The corneal epithelium, an essential refractive interface, plays an integral role in the corneal healing after corneal refractive surgery. All existing corneal refractive surgeries entail a degree of corneal epithelial remodeling; however, excessive epithelial remodeling precipitates adverse outcomes on the refractive correction efficacy of such surgeries. This review summarizes the application of corneal epithelial remodeling in the corneal refractive surgery, and more comprehensively investigates the influencing factors of perioperative epithelial remodeling after corneal refractive surgery, with a view to augmenting the safety, efficacy, predictability, and stability of corneal refractive surgical outcomes.

Within traditional teaching models,students frequently assume a passive role in acquiring knowledge,potentially resulting in diminished motivation and limited engagement,particularly within the realm of Medical Immunology education.The inte-gration of role-playing,informed by constructivist learning theory,situated learning theory,and multiple intelligences theory,has demonstrated encouraging outcomes within clinical medical education settings.However,the extent to which this approach has been explored within the context of Immunology instruction remains insufficiently examined.This study investigates the utilization of role-playing as a pedagogical approach in Medical Immunology education,wherein students are assigned specific scenarios to simulate the functions of various immune components.The primary objective is to augment interactivity and the overall appeal of the learning pro-cess.Efficacy of this instructional method was evaluated through in-class quizzes,surveys,and performance analysis.The findings demonstrate that role-playing substantially enhances student engagement,comprehension,knowledge retention,and examination per-formance.In practical application,the integration of role-playing with ideological and political elements has the potential to enhance learning outcomes and foster students'enthusiasm for engaging in cutting-edge literature and immunological research.This approach also necessitates greater proficiency in teachers'professional competencies and organizational skills,as well as increased allocation of class time and spatial resources.Future research should investigate the applicability of role-playing across various educational levels and examine its potential integration with classroom ideological and political education.

OBJECTIVES: This study evaluated the prognostic power of serum uric acid (UA) in predicting adverse events in elderly acute coronary syndrome (ACS) patients with diabetes mellitus (DM). METHODS: The analysis involved 718 ACS patients ‍>80 years old whose general clinical data and baseline blood biochemical indicators were collected prospectively from January 2006 to December 2012. These patients were classified into two groups based on DM status, and then followed up after discharge. The Kaplan-Meier method was used for major adverse cardiac event (MACE) rates and all-cause mortality. Multivariate Cox regression was performed to analyze the relationship between UA level and long-term clinical prognosis. Receiver operating characteristic (ROC) curves were analyzed to predict the cutoff value of UA in elderly ACS patients with DM. There were 242 and 476 patients in the DM and non-DM (NDM) groups, respectively, and the follow-up time after discharge was 40‒120 months (median, 63 months; interquartile range, 51‒74 months). RESULTS: The all-cause mortality, cardiac mortality, and MACE rates in both DM and NDM patients were higher than those in the control group ( CONCLUSIONS Serum UA level is a strong independent predictor of long-term all-cause death and MACE in elderly ACS patients with DM.

Objective:To investigate the effect of somatostatin on portal vein diameter and biochemical parameters in decompensated cirrhosis with upper gastrointestinal bleeding.Methods:From January 2018 to January 2019, 90 patients with decompensated cirrhosis complicated with upper gastrointestinal bleeding admitted to the gastroenterology department of the Second People's Hospital of Changzhi were selected, and they were divided into two groups according to the random digital table method.The control group(45 cases)was treated with pantoprazole + thrombin, and the observation group(45 cases)was treated with somatostatin on the basis of the control group.The two groups were compared in terms of efficacy, portal vein diameter before and after treatment, biochemical indicators[interleukin-6(IL-6), hypersensitive C-reactive protein(hs-CRP), and procalcitonin(PCT)].Results:The effective rate of the observation group was higher than that of the control group(82.22% vs.62.22%), the difference was statistically significant(χ 2=4.486, P<0.05). After treatment, the anterior and posterior diameter of portal vein in the observation group[(1.12±0.23)cm] was significantly shorter than that in the control group[(1.22±0.22)cm], the difference was statistically significant( t=2.107, P<0.05). The serum levels of IL-6, hs-CRP and PCT were significantly decreased in both two groups after treatment(all P<0.05). The serum levels of IL-6, hs-CRP and PCT in the observation group were(10.32±3.69)ng/L, (13.35±5.46)mg/L, (5.26±1.47)μg/L, which were significantly lower than those in the control group [(15.32±5.69)ng/L, (19.35±7.51)mg/L, (9.45±3.02)μg/L], the differences were statistically significant( t=6.807, 8.433, 10.566, all P<0.05). Conclusion:Somatostatin is effective in the treatment of decompensated cirrhosis with upper gastrointestinal bleeding, which can reduce portal vein dilatation and serum inflammatory factor levels.Somatostatin is effective in the treatment of decompensated cirrhosis with upper gastrointestinal bleeding, which can reduce portal vein dilatation and serum inflammatory factor levels.

Objective To compare the sensitivity and specificity of dot immunogold method (DIM) and particle agglutination (PA) for the diagnosis of mycoplasma pneumoniae (MP) infection. Methods The 190 serum specimens of 113 children with mycoplasmal pneumonia (infection group) and 50 serum specimens of 50 health children (health group) were tested for MP by PA and DIM- A and B. Results In infection group, the positive rates of DIM- A and B were 82.63% (157/190) and 84.74%(161/190), and there was no statistical difference (χ2 = 0.31, P>0.05); the positive rate of PA (titer ≥1:160) was 70.00%(133/190), the positive rate of PA was significantly lower than that in DIM-A and B, and there were statistical differences (P<0.05). In infection group, with the increase of PA titer, the positive rate of DIM was gradually increased, and there was a correlation between 2 methods (rA=0.972, rB=0.830);the positive rates of DIM- A and B in serum specimens of PA negative were 40.62%(13/32) and 53.12%(17/32), and in the PA titer of 1:5120, there was still a negative result in DIM. In health group, the positive rates of DIM-A and B were 26.00% (13/50) and 28.00% (14/50), and there was no statistical difference (χ2 = 0.66, P>0.05); the positive of PA was 8.00% (4/50), the positive rate of PA was significantly lower than that in DIM- A and B, and there were statistical differences (P<0.05 or<0.01). Conclusions Compared with the PA, DIM has low sensitivity and poor specificity for clinical diagnosis. DIM is not suitable for clinical diagnosis of MP infection.

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .

[Summary] A total of 128 individuals with type 2 diabetes underwent continuous glucose monitoring for 3 consecutive days.The dawn phenomenon was defined by three different parameters according to the previous research:(1)the absolute increase of glucose level from nocturnal nadir to prebreakfast value(?G) above 20 mg/dl;(2)?G above 10 mg/dl;( 3 ) insulin requirement increased at least 20%.The participants were secondarily separated by presence/absence of a dawn phenomenon based on the definitions above.The impact on blood glucose fluctuation of different groups was assessed according to the standard deviation of blood glucose( SDBG) , the area under curve above 10 mmol/L ( AUC ) , and the mean amplitude of glycemic excursions ( MAGE ) , etc.The frequencies of dawn phenomenon were 64.8%(?G≥20mg/dl), 85.2%(?G≥10 mg/dl), and 59.4%(rise in insulin requirement≥20%)respectively.The impacts on SDBG, AUC, MAGE, and MODD were without statistical difference(P>0.05) between the presence and absence of the dawn phenomenon patients when?G≥10 mg/dl.However, the differences reached statistical significance(P<0.05) when ?G≥20 mg/dl and the increase in insulin requirement≥20%. Besides, the incidence of dawn phenomenon was positively correlated with HOMA-IR, HbA1C , and free C-peptide.Dawn phenomenon is a very frequent event in type 2 diabetes and not only impacts the overall glycemic control but also exaggerates glucose fluctuation.To be clinically relevant, ?G≥20mg/dl should be taken as the quantitative criterion of the dawn phenomenon.

OBJECTIVETo study the dynamics of the reinfection of Schistosoma japonicum and related risk factors among the people in schistosomiasis endemic areas in China.

METHODSLiterature retrieval was conducted by using databases of PubMed, CNKI,VIP and Wanfang to collected all the data about the human re-infection of Schistosoma japonicum and related risk factors in the endemic areas in China. And a Mata-analysis was conducted on the literatures met the inclusion standards.

RESULTSEighteen studies involving 12 604 people for infection survey and 3 128 people for re-infection survey were included in the analysis. The overall infection rate was 20.8%, and the overall re-infection rate was 21.0% . The difference had no statistical significance (Z = 1.12, P = 0.26). The re-infection related factors included baseline infection intensity (OR = 3.58, 95% CI: 1.56-8.22); the index of contaminated water OR = 2.37, 95% CI: 1.08-5.22); distance from house to river-side (OR = 1.72, 95% CI: 0.41-7.30) and age (OR = 0.48, 95% CI: 0.19-1.23).

CONCLUSIONThe baseline infection intensity, the index of contaminated water and distance from house to river-side were the risk factors related to the re-infection of Schistosoma japonicum and age was a protective factor.

Objective To explore the value of a novel non-peptide renin inhibitor aliskiren on hypertension patients,and analyze the change of bradykinin (BK) and high sensitive C-reactive protein (hs-CRP).MethodsEighty patients with mild to moderate hypertension were selected.Patients were randomized divided into ramipril group,aliskiren 75 mg/d group,aliskiren 150 mg/d group,aliskiren 300 mg/d group with 20 cases each by random digits table method and received the following types of intervention:ramipril 5 mg/d,aliskiren 75 mg/d,aliskiren 150 mg/d and aliskiren 300 mg/d.Enzyme-linked immunosorbent assay method was used for detecting hs-CRP.Radioimmunoassay method was used for detecting BK.Results After treatment,the levels of BK and hs-CRP in aliskiren 75 mg/d group,aliskiren 150 mg/d group and aliskiren 300 mg/d group [(5.06 ± 1.61),(5.05 ± 1.87),(5.27 ± 1.39) μg/L and (0.38 ± 0.11 ),(0.25 ± 0.05),(0.33 ± 0.11 ) mg/L] were significantly lower than those in ramipril group [ (7.12 ± 1.12) μ g/L,(0.49 ± 0.19) mg/L ] (P＜0.05 ).After treatment,the levels of SBP and DBP had no significant difference among the four groups (P＞0.05).Conclusion Aliskiren has a very good effect in decreasing blood pressure and does not cause the levels of BK and hs-CRP increasing.

Objective To observe the effect of inhalation budesonide(pulmicort) in the treatment of cough variant asthma and(CVA) its influence on serum cytokine.Methods 112 children with CVA were randomly divided into the atomization group and control group,each group 56 cases.The atomization group was given pulmicort inhalation therapy,and the control group was given oral long-acting β2 agonist treatment.After 3 months of treatment,the efficacy and serum cytokine levels were compared between the two groups.Results 3 months after the treatment,the effective rate of the atomization group was 91.07％,and significantly higher than that of the control group(75.00％ )( x2 ＝ 5.13,P ＜ 0.05 ) ; The serum interleukin-4,γ-interferon,IgE,eosinophil counts of the atomized group were significantly lower than those of control group ( t =2.10,2.34,27.63,3.13,all P ＜ 0.05 ).Conclusion The effect of inhalation pulmicort in the treatment of cough variant asthma is good,and has good safety.