AIM:To investigate the visual quality and stereopsis after the implantation of PanOptix trifocal intraocular lens(TFNT00).METHODS: A prospective clinical study was conducted. A total of 36 cataract patients(50 eyes)who underwent phacoemulsification combined with TFNT00 implantation in Jinan Mingshui Eye Hospital from November 2022 to April 2024 were selected. They were followed up until 3 mo after the operation. The uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), uncorrected near visual acuity(UCNVA), objective scatter index(OSI), modulation transfer function cut off(MTF-cut-off), Strehl ratio(SR)and 100%, 20%, 9% contrast visual acuity(CVA)were observed. The binoptometer was used to collect the patients' far and near stereopsis acuities. The defocus curve was drawn after the operation; the Chinese version of the VF-14 Visual Function Index Scale was used to evaluate the visual quality and satisfaction after the operation.RESULTS: There were statistically significant differences in the UCDVA, UCIVA and UCNVA of the patients at different time after the operation(all P<0.05). The transition of the defocus curve was gentle between +0.5--3.0 D after the operation. The OSI value at 3 mo postoperatively after the operation was significantly lower than that before the operation(P<0.01), and the MTF-cut-off, SR, 100% CVA, 20% CVA and 9% CVA were significantly improved than those before operation(all P<0.01). The far and near stereopsis acuities of 34 patients were abnormal before the operation. The far stereopsis acuities of the patients who underwent bilateral eye surgeries were all normal after the operation, and the near stereopsis acuity of 12 patients was normal. Among the patients who underwent unilateral eye surgeries, the far stereopsis acuities of 13 patients were normal, and the near stereopsis acuities of 11 patients were normal. The far and near stereopsis acuities of the patients who underwent bilateral eye surgeries were significantly better than those patients who underwent unilateral eye surgeries.CONCLUSION: The PanOptix trifocal intraocular lens can provide patients with good full-range visual acuity. The stereopsis of the patients with bilateral implants is better than that of the patients with unilateral implants. The overall visual quality and satisfaction of the patients after the operation are relatively high.

Background Polycyclic aromatic hydrocarbons (PAHs) are widely known atmospheric pollutants, which can cause serious harm to human body and ecological environment. Objective To analyze the concentrations and sources of PAHs in atmospheric PM_2.5 in Zhifu District and Longkou City during the heating period in Yantai. Methods Two monitoring sites in Zhifu District and Longkou City of Yantai were selected, and PM_2.5 sample collection was carried out from April 2023 to March 2024. Gas chromatography-mass spectrometry was applied to analyze the concentrations of PAHs in atmospheric PM_2.5 during the heating period (from November 2023 to March 2024) and the non-heating period (from April to October 2023). The concentrations of PAHs in the two periods were compared and the sources of PAHs during the heating period were analyzed by characteristic ratio method. Results During the heating period, the total concentration ranges of PAHs in atmospheric PM_2.5 at the monitoring sites in Zhifu District and Longkou City of Yantai were (1.59-23.70) ng·m⁻³ and (2.08-149.72) ng·m⁻³ respectively, and the medians (M) and the 25th and 75th percentiles (P₂₅, P₇₅) were 4.99 (2.61, 8.09) ng·m⁻³ and 15.46 (8.15, 29.05) ng·m⁻³ respectively. The PAHs concentrations in Longkou City were significantly higher than those in Zhifu District in all months (P<0.05). The highest median total concentrations of PAHs in both sites were reported in January (8.14 ng·m⁻³ and 81.56 ng·m⁻³ respectively). In the non-heating period, the M (P₂₅, P₇₅) of the total PAHs concentrations at the two sites were 1.59 (1.59, 2.78) ng·m⁻³ and 4.11 (2.94, 7.97) ng·m⁻³ respectively, much lower than those in the heating period (P<0.01). The order of composition of PAHs by ring number in PM_2.5 at both sites was 4-ring> 5-ring> 6-ring, with the 4-ring contributing the largest proportion (65.33% and 46.39% respectively). Fluoranthene had the highest concentration among PAHs at both sites, with concentrations M (P₂₅, P₇₅) of 1.29 (0.51, 1.78) ng·m⁻³ and 2.32 (1.30, 3.82) ng·m⁻³ respectively. The characteristic ratios of fluoranthene/(fluoranthene + pyrene), fluoranthene/pyrene, benzo[a]anthracene/(benzo[a]anthracene + chrysene), pyrene/benzo[a]pyrene, benzo[a]pyrene/(benzo[a]pyrene + chrysene), benzo[a]pyrene/benzo[g,h,i]pyrene, and indeno[1,2,3-c,d]pyrene/(indeno[1,2,3-c,d]pyrene + benzo[g,h,i]pyrene) in Zhifu District were 0.62, 1.65, 0.41, 4.48, 0.50, 0.93 and 0.47 respectively, and those in Longkou were 0.57, 1.35, 0.40, 2.89, 0.29, 0.79 and 0.47 respectively. The results showed that PAHs pollutants were generated by combination of coal combustion, vehicle exhaust emissions and gasoline combustion. Conclusion During the heating period in Yantai area, the total concentration of PAHs in atmospheric PM_2.5 is significantly higher than that in the non-heating period. Among them, during the heating period, the pollution level in Longkou City is significantly higher than that in Zhifu District. The local PAHs may be sourced from mixed pollution, and the main sources include gasoline, and coal combustion and vehicle exhaust emissions.

AIM: To compare the accuracy of intraocular lens(IOL)calculation formulas based on different corneal refractive power in calculating IOL diopters of cataract patients with a history of corneal refractive surgery.METHODS: A prospective clinical study was conducted with a cohort of 32 cataract patients(42 eyes)who had previously undergone myopic laser corneal surgery at Jinan Mingshui Eye Hospital between February 2022 and August 2024. The study employed several IOL calculation formulas, including the Haigis-L formula, the Barrett True K formula based on simulated keratometry(SimK), the Haigis formula based on total keratometry(TK), the Potvin-Hill Pentacam(PVP)formula based on corneal true net power(TNP), and the OCT formula based on net corneal power(NCP). These formulas were used to calculate IOL power and predict postoperative refractive outcomes. At 1 mo postoperatively, subjective refraction was performed, and the prediction error(PE), mean absolute prediction error(MAE), median absolute prediction error(MedAE), and the percentage of prediction errors within the ranges of ±0.25, ±0.50, ±0.75, and ±1.0 D were determined.RESULTS: The intraclass correlation coefficient for the four types of corneal refractive power was 0.986(P<0.001). There was no significant difference between TNP and NCP(P=0.491), and there were differences between the other two groups(all P<0.001). Statistically significant differences were observed between PE and 0 for the Haigis-L(K)and Haigis(TK)formulas(all P<0.001). In contrast, no statistically significant differences were noted between PE and 0 for the PVP, OCT, and Barrett True K formulas(all P>0.05). The MedAE value of Barrett True K was the smallest 0.32(0.19, 0.71)D among the five formulas, and there was no significant difference in MedAE among the five formulas(P=0.870). The proportion of eyes with PE within ±0.25 and ±1.0 D in Barrett True K formula was 38%(16/42)and 95%(40/42), respectively. The proportion of eyes within ±0.50 D in PVP formula was 71%(30/42); and the proportion of eyes with PE within ±0.75 D in Haigis(TK)formula was 83%(35/42).CONCLUSION: After corneal refractive surgery, there are differences between different types of corneal refractive power. When calculating IOL, the accuracy of TK combined with Haigis formula is better than that of Haigis-L(K)formula, and Barrett True K formula shows good accuracy.

With the development of modern medical standards,autoimmune diseases and their associ-ated successive osteoporosis have received increasing attention in recent years.Patients with autoimmune diseases,due to the characteristics of the disease and the prolonged use of glucocorticoid hormone thera-py,may affect the bone formation and bone absorption of the patient,followed by severe successive osteo-porosis,thereby increasing the risk of osteoporotic vertebral fractures.Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures.Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases.Percutaneous vertebro-plasty(PVP)and percutaneous kyphoplasty(PKP)are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures.However,due to the operation of spinal puncture during the operation,there are serious surgical risks such as bone cement leakage,spinal epidural hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage in both PVP and PKP.As a result,it is necessary to evaluate the patient's body before surgery carefully,especially in the case of blood coagulation.This article reports a case of autoimmune disease patient admitted to Peking University People's Hospital due to lumbar 4 vertebral compression fracture combined with Sj?gren's syn-drome.The patient's preoperative examination showed that the activated partial thromboplastin time(APTT)was significantly prolonged.After completing the APTT extended screening experiment and lu-pus anticoagulant factor testing,the multi-disciplinary team(MDT)of Peking University People's Hospi-tal jointly discussed the conclusion that the patient's test results were caused by an abnormal self-immuni-ty anti-copulant lupus(LAC).Based on the results of the laboratory examination,the patient was con-sidered to be diagnosed with combined antiphospholipid syndrome(APS).For such patients,compared with the patient's tendency to bleed,we should pay more attention to the risk of high blood clotting in the lower limbs of the patient,pulmonary clots and so on.With timely anti-coagulation treatment,the patient safely passed the peripheral period and was successfully discharged from the hospital.Therefore,for pa-tients with autoimmune diseases with prolonged APTT in the perioperative period,doctors need to careful-ly identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.

AIM: To compare and observe the accuracy of five intraocular lens(IOL)power calculation formulas in patients with cataracts who have previously undergone corneal refractive surgery.METHODS: Prospective case series study. A total of 23 cataract patients(34 eyes)with a history of myopic corneal refractive surgery at Jinan Mingshui Eye Hospital from September 2021 to March 2023 were collected, including 1 eye treated with photorefractive keratectomy(PRK)and 22 patients(33 eyes)treated with laser-assisted in situ keratomileusis(LASIK). Preoperative ocular biometry was performed using the IOL Master 700, while corneal true net refractive power(TNP)was measured via Pentacam analyzer. Anterior segment optical coherence tomography(OCT)was used to assesse net corneal power(NCP), posterior corneal refractive power, and central corneal thickness(CCT). The Shammas, Haigis-L, Potvin-Hill Pentacam, OCT, and Barrett True K formulas were utilized for IOL power calculations, with the optimal power selected accordingly. At 1 mo postoperatively, actual refractive outcomes were determined through subjective refraction, based on objective optometry results. The refractive prediction error(RPE)and refractive absolute error(RAE)of each formula were calculated and compared, and the percentage of eyes with RAE ≤0.5 D and ≤1.0 D was counted.RESULTS: No significant statistical difference was found in the RPE of the five formulas when compared to zero(all P>0.05), nor were there significant differences in RPE and RAE among the formulas(F=0.554, P=0.696; H=4.402, P=0.354). The RAE was within ≤0.5 D for 26 eyes(76%)using the Potvin-Hill Pentacam formula and for 24 eyes(71%)using the Barrett True K formula, with both formulas achieving an RAE within ≤1.0D in 33 eyes(97%).CONCLUSIONS: The Barrett True K and Potvin-Hill Pentacam formulas demonstrated high predictive accuracy for IOL power calculations in post-corneal refractive surgery cataract patients. Given the variability in corneal refractive power among these patients, further research on IOL power calculation is warranted. Clinically, it is advisable to consider a range of formulas for optimal outcomes.

Objective To investigate the morphological changes in the upper airway after bimaxillary surgery in patients with skeletal Class Ⅲ malocclusion and the relationship between jaw movement and airway changes using CBCT.Methods This study involved 44 individuals(21 males and 23 females)receiving Class Ⅲ bimaxillary surgery.Preoperative and 3-6-month postoperative CBCT data were examined using Dophin3D 11.95 software.The alterations before and after upper airway surgery were analysed using paired t-test and non-parametric Wilcoxon rank sum test.The association between airway alterations and jaw movement was examined using Pearson's correlation coefficient.Results Patients who underwent Class Ⅲ bimaxillary surgery had significantly reduced upper airway volume,sagittal cross-sectional area,and minimum cross-sectional area(P＜0.01).A correlation exists between oropharyngeal volume change and point B change(P＜0.05).When B point recession was＞7 mm,the decrease in upper airway volume increased significantly(P＜0.01),as did the risk of minimum cross-sectional area of the patient's airway(P＜0.01).Conclusion ClassⅢbimaxillary surgery re-duces upper airway capacity.Postoperative reduction in upper airway capacity coincides with mandibular recession.Mandibular reces-sion(＞7 mm)may reduce postoperative upper airway capacity and increase the risk of OSAHS.Patients at risk of upper airway stenosis should have their protocol modified to reduce airway risk.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective:To conduct a retrospective study on the treatment outcomes of patients who underwent artificial temporomandibular joint (TMJ) replacement surgery and to evaluate the effectiveness of artificial TMJ treatment.Methods:This study selected 62 patients who received standard Biomet artificial TMJ treatment at Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University from May 2010 to September 2023 as the study subjects. Among them, there were 15 male patients and 47 female patients. The average age was 33.5 years old(ranging from 18 to 67 years). This study statistically analyzed postoperative indicators, including maximum mouth opening, forward jaw movement, lateral movement, postoperative pain scores, and patient satisfaction.Results:This study included a total of 62 patients with 99 TMJ joints. No infections occurred postoperatively. The average follow-up period was 33.7 months (ranging from 7 to 170 months). At 6 months postoperatively, the mean mouth opening was (36.1±6.2) mm, lateral movement was (2.1±0.9) mm, and forward jaw movement was (1.0±0.9) mm. The pain visual analog scale score at 6 months postoperatively was (2.8±0.6), and patient satisfaction with the surgery was (8.8±1.1). Spiral CT scans conducted after surgery showed no joint dislocation or migration, and the artificial joint remained stable during the follow-up period.Conclusions:Artificial TMJ replacement is a valuable method for effectively restoring TMJ structure and essential functions related to mouth opening and chewing. It is worthy of promotion as a reconstructive approach for the temporomandibular joint

Objective To investigate the current status of off-label drug use(OLDU)management in tertiary hospitals of Guizhou province and to provide baseline evidence for developing a unified administration regulation for OLDU in Guizhou province.Methods In line with the relevant policies and regulations,a questionnaire including basic information about the person filling out the form,basic information about the hospitals,and information about OLDU was developed.The questionnaire was sent to 84 tertiary hospitals in Guizhou province through the Wenjuanxing.Results A total of 84 questionnaires were distributed and recovered,with a response rate of 100.00%.Of the 84 hospitals,77 had OLDU,of which 68(88.31%)had established a management system for OLDU.Among the 77 hospitals with OLDU,65(84.42%),42(54.55%),58(75.32%),36(46.75%),15(19.48%),and 21(27.27%)hospitals respectively,required approval from the Committee on Drug Administration and Pharmacotherapy before OLDU,restricted the qualifications of doctors prescribing OLDU,required informed consent from patients or their families before OLDU,recorded the matters and reasons in the medical records of patients treated with OLDU,followed up patients in their files and evaluated the reasonableness of the OLDU,and carried out special reviews for OLDU.Only 30(38.96%)hospitals have set up a catalogue of OLDUs,and 58(75.32%)hospitals have urgent needs to set up a unified provincial catalogue of OLDUs.Conclusion The pharmacy administration level of OLDU in tertiary hospitals of Guizhou province is relatively low,so there is an urgent need to establish a unified OLDU management system and medication catalog.

Osteoporosis (OP) is a prevalent metabolic bone disease with a complex pathogenesis that has not yet been fully elucidated. Recent studies have revealed that the Toll-like receptor 4 (TLR4) signaling pathway plays a significant role in the development and progression of OP. TLR4, a crucial immune receptor primarily expressed in immune cells, is involved in inflammatory responses and immune regulation. The TLR4 signaling pathway influences bone metabolism and remodeling through multiple mechanisms. Therefore, investigating the role of the TLR4 signaling pathway in OP is of great significance for its prevention and treatment. Research targeting the TLR4 signaling pathway provides novel insights and approaches for OP therapy. Future studies should further explore the mechanisms of the TLR4 signaling pathway, develop therapeutic agents that modulate this pathway, and validate their efficacy in OP through clinical trials, thereby offering more options for the clinical management of OP.