Glaucoma is the leading cause of irreversible blindness worldwide. Reducing intraocular pressure through surgical interventions is a crucial approach for managing open-angle glaucoma(OAG). In recent years, minimally invasive glaucoma surgeries(MIGS)have gained prominence, providing a lot of options for the treatment of glaucoma. MIGS that target the trabecular meshwork-Schlemm's canal pathway act on the main pathway of aqueous humor outflow with less damage to the normal anatomical structures of the eye, and are gradually becoming the mainstream procedures. These surgeries can be categorized into three main types based on their mechanisms of action: trabeculotomy, trabecular meshwork bypass, and Schlemm's canal dilation. Representative procedures and devices include gonioscopy-assisted transluminal trabeculotomy(GATT), microcatheter-assisted trabeculotomy(MAT), Trabectome, kahook dual blade(KDB), tanito microhook(TMH), excimer laser trabeculotomy(ELT), iStent series, Hydrus, ABiC, PCP and 3T procedures. This article reviews the current literature on the application of MIGS targeting the trabecular meshwork-Schlemm's canal pathway in OAG. It aims to discuss the principles, efficacy and safety of such MIGS for the treatment of OAG, and to summarize the advantages and disadvantages of each procedure, with a view to informing the choice of surgical treatment and clinical research for OAG.

BACKGROUND: Primary pulmonary mucoepidermoid carcinoma (PMEC) is an exceedingly rare malignancy originating from bronchial submucosal glands, accounting for <0.2% of lung cancers. Histologically characterized by a triphasic composition of mucinous, epidermoid, and intermediate cells, PMEC is classified into low-grade (favorable prognosis) and high-grade (aggressive behavior) subtypes. This study aimed to investigate the clinicopathological characteristics and prognostic indicators of PMEC. METHODS: Clinicopathological, radiological, molecular, and survival data from 26 PMEC patients were retrospectively analyzed, including immunohistochemical profiles and MAML2 rearrangement status, supplemented by literature review. RESULTS: The cohort comprised 14 males and 12 females (mean age: 55.6 years). Eight patients (30.8%) were smokers, and 19 (73.1%) presented with symptoms. Central tumors predominated (n=19, 73.1%) versus peripheral lesions (n=7, 26.9%). Computed tomography (CT) imaging consistently revealed hypo-to-isodense masses/nodules. Pathologically, 19 cases were low-grade and 7 high-grade. Immunohistochemically, the tumor cells were positive for CK7, P40, P63 and CK5/6, and the Ki-67 index ranged from 2% to 70%. MAML2 rearrangement was detected in 52.4% (11/21) of tested cases. Clinical staging distribution: stage I (n=14), stage II (n=8), stage III (n=3), stage IV (n=1). Treatment modalities: radical surgery alone (n=13), surgery with adjuvant chemotherapy (n=11), chemoradiotherapy (n=1), and conservative management (n=1). With a median follow-up of 57 months, 6 patients (23.1%) died. Prognostic analysis demonstrated: (1) Significantly inferior survival in high-grade versus low-grade groups (P<0.05); (2) Lymph node metastasis, advanced stage, Ki-67>20%, and high-grade histology significantly correlated with reduced overall survival (P<0.05); (3) Lymph node metastasis constituted an independent poor prognostic factor (HR=12.73, 95%CI: 1.22-132.96). CONCLUSIONS PMEC exhibits distinct clinicopathological features, with MAML2 rearrangement present in approximately half of cases. Lymph node metastasis, advanced stage, high Ki-67 proliferation index, and high-grade histology are key determinants of poor prognosis, with lymph node metastasis serving as an independent risk factor.
Humans ; Male ; Female ; Middle Aged ; Carcinoma, Mucoepidermoid/mortality* ; Lung Neoplasms/mortality* ; Trans-Activators/genetics* ; Prognosis ; Adult ; Gene Rearrangement ; Aged ; Retrospective Studies ; Transcription Factors/genetics* ; DNA-Binding Proteins/genetics*

Objective:To determine the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema using Mendelian randomization (MR) analyses.Methods:This study was a secondary data analysis based on the summary data of genome-wide association studies (GWAS), which involved 293 723 participants (educational attainment) from the Social Science Genetics Association Consortium and 462 013 participants [allergic rhinitis and (or) eczema] from the UK Biobank. Genetic variants that were closely related to educational attainment were identified as instrumental variables. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger regression, weighted median method and weighted model-based estimation, were performed to investigate the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, in which the odds ratio ( OR) values were used as indicators. Results:A total of 70 single-nucleotide polymorphisms (SNPs) were chosen as instrumental variables. The MR-Egger regression results suggested that the genetic pleiotropy was unlikely to bias our results ( P=0.107). In the univariable MR analyses, IVW regression showed that the risk of allergic rhinitis and (or) eczema was OR=1.044 (95% CI: 1.020-1.069, P<0.001) and OR=1.170 (95% CI: 1.074-1.256, P<0.001), respectively, for the increase in the duration of education by one year or one standard deviation ( SD) (3.71 years). In the reverse MR analysis, IVW regression showed little evidence that allergic rhinitis and (or) eczema affected educational attainment ( OR=1.020, 95% CI: 0.927-1.023, P=0.683). The results of the weighted median method and weighted mode-based estimation were consistent with the results of IVW. Conclusion:This study suggests that there is a positive causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, which means that educational attainment can increase the occurrence of allergic rhinitis and (or) eczema.

Male ; Humans ; Liquid Chromatography-Mass Spectrometry ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Varicocele/diagnosis* ; Biomarkers

Objective:To determine the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema using Mendelian randomization (MR) analyses.Methods:This study was a secondary data analysis based on the summary data of genome-wide association studies (GWAS), which involved 293 723 participants (educational attainment) from the Social Science Genetics Association Consortium and 462 013 participants [allergic rhinitis and (or) eczema] from the UK Biobank. Genetic variants that were closely related to educational attainment were identified as instrumental variables. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger regression, weighted median method and weighted model-based estimation, were performed to investigate the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, in which the odds ratio ( OR) values were used as indicators. Results:A total of 70 single-nucleotide polymorphisms (SNPs) were chosen as instrumental variables. The MR-Egger regression results suggested that the genetic pleiotropy was unlikely to bias our results ( P=0.107). In the univariable MR analyses, IVW regression showed that the risk of allergic rhinitis and (or) eczema was OR=1.044 (95% CI: 1.020-1.069, P<0.001) and OR=1.170 (95% CI: 1.074-1.256, P<0.001), respectively, for the increase in the duration of education by one year or one standard deviation ( SD) (3.71 years). In the reverse MR analysis, IVW regression showed little evidence that allergic rhinitis and (or) eczema affected educational attainment ( OR=1.020, 95% CI: 0.927-1.023, P=0.683). The results of the weighted median method and weighted mode-based estimation were consistent with the results of IVW. Conclusion:This study suggests that there is a positive causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, which means that educational attainment can increase the occurrence of allergic rhinitis and (or) eczema.

Objective To improve the performance of auto-segmentation of prostate target area and organs-at-risk in online magnetic resonance image and enhance the efficiency of magnetic resonance imaging-guided adaptive radiotherapy(MRIgART)for prostate cancer.Methods A retrospective study was conducted on 40 patients who underwent MRIgART for prostate cancer,including 25 in the training set,5 in the validation set,and 10 in the test set.The planning CT images and corresponding contours,along with online MR images,were registered and input into a deep learning network for online MR image auto-segmentation.The proposed method was compared with deformable image registration(DIR)method and single-MR-input deep learning(SIDL)method.Results The overall accuracy of the proposed method for auto-segmentation was superior to those of DIR and SIDL methods,with average Dice similarity coefficients of 0.896 for clinical target volume,0.941 for bladder,0.840 for rectum,0.943 for left femoral head and 0.940 for right femoral head,respectively.Conclusion The proposed method can effectively improve the accuracy and efficiency of auto-segmentation in MRIgART for prostate cancer.

Objective Magnetic resonance simulator(MR Sim)is a novel type of simulation equipment utilized in radiotherapy.Acceptance testing is an essential quality assurance procedure prior to the clinical use of the MR Sim.The report provides the detailed procedures and result analysis of acceptance testing for an MR Sim.Methods The acceptance testing scheme was developed following the recently published AAPM TG284 report and the NCC/T-RT 002-2023 guidelines.Quality control equipments such as ACR(American College of Radiology)large phantom and geometric distortion measurement phantom were used for evaluating various aspects of the MR Sim,including the effectiveness of shielding,the functionality of imaging system,the image quality,the performance of radio frequency coils,the geometric accuracy of large field imaging,the precision of external laser markings,the couch movement accuracy,and the image transmission accuracy.Results The shielding effectiveness at a frequency of 150 MHz exhibited an average value of 105 dB.All of 8 image quality indices,namely geometric accuracy,slice position accuracy,slice thickness accuracy,image uniformity,artifact ratio,signal-to-noise ratio,high-contrast spatial resolution,and low-contrast resolution,fell within recommended tolerances.The maximum geometric distortion observed across a 25 cm field of view was less than 2 mm.The errors in external laser markings and couch movement accuracy were both less than 1 mm.The couch levelness was less than 1°.Both radio frequency coils and image transmission passed the required tests.Conclusion MR Sim is high-precision and complex.To ensure its precise application in radiotherapy,the acceptance testing for an MR Sim should be meticulously designed and executed following the established guidelines and accounting for its unique performance characteristics.

Objective: To understand the prevalence of HIV testing and related factors among young students who had sex in Guangdong Province, in order to provide evidence for relevant education programs and HIV testing promotion in young students. Methods: From September to December 2022, a convenient sampling method was used to select 48 749 young students from 16 universities and mechanic colleges in 6 cities including Guangzhou, Shantou, Maoming, Huizhou, Dongguan, and Zhongshan in Guangdong Province for online questionnaire survey. A total of 2 971 students who ever had sexual experiences were screened out, and the HIV testing situation and related factors were investigated by using the questionnaire designed by AIDS Prevention and Education Project for College Students of China STD and AIDS Prevention Association.The influencing factors of HIV testing were analyzed using Chi square test and multiple Logistic regression model. Results: Among students who had sexual experiences, 11.92% (354/2 971) were tested for HIV. The results of multivariate Logistic regression analysis showed that among young sexual students, using psychoactive substances during sexual activity in the last 1 year ( OR =7.70), having first sex with the same sex ( OR =3.87), having commercial sex ( OR =2.37), having heard of PEP ( OR =2.20), having a high level of self assessed understanding of HIV testing ( OR =1.73), inconsistent use of condoms ( OR =1.56), being aware of HIV infection ( OR =1.53), being aware of HIV knowledge ( OR =1.51) were more likely to test for HIV, and females ( OR =0.39) were less likely to test for HIV ( P < 0.05). Conclusions The proportion of HIV testing is low among sexually active young students in Guangdong Province. Targeted interventions should be tailored to promote HIV testing coverage.

Objective To explore the effect of lidocaine(LID)on ischemia-reperfusion injury in orthotopic liver transplantation(OLT)rats and to analyze its mechanism of action.Methods Sixty rats were randomly divided into Verteporfin group,high-dose LID(High LID),medium-dose LID(Medium LID),low-dose LID(Low LID),Model and Control groups,on average.The rest of the rats except the control rats were used to establish OLT models.Observe the pathological changes in liver tissue were with hematoxylin-eosin staining.Serum aspartate transaminase(AST),total bilirubin(TBIL),lactate dehydrogenase(LDH)activities and alanine transaminase(ALT)were detected.Measure liver tissue levels of proinflammatory factors tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β,and IL-10 with enzyme-linked immunosorbent assays.Reactive oxygen species(ROS)was detected by a fluorescence probe.Malondialdehyde(MDA)was detected by the thiobarbituric acid colorimetric method.Superoxide dismutase(SOD)was detected by nitrogen blue tetrazole colorimetry.Glutathione peroxidase(GSH-Px)was detected by a spectrophotometry method.Apoptosis of liver histiocytes was detected by in situ end labeling.Detect the expression of mammalian STE20 like protein kinase(MST1),phosphorylation(p)-MST1,large tumor suppressor factor 1(LATS1),p-LATS1,Yes associated protein(YAP),p-YAP,and apoptosis-related proteins B-cell lymphoma 2(Bcl-2)and Bcl-2 related X protein(Bax)with Western blot.Results Compared with the Control group,liver tissue in Model group rats showed injury,liver cell necrosis,and a large degree of inflammatory cell infiltration.Moreover,the cell apoptosis rate;serum AST,ALT,TBIL,and LDH activities;and liver tissue levels of TNF-α,IL-6,IL-1β,MDA,ROS,and Bax were significantly increased.Furthermore,liver tissue levels of IL-10,SOD,GSH-Px,Bcl-2,p-MST1/MST1,p-LATS1/LATS1,and p-YAP/YAP proteins were significantly reduced(P＜0.05).Compared with the Model group,liver tissue injury was reduced in Low LID,Medium LID,and High LID groups.The cell apoptosis rate;serum AST,ALT,TBIL,and LDH activities;and liver tissue levels of TNF-α,IL-6,1L-1β,MDA,ROS,and Bax were significantly reduced.Moreover,liver tissue levels of IL-10,SOD,GSH-Px,Bcl-2,p-MST1/MST1,p-LATS1/LATS1,and p-YAP/YAP proteins were significantly increased(P＜0.05).Hippo-YAP signaling pathway inhibitor verteporfin reversed the improving effect of LID on ischemia-reperfusion injury in OLT rats(P＜0.05).Conclusions LID may activate the Hippo-YAP pathway,which reduces the inflammatory response,oxidative stress,and liver cell apoptosis,and improves liver ischemia-reperfusion injury in OLT rats.

Objective:To establish a radiotherapy treatment planning process of high ventilation functional lung avoided (HVFLA) for thoracic tumors based on 4D-CT lung ventilation functional images and determine the treatment planning strategy of HVFLA radiotherapy, and so as to provide support for the clinical trials of HVFLA radiotherapy in thoracic cancer patients.Methods:A deep learning-based 4D-CT lung ventilation functional imaging model was established and integrated into the radiotherapy treatment planning process. Furthermore, ten thoracic cancer patients with 4D-CT simulation positioning were retrospectively enrolled in this study. The established model was used to obtain the 4D-CT lung ventilation functional imaging for each patient. According to the relative value of lung ventilation, the lung ventilation areas are equally segmented into high, medium and low lung ventilation and then imported them into Pinnacle 3 treatment planning system. According to the prescription dose of target and dose constraints of organ at risks (OARs), the clinical and HVFLA treatment plans were designed for each patient using volumetric modulated radiotherapy technique, and each plan should meet the clinical requirements and adding dose constraints of high ventilation functional lung for HVFLA plan. The dosimetric indexes of the target, OARs (lungs, heart and cord) and high functional lung (HFL) were used to evaluated the plan quality. The dosimetric indexes included D2, D98 and mean dose of target, V5, V10, V20, V30 and mean dose of lungs and HFL, V30, V40 and mean dose of heart, and D1 cm 3 of cord. Paired samples t-test was used for statistical analysis of the two groups of plans. Results:The target and OARs of the clinical plan and HVFLA plan meet the clinical requirements. The HVFLA plan resulted in a statistically significant reduction in the mean dose, V5, V10, V20, and V30 of the high functional lung by 1.2 Gy, 5.9%, 4.2%, 2.6%, and 2.3%, respectively ( t=-8.07, 4.02, -6.02, -7.06, -6.77, P<0.05). There was no statistical difference in the dosimetric indexes of lungs, heart and cord. Conclusions:We established the treatment planning process of HVFLA radiotherapy based on 4D-CT lung ventilation functional images. The HVFLA plan can effectively reduce the dose of HFL, while the doses of lungs, heart and cord had no significant difference compared with the clinical plan. The strategy of HVFLA radiotherapy planning is feasible to provide support for the implementation of HVFLA radiotherapy in thoracic cancer patients.