AIM: To investigate the effects of Conbercept on various optical coherence tomography(OCT)biomarkers in patients with retinal vein occlusion-related macular edema(RVO-ME), and to analyze the correlation of these biomarker changes with visual prognosis.METHODS: Retrospective study. A total of 57 patients(57 eyes)with RVO-ME, including 25 patients(25 eyes)with central retinal vein occlusion(CRVO)and 32 patients(32 eyes)with branch retinal vein occlusion(BRVO), were enrolled in this study. All the patients received intravitreal injection of conbercept once a month, three times in total. The preoperative and postoperative best-corrected visual acuity(BCVA), and changes in OCT biomarkers, including central macular thickness(CMT), the length of disorganization of the retinal inner layers(DRIL), the number of hyperreflective dots(HRD), the area of intraretinal fluid(IRF), the area of subretinal fluid(SRF), and the length of ellipsoid zone(EZ)disruption were compared. Furthermore, the relationship of these changes with BCVA was analyzed.RESULTS:Compared with the baseline, at 3 mo post-treatment, BCVA(LogMAR)was improved, CMT was decreased, the length of DRIL was shortened, the number of HRD was reduced, the area of IRF was decreased, the area of SRF was reduced, and the length of EZ disruption was shortened(all P<0.05). Spearman correlation analysis showed that there was no correlation between the changes in CMT, the length of DRIL, the number of HRD, the area of IRF, the area of SRF and the change in BCVA before and after treatment(P>0.05). However, the change in the length of EZ disruption was positively correlated with the change in BCVA(rs=0.34, P=0.011), and the R2 value of the fitting curve between the change in the length of EZ disruption and the change in BCVA was 0.113(P=0.011). When comparing the pre- and post-treatment changes in BCVA, the length of DRIL, the number of HRD, the area of IRF, the area of SRF, and the length of EZ disruption between patients in the CRVO group and BRVO group, no significant differences were observed(all P>0.05). In contrast, a significant difference was found in the change in CMT between the two groups(P=0.002).CONCLUSION:Conbercept effectively improves multiple OCT biomarkers in patients with RVO-ME. Repair of EZ disruption is a key driver of visual recovery, and its stability may serve as a novel indicator for personalized decision-making in anti-vascular endothelial growth factor therapy.

AIM: To observe the characteristics of best corrected visual acuity(BCVA), microperimetry(MP), multifocal electroretinogram(mfERG), and optical coherence tomography angiography(OCTA)parameters in patients with idiopathic epiretinal membrane(IERM), and conduct a comparative study and correlation analysis on these parameters.METHODS:This was a cross-sectional study. A total of 56 patients(56 eyes)diagnosed with IERM who visited our hospital between February 2021 and November 2024 were collected as IERM group, and 33 healthy individuals(33 eyes)undergoing physical examinations were included as control group. Parameters were compared between the IERM group and the control group, as well as among IERM subgroups at different stages. Additionally, correlations among visual function parameters and between these visual function parameters and vascular structural OCTA parameters were analyzed.RESULTS: The general data of patients in the control group and IERM group were comparable. In the IERM group, BCVA, retinal sensitivity(RS), P1 wave amplitude in ring 1, superficial capillary plexus parafoveal vessel density(SCPpfvd), deep capillary plexus parafoveal vessel density(DCPpfvd), and the foveal avascular zone(FAZ)area were significantly lower than the control group(all P<0.01). In contrast, central retinal thickness(CRT), superficial capillary plexus foveal vessel density(SCPfvd), and deep capillary plexus foveal vessel density(DCPfvd)were significantly increased(all P<0.001). When comparing different stages of IERM, significant differences were observed in BCVA, CRT, RS, SCPfvd, and FAZ(all P<0.01). In eyes affected by IERM, BCVA(LogMAR)was negatively correlated with RS; P1 wave amplitude in ring 1 positively correlated with P1 wave implicit time in ring 1; SCPfvd positively correlated with BCVA(LogMAR)and negatively correlated with RS; DCPfvd negatively correlated with P1 wave implicit time in ring 1; and DCPpfvd positively correlated with RS(all P<0.05).CONCLUSION: Eyes with IERM exhibit abnormalities in visual function parameters and vascular structure, with varying degrees of alteration in BCVA, CRT, RS, SCPfvd, and FAZ across different stages. Comprehensive evaluation of BCVA, MP, mfERG, and OCTA contributes to a deeper understanding of the nature of IERM and aids in formulating appropriate diagnosis and treatment plans.

Objective:To investigate the early and mid-term outcomes of aortic endovascular remodeling device (AERD) for Stanford type A aortic dissection (TAAD) in type Ⅱhybrid surgery, and to evaluate its clinical efficacy.Methods:46 patients with TAAD, including 14 females and 32 males, participated in the single-center clinical trial of West China Hospital of Sichuan University and underwent type II hybrid surgery (Bentall / ascending aorta replacement + AERD implantation) from February 2021 to October 2023. The safety and efficacy of AERD in type Ⅱ hybrid surgery for TAAD were estimated by clinical indicators (postoperative mortality, cardiovascular and cerebrovascular accidents, paraplegia, ischemia), and blood flow condition (volume of the true and false lumen, and suprachial branches).Results:Three patients (6.52%) died during the follow-up period, and the operation-related mortality was 4.35% (2/46). The remaining 43 patients were followed up for an average of (25.53±9.60) months. There were two cases (4.35%) of stroke after the operation, and paraplegia, acute renal insufficiency, and other severe complications were not noticed. The blood flow of the superior branch of the aortic arch was unobstructed, and there was no significant difference in the blood flow of the branch before the operation and at each follow-up time point. Compared to the pre-operation, the true lumen volume of the stent part increased by 59.0% and the false lumen volume decreased by 82.4%.Conclusion:AERD is a safe and effective alternative in type II hybrid surgery for acute TAAD, which is helpful in improving perioperative and short- and long-term survival rates and clinical outcomes.

Objective:To analyzed the 3-year follow-up results in a single center to evaluate the mid-term clinical efficacy of aortic endovascular remodeling device(AERD).Methods:From January 2019 to June 2019, 18 patients with residual aortic dissection after proximal repair of acute aortic dissection were treated with AERD in our heart center of West China Hospital of Sichuan University. They were followed up for 3 years after surgery and underwent vascular enhanced CT review. The primary outcome of our study included all-cause mortality and stent-related mortality. Secondary outcome included branch patency rate, reoperation rate and the incidence of serious adverse events. Morphological measures assessed the effectiveness of AERD in treating residual distal dissection.Results:17 patients completed the 3-year follow-up, and 1 was lost to follow-up. There was no stent-related death, branch artery occlusion, or new serious adverse events. 12 patients completed vascular enhanced CT review, the true lumen was significantly expanded and the false lumen was reduced considerably at 3-year follow-up, true lumen volume, (52.39±22.32)cm 3 vs. (74.34±14.64) cm 3( P<0.01), false lumen volume(50.42±25.44) cm 3 vs. (32.32±31.75)cm 3( P<0.01). Increased true lumen diameter and area ( P<0.001) and decreased false lumen diameter( P<0.001) were significantly different from those before operation, especially in the level below the renal artery and 5 cm below the renal artery. Conclusion:The mid-term effect of AERD in treating distal residual dissection is satisfactory, and it promoted positive distal aorta remodeling with safety and effectiveness.

Objective:To compare the cost-effectiveness between open surgery and minimally invasive rotational surgery in patients with benign breast tumor, and to provide a theoretical support for the choice of surgical approach.Methods:The clinical data of 1 389 benign breast tumor patients underwent surgery from January 2017 to January 2020 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. Among them, 374 patients were treated with open surgery (open group), and 1 015 patients were treated with minimally invasive rotational surgery (minimally invasive group). The surgery-related and cost-effectiveness analysis indexes were compared between two groups.Results:The operation time, incidence of hematoma/subcutaneous bruising and cosmetic result satisfactory rate in minimally invasive group were significantly higher than those in open group: (37.37 ± 6.66) min vs. (34.58 ± 8.95) min, 10.54% (107/1 015) vs. 5.35% (20/374) and 98.72% (1 002/1 015) vs. 95.99% (359/374); while the incision length, length of hospital stay and pain score were significantly less than those in open group: (5.00 ± 0.00) mm vs. (26.55 ± 4.73) mm, (1.03 ± 0.36) d vs. (2.85 ± 1.99) d, (1.76 ± 1.56) scores vs. (2.72 ± 1.27) scores, and there were statistical differences ( P<0.01). The patients were followed up until May 2022. There were no incision infection, recurrence and residual lesions in the two groups. The total cost and cost-effectiveness ratio in minimally invasive group were significantly lower than those in open group: (6 553 ± 1 150) yuan vs. (7 965 ± 3 323) yuan and 71.10 ± 13.61 vs. 88.96 ± 37.48, the benefit score was significantly higher than that in open group: (96.50 ± 3.89) scores vs. (88.92 ± 6.39) scores, and there were statistical differences ( P<0.01). Conclusions:Compared with open surgery, minimally invasive rotational surgery is less costly and more benefits, so minimally invasive surgery should be the preferred surgical procedure for benign breast tumor.

As for the treatment of microtia, the status quo is as follows. The ear reconstruction with autologous costal cartilage has been generally accepted as the therapeutic strategy for type Ⅲ/Ⅳ patients with only small ear lobe remaining or complete absence of auricle, and the outcomes are improved steadily with the advances in technology; but for type Ⅰ/Ⅱ patients with larger remnant ear, there is insufficient evidence to be able to support any specific treatment methods as the potential unified approach for surgeons to choose from. Non-surgical treatment with appliance wearing may play an auxiliary role in the treatment of microtia, which is worthy of further research. The authors proposed a serialized treatment system based on their clinical practice and literature review. It is expected to be helpful for the treatment of microtia.

As for the treatment of microtia, the status quo is as follows. The ear reconstruction with autologous costal cartilage has been generally accepted as the therapeutic strategy for type Ⅲ/Ⅳ patients with only small ear lobe remaining or complete absence of auricle, and the outcomes are improved steadily with the advances in technology; but for type Ⅰ/Ⅱ patients with larger remnant ear, there is insufficient evidence to be able to support any specific treatment methods as the potential unified approach for surgeons to choose from. Non-surgical treatment with appliance wearing may play an auxiliary role in the treatment of microtia, which is worthy of further research. The authors proposed a serialized treatment system based on their clinical practice and literature review. It is expected to be helpful for the treatment of microtia.

Objective    To analyze the differences in proteins between aneurysm/dissection patients and healthy subjects, and subsequently figure out differential proteins related to medial degeneration of aortic aneurysm/dissection. Methods    Aortic wall samples were collected from 6 male aortic aneurysm patients (an aortic aneurysm group, mean age 56.50±8.19 years), 6 male aortic dissection patients (an aortic dissection group, mean age 54.17±6.68 years) and 6 male healthy subjects (a normal group, mean age 40.50±9.31 years) between December 2019 and May 2020 in West China Hospital of Sichuan University. Quantitative proteomics was performed using tandem mass tag (TMT) techniques, followed by gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results    A total of 63 differential proteins were obtained both in the aortic aneurysm group and the aortic dissection group compared with the normal group, with 30 up-regulating and 33 down-regulating. The differential proteins were involved in multiple biological processes and clusted on peroxisome proliferators-activated receptor (PPAR) signaling pathway, extracellular matrix-receptor interaction signaling pathway and complement and coagulation cascades signaling pathway. Conclusion    The identified proteins may help to demonstrate new molecular mechanisms related to medial degeneration of aortic aneurysm/dissection.

The conventional total arch replacement (cTAR) with frozen elephant trunk implantation is commonly regarded as the gold standard for aortic pathologies involving ascending aorta and proximal aortic arch. By combining open supra-aortic vessels debranching and emerging endovascular technologies, hybrid arch repair (HAR) has been increasingly performed as a promising alternative in risky patients with comorbidities and frailties. Nevertheless, the advantages or disadvantages of hybrid arch procedures and cTAR in terms of survival and related outcomes remain controversial. This study is aimed to briefly review the role and results of HAR in the management of aortic arch pathology in comparison of contemporary cTAR.

Objective:To investigate the interventional effect of metformin on pulmonary inflammation and pulmonary fibrosis in silicotic rats.Methods:In April 2019, 48 Wistar male rats of SPF grade were randomly divided into negative control group, metformin control group, silicon dioxide (SiO 2) model group, low, medium and high dose metformin intervention group according to the random number table method, 8 rats in each group. The SiO 2 model group and the low, medium and high dose metformin intervention groups were given 1 ml 50 mg/ml of SiO 2 by intratracheal instillation, the negative control group and the metformin control group were given 1 ml normal saline by intratracheal instillation. 24 hours later, the low, medium and high dose metformin intervention groups and the metformin control group were treated with 100, 200, 400 and 400 mg/kg metformin daily, the control and SiO 2 model groups received normal saline daily. Then the rats were sacrificed at the 28th day after SiO 2 exposure. The changes of rat body weight and pathological examination of rat lung tissue were observed, and the lung organ coefficient, the content of hydroxyproline (HYP) , the expression levels of inflammatory factors transforming growth factor beta1 (TGF-β1) , tumor necrosis factor-alpha (TNF-α) , interleukin-1beta (IL-1β) and the protein expression of E-cadherin (E-Cad) , Vimentin, α-SMA were detected. Results:Compared with the negative control group, SiO 2 model group had a significant decrease in the body weight of rats ( P<0.05) , lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-β1, TNF-α, IL-1β were all significantly increased ( P<0.05) . Compared with the SiO 2 model group, the weights of the rats in the medium and high dose intervention group of metformin increased significantly ( P<0.05) . And after intervention with different doses of metformin, the lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-β1, TNF-α and IL-1β were significantly decreased ( P<0.05) . Immunohistochemistry and Western blotting results showed that compared with the negative control group, the expression of E-Cad of the SiO 2 model group was decreased, and the expression levels of Vimentin and α-SMA were significantly increased ( P<0.05) . After metformin intervention, the expression of E-Cad was significantly increased, the expression levels of Vimentin and α-SMA were significantly decreased ( P<0.05) . Conclusion:Metformin can reduce lung tissue inflammation and fibrosis in rats exposed to SiO 2 dust, which may be related to reducing the expression of inflammatory factors in lung tissue and inhibiting the EMT process.