AIM: To investigate the distribution characteristics of pathogens in patients with post-traumatic infectious endophthalmitis(PTIE)and their relationship with serum levels of macrophage inflammatory protein 1α(MIP-1α), heat shock protein 70(HSP70), and soluble triggering receptor expressed on myeloid cells 1(sTREM-1).METHODS:A total of 157 patients with PTIE from the Handan City Eye Hospital(The Third Hospital of Handan)from May 2023 to May 2025 were selected as the study group. They were divided into a good prognosis group and a poor prognosis group based on their uncorrected visual acuity at discharge. Meanwhile, 157 patients with ocular trauma but without endophthalmitis during the same period were selected as control group 1, and 157 healthy volunteers who underwent physical examinations during the same period were selected as control group 2. Aqueous humor and vitreous fluid samples were collected from the study group to detect the distribution of pathogens. The levels of serum MIP-1α, HSP70, and sTREM-1 were measured using the enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was performed to identify risk factors for poor prognosis. The predictive value of serum MIP-1α, HSP70, and sTREM-1 levels for poor prognosis was evaluated using receiver operating characteristic(ROC)and decision curve analysis(DCA).RESULTS: The general data of the participants in the three groups was comparable. A total of 173 pathogens were detected in the 157 patients with PTIE, with Gram-positive bacteria being the predominant type. The levels of serum MIP-1α and sTREM-1 in the study group were higher than those in control groups 1 and 2, while the level of HSP70 was lower than those in control groups 1 and 2(all P<0.05). There were no significant differences in the levels of serum MIP-1α, HSP70, and sTREM-1 between control groups 1 and 2(all P>0.05). In the poor prognosis group, the time of wound suture was ≥24 h, the wound location was in zones II/III, the type of trauma was rupture, the proportion of rupture injuries, and the levels of serum C-reactive protein, MIP-1α, and sTREM-1 were higher than those in the good prognosis group, while the level of HSP70 was decreased(all P<0.001). Multivariate Logistic regression analysis showed that the time of wound suture, wound location, type of trauma, C-reactive protein, MIP-1α, HSP70, and sTREM-1 were risk factors for poor visual prognosis in patients with PTIE(all P<0.05). The ROC curve results showed that the combined prediction of serum MIP-1α, HSP70, and sTREM-1 for poor visual prognosis in PTIE patients had an AUC value of 0.965, which was significantly higher than that of individual predictions(ZMIP-1α, ZHSP70, ZsTREM-1=3.628, 4.705, 3.930, all P<0.05). Additionally, the DCA curve showed that the combined prediction had a higher net benefit rate than individual predictions in the high-risk threshold range of 0.03-0.97.CONCLUSION:Gram-positive bacteria are the predominant type of pathogenic bacteria in patients with PTIE, with elevated levels of serum MIP-1α and sTREM-1 and decreased levels of HSP70. The combined detection of these three factors has a high predictive efficacy for visual prognosis in patients.

Tumor treating fields (TTF) therapy is an innovative tumor treatment modality. Currently, the TTF devices predominantly employ insulated ceramic electrodes as the electric field transmission medium, resulting in low energy transfer efficiency of the electric field and poor portability of the devices. This study proposed an innovative TTF transmission mode and independently designed a conducted-electrode TTF cell culture dish utilizing inert titanium materials. The electric field conduction characteristics were verified through finite element simulations and experimental tests. Finally, based on the self-manufactured conducted-electrode TTF cell culture dish, experiments on the proliferation inhibition of U87 tumor cells by TTF were conducted. The results demonstrated that under an applied TTF voltage of 10 V and frequency of 200 kHz, the electric field intensities within the medium for conducted and insulated electrodes are approximately 2.5 V/cm and 0.7 V/cm, respectively. Compared to conventional insulated TTF systems, the conducted-electrode TTF configuration exhibited a lower electrode voltage drop and a higher electric field intensity in the culture medium, indicating superior electric field transmission efficiency. Following 36 hours of treatment with conducted-electrode TTF on U87 cells, the proliferation inhibition rate reached approximately 50%, demonstrating effective suppression of tumor cell growth. This approach presents a potential direction for optimizing TTF treatment modality and device design.
Humans ; Electrodes ; Neoplasms/pathology* ; Cell Line, Tumor ; Cell Proliferation/radiation effects* ; Electric Stimulation Therapy/methods* ; Electromagnetic Fields

OBJECTIVES: Intracranial aneurysm (IA) has an insidious onset, and once ruptured, it carries high rates of mortality and disability. Cardiometabolic factors may be associated with the formation and rupture of IA. This study aims to summarize the application of Mendelian randomization (MR) methods in research on cardiometabolic factors and IA, providing insights for further elucidation of IA etiology and pathogenesis. METHODS: Literature about MR-based IA studies published up to February 21, 2024, was retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang. Two researchers independently performed literature screening, data extraction, and quality assessment. A narrative synthesis approach was used to conduct a qualitative systematic review of the included studies. RESULTS: A total of 11 MR-based studies on IA published between 2017 to 2024 were included, of which 4 were rated as high quality. These studies investigated the associations between blood pressure, blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines with IA and its subtypes, though issues of duplication were noted. Four MR studies based on the same European population but using different instrumental variable selection criteria, as well as another MR study in a different European cohort, consistently identified blood pressure as a risk factor for IA and its subtypes. Findings for blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines were inconsistent across MR studies. CONCLUSIONS Blood pressure appears to increase the risk of IA and its subtypes. Associations between other cardiometabolic factors and IA/subtypes require further in-depth investigation. Given the inherent limitations of MR studies, causal inferences should be made cautiously in combination with other lines of evidence.
Humans ; Mendelian Randomization Analysis ; Intracranial Aneurysm/etiology* ; Risk Factors ; Blood Pressure ; Blood Glucose ; Obesity/complications* ; Cardiometabolic Risk Factors ; Lipids/blood*

[This corrects the article DOI: 10.1016/j.apsb.2021.07.004.].

The theory of " Sui Qi Suo De" originates from Zhang Zhongjing's Jin Gui Yao Lue and has been further developed by later generations of practitioners, offering significant guidance for clinical practice. Myelodysplastic syndromes (MDS) are common malignant disorders of the hematopoietic system, characterized by high heterogeneity and progressive mutational changes. In Traditional Chinese Medicine (TCM), MDS falls under the category of "marrow toxin exhaustion". This article applies the theory of " Sui Qi Suo De" in TCM to analyze the pathophysiological changes during different stages of MDS. Specifically, it explores the precursor stage (focusing on health maintenance and prevention before illness, addressing the " Suo De" of "gradual decline of vital qi"), the low-risk stage (strengthening the spleen and kidneys, clearing toxic pathogens, addressing the " Suo De" of "weakened vital qi invaded by pathogens"), and the medium-to-high-risk stage (detoxifying and reinforcing the body, harmonizing physical and mental health, addressing the " Suo De" of "dominant pathogens and declining vital qi"). The goal is to provide new directions and theoretical insights for the TCM treatment of MDS.

Natural killer cells(NK)are important innate immune cells that do not require prior antigen exposure and can directly recognize and attack virus-infected cells and tumor cells.The activation and effector functions of NK cells are regulated by a balance of signals delivered through their surface activating receptors and inhibitory re-ceptors,which bind to ligands on target cells to achieve cytotoxicity via"induced self"and"missing self"recogni-tion models.The killing mechanisms of NK cells primarily include release of cytotoxic granules such as perforin and granzymes to induce target cell lysis,death receptor-mediated apoptosis,secretion of various cytokines,chemokines and growth factors to coordinate with other immune cells in killing tumor cells,thereby generating secondary im-mune responses and antibody-dependent cellular cytotoxicity(ADCC).

Objective To investigate the impact of smoking cessation on high-resolution compu-ted tomography(HRCT)phenotypes in smokers with chronic obstructive pulmonary disease(COPD)and its relationship with the frequency of acute exacerbations.Methods A retrospective study was conducted in 237 smokers with COPD who could cooperate with a 1-year follow-up.Among them,160 patients underwent a comprehensive 1-year smoking cessation intervention,and were divided into smoking cessation failure group(87 patients)and smoking cessation success group(73 patients)based on whether they successfully quited smoking.The remaining 77 smokers with COPD who did not receive smoking cessation intervention were designated as smoking group.HRCT phenotypes,total lung volume(TLV),total emphysema volume(TEV),emphysema index(EI)and the number of acute exacerbation at different time points were compared among the three groups.Pearson correlation analysis was used to explore the correlation between smoking cessation and the number of acute exac-erbations.Results There was no statistically significant difference in the proportion of A phenotype patients among the three groups before intervention and at 3 and 6 months of intervention(P＞0.05).At the 9th and 12th months of intervention,the proportion of patients with A phenotype in the smoking group was lower than that in the smoking cessation failure group and smoking cessation success group(P＜0.05).Before the intervention and at the 3rd,6th and 9th months of interven-tion,there were no statistically significant differences in the proportion of patients with E phenotype among the three groups(P＞0.05).Before intervention and at the 3rd and 6th months of interven-tion,there were no statistically significant differences in the proportion of patients with M phenotype among the three groups(P＞0.05).At the 9th and 12th months of intervention,the proportion of patients with M phenotype in the smoking group was higher than that in the smoking cessation failure group and smoking cessation success group(P＜0.05).Before intervention,there were no statisti-cally significant differences in TLV,TEV and EI among the three groups(P＞0.05).One year af-ter the intervention,TLV,TEV and El in the smoking cessation failure group and smoking cessation success group were lower than those in the smoking group(P＜0.05).At the 3rd,6th,9th and 12th months of intervention,the number of acute exacerbations in the the smoking cessation failure group and smoking cessation success group was less than that in the smoking group(P＜0.05).At the 9th and 12th months of intervention,the number of acute exacerbation in the smoking cessation success group was less than that in the smoking cessation failure group(P＜0.05).The results of Pearson correlation analysis showed that smoking cessation was negatively correlated with the number of acute exacerbation in smokers with COPD(P＜0.05),and this negative correlation gradually in-creased with the extension of smoking cessation duration.Conclusion Smoking cessation can im-prove HRCT phenotypes and effectively reduce the number of acute exacerbation in smokers with COPD.

ObjectiveTo evaluate the clinical efficacy and safety of Tongluo Mingmu capsules in the treatment of diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome. MethodA randomized， double-blind， positive-control， and multi-center clinical trial design method was used. 416 patients with diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome in four test centers were included （the ratio of the treatment group to the control group was 3∶1）. On the basis of standardized hypoglycemic treatment， the treatment group was given both four Tongluo Mingmu capsules and two Calcium Dobesilate capsule agents three times a day， while the control group were given both two Calcium Dobesilate capsules and four Tongluo Mingmu capsule agents three times a day. The course of treatment was 12 weeks. The curative effect of Tongluo Mingmu capsules was evaluated by comparing the comprehensive curative effect of diabetic retinopathy， traditional Chinese medicine（TCM） syndrome score， corrected visual acuity， fundus changes， fundus fluorescence angiography， and other curative effect indexes before and after treatment in the two groups. At the same time， general examination， laboratory examination， and adverse events were performed to evaluate the safety of the drug. ResultThe baseline demographic data and disease characteristics of the treatment group and the control group were balanced and comparable， with the difference not statistically significant. After 12 weeks of treatment， the total effective rate of the comprehensive curative effect of diabetic retinopathy in the treatment group （61.0%， 189/310） was better than that in the control group （44.1%， 45/102）， and the difference was statistically significant （χ²=8.880， P<0.01）. The total effective rate of TCM syndromes in the treatment group （88.4%， 259/293） was better than that in the control group （69.9%， 65/93）， and the difference was statistically significant （χ²=17.927， P<0.01）. The disappearance rate of dry eyes （χ²=8.305）， dull complexion （χ²=4.053）， lassitude （χ²=10.267）， shortness of breath （χ²=8.494）， and dry stool （χ²=8.657） in the treatment group was higher than that in the control group， and the difference between the groups was statistically significant （P<0.05， P<0.01）. In terms of improving corrected visual acuity （χ²=8.382）， fundus changes （χ²=6.026） ， the treatment group was significantly better than the control group （P<0.05）. During the trial， the incidence of adverse events in the treatment group and the control group was 1.3% and 2.9%， respectively. There was no significant difference between the two groups. In addition， there were no serious adverse events and adverse events leading to withdrawal in both groups. ConclusionTongluo Mingmu capsules can improve the comprehensive curative effect of diabetic retinopathy and enhance the efficacy of TCM syndromes， visual acuity， fundus changes， and fundus fluorescein angiography， with great safety. Therefore， it can provide a new alternative therapeutic drug for patients with diabetic retinopathy.

Objective:To explore the application effect of hydration therapy in patients with intermittent claudication (IC) of peripheral arterial disease, and to provide reference for clinical application.Methods:A randomized controlled trial method was used to select 86 patients with IC of peripheral arterial disease who attended the Department of Vascular Surgery of Shanxi Bethune Hospital from June to September 2023 as the study subjects by convenience sampling method, and they were divided into the control group and the intervention group by using the method of randomized numerical table, each group had 43 cases. In the control group, routine care was provided, and in the intervention group, hydration therapy was implemented on the basis of the control group. Ankle-brachial index, transcutaneous partial pressure of oxygen, and claudication distance were assessed in both groups 1d before and 6 months after the intervention.Results:Forty-two patients in each group completed the study, 21 males and 21 females, aged (61.33 ± 8.93) years in the intervention group; 24 males and 18 females, aged (61.33 ± 9.01) years in the control group. Compared with the ankle-brachial index, transcutaneous oxygen partial pressure and limp distance of the 2 groups 1 d before intervention, the differences were not statistically significant (all P>0.05), and 6 months after the intervention, the transcutaneous oxygen partial pressure of the patients in the intervention group was (37.69 ± 8.86) mmHg (1 mmHg=0.133 kPa), and that of the control group was (29.69 ± 7.79) mmHg, and the differences between the 2 groups were statistically significant ( t=4.40, P<0.05). The differences in patients′ transcutaneous partial pressure of oxygen and limp distance before and after intervention in the intervention group were -7.00 (-13.00, -1.75) mmHg and -50.00 (-100.00, 0.00) m, respectively, and in the control group were 0.01 (-1.00, 1.00) mmHg and 0.01 (-1.25, 20.00) m, respectively, and the differences between the 2 groups were statistically were statistically significant ( Z=5.59, 4.33, both P<0.05). Conclusions:Hydration therapy improves transcutaneous oxygen partial pressure values and claudication distance in patients with peripheral arterial disease IC, and improves microcirculation of the affected limbs in patients.

Objective:To explore the correlation between blastomere count variations “skip value” which extracted from by time-lapse technology (TLT) combined with artificial intelligence (AI) and morphological features of in vitro fertilization (IVF) embryo, and to test its feasibility in clinical applications.Methods:This study was a diagnostic experiment (AI reassessment of embryo transferred patients), a total of 6 545 embryos from 1 226 patients who underwent IVF at the Women and Children′s Hospital of Chongqing Medical University from December 2020 to December 2021 were retrospectively analyzed, of which 2 869 embryos were attempted to cultured to blastocyst stage by TLT. The embryo dynamic map (EDM) was drawn by Embryo Viewer, a TLT recording software, based on embryo developmental kinetics. The self-developed AI embryo evaluation software identified and recorded the number of cleavages in real time during embryonic development, and compared with the EDM, the correlation between the skip value formed by the change of cleavage sphere counts and the outcomes of the embryos was analyzed. The correlation among skip value, morphological score of embryo, implantation rate and live birth rate were performed by Spearman and step-up logistic regression. The receiver operating characteristic (ROC) curve was selected for reporting there relationship of skip value and morphology. Finally, predicting power of skip value for implantation and live birth rate were performed by ROC analysis.Results:The total skip values extracted from the blastomere count of embryos (72 hours post-fertilization) were negatively correlated with abnormal cleavage, blastocyst formation rate, day 3 (D3)-cell score, uneven size and fragmentation (the β values were -0.268, -0.116, -0.213, -0.159 and -0.222, respectively; all P<0.001); positively correlated with D3-cell number ( β=0.034; P<0.001); negatively correlated with blastocyst formation rate and implantation rate ( OR=0.97, 95% CI: 0.93-0.99, P=0.034; OR=0.96, 95% CI: 0.93-0.98, P=0.044). The power of predicting implantation were similar between the order selection of skip values and traditional morphology criteria [area under curve (AUC): 0.679 vs 0.620]. Live birth rate were negatively correlated with female age ( OR=0.91, 95% CI: 0.88-0.93; P<0.001), D3 general score ( OR=0.77, 95% CI: 0.59-0.99; P=0.045) and order selection of skip values ( OR=0.98, 95% CI: 0.96-0.99; P=0.038), while positively correlated with retrieved oocyte number and endometrial thickness in embryo transferred ( OR=1.08, 95% CI:1.05-1.11, P<0.001; OR=1.09, 95% CI:1.06-0.12, P<0.001, respectively) from multivariate regression analysis, and the power of predicting live birth was 0.666 for AUC. Conclusions:The skip value and its order form is a systematic quantification of embryo development, correlated with embryo developmental quality and clinical outcome. It could be an addition parameter for embryo culture and selection.