Objective To systematically evaluate the control effects of different concentrations of atropine on myopia in Chinese children.Methods PubMed,Embase,The Cochrane Library,Web of Science,CBM,WanFang Data,VIP and CNKI databases were retrieved to collect the studies on children's myopia control by atropine from the establishment of the database to April 2023.After the literature screening,data extraction and bias risk valuation were carried out by 2 research-ers,a Meta-analysis was performed via RevMan 5.4 software.Results A total of 32 studies were included,comparing the effects of 7 different concentrations of atropine and placebo.The Meta-analysis showed that compared with placebo,0.1 g·L-1 atropine had a significant impact on the change of spherical equivalent[MD=0.39,95％CI(0.26,0.52),P＜0.05],and significantly suppressed the axial length increment[MD=-0.18,95％CI(-0.24,-0.12),P＜0.05].Among other concentrations,0.2g·L-1,0.5g·L-1 and 10 g·L-1 atropine had sound effects on myopia control.Conclusion Exist-ing evidence shows that compared to placebo,atropine at concentrations of0.1 g·L-1,0.2 g·L-1,0.5 g·L-1and 10 g·L-1 has better effects on controlling the spherical equivalent and axial length of children with myopia.Among them,at-ropine at the concentration of 0.1 g·L1 may have the best effect.

Objective:To investigate the risk factors of lower extremity deep venous thrombosis (LEDVT) in patients with sepsis during hospitalization in intensive care unit (ICU), and to construct a nomogram prediction model of LEDVT in sepsis patients in the ICU based on the critical care scores combined with inflammatory markers, and to validate its effectiveness in early prediction.Methods:726 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2015 to December 2021 were retrospectively included as the training set to construct the prediction model. In addition, 213 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2022 to June 2023 were retrospectively included as the validation set to verify the performance of the prediction model. Clinical data of patients were collected, such as demographic information, vital signs at the time of admission to the ICU, underlying diseases, past history, various types of scores within 24 hours of admission to the ICU, the first laboratory indexes of admission to the ICU, lower extremity venous ultrasound results, treatment, and prognostic indexes. Lasso regression analysis was used to screen the influencing factors for the occurrence of LEDVT in sepsis patients, and the results of Logistic regression analysis were synthesized to construct a nomogram model. The nomogram model was evaluated by receiver operator characteristic curve (ROC curve), calibration curve, clinical impact curve (CIC) and decision curve analysis (DCA).Results:The incidence of LEDVT after ICU admission was 21.5% (156/726) in the training set of sepsis patients and 21.6% (46/213) in the validation set of sepsis patients. The baseline data of patients in both training and validation sets were comparable. Lasso regression analysis showed that seven independent variables were screened from 67 parameters to be associated with the occurrence of LEDVT in patients with sepsis. Logistic regression analysis showed that the age [odds ratio ( OR) = 1.03, 95% confidence interval (95% CI) was 1.01 to 1.04, P < 0.001], body mass index (BMI: OR = 1.05, 95% CI was 1.01 to 1.09, P = 0.009), venous thromboembolism (VTE) score ( OR = 1.20, 95% CI was 1.11 to 1.29, P < 0.001), activated partial thromboplastin time (APTT: OR = 0.98, 95% CI was 0.97 to 0.99, P = 0.009), D-dimer ( OR = 1.03, 95% CI was 1.01 to 1.04, P < 0.001), skin or soft-tissue infection ( OR = 2.53, 95% CI was 1.29 to 4.98, P = 0.007), and femoral venous cannulation ( OR = 3.72, 95% CI was 2.50 to 5.54, P < 0.001) were the independent influences on the occurrence of LEDVT in patients with sepsis. The nomogram model was constructed by combining the above variables, and the ROC curve analysis showed that the area under the curve (AUC) of the nomogram model for predicting the occurrence of LEDVT in patients with sepsis was 0.793 (95% CI was 0.746 to 0.841), and the AUC in the validation set was 0.844 (95% CI was 0.786 to 0.901). The calibration curve showed that its predicted probability was in good agreement with the actual probabilities were in good agreement, and both CIC and DCA curves suggested a favorable net clinical benefit. Conclusion:The nomogram model based on the critical illness scores combined with inflammatory markers can be used for early prediction of LEDVT in ICU sepsis patients, which helps clinicians to identify the risk factors for LEDVT in sepsis patients earlier, so as to achieve early treatment.

Microglia, originating from primitive macrophages in the yolk sac, serves as both immune system defenders and regulators of homeostasis. These cells exhibit two primary polarization states: conventionally activated(M1)and alternatively activated(M2). The polarization of microglia plays a crucial role in influencing inflammatory disorders, metabolic imbalances, and neural degeneration. This process is implicated in various aspects of ocular diseases, especially age-related macular degeneration(AMD), including inflammation, oxidative stress and pathological angiogenesis. The distinct functional phenotypes of microglia impact disease progression and prognosis. Thus, regulating the polarization or functional phenotype of microglia at different stages of AMD holds promise for personalized therapeutic approaches. This comprehensive review outlines the involvement of microglia polarization in both physiological and pathological conditions, emphasizing its relevance in AMD. The discussion underscores the potential of polarization as a foundation for personalized treatment strategies for AMD.

To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research.

Objective:To investigate the value of electronic nasolaryngoscope combined with nasopharyngeal three dimensional computed tomography(3D-CT)in postoperative assessment for the surgery of pediatric tonsil adenoid.Methods:A total of 106 pediatric patients with tonsil adenoid admitted to the Affiliated Hospital of Weifang Medical College from January 2021 to January 2024 were selected,and all of them underwent electronic nasal laryngoscopy combined with nasopharyngeal 3D-CT before and after surgery.According to different assessment methods,pediatric patients who underwent the assessment of electronic nasolaryngoscope combined with nasopharyngeal 3D-CT were included in the combined assessment group(42 patients),and pediatric patients who underwent the assessment of electronic nasolaryngoscope were included in the electronic nasolaryngoscope assessment group(30 patients),and pediatric patients who underwent the assessment of nasopharyngeal 3D-CT were included in the nasopharyngeal 3D-CT assessment group(34 patients).Descriptive statistics was conducted on the basic characteristics of the three groups.The accuracies of nasopharyngeal 3D-CT combined with electronic nasolaryngoscope,the single electronic nasolaryngoscope,and the single nasopharyngeal 3D-CT in the postoperative assessment were calculated and compared.Results:In assessment effect of 42 pediatric patients of the combined assessment group,20 cases were effective,and 22 cases were ineffective,and the effective rate of assessment was 47.62%(20/42).In assessment effect of 30 pediatric patients of the electronic nasolaryngoscope assessment group,5 cases were effective,and 25 cases were ineffective,and effective rate of assessment was 16.67%(5/30).In assessment effect of 34 pediatric patients of the nasopharyngeal 3D-CT assessment group,13 cases were effective and 21 cases were ineffective,and the effective rate of assessment was 38.24%(13/34).The effective rate of the assessment of the combined assessment group was significantly higher than that of each single assessment group,and the difference was statistically significant(x2=7.414,P<0.05).The sensitivity,specificity,accuracy,positively predictive value and negatively predictive value of the combined assessment were respectively 47.60%,83.30%,55.60%,80.00%and 53.60%.These indicators of single electronic nasolaryngoscope assessment were respectively 16.70%,47.60%,35.70%,18.20%and 44.40%.These indicators of single nasopharyngeal 3D-CT assessment were respectively 38.20%,83.30%,50.00%,72.20%and 54.30%.Conclusion:The combined application of nasopharyngeal 3D-CT and electronic nasolaryngoscope can improve the accuracy of postoperative assessment for the surgery of pediatric tonsil adenoid,and it is helpful to timely find and deal with postoperative problems,and improve the treatment effect.

This study aims to prepare altrenogest extended-release tablets,evaluate their quality and establish a content determination method.The hydrophilic gel skeleton type,dosage and core thick-ness of altrenogest extended-release tablets were used as the investigating factors,and the release degree of the tablets was used as the investigating index,the prescription process of altrenogest ex-tended-release tablets was optimized by one-factor screening and central combinatorial design re-sponse surface method,and quality evaluation was carried out,the in vitro release model was es-tablished,and a high-performance liquid chromatography(HPLC)assay method was set up for the determination of altrenogest extended-release tablets.The results showed that the optimal pre-scription of altrenogest extended-release tablets was 2％as the main drug,70％as the solubilizer,0.5％as the lubricant,19.1％as the filler,8.4％as the hydrophilic gel skeleton material,and the thickness of the tablets was 3.8 mm.The in vitro drug release conformed to the Higuchi model,and the altrenogest showed a good linear relationship with the R2=0.999 98 in the range of 10-80 mg/L.The optimized process for the extended-release tablets was stable and had a good quality.The extended-release tablets were stable and had significant slow-release effect.The HPLC method is accurate and reliable and can be used for the determination of altrenogest in extended-release tablets.

Objective:To analyze the clinical features, treatment, and outcomes of fetal/neonatal atrial flutter (AFL) at the onset of the perinatal period to improve the management of this condition.Methods:This retrospective study analyzed the clinical data, treatment, and follow-up results of fetal/neonatal AFL cases transferred to Shanghai Children's Medical Center from November 2013 to August 2021. Clinical characteristics, cardioversion procedures, and outcomes were summarized. Descriptive method was used for statistical analysis.Results:A total of 21 fetuses/neonates presenting with AFL in the perinatal period were involved in this study, including 17 males and four females. Ten of them were born at full term, and 11 were preterms. All of the patients were delivered by cesarean section at 32 to 41 gestational weeks [ (36.6±1.9) weeks] with a birth weight of 2 130 to 4 450g [ (3 059±528) g]. Increased fetal heart rate was all detected after 32 weeks of gestation, and three of them were diagnosed with AFL by fetal echocardiography before being born. The heart rate remained elevated in all cases after birth. All were diagnosed as AFL based on an electrocardiogram on the day of birth, which showed a 2 to 6 over one ratio of atrioventricular conduction. Among the six cases of cardiac insufficiency and low blood pressure complicated by dyspnea and cyanosis, the symptoms were relieved in four cases after mask oxygenation and two cases after ventilation. Among the 21 cases, one was converted spontaneously to normal sinus rhythm and the other 20 recovered after medication or electrical cardioversion. Seven cases were initially treated by drug conversion with a success rate of 5/7 and hospitalized for 23 d (13-25 d). There was one with cardiac insufficiency before treatment and three newly developed cardiac insufficiency during treatment among the seven cases. Thirteen cases were offered electrical cardioversion initially, and the success rate of cardioversion was 12/13. There were five cases of cardiac insufficiency before treatment, while no new cases of cardiac insufficiency was reported during treatment. The duration of hospitalization was 11 d (9-14 d). Apart from one case, the rest 20 infants were followed up from one month to eight years old, and no recurrence was reported.Conclusions:For fetal/neonatal AFL with the onset during the perinatal period, the symptoms mainly manifest in late pregnancy. Its diagnosis depends on fetal echocardiography before birth or electrocardiogram after birth, and electrical cardioversion is a fast and effective measure. While the prognosis of perinatal-onset AFL is generally good.

To analyze the methodological and reporting quality of systematic reviews of prediction models published in Chinese journals, with the aim of providing reference for enhancing the overall quality of Chinese systematic reviews of prediction models.

Objective:To investigate the status of caregivers' benefit finding of senile dementia patients in Shiyan city, Hubei Province, and to analyze its influencing factors, so as to provide basis for carrying out targeted intervention measures.Methods:Totally 252 caregivers of senile dementia patients who visited Taihe Hospital, Shiyan People′s Hospital and Sinopharm Dongfeng General Hospital in Shiyan City, Hubei Province from July 2019 to July 2021 were selected as the research objects by convenience sampling method. The general Information Questionnaire, the Caregiver benefit finding questionnaire, the General self-efficacy Scale (GSES) and the Perceived Social Support Scale (PSSS) were used. The Pearson correlation analysis method was used for the correlation between caregivers' self-efficacy, social support and perceived benefit. Catreg was used to analyze the influencing factors of caregivers' benefit finding in senile dementia patients.Results:The total score of caregiver benefit questionnaire for 252 caregivers of senile dementia patients was (104.74 ± 14.82), the item "made me realize the significance of my health to my family and society" received the highest score (4.70 ± 0.55), while the item "made me quit bad habits" received the lowest score (3.22 ± 1.17). The GSES and PSSS scores of 252 caregivers of senile dementia patients were (24.74 ± 7.02) and (54.21 ± 13.32), which were positively correlated with the benefit finding ( r=0.565, 0.459, both P<0.01). The catreg analysis showed that the age of the caregiver, the average monthly income of the family, self-efficacy and social support were the influential factors of the perceived benefit level of the caregiver of senile dementia patients ( F values were 3.30-104.92, all P<0.05), which could explain 42.4% of the variance. Conclusions:The benefit finding of caregivers of senile dementia patients still needs to be improved. Medical staff should pay attention to the evaluation of benefit finding of caregivers of senile dementia patients, and provide personalized intervention measures to relieve caregivers' care pressure, maintain their physical and mental health, and improve the care quality of caregivers of senile dementia patients.

Objective To analyze the rebleeding rate in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) after endoscopic treatment of esophagogastric variceal bleeding and then assessed the risk factors of the rebleeding in the patients. Methods This study retrospectively recruited 169 hepatitis B-associated HCC patients complicated with PVTT and esophagogastric variceal bleeding treated by endoscopy in Department of Gastroenterology, Beijing Ditan Hospital from September 2008 to December 2016. Among them, 47 patients had PVTT Ⅱ, 67 patients had PVTT Ⅲ, and 55 patients had PVTT Ⅳ. Their clinicopathological and follow-up data were retrieved from the medical records and statistically analyzed. Continuous data were compared among groups using ANOVA or Kruskal-Wallis H test. Categorial data were compared among groups using Chi-square test or corrected Fisher test. The Kaplan-Meier curves and Log-rank test were performed to analyze the rebleeding rate and cumulative survival rates after treatment. The univariate multivariate Cox regression analyses were used to identify the risk factors affecting the rebleeding of patients. Results Compared with PVTT Ⅱ and Ⅲ, PVTT Ⅳ patients had a higher serum level of the direct bilirubin ( Z =6.153, P =0.046). The endoscopy treatment successfully blocked esophagogastric variceal bleeding in all patients. There was no significant difference in the rebleeding rates within six months and a year after the treatment (all P > 0.05). It was also no statistically significant difference in cumulative survival rates in six months and l-, 2-, and 3-year after the treatment in PVTT Ⅱ, Ⅲ, and Ⅳ patients (all P > 0.05). Cox multivariate regression analysis showed that hepatic encephalopathy ( HR =3.643, 95% CI : 2.099-6.325, P < 0.001), γ-glutamyltransferase ( HR =1.002, 95% CI : 1.000-1.005, P =0.029), AFP ( HR =1.000, 95% CI : 1.000-1.000, P =0.002) and numbers of tumor lesions ( HR =1.647, 95% CI : 1.011-2.684, P =0.045) were all independent risk factors for 1-year rebleeding in these PVTT patients with esophagogastric variceal bleeding after endoscopic treatment. Conclusion Endoscopic hemostasis is a feasible treatment option for HCC patients with PVTT and esophagogastric variceal bleeding. However, there was no significant difference in the rebleeding and cumulative survival rates in these patients. Furthermore, hepatic encephalopathy, γ-glutamyltransferase, AFP and numbers of tumor lesions were all independent risk factors for 1-year rebleeding in these patients.