Compared to other refractive surgeries, the implantable collamer lens(ICL)implantation procedure has become one of the most popular surgical options in refractive surgery. ICL surgery offers advantages such as reversibility, high-definition visual outcomes, and preservation of the corneal anatomical structure. The V4c model, which features a central port, is currently the most widely used in clinical practice and eliminates the need for peripheral iridotomy during the perioperative period. Although excellent uncorrected visual acuity can be achieved postoperatively, some patients may experience visual disturbances in the early postoperative period, such as halo and glare, which may affect visual comfort particularly under low-light conditions. This article reviews visual quality metrics after ICL V4c implantation, including higher-order aberrations(HOA), modulation transfer function(MTF), and contrast sensitivity(CS), along with influencing factors, and discusses potential relative deficits in postoperative visual quality and their underlying mechanisms.

Glaucoma is a blinding eye disease characterized by optic nerve damage and visual field defects,with a complex pathogenesis.Studies have shown that the abnormal activation of the cyclic GMP-AMP synthase-stimulator of in-terferon genes(cGAS-STING)signaling pathway may be closely related to the occurrence and development of glaucoma.New therapeutic strategies targeting this pathway,such as the cGAS small-molecule inhibitor RU.521 and the STING inhibi-tor H-151,have been shown to effectively alleviate pathological changes associated with glaucoma,and research into their mechanisms of action is becoming increasingly in-depth.This article aims to review the basic mechanisms of the cGAS-STING signaling pathway and its role in the pathogenesis of glaucoma,as well as the latest research progress of compounds targeting cGAS and STING in the treatment of glaucoma,in order to provide a new perspective for the immunotherapy of glaucoma.

Objective To investigate the effect of Modified Renshen Wumei Decoction on the TLR4/MyD88/pNF-κBp65 signaling pathway and elucidate the potential mechanism by which this formula repairs the intestinal mucosal barrier in diarrheal rats.Methods Twelve rats were randomly selected from a total of 48 rats to serve as the blank control group(CK),while the remaining 36 rats were used to establish a disease model via a compound method.After 14 days of model preparation,the rats were randomly divided into three groups:the model group(MC),the western medicine group(MV),and the traditional Chinese medicine group(MRWD).Each of the four groups(including CK)received corresponding interventions for 7 days.The concentrations of serum diamine oxidase(DAO),D-lactic acid(D-Lac),interleukin-1β(IL-1β),IL-6,IL-10,tumor necrosis factor-α(TNF-α),mucin 2(MUC2),MUC4,MUC6,and colonic homogenate secretory immunoglobulin A(SIgA)were measured using ELISA.Additionally,the protein and gene expressions of colonic toll-like receptor 4(TLR4),myeloid differentiation primary response 88(MyD88),phosphorylated nuclear factor kappa-light-chain-enhancer of activated B cells p65(pNF-κBp65),occludin,claudin-1,and zonula occludens-1(ZO-1)were analyzed by Western blot and RT-PCR.Results(1)Intestinal mucosal injury markers:Compared with the blank group,the serum levels of DAO and D-Lac in the model group were significantly increased(P<0.05).Compared with the model group,both the Chinese medicine group and Western medicine group significantly decreased the serum levels of DAO(P<0.001),while the traditional Chinese medicine group also significantly reduced the serum levels of D-Lac(P<0.05).There was no significant difference in the changes of DAO and D-Lac serum levels between the Chinese medicine group and Western medicine group(P>0.05).(2)Inflammatory indicators:Compared with the blank group,the model group exhibited significant upregulation of TLR4,MyD88,pNF-κ Bp65 protein and gene expression,as well as serum levels of IL-1β,IL-6,and TNF-α(P<0.05),along with a significant decrease in IL-10 serum levels(P<0.05).Compared with the model group,both the Chinese medicine group and Western medicine group significantly downregulated TLR4,MyD88,pNF-κBp65 protein and gene expression,as well as serum levels of IL-1β,IL-6,and TNF-α(P<0.05),and significantly upregulated IL-10 serum levels(P<0.05).There was no significant difference in serum levels of TLR4,MyD88,pNF-κBp65 protein,gene expression,and IL-1β,IL-6,IL-10,and TNF-α between the Chinese medicine group and Western medicine group(P>0.05).(3)Intestinal mucosal barrier factors:Compared with the blank group,the model group exhibited significant downregulation in MUC2,MUC6,SIgA content,as well as Claudin-1,ZO-1 protein and gene expression,and Occludin protein expression(P<0.05).Compared with the model group,both Chinese and Western medicine groups significantly upregulated the content of MUC2 and SIgA,as well as the protein and gene expression of Claudin-1 and ZO-1(P<0.05).The traditional Chinese medicine group also significantly increased the content of MUC6 and Occludin protein expression(P<0.05).No significant differ-ences were observed between the Chinese and Western medicine groups in terms of MUC2,MUC6,SIgA serum content,and Claudin-1 and ZO-1 gene expression(P>0.05).However,the Western medicine group showed better Claudin-1 protein expression than the Chinese medicine group(P<0.05),while the ZO-1 protein expression was higher in the traditional Chinese medicine group compared to the Western medicine group(P<0.05).Conclusion Modified Renshen Wumei Decoction exerts an intestinal mucosal barrier repair effect in diarrhea rats by modulating the TLR4/MyD88/pNF-κBp65 signaling pathway.

There are differences in the images of the same visual object projected onto the retinas of the two eyes.Stereopsis is the perceptual ability of the brain to discern three-dimensional depth from these two-dimensional images with binocular disparities,enabling humans to accurately perceive the relative distance between objects and assess their relative depth in space.Panum's fusional area(PFA)encompasses the depth range,including the horopter where the visual object lies and the areas in front of and behind it,within which fused single vision can be achieved.Visual function within the PFA is closely related to the formation of depth perception.The monocular visual direction,the depth of the binocular horopter position,and the measurement methods and models for the theoretical horopter and empirical horopter are all closely asso-ciated with the characteristics of depth perception within the PFA range.This holds significant importance for studying the construction process of stereopsis.

Objective:To investigate the value of tumor volume to uterine volume ratio (N/U) combined with the expression of alpha-fetoprotein (AFP), sugar antigen 199 (CA199) and human epididymal secretory protein 4 (HE4) in evaluating the pathologic grade and prognosis of endometrial carcinoma (EC) .Methods:A total of 160 EC patients admitted to Linyi Central Hospital from Jan. 2021 to Dec. 2023 were divided into low-grade group and high-grade group according to FIGO grading method, and were divided into poor prognosis group and good prognosis group according to cancer death, recrudescence. The levels of N/U, AFP, CA199 and HE4 in patients with different pathologic grades and prognosis were compared. COX regression was used to analyze the influencing factors of EC adverse prognosis, ROC curve was used to analyze the value of N/U combined with serum AFP, CA199 and HE4 in predicting EC adverse prognosis, and a nomogram model was constructed.Results:Pathological examination of 160 EC patients showed that 12 cases were non-endometrioid adenocarcinoma, 148 cases were endometrioid adenocarcinoma, 41 cases were high-grade and 119 cases were low-grade.According to the follow-up, 94 of the 160 EC patients had good prognosis and 66 had poor prognosis. The levels of N/U, AFP, CA199 and HE4 in the poor prognosis group were higher than those in the good prognosis group ( P<0.05). COX regression analysis showed that high levels of N/U, AFP, CA199 and HE4 were all factors affecting the poor prognosis of EC patients ( P<0.05). The AUC value of combined detection of N/U, AFP, CA199 and HE4 in predicting adverse prognosis of EC patients was higher than that of single detection ( Z=3.140, 3.658, 4.277, 4.378, P<0.05) .The ROC curve AUC (95% CI) of the training set and the validation set were 0.84 (0.77-0.92) and 0.90 (0.81-0.98) respectively for the training set and the validation set to predict the adverse prognosis of EC patients. Calibration curve results showed that the calibration curve for EC patients predicted by the nomogram model was close to the ideal curve ( P=0.521, 0.743). The DCA curve shows that the probability threshold of the nomogram model has a higher positive net return at 20%~100%. Conclusion:The levels of N/U, AFP, CA199 and HE4 in EC patients are related to the pathologic grade, and the combined detection of these indicators can predict the poor prognosis of EC patients, and the nomogram model constructed based on these indicators has high predictive value.

Objective To investigate the correlation between the triglyceride-glucose(TyG)index,its derivatives in combination with obesity indicators and the risk of albuminuria in patients with type 2diabetes mellitus(T2DM).Methods T2DM inpatients who were hospitalized in the Department of Endocrinology from January 2020 to March 2023 were consecutively collected as study subjects,and divided into the group with no albuminuria(n=246)and the group with albuminuria(n=221).Spearman correlation analysis was used to analyze the correlation between TyG index,its derivative index and clinical indicators,and multivariate Logistic regression was used to analyze the correlation between TyG index,its derivative indexes and albuminuria.Results The TyG index and its derived indices[TyG-body mass index(TyG-BMI),TyG-waist-to-hip ratio(TyG-WHR),TyG-waist-to-height ratio(TyG-WtHR)]were significantly higher in the albuminuric group of patients with T2DM than in the group without albuminuria(all P＜0.001).The inci-dence of albuminuria gradually increased with increasing tertile groupings of all four indicators(all P＜0.001).In multivariate Logistic regression analysis,after correcting for screened risk factors,the TyG index(OR=1.50,95％CI:1.07-2.08,P=0.019),TyG-BMI(OR=1.01,95％CI:1.00-1.01,P=0.009),TyG-WHR(OR=1.45,95％CI:1.12-1.88,P=0.005),and TyG-WtHR(OR=1.39,95％CI:1.00-1.91,P=0.048)were the independent risk factors for albuminuria.For categorical variables,using the 1st quartile group(Q1)as a control group,the 3rd quartile group(Q3)of all four indices were all risk factors for albuminuria,whereas the Q3group of TyG-WHR was more significantly associated with albuminuria compared to the TyG index alone and the other de-rived indices(OR=2.55,95％CI:1.44-4.51,P=0.002).Conclusion In patients with T2DM,both TyG index and its derivatives combined with obesity indicators were significantly associated with albuminuria,and in patients with higher index levels,the risk of albu-minuria was higher in patients with high levels of TyG-WHR compared with single TyG index and other derivatives.Therefore,TyG-WHR may be a novel biological indicator to predict the development of DKD in T2DM patients.

There are differences in the images of the same visual object projected onto the retinas of the two eyes.Stereopsis is the perceptual ability of the brain to discern three-dimensional depth from these two-dimensional images with binocular disparities,enabling humans to accurately perceive the relative distance between objects and assess their relative depth in space.Panum's fusional area(PFA)encompasses the depth range,including the horopter where the visual object lies and the areas in front of and behind it,within which fused single vision can be achieved.Visual function within the PFA is closely related to the formation of depth perception.The monocular visual direction,the depth of the binocular horopter position,and the measurement methods and models for the theoretical horopter and empirical horopter are all closely asso-ciated with the characteristics of depth perception within the PFA range.This holds significant importance for studying the construction process of stereopsis.

Objective To explore the differences of coronary computed tomography-derived fractional flow reserve(CT-FFR)and dynamic stress computed tomography myocardial perfusion imaging(CT-MPI)parameters in obstructive coronary artery disease(CAD),and their correlation with coronary computed tomography angiography(CCTA)vessel stenosis.Methods A retrospective analysis was conducted on 37 patients with obstructive CAD who underwent combined CCTA and dynamic stress CT-MPI scans.Based on the CCTA results,the patients were divided into moderate CAD group(22 cases)and severe CAD group(15 cases).The lowest CT-FFR value and perfusion parameter values between the two groups were analyzed.A total of 111 vessels including the left anterior descending branch(LAD),left circumflex branch(LCX),and right coronary artery(RCA)were classified into the mild vessel stenosis group(＜25％)with 42 vessels,moderate vessel stenosis group(25％-69％)with 49 vessels,and severe vessel stenosis group(≥70％)with 20 vessels.The lowest CT-FFR value and lowest perfusion parameter value among these three groups were analyzed.The correlation between CT-FFR value and CT-MPI perfusion parameter values and their diagnostic efficacy were analyzed.Results At the patient level,the relative myocardial blood flow(rMBF),myocardial blood flow(MBF),myocardial blood volume(MBV),flow extraction product(FEP)in the severe CAD group were significantly lower than those in the moderate CAD group(P＜0.05),while there was no significance in CT-FFR and perfusion capillary blood volume(PCBV)between these two groups(P=0.061,0.098).At the vascular level,there were significant differences in rMBF and MBV among mild,moderate,and severe vessel stenosis groups(P＜0.05).CT-FFR showed significant difference between mild vs moderate vessel stenosis groups and mild vs severe vessel stenosis groups(P＜0.001),and no significant difference between moderate and severe vessel stenosis groups(P=0.355).rMBF had the highest correlation with the degree of vessel stenosis(r=-0.674).CT-MPI combined with CT-FFR had a high efficacy in diagnosing CCTA vessel stenosis,area under the curve(AUC)≥0.90.Conclusion rMBF is more effective than CT-FFR in evaluating the degree of vessel stenosis in CCTA.CT-FFR combined with CT-MPI is helpful to evaluate functional vascular stenosis.

ObjectiveTo explore the mechanism of modified Xiehuangsan in treating tic disorders （TD） based on microglial polarization and the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor （NF）-κB pathway. MethodsSeventy-two Sprague-Dawley （SD） rats were randomly assigned into six groups： control， model， tiapride （0.025 g·kg^-1）， and low-， medium-， and high-dose （12， 24， 48 g·kg^-1， respectively） modified Xiehuangsan， with 12 rats in each group. Except the control group， the other groups received intraperitoneal injection of 3，3'-iminodipropionitrile （IDPN） for 7 consecutive days for the modeling of TD. After successful modeling， the control and model groups were given normal saline via gavage， and the other groups were administrated with corresponding drugs by gavage. After 28 days of continuous intervention， rat behaviors were observed， and the modified Xiehuangsan group showing the best anti-TD effect was selected for deciphering the treatment mechanism. Hematoxylin and eosin staining was conducted to observe morphological changes in the rat striatum. Immunohistochemistry was employed to detect the expression of CD16 and CD206 in the striatum. Real-time PCR was employed to measure the mRNA levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， IL-4， TLR4， MyD88， and NF-κB p65 in the striatum. Western blot was employed to determine the protein levels of ionized calcium-binding adapter molecule 1 （Iba1）， Fc receptor family for immunoglobulin （Ig）G type Ⅲ （CD16）， mannose receptor （CD206）， TLR4， MyD88， and NF-κB p65 in the striatum. ResultsCompared with the control group， the model group showed increased stereotyped behaviors， locomotor activity， total movement distance， and movement speed， shortened resting time （P<0.01）， and noticeable pathological changes in the striatum. Compared with the model group， the tiapride group and modified Xiehuangsan groups exhibited reduced stereotyped behavior， locomotor activity， total movement distance， and movement speed， prolonged resting time （P<0.05， P<0.01）， and alleviated pathological changes in the striatum. Among the modified Xiehuangsan groups， the high-dose group had the best intervention effect and the mildest pathological changes. Therefore， the high-dose group was selected for further research. Compared with the control group， the modeling of TD increased Iba1 and CD16 expression （P<0.05， P<0.01）， up-regulated the mRNA levels of IL-1β and TNF-α （P<0.05， P<0.01）， down-regulated the mRNA level of IL-4 （P<0.05）， up-regulated the mRNA and protein levels of TLR4 and MyD88 （P<0.05， P<0.01）， and up-regulated the protein level of NF-κB p65 （P<0.01）. Compared with the model group， modified Xiehuangsan reduced Iba1 and CD16 expression （P<0.05， P<0.01）， up-regulated the protein level of CD206 （P<0.05， P<0.01）， down-regulated the mRNA levels of IL-1β and TNF-α （P<0.05）， up-regulated the mRNA level of IL-4 （P<0.01）， and down-regulated the mRNA and protein levels of TLR4， MyD88， and NF-κB p65 （P<0.05， P<0.01）. ConclusionModified Xiehuangsan demonstrated a definite therapeutic effect on TD in rats. It may reduce neuroinflammation in TD rats by regulating the polarization of microglia in the striatum via the TLR4/MyD88/NF-κB signaling pathway.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP