AIM:To investigate the safety and efficacy of selecting implantable collamer lens(ICL)size for postoperative vaults using sulcus to sulcus(STS)and other data measured by ultrasound biomicroscopy(UBM), and to explore the relevant factors affecting vaults.METHODS: Prospective case observational study. A total of 95 patients(188 eyes)with ametropia who underwent ICL size optimization and 90 patients(174 eyes)without ICL size optimization, from January to December 2022 and underwent regular follow-up for 6 mo were selected. Patients were divided into an optimized group and a standard group based on whether ICL size optimization was performed. The patients were followed up at 1 d, 1 wk, 1, 3, and 6 mo, and uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction state, intraocular pressure(IOP), corneal status, anterior chamber depth(ACD), angle opening, vaults and corneal endothelial cell count were collected.RESULTS: No significant difference in spherical equivalent, UCVA and BCVA was found between the two groups(all P >0.05). The safety index was 1.21±0.24 and 1.19±0.21 at 6 mo for the two groups, respectively, while the efficacy index were 1.18±0.22 and 1.07±0.26. The vaults at 6 mo for the two groups was 407.77±159.31 and 467.16±250.07 μm, respectively. In the optimization group, 92.0% of eyes achieved the desired vaults postoperatively, while 74.1% of eyes in the standard group reached the desired vaults. Both groups exhibited a slight downward trend in vaults over time, with no significant differences between the two groups(F=3.478, P=0.063). However, the standard group experienced 6 eyes of ICL replacement and 2 eyes of ICL removal due to acute angle-closure glaucoma induced by angle closure.CONCLUSION: Selecting the ICL size and determining the implantation orientation based on sulcus to sulcus(STS)and other data measured by UBM provides good safety, efficacy, and predictability for postoperative vaults.

AIM:To investigate the safety and efficacy of selecting implantable collamer lens(ICL)size for postoperative vaults using sulcus to sulcus(STS)and other data measured by ultrasound biomicroscopy(UBM), and to explore the relevant factors affecting vaults.METHODS: Prospective case observational study. A total of 95 patients(188 eyes)with ametropia who underwent ICL size optimization and 90 patients(174 eyes)without ICL size optimization, from January to December 2022 and underwent regular follow-up for 6 mo were selected. Patients were divided into an optimized group and a standard group based on whether ICL size optimization was performed. The patients were followed up at 1 d, 1 wk, 1, 3, and 6 mo, and uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction state, intraocular pressure(IOP), corneal status, anterior chamber depth(ACD), angle opening, vaults and corneal endothelial cell count were collected.RESULTS: No significant difference in spherical equivalent, UCVA and BCVA was found between the two groups(all P >0.05). The safety index was 1.21±0.24 and 1.19±0.21 at 6 mo for the two groups, respectively, while the efficacy index were 1.18±0.22 and 1.07±0.26. The vaults at 6 mo for the two groups was 407.77±159.31 and 467.16±250.07 μm, respectively. In the optimization group, 92.0% of eyes achieved the desired vaults postoperatively, while 74.1% of eyes in the standard group reached the desired vaults. Both groups exhibited a slight downward trend in vaults over time, with no significant differences between the two groups(F=3.478, P=0.063). However, the standard group experienced 6 eyes of ICL replacement and 2 eyes of ICL removal due to acute angle-closure glaucoma induced by angle closure.CONCLUSION: Selecting the ICL size and determining the implantation orientation based on sulcus to sulcus(STS)and other data measured by UBM provides good safety, efficacy, and predictability for postoperative vaults.

Objective To quantitatively evaluate age-,sex-,and segment-related characteristics of lumbar disc degeneration(LDD)in patients with low back pain(LBP)using T1rho MRI,and assess its diagnostic value in early-stage disc degeneration.Methods A retrospective cross-sectional study was conducted on 89 LBP patients(balanced distribution across ages 20～29,30～39,40～49,50～59 years and genders)admitted in Department of Orthopedics of First Affiliated Hospital of Army Medical University from March 2024 to February 2025.All patients underwent lumbar MRI including T1rho sequences.Two senior radiologists performed blinded Pfirrmann grading on 445 intervertebral discs and measured T1rho values of the nucleus pulposus(NP).Kappa test was used to evaluate the inter-observer agreement of Pfirrmann grading,and Spearman correlation coefficient was employed to analyze the correlation between Pfirrmann grade and NP-T1rho value.Disc degeneration characteristics were compared across different ages,sexes,and spinal segments.After adjusting for body mass index(BMI)and gender,partial correlation analysis was used to assess the correlation between NP-T1rho value of each lumbar segment and age.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic performance of T1rho quantification for early LDD in LBP patients.Results Good inter-observer agreement was observed in Pfirrmann grading across segments,with a Kappa coefficient of>0.70.The NP-T1rho values of all NP were in a strong negative correlation with Pfirrmann grades(r=-0.877,P<0.001).The NP-T1rho values were progressively decreased from Pfirrmann gradesⅠ to Ⅳ(P<0.001),with a steep decline between gradesⅡ and Ⅲ.The patients aged 20～29 and 30～39 years showed significantly higher NP-T1rho values in Pfirrmann grades Ⅰ and Ⅱ discs when compared with those aged 40～49 and 50～59 years(P<0.05).The males had significantly higher mean NP-T1rho values in grade I than the females(P=0.006).In the upper spinal segments(L1～L4),the males exhibited significantly higher mean NP-T1rho value than the females(P=0.025),and NP-T1rho value was decreased obviously with increase of age across all age groups(P<0.05).Except L5/S1 segments,NP-T1rho value and age in all spinal segments had significant negative correlations(r=-0.548～-0.349,P<0.001).The area under the curve(AUC)for distinguishing grade Ⅰ from Ⅱ discs was 0.824(95%CI:0.772～0.876),and for grades Ⅱ from Ⅲ was 0.978(95%CI:0.964～0.992).Conclusion T1rho MRI provides accurate quantitative assessment of early lumbar disc degeneration in LBP patients,with an NP-T1rho value of 79.87 ms serving as a discriminative threshold between grade Ⅱ and grade Ⅲ.

The biotransformation processes in the human body play a crucial role in maintaining the inter-nal environment's stability by converting exogenous compounds and endogenous metabolites into substances with increased polarity or water solubility.This alteration in toxicity or pharmacological effects facilitates their excretion from the body.Sulfation,an important type of phase Ⅱ biotransformation reaction,is primarily me-diated by members of the cytosolic sulfotransferases(also known as sulfotransferases,SULTs)superfamily.Recent studies have uncovered the significant roles of SULTs in drug metabolism,tumorigenesis,inflammato-ry responses,hormone regulation,and energy metabolism.This article provides a comprehensive review of the regulatory roles and molecular mechanisms of the SULTs superfamily members in carbohydrate and lipid me-tabolism,aiming to offer new insights into the mechanism research and drug development for disorders related to carbohydrate and lipid metabolism dysregulation.

Objective:To evaluate the utility of pulse oximetry-derived parameters—specifically, the pulse oximetry plethysmographic waveform area under the curve (POP AUC) and the peripheral perfusion index (PPI)—in assessing disease severity and predicting prognosis in patients with sepsis. Methods:In this prospective descriptive study, 68 patients with sepsis were categorized based on illness severity into septic shock and non-shock groups, and by 28-day outcome into survival and non-survival groups. POP AUC, PPI, and lactate (Lac) levels were recorded at 0, 24, 48, 72, and 96 hours after admission. APACHEⅡ and SOFA scores were calculated within the first 24 hours. The prognostic value of these parameters was evaluated. Results:Significant differences were observed between the septic shock and non-shock groups in POP AUC, PPI, Lac (all P < 0.05 except at 96 h), APACHEⅡ, and SOFA scores (all P < 0.05). These differences were most pronounced at admission: POP AUC0 (2475.1 ± 899.0) vs. (4260.3 ± 1028.5), PPI 0 (0.78 ± 0.74) vs. (3.13 ± 2.18), Lac 0 (4.95 ± 4.32) vs. (2.07 ± 1.55), APACHE Ⅱ (16.78 ± 5.59) vs. 11.82 ± 4.89), and SOFA (8.89 ± 3.25) vs. (5.06 ± 2.60). Optimal prognostic cut-off values were 2741.43 for POP AUC, 0.97 for PPI, 2.05 for Lac, 12.5 for APACHEⅡ, and 5.5 for SOFA. ROC curve analysis showed that at 24 hours, POP AUC and PPI had significantly larger AUC values than Lac ( P < 0.05), while no significant differences were found among other parameters. Significant differences between non-survivors and survivors were also found in POP AUC, PPI (at 0, 24, and 48 h), APACHE II, and SOFA (all P < 0.05). No significant differences were observed in PPI (72 h and 96 h) or Lac between the two outcome groups. Conclusions:POP AUC and PPI, as derived from pulse oximetry, are non-inferior to Lac, SOFA, and APACHEⅡ scores in evaluating disease severity and predicting 28-day mortality in sepsis patients. These parameters show promise as practical and non-invasive tools for clinical assessment in sepsis.

Objective:To investigate the prevalence of and risk factors associated with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and high-risk human papillomavirus (HPV) coinfections among patients with newly diagnosed syphilis at a hospital in Nanjing. Methods:A cross-sectional study was conducted on patients with newly diagnosed syphilis at the STD Clinic, Hospital of Dermatology, Chinese Academy of Medical Sciences in Nanjing, China from May 2023 to April 2024. Urethral, cervical or rectal swabs were collected according to the gender and types of sexual behavior of the patients. Screening tests for CT, NG and HPV infections were then performed by nucleic acid amplification testing. High-risk HPV testing was performed only in female patients. Univariate analysis was carried out to investigate risk factors associated with CT infection. The chi-square test, chi-square test with continuity correction, or Fisher's exact test was chosen based on the sample size and expected values.Results:A total of 111 newly diagnosed syphilis patients with test specimens were collected, including 71 males (64%) and 40 females (36%), and their ages ranged from 16 to 87 years; there were 82 patients with early syphilis and 29 with late latent syphilis; the number of sexual partners in the past 3 months ranged from 0 to 3. Among the 60 male patients with early syphilis, 1 (1.7%) was co-infected with NG, and 12 (20%) with CT; among the 16 men who have sex with men, 7 (43.8%) were co-infected with CT, while 5 (11.4%) of the 44 heterosexual patients were co-infected with CT, showing a significant difference in CT infection rates between the two groups ( χ2 = 5.80, P = 0.016). Among the 22 female patients with early syphilis, 1 (4.5%) was co-infected with NG, and 8 (36.4%) with CT; among the 12 female patients aged < 25 years, 8 (66.7%) were infected with CT, while none of the 7 patients aged 25-44 years or the 3 patients aged ≥ 45 years were infected with CT, showing a significant difference in CT infection rates among the 3 age groups ( P = 0.005) ; among the 16 female patients with 1 sexual partner in the past 3 months, 3 were infected with CT, while 5 were infected with CT in the 6 female patients with 2-3 sexual partners in the past 3 months, with a significant difference in CT infection rates between the two groups ( P = 0.011). Out of the 40 female patients with syphilis, 16 (40%) were co-infected with high-risk HPV; the HPV infection rates did not differ among different age groups (age groups of < 25 years, 25-44 years, ≥ 45 years: 8/14, 2/9, 6/17, respectively; P = 0.265) . Conclusion:The CT infection rate was relatively high in patients with newly diagnosed early syphilis, and a relatively high infection rate of high-risk HPV was observed in female patients with syphilis aged < 25 years.

Objective:To explore differences in the clinical and pathological features and postoperative survival after radical resection of biliary tract cancer in different locations such as intrahepatic cholangiocarcinoma,perihilar cholangiocarcinoma,distal cholangiocarcinoma,and gallbladder cancer.Methods:This is a retrospective case series study. The clinical and pathological data of 4 852 patients with biliary tract cancer admitted to the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi ′an Jiaotong University from January 2013 to December 2022 were retrospectively analyzed. Among them, 2 110(43.49%%) patients were male and 2 742(56.51%) patients were female,aged from 26 to 88 years with age of (61.3±10.8) years. Observation indicators: (1) The distribution,diagnosis and treatment of patients with biliary tract cancer; (2) Comparison of clinical and pathological features of patients with biliary tract cancer after curative-intent resection; (3) Survival analysis of patients with biliary tract cancer after curative-intent resection; (4) Analysis of effect on adjuvant therapy for patients with biliary tract cancer after curative-intent resection. One-way analysis of variance,Kruskal-Wallis H test and χ 2 test were used for among-group comparisons,respectively. Survival univariate analysis was performed using the Kaplan-Meier method and Log-rank test. Results:Among the 4 852 patients with biliary tract cancer,there were 2 303 cases (47.46%) of gallbladder cancer,952 cases (19.62%) of intrahepatic cholangiocarcinoma,892 cases (18.38%) of perihilar cholangiocarcinoma,and 705 cases(14.53%) of distal cholangiocarcinoma. From the perspective of the year of diagnosis and treatment,the overall number of patients diagnosed and treated for biliary tract cancer has shown an upward trend. From the perspective of diagnosis and treatment,the curative-intent resection rate was 33.37%(1 619/4 852),and the curative-intent resection rate of distal cholangiocarcinoma was higher than that of other biliary tract cancer ( χ2=23.897, P<0.01). Univariate analysis showed that there were statistical differences in gender,age,bile duct stones,total bilirubin at admission,carcinoembryonic antigen,CA19-9,CA125,the degree of pathological differentiation,vascular invasion,microvascular invasion,perineural invasion,surgical margins,pT staging,and pN staging among patients for biliary tract cancer in different locations (all P<0.05). Survival comparison analysis showed that recurrence-free survival and overall survival of patients with gallbladder cancer after curative-intent resection were significantly better than those of intrahepatic cholangiocarcinoma,perihilar cholangiocarcinoma,and distal cholangiocarcinoma ( χ 2=87.780,83.717,both P<0.01). Comparing the postoperative prognosis of patients with biliary tract cancer between the two periods of 2013 to 2017 and 2018 to 2022, the results showed that recurrence-free survival and overall survival of patients with biliary tract cancer from 2018 to 2022 were significantly better than those from 2013 to 2017 ( χ 2=31.202,25.615, both P<0.01),and the proportion of early recurrence and short-term death after curative-intent resection was significantly reduced ( χ 2=21.588,9.623, both P<0.01),with gallbladder cancer being the most significant ( P<0.01). Postoperative adjuvant therapy for patients with biliary tract cancer can effectively prolong recurrence-free survival and overall survival ( χ 2=5.033,11.273,both P<0.05). Conclusions:Gallbladder cancer remains the most common biliary tract cancer with a relatively favorable prognosis after radical resection. There are significant differences in the clinical and pathological features of biliary tract cancer in different locations,and patients with adjuvant therapy effectively improving prognosis.

Objective To observe the value of machine learning(ML)models based on quantitative ultrasound(QUS)and clinical indexes for predicting metabolic associated fatty liver disease(MAFLD).Methods Totally 298 patients underwent abdominal MR and QUS examinations were retrospectively enrolled,including 150 cases with and 148 cases without MAFLD.The patients were divided into training set(including 107 cases of MAFLD and 101 cases of non-MAFLD)and test set(including 43 cases of MAFLD and 47 cases of non-MAFLD)at a ratio of 7∶3.Features were selected using least absolute shrinkage and selection operator(LASSO)regression and logistic regression(LR),based on which predictive models were constructed using 6 ML classifiers,including Gaussian naive Bayes(GNB),LR,random forest(RF),support vector machine(SVM),extreme gradient boosting(XGBoost)and K-nearest neighbor(KNN),respectively.Then the receiver operating characteristic curves were drawn,and the area under the curve(AUC)and the Brier score were calculated to evaluate the predictive efficacy of the models.Results The elevated age,glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT),uric acid(UA),low-density lipoprotein cholesterol(LDL-C),controlled attenuation parameter(CAP),ultrasound-derived fat fraction(UDFF)and shear wave velocity(SWV),as well as blurred liver contour were all independent indicators for higher likelihood of MAFLD(all P＜0.05).The AUC and Brier score of XGBoost model in training set was 0.991 and 0.006,in test set was 0.973 and 0.069,respectively,both higher than those of other models,and decision curve analysis(DCA)indicated that XGBoost model had high net benefit.Conclusion ML models based on QUS and clinical indexes,especially XGBoost model had high efficacy for predicting MAFLD.

Objective To investigate the clinical and CT findings features of nonaneurysmal perimesencephalic subarachnoid hem-orrhage(NAPSAH).Methods A retrospective analysis was conducted on 19 cases of NAPSAH confirmed by clinical treatment and follow-up,and their clinical and CT findings features were summarized.Results All patients exhibited mild clinical symptoms and had a good prognosis without complications.The sites of NAPSAH involved the anterior cistern in 17 cases,the suprasellar cistern in 8 cases,the interpeduncular cistern in 7 cases,the anterior cistern only in 1 case,and the suprasellar cistern only in 1 case;Among them,4 cases had vertebrobasilar dolichoectasia(VBD)and 3 cases had tortuous prolongation of vertebrobasilar artery.Conclusion The incidence of NAPSAH is low,the clinical symptoms are mild and good prognosis.It has typical imaging features.Most of its hemorrhage sites are confined to the anterior cistern,suprasellar cistern and interpeduncular cistern.Combining clinical and CT find-ings helpful to improve the accuracy of diagnosis.

Objective:To explore the effectiveness of generative artificial intelligence (GAI) -empowered interprofessional collaborative learning model in nursing psychology practical teaching for undergraduate nursing students.Methods:From November to December 2024, 109 second-year nursing students from the Xiangya School of Nursing, Central South University were selected as research subjects using convenience sampling. Two classes were randomly divided into an experimental group (55 students) and a control group (54 students) using a random draw method. Control group received a traditional teaching model based primarily on case discussion and scenario simulation teaching, while experimental group used the GAI-empowered interprofessional collaborative learning model on the basis of control group. The teaching effectiveness was evaluated using the Psychological Nursing Practice Competency Assessment Scale, Caring Ability Inventory (CAI), Readiness for Interprofessional Learning Scale (RIPLS), and Satisfaction Survey Questionnaire.Results:After teaching, experimental group's practical course assessment scores, CAI total scores, and scores in each dimension were all higher than those of control group, with statistically significant differences ( P<0.01). The RIPLS score of nursing students in experimental group after teaching was higher than that before teaching, and the difference was statistically significant ( P<0.01). 90.9% of nursing students supported the introduction of GAI into the classroom, and 90.9% of nursing students recognized the auxiliary role of GAI in achieving learning objectives, and the teaching satisfaction was 96.4%. Conclusions:This study validates the effectiveness of GAI-empowered interprofessional collaborative learning model in nursing psychology practical teaching for undergraduate nursing students, providing new ideas for nursing education reform.