In recent years, the incidence of myopia has been increasing alongside the growing global population, emerging as a significant public health challenge worldwide. Individuals with myopia exhibit an elongated axial length, which leads to various structural and functional ocular changes, resulting in the risk of related eye diseases and, in severe cases, blindness. Unfortunately, once myopia develops, it is irreversible. The only way to prevent or slow its progression is through appropriate treatment. The current focal point in myopia prevention and control is the peripheral myopic defocus theory. This paper summarizes the relevant research on defocus incorporated multiple segments(DIMS)lenses, following a systematic analysis of the literature. It analyzes the advantages and disadvantages of DIMS compared to other myopia control methods, and discusses the application prospects and future directions of defocus lenses represented by DIMS, aiming to provide reference and guidance for the control of myopia progression in children and adolescents.

Background and Aims:Postoperative intra-abdominal infection(PIAI)is a common postoperative complication in abdominal surgery and a challenging issue worldwide,with a treatment failure rate of 68.3％and an in-hospital mortality rate as high as 40.8％.The key to managing this condition is early control of the infection source,debridement and adequate drainage.Delayed control of the infection source is an independent risk factor for predicting treatment failure.Many PIAI lesions are located deep within the abdominal cavity,lacking optimal routes for percutaneous drainage,and the risks and difficulties of reoperation are significant.Thus,controlling the infection source in PIAI is a difficult task.Here,the authors report the management of 4 PIAI patients treated with nephroscopic debridement and catheter irrigation and drainage via the sinus tract,aiming to provide clinical insights and references. Methods:The clinical data of 4 patients undergoing nephroscopic debridement,catheter irrigation and drainage for PIAI from October 2020 to September 2022 in the Department of Hepatobiliary and Pancreatic Surgery of the Second Affiliated Hospital of Guilin Medical University were retrospectively analyzed.Key techniques of nephroscopic management of PIAI were summarized and contextualized with relevant literature. Results:The 4 PIAI cases included a right-sided retroperitoneal abscess after catheter drainage for severe acute pancreatitis,a hepatic abscess at the liver raw surface after right hemihepatectomy,bile leakage and secondary duodenal fistula after laparoscopic choledocholithotomy and T-tube drainage,and a pancreatic abscess at the pancreatic raw surface after distal pancreatectomy with splenectomy.All patients underwent nephroscopic debridement and catheter irrigation and drainage via the sinus tract:guidewires were inserted into the drainage sinus tract,followed by a minimally invasive expansion drainage kit and nephroscopy;pus was irrigated out,and pus moss was clamped out with foreign body forceps under nephroscopy.Then,irrigation drainage tubes were placed under the guidance of the guidewire,and continuous irrigation and drainage were performed.The 4 patients underwent a total of 5 nephroscopic debridement and catheter irrigation and drainage procedures,with one case requiring two operations.The preoperative catheterization time ranged from 14 to 58 d,with an average of 38.4 d.One patient concurrently underwent choledochoscopy for stone extraction and biliary drainage via the T-tube sinus tract.The operative time ranged from 30 to 115 min,with an average of 67.4 min.Aside from one case of minor intraoperative bleeding,which stopped after injecting diluted norepinephrine solution into the sheath and blocking the sheath,there were no surgical complications in the other three cases.The postoperative drainage tube duration ranged from 7 to 30 d,with an average of 20.75 d.After treatment,all PIAI lesions disappeared,and no recurrence was observed during follow-up,which ranged from 16 to 40 months. Conclusion:Nephroscopic debridement and catheter irrigation and drainage via the sinus tract for PIAI is simple,feasible,and safe,allowing for direct visualization to avoid organ damage.It is effective in removing pus and necrotic tissue,replacing drainage tubes,and can be repeatedly performed with high efficiency and remarkable results.This method is particularly suitable for patients with postoperative abdominal drainage tube obstruction combined with encapsulated intra-abdominal fluid collections.

Objective To investigate the clinical efficacy and safety of nivolumab(PD-1 inhibitor)in combination with lenvatinib and FOLFOX regimen[5-fluorouracil(5-FU),oxaliplatin(L-OHP),and calcium folinate(LV)]in the treatment of intermediate and advanced hepatocellular carcinoma(HCC)via hepatic arterial infusion chemotherapy(HAIC).Methods A total of 160 patients with intermediate and advanced HCC admitted to the Second Affiliated Hospital of Guilin Medical University from January 2021 to January 2023 were randomly divided into the control group and the observation group,with 80 patients in each group,using a random number table.The control group received once-daily oral lenvatinib and intravenous carrizumab infusions for 12 weeks as part of transcatheter arterial chemoembolization(TACE)therapy.The observation group was administered with FOLFOX regimen via HAIC chemotherapy,plus intravenous infusion of carrizumab for 12 weeks and once-daily oral lenvatinib.All the patients were followed up regularly.The clinical efficacy was evaluated using the mRECIST criteria.The objective response rate(ORR),disease control rate(DCR),overall survival(OS),progression-free survival(PFS),and incidence of adverse reactions were compared between the two groups.Results There were no significant differences in the objective response rate and incidence of adverse reactions between the groups.The disease control rate,overall survival,and progression-free survival in the observation group were significantly higher than those in the control group(P<0.05).Conclusions The FOLFOX-HAIC regimen in combination with nivolumab and lenvatinib is safe and effective for the treatment of intermediate and advanced HCC,without adverse reactions.It can prolong the overall survival and progression-free survival,and improve the patient's quality of life.

Objective To investigate the effect of afferent blockade of visceral adipose tissue(VAT)on cardiac function and cardiac neural remodeling in rats after myocardial infarction(MI).Methods After 30 healthy SPF-grade male SD rats were subjected,12 of them were randomly divided into control group(n=6)and activation group(n=6).In the activation group,low-dose capsaicin(1 mmol/L)was used to activate VAT afferent nerves,while in the control group,an equal amount of normal saline was injected,and real-time blood pressure and heart rate were monitored for 30 min.The other 18 rats were randomly assigned into sham group(n=6),MI group(n=6),and high-dose capsaicin blockade group(n=6).The MI model was established by ligating the left anterior descending coronary artery.After MI modeling,the high-dose capsaicin blockade group was give 33 mmol/L capsaicin to block VAT afferent nerve,and the sham opera-tion group and MI group were injected with the same amount of normal saline.After 2 weeks,car-diac function was measured by echocardiography,infarct size was measured by TTC staining,heart rate variability was analyzed,and myocardial tyrosine hydroxylase(TH)was measured.The levels of myocardial superoxide dismutase(SOD)and malondialdehyde(MDA)were measured by biochemical methods.Results More significant changes in blood pressure and heart rate were observed in the activation group than the control group(P＜0.01).The MI group had obviously larger infarct size,higher LVEDD and LVESD,and increased myocardial TH density and MDA level,but lower LVEF and myocardial SOD activity than the sham group(P＜0.05).However,the infarct size,LVEDD(9.15±0.37 mm vs 10.1±0.85 mm),LVESD(6.33±0.40 mm vs 7.87±0.86 mm)were obviously decreased,while LVEF[(67.04±3.34)％vs(47.10±3.89)％]and myocar-dial FS[(33.26±2.50)％vs(20.81±2.14)％]activity were greatly increased in the high dose capsaicin group than the MI group(P＜0.05).Conclusion Activation of VAT afferent nerve can increase blood pressure and heart rate;while its blockade can reduce the infarct size,protect cardiac function and inhibit cardiac nerve remodeling in MI rats,possibly by reducing oxidative stress.

Objective To examine the effect of ground cage use on Oncomelania hupensis spread, so as to provide insights into precision snail control. Methods Twenty ground cages that were frequently used to capture rice field eels were purchased, including 11 packaging tape-made cages, 7 plastic cages and 2 nylon rope-made cages. The eel-capturing activity was mimicked, and 20 ground cages were assigned in settings with relatively high (1.00 snail/0.1 m² and higher) and low snail densities (< 1.00 snail/0.1 m²) in Xindai Township, Pinghu City, Zhejiang Province during the period from 15 : 00 to 8 : 00 of the following day on April 13, 26 and 28. The numbers of snails carried by different types of ground cages were compared in settings with different types of snail densities using the rank-sum test. Results A total of 11 cage-times were assigned in settings with a high snail density, and a total of 77 snails were captured, with a mean number of 7 snails in each cage-time and 2.15 snails in 0.1 m² ground cage. The mean numbers of snails carried by packaging tape-made and plastic cages were 2.47 snails/0.1 m² cage and 0.37 snails/0.1 m² cage, respectively. A total of 24 cage-times were assigned in settings with a low snail density, and a total of 8 snails were captured, with a mean number of 0.33 snails in each cage-time and 0.09 snails in 0.1 m² ground cage. The mean numbers of snails carried by packaging tape-made cages were 0.12 snails/0.1 m² cage; however, no snails were carried by plastic or nylon rope-made cages. The number of snails carried by ground cages was higher in settings with a high snail density than in settings with a low snail density (Z = −4.019, P < 0.01), and the number of snails carried by packaging tape-made cages was higher in settings with a high snail density than in settings with a low snail density (Z = −4.086, P < 0.01). No significant differences were found in the numbers of snails carried by different types of ground cages. Conclusion The use of ground cage in snail habitats is a contributor to snail spread.

OBJECTIVE To systematically evaluate the efficacy and safety of the sedative effect of remimazolam in endoscopy and to compare it with propofol and midazolam. METHODS Search PubMed, Embase, Cochrane Library, Wanfang database, CNKI and other databases to collect the literature of randomized controlled trials of remimazolam for sedation in endoscopy. The search period was from 2018 onwards when remimazolam was approved for clinical trials until April 2022. The search strategy included the following variable keywords: remimazolam, gastroscopy, bronchoscopy, and colonoscopy. The quality of the included literature was assessed and the collected data were subjected to meta-analysis by RevMan 5.4 software. RESULTS Ten relevant RCTs involving midazolam and propofol, involving a total of 2 076 patients were included in the analysis. The results showed that the sedative effect of remimazolam was significantly higher than that of midazolam [OR=0.03, 95%CI(0.02, 0.05), I2=0%, P<0.000 01]; but lower than that of propofol [OR=11.32, 95%CI(2.12, 60.56), I2=0%, P=0.005]. The onset time of remimazolam was longer than that of propofol, but shorter than that of midazolam; the recovery time was faster than that of propofol and midazolam. Compared with midazolam, there was no significant difference in the incidence of adverse reactions. Compared with propofol, remimazolam was associated with lower rates of hypotension, slowed heart rate, hypoxemia, and injection pain, but higher risk ratio of nausea, with no difference invomiting. CONCLUSION The sedative effect and onset of action of remimazolam are better than midazolam but less than propofol when used for endoscopy. Wake-up time is faster than that of propofol and midazolam. The incidence of respiratory and circulatory depression is lower with remimazolam than with propofol, and there are no significant differences in adverse effects compared with midazolam.

Objective To evaluate the influence of routine lateral release to the clinical outcomes after total knee arthroplasty without patellar resurfacing.Methods The study involved all patients divided into two groups using a randomised group method.During total knee arthroplasty(TKA),forty-three patients were treated with lateral release in the treatment group,while Forty-two patients in the control group were not treated with lateral release.Both groups were assessed for anterior knee pain,patient satisfaction,Knee Surgery Society(KSS)score,KSS function score,patella score,and incidence of postoperative complications.Results After 24 months of follow-up,the treatment group was found to have a lower incidence of anterior knee pain compared to the control group(P<0.05),and there were no statistically significant differences in postoperative satisfaction,complication rate,KSS knee score,KSS function score,and patella score between the two groups(P>0.05).Conclusion The study suggests that routine lateral release can reduce anterior knee pain and does not increase the risk of postoperative complications after total knee arthroplasty without patellar resurfacing.

Objective To explore the clinical value of 99mTc-diethylenetriaminepentaacetic acid(DTPA)renal dynamic imaging in evaluating renal tubulointerstitial injury in early adult primary nephrotic syndrome(PNS)patients.Methods A total of 42 early adult PNS patients were selected as case group,and the diagnostic efficacy of 99mTc-DTPA renal dynamic imaging quantitative indicators and biochemical indicators of serum creatinine(SCr),blood urea nitrogen(BUN),blood uric acid(UA),blood retinol-binding protein(RBP),and blood β2-microglobulin(β2-MG)levels in renal tubulointerstitial injury was analyzed based on pathological results with or without renal interstitial injury as the standard.Results ①The total glomerular filtration rate(GFR),left kidney GFR and right kidney GFR were negatively correlated with blood SCr,BUN and β2-MG levels of patients in case group.②The diagnostic efficiency of total GFR in diagnosis of tubulointerstitial injury in early adult PNS patients is better than that of blood SCr,BUN and β2-MG,total GFR combined with time to peak(Tp),half discharge time(T1/2)and 20 minute residual rate(R20/p)can improve the diagnostic efficiency.Conclusion 99mTc-DTPA renal dynamic imaging is helpful in early diagnosis of tubulointerstitial injury in early adult PNS patients.

Objective To explore the safety and effectiveness of catheter aspiration combined with catheterization thrombolysis in the treatment of acute renal infarction(ARI),so as to provide reference for the treatment of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 11 ARI patients treated with catheter aspiration combined with catheter thrombolysis at our hospital during Jan.2019 and Jun.2023.Results Among the 11 patients,upon admission,7 manifested with abdominal pain,5 with lumbar pain,5 with nausea,and 1 with fever.All patients were successfully treated with catheter aspiration combined with catheterization and thrombolysis.After thrombolysis,computed tomography angiography(CTA)showed the renal artery trunk and branch vessels.In 11 patients,the renal artery,branch artery and splenic artery branch vessels were patent.D2 aggregates returned to the normal level 1 month after surgery(＜0.5 mg/L).During the follow-up of 3,6,12 months,no previous symptoms were observed.Ultrasound or CTA showed that the renal artery remained unobstructed.Conclusion The use of catheter aspiration combined with catheter thrombolysis for the treatment of ARI caused by renal artery thrombosis is effective,minimally invasive,and worth clinical promotion.

Objective:To investigate the effect of tocilizumab (TCZ) on ventricular arrhythmias (VAs) after myocardial infarction (MI) in Sprague-Dawley rats and explore its potential mechanism.Methods:The random number table method was used to divide 32 adult male Sprague-Dawley rats into 4 groups: Sham group, TCZ group, MI group and MI+TCZ group, with 8 rats in each group. The MI model was established by ligation of the left anterior descending branch of the coronary artery in the MI and MI+TCZ groups, and only sutured without ligation in the Sham and TCZ groups. TCZ was injected into the left superior cervical ganglion (SCG) of rats in the TCZ and MI+TCZ groups after successful modeling or sham operation, and the same amount of normal saline was injected in the Sham and MI groups. 24 h after successful modeling, ECG of rats in each group was recorded, heart rate variability (HRV, including low frequency power (LF), high frequency power (HF), LF/HF ratio), QT interval, QTc interval were calculated, and left ventricular effective refractory period (ERP) and VA inducibility were measured. Myocardial infarct size and tissue changes were observed with triphenyl tetrazolium chloride staining and HE staining. Real-time PCR analysis was used to detect the messager RNA (mRNA) expression of interleukin-6 (IL-6) and signal transducer and activator of transcription (STAT) 3 in SCG and potassium voltage-gated channel subfamily D member 2 (Kcnd2) in myocardial infarction periphery. The expression of c-fos in SCG was detected by immunofluorescence staining.Results:Compared with Sham group and MI+TCZ group, rats in MI group had higher LF and LF/HF ratio, longer QT interval and QTc interval, more VAs induced, lower HF and shorter ERP ( P all<0.05). Triphenyl tetrazolium chloride staining and HE staining showed that rats in the Sham and TCZ groups had normal myocardial tissue structure, those in the MI group had severe myocardial injury, and those in the MI+TCZ group had less myocardial injury than those in the MI group. Real-ime PCR analysis showed that compared with Sham group and MI+TCZ group, mRNA expression levels of IL-6 and STAT3 in SCG of rats in MI group were higher, and mRNA expression level of myocardial Kcnd2 was lower ( P all<0.05). Immunofluorescence staining showed that the content of c-fos in SCG of rats in MI group was higher than that of Sham group and MI+TCZ group ( P all<0.05). Conclusions:TCZ may reduce neural activity of the SCG after MI by inhibiting the IL-6/STAT3 signaling pathway, thereby alleviating myocardial injury and inhibiting VAs.