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AIM: To analyze the clinical outcomes of cyclosporine combined with lacrimal plug in the treatment of dry eye in patients with primary Sjögren's syndrome.METHODS: The clinical data of 60 patients(120 eyes)who were admitted to the ophthalmology department and rheumatology and immunology department of Baoding No.1 Central Hospital and were diagonosed with siogren's syndrome dry eye after multidisciplinary consultation from June 2022 to September 2023 were retrospectively analyzed. All the patients received regular treatment of primary Sjögren's syndrome, and they were divided into three groups according to treatment methods: A, B and C, with 20 cases(40 eyes)in each group. The group A received 0.3% sodium hyaluronate eyedrops, the group B received 0.3% sodium hyaluronate eyedrops plus 0.05% cyclosporine eyedrops, and the group C received 0.3% sodium hyaluronate eyedrops plus 0.05% cyclosporine eyedrops combined with binocular lacrimal plugs. The ocular surface disease index(OSDI)score, conjunctival hyperemia score, tear film breakup time(BUT), tear meniscus height(TMH), corneal fluorescein staining(FL)score and tear secretion of the three groups of patients were compared before and at 4, 8 and 12 wk after treatment. The contents of inflammatory factors such as interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in tears were detected before and at 12 wk after treatment.RESULTS: At 4, 8 and 12 wk after treatment, the scores of OSDI, conjunctival hyperemia score and FL in the three groups of patients were lower than those before treatment, and the BUT, TMH and tear secretion were higher than those before treatment(all P0.05).CONCLUSION: The combined use of cyclosporine and lacrimal plug is safe and effective in improving the clinical symptoms of patients with moderate and severe dry eye, promoting the function of tear film and cornea, increasing tears secretion, and reducing the level of tear inflammatory factors.

Background: In this prospective cohort study, we determined the phenotypic characteristics of children with regressive autism spectrum disorder (ASD) and explored the effects of rehabilitation. Methods: We recruited 370 children with ASD aged 1.5–7 years. Based on the Regression Supplement Form, the children were assigned to two groups: regressive and non-regressive. The core symptoms and neurodevelopmental levels of ASD were assessed before and after 1 year of behavioral intervention using the Autism Diagnostic Observation Schedule (ADOS), Social Response Scale (SRS), Children Autism Rating Scale (CARS), and Gesell Developmental Scale (GDS). Results: Among the 370 children with ASD, 28.38% (105/370) experienced regression. Regression was primarily observed in social communication and language skills. Children with regressive ASD exhibited higher SRS and CARS scores and lower GDS scores than those with non-regressive ASD. After 1 year of behavioral intervention, the symptom scale scores significantly decreased for all children with ASD; however, a lesser degree of improvement was observed in children with regressive ASD than in those with non-regressive ASD. In addition, the symptom scores of children with regressive ASD below 4 years old significantly decreased, whereas the scores of those over 4 years old did not significantly improve. Children with regressive ASD showed higher core symptom scores and lower neurodevelopmental levels. Nevertheless, after behavioral intervention, some symptoms exhibited significant improvements in children with regressive ASD under 4 years of age. Conclusion: Early intervention should be considered for children with ASD, particularly for those with regressive ASD. [ABSTRACT FROM AUTHOR]

The exploitation of economical and high‐efficient heterogeneous catalysts plays a vital role in ammonia‐borane (NH3BH3, AB) hydrolysis for hydrogen evolution. Herein, poly(N‐vinyl‐2‐pyrrolidone) (PVP) stabilized highly dispersed Ru–Ni nanoclusters immobilized on reduced graphene oxide (rGO) are successfully synthesized via in situ chemical reduction. The optimized Ru1Ni1@PVP/rGO‐1 catalyst exhibits a superior catalytic performance toward hydrolytic dehydrogenation of AB for hydrogen evolution, with a low activation energy (Ea) of 21.1 kJ mol−1 and a high turnover frequency (TOF) value of 425.1 molH2 molRu−1 min−1at 298 K. Moreover, an outstanding recyclability with 82.1% of the initial catalytic activity is achieved after 20 consecutive cycles due to PVP coating that can effectively prevent the agglomeration of nanoclusters during the recycling tests. Experimental analyses and DFT calculations reveal a synergistic effect in Ru–Ni nanoclusters, resulting in a strong adsorption of AB molecules and an easy activation of water molecules on Ru–Ni nanoclusters. These findings in this study open a new avenue for a hopeful design of highly efficient heterogeneous catalysts. [ABSTRACT FROM AUTHOR]

[Display omitted] Large language models (LLMs) such as ChatGPT are increasingly explored in medical domains. However, the absence of standard guidelines for performance evaluation has led to methodological inconsistencies. This study aims to summarize the available evidence on evaluating ChatGPT's performance in answering medical questions and provide direction for future research. An extensive literature search was conducted on June 15, 2023, across ten medical databases. The keyword used was "ChatGPT," without restrictions on publication type, language, or date. Studies evaluating ChatGPT's performance in answering medical questions were included. Exclusions comprised review articles, comments, patents, non-medical evaluations of ChatGPT, and preprint studies. Data was extracted on general study characteristics, question sources, conversation processes, assessment metrics, and performance of ChatGPT. An evaluation framework for LLM in medical inquiries was proposed by integrating insights from selected literature. This study is registered with PROSPERO, CRD42023456327. A total of 3520 articles were identified, of which 60 were reviewed and summarized in this paper and 17 were included in the meta -analysis. ChatGPT displayed an overall integrated accuracy of 56 % (95 % CI: 51 %–60 %, I2 = 87 %) in addressing medical queries. However, the studies varied in question resource, question-asking process, and evaluation metrics. As per our proposed evaluation framework, many studies failed to report methodological details, such as the date of inquiry, version of ChatGPT, and inter-rater consistency. This review reveals ChatGPT's potential in addressing medical inquiries, but the heterogeneity of the study design and insufficient reporting might affect the results' reliability. Our proposed evaluation framework provides insights for the future study design and transparent reporting of LLM in responding to medical questions. [ABSTRACT FROM AUTHOR]

Objective: To observe the therapeutic effect of natamycin combined with voriconazole in the treatment of fungal keratitis (FK)., Methods: This is a retrospective study. The subjects of this study were 64 patients with FK who were admitted to Baoding No.1 Central Hospital from February 2019 to July 2022. The enrolled patients were divided into control group ( n = 32) and study group ( n = 32) by the random number table method. The control group was treated with natamycin alone, and the study group was treated with natamycin combined with voriconazole. The total efficacy, time of disappearance of ocular symptoms, visual acuity level, keratitis severity score, corneal ulcer area, tear fungus index and incidence of adverse reactions were compared between the two groups., Results: The total efficacy,of the study group was significantly higher than that of the control group. The disappearance time of corneal ulcer, photophobia, foreign body sensation and hypopyon in the study group was shorter than those in the control group. Keratitis severity score and (1,3)-β-D-glucan level in the study group were lower than those in the control group. The corneal ulcer area was narrowed in the study group than that of the control group, and the visual acuity level in the former group was higher than that of the latter group. Besides, there was no significant difference in the frequency of adverse reactions between the two groups., Conclusion: Natamycin combined with voriconazole is safe and effective in the treatment of FK., (Copyright: © Pakistan Journal of Medical Sciences.)

Purpose: To evaluate the effecting and complications of the vitreous surgery combined with intraocular lens implantation in proliferative diabetic retinopathy., Methods: Forty-one eyes of 38 cases of proliferative diabetic retinopathy complicated with serious cataract were treated with phacoemulsification, pars plan vitctomy, peeling, photocoagulation, intraocular lens implantation and gas tampanade. Preoperative and postoperative visual acuity, anterior segment by slit lamp, fundus fluorescein angiography and surgery complications were analyzed., Results: Average follow-up was 9 months. The visual acuity was improved in 36 eyes. The anterior response of operation was slight. The complications included cornea edema in 1 eye, high intraocular press in 1 eye, rubeosis in 1 eye and retinal detachment in 1 eye., Conclusions: The vitreous surgery combined with intraocular lens implantation was an effective operation for proliferative diabetic retinopathy with serious cataract.