=0.440, P<0.05). Conclusions: Serological ABC method and histological OLGA/OLGIM staging system are closely linked in risk assessment of gastric precancerous lesions. Serum PGs test could be applied for screening of gastric precancerous lesions in China, identifying high risk population for further gastroscopy.