AIM: To assess the gap between the peak of the base curve to the surface of the cornea, as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT), providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens.METHODS: Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included. Examinations, including naked vision, slit lamp, non-contact intraocular pressure, ocular fundus, eye position, corneal diameter, corneal topography, tear film rupture time, optometry, etc., were performed on all patients before fitting. The trial lens parameter was selected according to the examination results, and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses. According to the performance of fluorescein staining, the inspected eyes are divided into three groups: lens loose group, lens fitting group, and lens tight group. In addition, the tear film thickness of three groups of subjects was measured by OCT, and the differences between the three groups of data were evaluated.RESULTS: A total of 49 myopic patients(77 eyes)were included. The average sphere degree was -3.10±1.25 D, the average cylinder degree was -0.43(-0.75, 0)D, the average horizontal keratometry(HK)was 42.48±0.81 D, and vertical keratometry(VK)was 42.98(42.25, 43.50)D. There were 21 cases(34 eyes)in the lens fitting group, with 13 cases of bilateral eyes, 8 cases of one eye, 14 cases(22 eyes)in the lens loose group, with 8 cases of bilateral eyes, 6 cases of one eye, and 14 cases(21 eyes)in the lens tight group, with 7 cases of bilateral eyes, 7 cases of one eye. There was no statistical difference in the main basic data of the subjects in the three groups(all P>0.05). OCT showed that the tear film thickness of the lens fitting group, the lens loose group, and the lens tight group was 231.18(219.0, 243.0), 220.41(214.0, 224.3), and 249.00(241.5, 258.0)μm, respectively, and there was statistical significance in the thickness among the three groups(P<0.05).CONCLUSION: OCT can serve as a safe and reliable method for measuring the tear film thickness, which can help evaluate the suitability of orthokeratology and provide a non-invasive, more intuitive, and quantitative evaluation method for the fitting and evaluation of orthokeratology.

Objective To analyze the colorectal cancer screening of community residents in Pudong New Area in Shanghai and provide reference for the promotion and strategy optimization of colorectal cancer screening programs. Methods Residents aged 50-74 years in the colorectal cancer screening project of Pudong New Area in Shanghai from 2013 to 2023 were recruited in this analysis. The situation of primary screening and colonoscopy in the community was described, and results of different age groups in primary screening and colonoscopy surveys were evaluated. Chi-square test was used to determine differences between groups. Results From 2013 to 2023, 907 030 residents were screened in Pudong New Area, of which 183 724 residents were positive, and the positive rate was 20.3%. The positive rate was the lowest in the 50-54 age group and the highest in the 70-74 age group. The positive rate was higher in men than in women. The overall colonoscopy rate was 27.1%, with the highest rates in the 50-54 age group in men and the 55-59 age group in women, respectively. The participation rate of colonoscopy increased with the increase of the year. A total of 19 094 cases of intestinal lesions were found by colonoscopy. Among these lesions, 1 147 cases were colorectal cancer, accounting for 6.0%, and the population detection rate was 126.5/100 000. In addition, 4 751 cases of precancerous lesions were found, accounting for 24.9%, and the detection rate was 523.8/100 000. Conclusion Colorectal cancer screening improves the detection rate of precancerous lesions and early cancer and is of great significance for reducing the incidence and mortality of colon cancer. Measures should be taken to optimize the screening strategy based on age differences and increase the participation rate of primary screening and colonoscopy to achieve the best effect of local colorectal cancer prevention and treatment.

ObjectiveTo explore the effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients. MethodsFrom October, 2020 to September, 2022, 54 stroke patients were randomly divided into control group (n = 18), external diaphragm pacing group (n = 18) and combined treatment group (n = 18). All the groups received breathing training, while the external diaphragm pacing group received external diaphragm pacing therapy, and the combined treatment group received external diaphragm pacing and abdominal functional electrical stimulation therapy, for two weeks. They were measured forced vital capacity (FVC), forced expiratory volume in first second (FEV₁), ratio of forced expiratory volume in first second in forced vital capacity (FEV₁/FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with pulmonary function instrument; measured diaphragmatic excursion (DE) and diaphragmatic thickness (DT) with ultrasound, before and after treatment. ResultsThree cases in the control group, two cases in the external diaphragm pacing group and one case in the combined treatment group dropped off. The FVC, FEV₁, PEF, MIP, MEP and DE improved in all the groups (|t| > 3.366, P < 0.01) after treatment; and the FVC, FEV₁, MIP and DE increased more in the combined treatment group and the external diaphragm pacing group than in the control group (P < 0.05); the FVC and FEV₁ increased more in the combined treatment group than in the external diaphragm pacing group (P < 0.05). ConclusionExternal diaphragm pacing therapy may improve ventilation and inspiratory muscle strength, and increase diaphragm movement for stroke patients; while the ventilation improved more after combining with abdominal functional electrical stimulation.

Objective : To investigate the effect of sinomenine on proliferation and migration of multiple myeloma (MM) cells by regulating STAT3 and NF-κB signaling pathway． Methods : The cultured U266 cells were treated with different concentrations of sinomenine (0，0．5，1，2 mmol / L) ．The control group was added DMSO with 0．5% concentration．CCK-8 assay was used to detect the proliferation of U266 cells．Flow cytometry was used to detect the apoptosis of U266 cells．Western blot assay was used to detect the expression levels of apoptosis-related proteins， STAT3 and NF-κB signaling pathway proteins in the each group. Results : Compared with CON group，the apopto- sis of U266 cells increased after Sinomenine treatment，the proliferation was inhibited ; B lymphoma-2 (Bcl-2) mye- loid and cell leukemia-1 (Mcl-1) expression level decreased ; activated Caspase-3 (cleaved Caspase-3) and PARP (Cleaved Caspase-3) expression levels increased ; the activity of STAT3 and NF-κB signaling pathway decreased. Conclusion Sinomenine can down-regulate the activity of STAT3 and NF-κB signaling pathway，promote the apop- tosis of U266 cells and inhibit the proliferation of U266 cells.

Objective:To systematically synthesize qualitative research on the illness experience of patients with mild cognitive impairment (MCI) , so as to provide a basis for developing effective intervention plans and implementing extended care.Methods:Qualitative studies on the illness experience of MCI patients were searched in WanFang Data, China National Knowledge Infrastructure, VIP, China Biomedical Medicine Disc, PubMed, Embase, CINAHL, Web of Science, and Cochrane Library. The search period was from the establishment of the database to June 2023. The article quality was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation integration method was used to synthesize the results.Results:A total of 14 articles were included, and 55 research results were extracted to form 11 categories, which were combined into four synthesized results. The synthesized results included patients experiencing multi-dimensional functional changes, current and future challenges, patients with low levels of disease cognition, and a desire to receive support from multiple aspects, and vastly different coping styles among patients.Conclusions:MCI patients face cognitive, physical, psychological, and social challenges. Families and hospitals should pay attention to the problems and needs of patients, provide them with continuous and dynamic emotional support and comprehensive intervention, and guide them to actively respond to the illness.

Objective:To observe the dynamic changes of serum RANTES during the treatment with nucleos(t)ide analogues combined with pegylated interferon alpha (peginterferon-α), and further analyze the predictive effect of RANTES on HBsAg clearance in patients with chronic hepatitis B.Methods:98 cases of chronic hepatitis B with quantitative HBsAg < 3 000 IU/ml and HBV DNA < 20 IU/ml after≥1 year NAs treatment were enrolled. Among them, 26 cases continued to receive NAs monotherapy, 72 cases received NAs combined with pegylated interferon alpha therapy. The changes in RANTES during treatment were observed. The receiver operating characteristic curve was used to analyze the early changes of RANTES to predict the HBsAg clearance during 48 weeks.Results:During 48 weeks, 15 cases (20.83%) had achieved HBsAg clearance in combination group, while no patient had achieved HBsAg clearance in NAs group. The overall serum RANTES level had decreased from baseline in NAs and combination group. At week 48, in the combination group, the serum RANTES level was decreased more significantly in patients with HBsAg clearance than patients without. Further analysis showed that, in combination group, HBsAg clearance rate of patients with serum RANTES decreased at week 12 and 24 was higher than patients with elevated (29.17% vs. 4.17%, P = 0.014; 28.00% vs. 4.55%, P = 0.052), and quantitative HBsAg reduction was larger significantly [(1.49 ± 1.26) log 10IU/ml vs. (0.73 ± 0.81) log 10IU/ml, P = 0.017; (1.54 ± 1.27) log 10IU/ml vs. (0.57 ± 0.56) log 10IU/ml, P = 0.004]. Receiver operating characteristic curve analysis showed that the baseline quantitative HBsAg and the reduction in quantitative HBsAg and serum RANTES during the early period were predictors of HBsAg clearance after 48-week combination therapy. Furthermore, the combination of baseline quantitative HBsAg and 12 - or 24-week reduction of serum RANTES were better predictors of HBsAg clearance than that of baseline quantitative HBsAg combined with HBsAg decrease at week 12 or 24. The area under the receiver operating characteristic curve of the former was 0.925 and 0.939, while that of the latter was 0.909 and 0.929, respectively. Conclusion:Early reduction of serum RANTES at week 12 and 24 can predict HBsAg loss in CHB patients receiving addition of peginterferon-α to ongoing NAs Therapy, so serum RANTES could be one of the key immunological markers for predicting HBsAg clearance.

Objective: To understand the prevalence of alcohol use and related factors in HIV positive and HIV negative males. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. The information about alcohol use in the last month was collected through a face-to-face questionnaire interview. Participants were categorized into non-current drinkers, light/moderate drinkers and heavy drinkers according to the US National Institute on Alcoholism and Alcohol Abuse (NIAAA) standard. Results: A total of 1 367 HIV positive males and 2 418 HIV negative males were included. Current alcohol use rate (35.2%, 481/1 367) and heavy alcohol use rate (5.0%, 24/481) were significantly lower in HIV positive males than in HIV negative males (48.0%, 1 161/2 418; 23.5%, 273/1 161), but the proportion of drinking wine and yellow rice wine were significantly higher (21.8%, 105/481; 9.1%, 44/481) in HIV positive males than in HIV negative males (13.5%, 157/1 161; 5.8%, 67/1 161). The multivariate multinomial logistic regression analysis results showed that larger waist circumference, current smoking and regular physical exercise were associated with heavy alcohol use behavior in HIV positive males, and age ≥30 years, current smoking, regular physical exercise, higher score of depressive symptoms, heterosexual transmission route and baseline CD₄⁺T cells counts of 200-499 cells/μl were significantly associated with mild/moderate alcohol use behavior in HIV positive males. Conclusions The alcohol use rate was significantly lower in HIV positive males than in HIV negative males in Taizhou. It is important to strengthen intervention on alcohol drinking behavior and chronic disease risk factors, such as larger waist circumference, smoking and so on.

Objective: To understand the characteristics of sleep disorder in HIV positive and negative individuals, and compare the distributions and epidemiologic characteristic of different subtypes of sleep disorder between two groups. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. A total of 459 HIV positive patients and 798 HIV negative controls with sleep disorders (Pittsburg Sleep Quality Index >5 or at least one question with answers of "most nights" or "every night" for Jenkins Sleep Scale) were included in the analysis. Cluster analysis was conducted to identify the different subtypes of sleep disorder based on 15 sleep-related questions. Results: A total of 1 257 participants were divided into three groups (clusters), i.e. difficulty falling asleep and sleep keeping group (cluster 1), the mild symptoms group (cluster 2), and restless night and daytime dysfunction group (cluster 3), accounting for 19.4% (89/459), 63.8% (293/459) and 16.8% (77/459) in HIV positive group and 13.8% (110/798), 60.5% (483/798) and 25.7% (205/798) in HIV negative group (χ²=16.62, P<0.001). In HIV positive group, the patients in cluster 1 and 3 were older and had higher frailty score, the patients in cluster 1 had highest level of depression, and the more patients in cluster 3 had low body weight or overweight (χ²=13.29, P=0.039; χ²=23.33, P<0.001; χ²=25.71, P<0.001; χ²=15.37, P=0.004). In HIV-negative group, similar findings were found for age, depressive symptoms and frailty score. In addition, the proportion of those who were illiteracy or with primary school education level was significantly high in cluster 1, and the proportion of abnormal waist-to-hip ratio was significantly higher in cluster 1 and 3 (χ²=30.59, P<0.001; χ²=11.61, P=0.003). Conclusions The proportion of every subtype of sleep disorder in HIV positive individuals were different to those in HIV negative individuals. Mental and physical health status were the main factors affecting the prevalence of sleep disorder. It is necessary to conduct targeted interventions to improve sleep quality.

Objective: To investigate the distribution of mitochondrial haplogroups and their correlation with neurocognitive disorder (NCD) in HIV positive individuals. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. A cross-sectional survey was performed in 448 HIV positive individuals. Sanger method was used for the sequencing and genotyping of whole mitochondrial genome of HIV positive individuals. NCD prevalence in the HIV positive individuals was assessed by Mini-mental State Examination (MMSE) in questionnaire interviews. Multivariable logistic regression analysis was performed to assess the associations between mtDNA haplogroups and NCD. Results: In this sample, mitochondrial haplogroups D (19.6%, 88/448), B (19.4%, 87/448) and F(17.0%, 76/448) were the most predominant haplogroups. The overall prevalence rate of NCD was 20.3% (91/448), and was high in haplogroups A (23.1%, 9/39), D (21.6%, 19/88), F (26.3%, 20/76) and M7 groups (26.1%, 12/46), respectively. In multivariable logistic regression analysis after adjusting confounding factors, such as age and gender, compared with haplogroup A, there were no differences in the prevalence rate of NCD among HIV positive individuals with haplogroup B, D, F, M7, M8, N9, and others. Conclusion The study explored primarily correlation between mitochondrial haplogroups and NCD among HIV positive individuals and suggested that there is no significant association between mitochondrial haplogroups and NCD, but further longitudinal investigation with large sample size of HIV positive population is needed to confirm this finding.

Objective To establish chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography (FFRcT) in Bama miniature pig,and to evaluate its reliability.Methods Sixteen Bama miniature pigs were used to establish chronic coronary stenosis models through placing Ameroid constrictor into proximal or middle segments of left anterior descending arteries (LAD).In the 2nd week after modeling,the degrees of stenosis were monitored with coronary CTA.Invasive coronary angiography was used to verify stenosis degrees and measure fractional flow reserve (FFR) within 2 days of last coronary CTA examination.Computational fluid dynamics model was constructed and FFRcT was calculated by the specialized laboratory based on coronary CTA data respectively.Simulated FFRcT and FFR values were compared to verify this model.Results Models were successfully established in 10 pigs with a total of 24 coronary CT examinations,of which image quality met the diagnostic requirements.All models were with LAD stenosis＜25 ％ in the 2nd week after operation.LAD stenosis ＞50％ was found in the 3rd week in 9 pigs,and the other one was found with LAD stenosis ＞50％ in the 4th week.The results of coronary CTA corresponded to those of coronary angiography.There was no significant difference between simulated FFRcT and FFR value (t =-1.13,P =0.29).Conclusion Through placing Ameroid constrictor into LAD of Bama miniature pig and monitoring the degree of stenosis with coronary CTA,model of chronic coronary stenosis could be successfully established,which are suitable for noninvasive simulating hemodynamics study based on coronary CTA.