AIM:To evaluate the characteristics of ocular biometric parameters and the distribution of corneal astigmatism(CA)in patients with high myopia before cataract surgery.METHODS:A prospective cross-sectional study was conducted, and 695 cataract patients(695 eyes)with high myopia [defined as an axial length(AL)≥26.00 mm] scheduled to undergo cataract surgery at our hospital from January 2022 to December 2024 were consecutively enrolled, another 695 cataract patients(695 eyes)with normal ALs(22.00 mm ≤AL≤25.00 mm)who underwent cataract surgery at our hospital during the same period were included in the control group. For patients with both eyes eligible, the right eye was used for analysis. Before cataract surgery, IOL Master 700 was used to measure the ocular biometric parameters of both eyes for each patient in the two groups. The medical records and ocular biometric data in the two groups were recorded and collected.RESULTS:There were no statistically significant differences between the two groups in genger, age, corneal diameter, and central corneal thickness(all P>0.05). In the high myopia group, the mean AL was 29.20±2.61 mm, and 252 eyes(34.1%)had AL ≥30.00 mm(extremely high myopia). The mean anterior chamber depth(ACD), lens thickness, vitreous chamber depth(VCD), CA, AL/corneal radius of curvature and VCD/AL in the high myopia group were 3.45±0.40, 4.41±0.47, 21.34±2.60 mm, 1.18±0.78 D, 3.79±0.38, and 0.73±0.03, respectively, which were all greater than those in the control group(all P<0.01). In the high myopia group, 350 eyes(50.4%)had CA ≥1.00 D, 192 eyes(27.6%)had CA ≥1.50 D, and 94 eyes(13.5%)had CA ≥2.00 D, which were all higher than those in the control group(32.8%, 15.1%, and 6.6%, respectively; all P<0.001). In the high myopia group, 87 eyes(12.5%)had flat corneas, 424 eyes(61.0%)had moderate CA, and 40 eyes(5.8%)had high CA. These proportions were all higher than those in the control group(6.0%, 46.9%, and 2.9%, respectively; all P<0.001). In the high myopia group, ACD and ACD/AL were negatively correlated with AL(r=-0.162 and -0.661, respectively; all P<0.001), while both ACD and ACD/AL in the control group were positively correlated with AL(r=0.338 and 0.105, respectively; both P<0.01). In the high myopia group, CA increased with age when the patient's age was ≥50 years(r=0.197, P<0.001), which was consistent with the control group.CONCLUSION: The standardized ocular biometric data of cataract patients with high myopia before cataract surgery are helpful for ophthalmologists to accurately calculate the intraocular lens(IOLs)power and select the appropriate IOL type. The majority of high myopia patients need simultaneous correction of CA during cataract surgery.

Objective:To explore the correlation between the methylation of sclerostin (SOST) promoter and glucocorticoid-induced osteoporosis (GIOP) in children.Methods:Children with GIOP ( n=66) were selected as the experimental group. At the same time, children treated with glucocorticoid whose bone mass were selected as the control group ( n=72). The general clinical information of all children was compared, and the data collected by CT were detected by lumbar QCT, and the levels of bone metabolism related indexes were detected by biochemical analyzer. The mRNA expression of SOST was detected by fluorescence quantitative PCR, and the protein content of SOST was detected by enzyme-linked Immunosorbent Assay (ELISA). Methylation status of SOST gene promoter was detected by methylation-specific PCR (MSP), and the risk factors affecting GIOP were compared and analyzed, and the diagnostic and therapeutic value of each index for children with GIOP was evaluated. Results:Compared with the control group, the duration of hormone application and the current dose of hormone in the experimental group were higher, and the expression levels of bone metabolism indexes β-collagen carboxy terminal peptide ( β-CTX) ( t=9.87, P<0.01), typeⅠprocollagenamino-terminal peptide (P1NP) ( t=16.09, P<0.001), osteopontin (OPN) ( t=21.32, P<0.001) and N-MID ( t=15.21, P<0.01) were significantly increased, with statistical significance. However, in terms of bone mineral density, the related level of children in the experimental group was low ( t=22.49, P<0.001), and the expression of SOST mRNA ( t=9.48, P<0.01) and protein content ( t=7.70, P<0.01) was significantly decreased, and the children in the experimental group showed methylation status of SOST. Pearson analysis showed that the level of serum SOST protein in the experimental group was negatively correlated with the levels of β-CTX ( r=-0.16, P=0.012), P1NP ( r=-0.35, P=0.021), OPN ( r=-0.25, P=0.043) and N-MID ( r=-0.09, P=0.036). At the same time, the Logistic regression analysis showed that the high expression of P1NP ( SE=0.35, P<0.001), OPN (S E=0.37, P<0.001) and SOST ( SE=0.33, P<0.001) were risk factors for glucocorticoid-induced osteoporosis in children. The receiver operating characteristic (ROC) curve showed that the area under the curve of SOST was 0.874 (95% CI: 0.824-0.934), with higher sensitivity and specificity. Conclusions:There is a correlation between the methylation of SOST promoter and the GIOP of children. Besides, SOST can be used as a potential diagnostic index of GIOP with high value among many factors affecting children’s GIOP. In this case, the medical industry needs to further strengthen the prevention and treatment of children’s GIOP.

Intracranial atherosclerosis has been regard as the most common cause of ischemic stroke.The information of the types and degree of vascular wall lesions is important basis for the diagnosis and treatment of ischemic stroke.High-resolution MR vessel wall imaging can directly display the lumen and wall of intracranial vessels,evaluate the characteristics of atherosclerotic plaque qualitatively and quantitatively,including intra-plaque hemorrhage,plaque enhancement,and plaque distribution.Thus,high-resolution MR vessel wall imaging may play an important role in risk stratification,pathogenesis,treatment and prognosis evaluation in ischemic stroke patients.This review summarizes the progress of high-resolution MRI vessel wall imaging in the evaluation of intracranial atherosclerosis,especially the pathogenesis of plaque features and treatment-related information.

Objective:An artificial intelligence(AI)model based on deep learning algorithms was constructed using clinical data to evaluate the feasibility of predicting the efficacy of neoadjuvant immunotherapy combined with chemotherapy for non-small cell lung cancer(NSCLC).Methods:Clinical and pathological data of 132 patients with NSCLC who were diagnosed and treated with neoadjuvant immunotherapy combined with chemotherapy between January 2020 and January 2024 at Beijing Chest Hospital/Beijing Tuberculosis and Thoracic Tumor Research Institute were collected.Statistical analysis was conducted to identify the main factors affecting the efficacy of neoadjuvant im-munotherapy combined with chemotherapy.Variables were selected based on statistical results and relevant literature,and a variable data-set was constructed.A deep learning model was established using a multi-layer perceptron(MLP)algorithm with 5-fold cross-validation,and the performance of the model was evaluated using receiver operating characteristic curve(ROC).Results:Among the 132 patients,univari-ate analysis demonstrated statistically significant differences in sex(P=0.020),smoking history(P=0.004),carcinoembryonic antigen(CEA)(P=0.038)and programmed death-ligand 1(PD-L1)≥1%(P=0.038)between the major pathological response(MPR)and non-MPR groups.Patients in the complete pathological response(pCR)group and non-pCR groups showed statistical differences in tumor size(P=0.007)and CEA levels(P=0.010).After 5-fold cross-validation,the average area under the curve(AUC)of the MPR prediction model in the validation and test sets was 0.72 and 0.71,respectively.Conclusions:The deep learning model can effectively predict the efficacy of neoadjuvant chemoim-munotherapy in patients with NSCLC.

Objective To explore the effect of evidence-based thinking oriented micro-course and case-based learning(CBL)on cultivation of clinical thinking ability of nurses who are taking the standardised nursing training in intensive care unit(ICU)so as to provide a new teaching method in the training of nurses.Methods A total of 72 nurses taking standardised nursing training in ICU of our hospital from November 2021 to October 2023 were selected as the research objects.Thirty-six of nurses who took rotation in the ICU from November 2021 to October 2022 were assigned in the control group,and other 36 nurses who took rotation in the ICU from November 2022 to October 2023 were assigned in the trial group.In the control group,CBL teaching method was adopted in the standardised nursing training,while both of evidence-based thinking oriented micro-course and CBL teaching mothed were adopted in the trial group for the standardised nursing training.The two groups were compared in terms of scores of clinical thinking ability,assessment of theory and clinical skills,as well as nurses'satisfaction with the teaching.Results After the training,nurses in the trial group exhibited significant superiority to the control group in total scores of clinical thinking ability and its three dimensions,critical thinking ability,systematic thinking ability and evidence-based thinking ability(P<0.05 for all).Furthermore,nurses in the trial group achieved significantly higher scores in theoretical assessment and assessment of clinical skills in comparison with those in the control group(P<0.05).Moreover,the trial group reported significantly higher satisfaction with both of the teaching method and learning atmosphere than those of the control group(P<0.05 for both).Conclusion Evidence-based thinking oriented micro-course and CBL teaching method can effectively improve the clinical thinking ability,theoretical knowledge and operational skills among the nurses taking standardised nursing training in ICU.

Artificial neural network(ANN)is a simulation of a biological neural network.It is an adaptive,non-linear,dynamic network system formed by interconnections.The advantages of ANN include easy optimization,simple modeling,and ac-curate results.This review examines the application of ANN in therapeutic drug monitoring for immunosuppressants,antibacteri-als,and anti-epileptic drugs.It discusses the advantages and disadvantages of the current ANN models and highlights future de-velopment directions.The aim is to provide valuable reference information for future researchers.The use of ANN for therapeutic drug monitoring shows great potential and holds promise as an effective method of personalizing patient medication.

Objective:To investigate the predictive value of enhanced CT-based radiomics for brain metastasis (BM) and selective use of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC).Methods:Clinical data of 97 patients diagnosed with LS-SCLC confirmed by pathological and imaging examination in Shanxi Provincial Cancer Hospital from January 2012 to December 2018 were retrospectively analyzed. The least absolute shrinkage and selection operator (LASSO) Cox and Spearman correlation tests were used to select the radiomics features significantly associated with the incidence of BM and calculate the radiomics score. The calibration curve, the area under the receiver operating characteristic (ROC) curve (AUC), 5-fold cross-validation, decision curve analysis (DCA), and integrated Brier score (IBS) were employed to evaluate the predictive power and clinical benefits of the radiomics score. Kaplan-Meier method and log-rank test were adopted to draw survival curves and assess differences between two groups.Results:A total of 1272 radiomics features were extracted from enhanced CT. After the LASSO Cox regression and Spearman correlation tests, 8 radiomics features associated with the incidence of BM were used to calculate the radiomics score. The AUCs of radiomics scores to predict 1-year and 2-year BM were 0.845 (95% CI=0.746-0.943) and 0.878 (95% CI=0.774-0.983), respectively. The 5-fold cross validation, calibration curve, DCA and IBS also demonstrated that the radiomics model yielded good predictive performance and net clinical benefit. Patients were divided into the high-risk and low-risk cohorts based on the radiomics score. For patients at high risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 18.2% in the PCI group, and 61.8% and 75.4% in the non-PCI group, respectively ( P<0.001). In the PCI group, the 1-year and 2-year overall survival rates were 92.9% and 78.6%, and 85.3% and 36.8% in the non-PCI group, respectively ( P=0.023). For patients at low risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 0% in the PCI group, and 10.0% and 20.2% in the non-PCI group, respectively ( P=0.062). In the PCI group, the 1-year and 2-year overall survival rates were 100% and 77.0%, and 96.7% and 79.3% in the non-PCI group, respectively ( P=0.670). Conclusion:The radiomics model based on enhanced CT images yields excellent performance for predicting BM and individualized PCI.

Objective:To investigate the etiology, clinical manifestations, clinicopathological features of cystic neutrophil granulomatous mastitis (CNGM).Methods:From Jan 2019 to Dec 2020, 95 CNGM cases diagnosed by biopsy pathology at Chongqing Hospital of Traditional Chinese Medicine and Chongqing Liangping District Hospitol of Traditional Chinese Medicine were reviewed.Results:There were 95 female patients, aged 21 to 50 years, with a median age of 32 years. Laboratory examination showed that 56% (53/95) cases had elevated rheumatoid antibody level, 27 % (26/95) had increased level of serum thyroid antibody, 15% (14/95) had elevated antineutrophil antibody, 35% (33/95) had increased ESR, 38% (36/95) had increased C-reactive protein. The positive rate of Gram-stained bacilli was 82% (78/95). Histology: pyogenic granuloma with lobule of breast as the center, the center of granuloma was cystic vacuole.Immunohistochemistry showed that the inflammatory cells in and around granuloma were mainly CD3 + cells, and CD4 + cells were more than CD8 + cells. Conclusions:The cystic neutrophilie granulo matous mastitis is a rare type of idiopathic granulomatous mastitis. The diagnosis of CNGM is dependent on its specific pathological features.

Peripapillary intrachoroidal cavitation(PICC)is a common fundus lesion in high myopia.The typical mani-festation of PICC in fundus color photography is orange lesions with clear boundaries,which often occur below the myopic arc,and a weak reflection cavity in the choroid in optical coherence tomography(OCT).With the development and wide-spread application of OCT technology,researchers have gained a clearer understanding of the imaging features,pathogene-sis and clinical significance of PICC.This article introduces the definition,imaging features,pathogenesis,and relationship with glaucoma of PICC to provide new ideas for further elucidating the pathogenesis and clinical significance of PICC.

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*