Rhegmatogenous retinal detachment(RRD)is a common blinding ophthalmic disease that has always received significant attention in clinical treatment. The foldable capsular buckle(FCB), as a new method for extraocular treatment of RRD, offers“Five Noes” advantages over traditional treatments such as scleral buckling(SB), pars plana vitrectomy(PPV), and pneumatic retinopexy(PR), including no retrobulbar anesthesia, no muscle traction, no scleral fluid release, no intraoperative positioning, and no cryotherapy. This effectively reduces postoperative complications in RRD patients and shortens the operation time. This review aims to investigate the development process and treatment principle of FCB, and focus on its therapeutic advantages, indication selection, efficacy and safety for RRD. It is expected to play a more important role in the treatment of a variety of retinal diseases through technological innovation and application field expansion.

Objective To describe the status and influencing factors of psychological distress in older people living with HIV in Shanghai.Methods Convenience sampling was used to select HIV patients with the age of 50 years old and above who attended follow-up visits at the voluntary counselling & testing clinic in Shanghai Public Health Clinical Center from December 2022 to October 2023.Data were collected using a general information questionnaire,HIV disclosure questionnaire,Distress Thermometer and Lubben Social Network Scale-6.Binary logistic regression was employed to analyze the factors influencing psychological distress.Results The prevalence of psychological distress among 332 participants was 105 cases(31.6％).The top 3 items selected by participants in Psychological Distress Problem List were insurance/financial issues,worry and sleep,relationship with children.Factors associated with a higher level of psychological distress included lower monthly income,not HIV disclosure and higher levels of social isolation.Conclusion Psychological distress among older people living with HIV remains to be further reduced,and it is affected by many factors.Health care providers should pay more attention to psychological distress among older HIV patients,and develop targeted intervention according to relevant influencing factors,aiming to reduce their psychological distress.

Objective To explore the prediction of heart diseases using machine learning-based methods,including decision trees(DT),random forest(RF),support vector machine(SVM),K-nearest neighbors(KNN),and naive Bayes(NB).Methods The Cleveland heart disease dataset was utilized as the data source.Significant features were selected using Pearson correlation coefficients.Heart disease prediction models were constructed using DT,RF,SVM,KNN,and NB algorithms,separately,and the model performance was evaluated with multiple metrics,including accuracy,precision,recall rate,F1 score,and AUC value.Results The study included 303 samples,and among the 13 clinical features,11 were found to be significant.RF prediction model achieved the highest accuracy(0.869),recall rate(0.906),F1 score(0.879),and AUC value(0.93),while NB prediction model obtained the highest precision(0.900).Conclusion Machine learning-based methods are promising in heart disease prediction,with the RF prediction model demonstrating significant advantages and NB prediction model exhibiting satisfactory performance.

AIM: To understand the publication status, research trends, and cutting-edge and hot topics in this field by conducting a bibliometrics analysis of relevant literatures on the pathogenesis of primary open angle glaucoma(POAG)in the past 30 a.METHODS:A total of 986 relevant literatures on the pathogenesis of POAG published on the core databases of China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)from 1 September 1993 to 1 September 2023 were retrieved. CiteSpace(6.2.R.4)and VOSviewer(1.6.18)software were used to conduct knowledge graph analysis on the retrieved literature, including publication volume, author, research institution, country/region, and keywords.RESULTS:The United States(243 articles)has the highest number of publications, followed by China(121 articles). The foreign institution with the highest number of publications is Harvard University(37 articles), while domestic institutions such as Zhongshan Ophthalmic Center, Sun Yat-sen University, ophthalmology department of Xuanwu Hospital of Capital Medical University, and Peking University First Hospital tied for the highest number of publications. Louis R. Pasquale(21 articles)is the most prolific English author. Wang Ningli is the most active Chinese researcher in this field. Keywords include trabecular meshwork, intraocular pressure, aqueous humor, glucocorticoid, hemorheology, etc.CONCLUSION: The research on the pathogenesis of POAG is in a period of vigorous development. The United States has the largest number of publications in this field, and Harvard University is a leading institution in this field. The research focus in the field of POAG has shifted from the structural aspect to the genetic level, and gene research and traditional Chinese medicine treatment have broad application prospects in this field.

Objective Microcystin-leucine-arginine(MC-LR)exposure induces lipid metabolism disorders in the liver.Secreted frizzled-related protein 5(SFRP5)is a natural antagonist of winglesstype MMTV integration site family,member 5A(Wnt5a)and an anti-inflammatory adipocytokine.In this study,we aimed to investigate whether MC-LR can induce lipid metabolism disorders in hepatocytes and whether SFRP5,which has anti-inflammatory effects,can alleviate the effects of hepatic lipid metabolism by inhibiting the Wnt5a/Jun N-terminal kinase(JNK)pathway. Methods We exposed mice to MC-LR in vivo to induce liver lipid metabolism disorders.Subsequently,mouse hepatocytes that overexpressed SFRP5 or did not express SFRP5 were exposed to MC-LR,and the effects of SFRP5 overexpression on inflammation and Wnt5a/JNK activation by MC-LR were observed. Results MC-LR exposure induced liver lipid metabolism disorders in mice and significantly decreased SFRP5 mRNA and protein levels in a concentration-dependent manner.SFRP5 overexpression in AML12 cells suppressed MC-LR-induced inflammation.Overexpression of SFRP5 also inhibited Wnt5a and phosphorylation of JNK. Conclusion MC-LR can induce lipid metabolism disorders in mice,and SFRP5 can attenuate lipid metabolism disorders in the mouse liver by inhibiting Wnt5a/JNK signaling.

Objective To evaluate the effect of parasternal intercostal plane block(PIB)on postopera-tive fatigue in elderly patients undergoing off-pump coronary artery bypass grafting(CABG).Methods A to-tal of 111 elderly patients undergoing elective off-pump CABG in Xuzhou Municipal Central Hospital from May 2021 to January 2023 were selected as the study subjects.The patients were divided into the control group(group C,n=55)and PIB group(group P,n=56)by adopting the random number table method.After induction of anesthesia,the patients in the group P received the ultrasound-guided bilateral PIB,and the group C received the equal volume of normal saline at the same site.The incidence rate of postoperative fatigue syn-drome(POFS)on postoperative 1,3,5,7 d and postoperative 8 weeks,NRS scores immediately after extuba-tion and at postoperative 12,24,48 h,postoperative opioid drugs consumption,ICU stay duration,hospitaliza-tion duration and adverse events occurrence were compared between the two groups.Results Compared with the group C,the incidence rates of POFS on postoperative 1,3,5,7 d and postoperative 8 weeks in the group P were significantly decreased,the NRS scores immediately after extubation and at postoperative 12,24 h in the group P were lower,the postoperative opioid drugs consumption were smaller,the ICU stay duration was shorter,and the differences were statistically significant(P＜0.05).The NRS score at postoperative 48 h and hospitalization duration had no statistical differences between the two groups(P＞0.05).No nerve block re-lated adverse events in the patients appeared during the study period.Conclusion The ultrasound guided PIB could effectively reduce the incidence rate of POFS in elderly patients undergoing off-pump CABG,promote the patients'prognosis and improve the recovery quality of the patients.

Objective:To explore the prognosis efficacy of psycho-cardiological therapy and management on patients with coronary atherosclerosis disease (CAD).Methods:This was a clinical randomized controlled study. This study included inpatients with CAD at the cardiology department in Beijing Anzhen Hospital, Capital Medical University from August 2021 to January 2024. The patients enrolled in this study were asked for basic information, and received measurements for depression, anxiety, sleep quality and living quality by the scales of Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder scale-7 (GAD-7), Athens Insomnia Scale (AIS), EuroQol 5-dimension 5-level (EQ-5D-5L) respectively. The patients were randomly grouped into a regular treatment group and a psycho-cardiological treatment group which included WeChat management or antidepressant/antianxiety medical therapy according to the situation. After the patients discharging from hospital for 2, 4, 12, 24, 48, 72, and 96 weeks, professional cardiovascular doctors would follow up by telephone, WeChat, and outpatient department, including scales (2-48 weeks), and cardiac events (2-96 weeks). Kaplan-Meier survival curve and multivariate Cox proportional hazards model were used for analyzing the association between psycho-cardiological treatment and cardiac events.Results:This study recruited a total of 552 patients with CAD, aged 61.0(54.0, 67.0) years, and 379 (68.7%) were male. There were 279(50.5%) in the regular treatment group and 273(49.5%) in the psycho-cardiological treatment group. After treatment for 4, 12 and 48 weeks, the PHQ-9 score in psycho-cardiological was significantly lower than the regular treatment group; After treatment for 12 weeks, the EQ-5D-5L effective value in psycho-cardiological group was higher than the regular treatment group; After treatment for 2, 4, 12, 24 and 48 weeks, the EQ-5D-5L VAS score in psycho-cardiological group was higher than the regular therapy group (all P<0.05). The Kaplan-Meier survival curve showed that, during the different follow-up periods, the rate of cardiac events in psycho-cardiological treatment group was lower than regular treatment group (log-rank P<0.001). The multivariate Cox proportional hazards model adjusted the factor of age, the psycho-cardiological treatment contributed to reducing the cardiac events rate by 80.3% ( HR=0.197, 95% CI: 0.067-0.582, P=0.003). Conclusion:Psycho-cardiological treatment is beneficial for improving psychological stress, living quality, and reducing cardiac events, and helps to improve prognosis and psycho-cardiological rehabilitation in CAD patients.

Objective:To analyze the research progress and hotspots on drug resistance of helicobacter pylori in China and abroad since 2000, in order to provide theoretical reference and basis for the study of digestive system diseases.Methods:The Chinese and English literature related to helicobacter pylori resistance, which were included in the Chinese National Knowledge Infrastructure (CNKI) database and the Web of Science database, were searched from 2000 to 2021. We imported the retrieved literature into Citespace6.1.R2 software, performed visual analysis on authors, countries and institutions, keywords, cited literature, and drew visual graphs.Results:A total of 2 824 Chinese literature and 1 885 English literature were included. The authors with the highest volume of publications in Chinese and English literature are Hu Fulian and Gisbert JP, respectively. The institutions with the highest volume of publications are the First School of Medicine, Beijing University and the Baylor School of Medicine in the United States. The keywords with high centrality in Chinese literature include clarithromycin, eradication rate, drug resistance, amoxicillin, metronidazole, etc. In the analysis of cited literature, it was observed that the Maastricht Consensus report holds an important position in this field.Conclusions:The use of Citespace visualization analysis has intuitively elucidated the research hotspots on the drug resistance of Helicobacter pylori.

The effect of vitamin D supplementation on individuals with autism spectrum disorder (ASD) is inconclusive. We aimed to conduct a meta-analysis of the available randomized controlled trials (RCTs) to explore whether vitamin D supplementation can improve core symptoms and coexisting conditions in children with ASD. Data were obtained by searching the PubMed, Embase, Web of Science, CINAHL and Cochrane Library databases up to February 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a random-effects model, mean differences with 95% confidence intervals (CIs) were calculated through a meta-analysis. There were eight RCTs with 266 children with ASD in the present review, among which six RCTs were included in the meta-analysis.Children who received vitamin D supplementation showed a significant improvement in stereotypical behavior scores (pooled mean difference (MD): −1.39; 95% CI: −2.7, −0.07; p = 0.04) with low heterogeneity (I2 = 34%), and there was a trend toward decreased total scores on the Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS, p = 0.05); however, there were no other significant differences in the core symptoms of ASD and coexisting conditions between groups as measured by the Aberrant Behavior Checklist (ABC). Vitamin D supplementation appears to improve stereotypical behaviors but does not improve other core symptoms and coexisting conditions. Further randomized controlled trials with large sample sizes and individualized doses are needed.

Objective:To analyze the clinical features, postoperative recurrence and prognostic factors of young patients with cervical cancer.Methods:The clinical data of hospitalized cervical cancer patients in the Affiliated Hospital of Qingdao University from January 2004 to March 2019 were retrospectively studied. 243 young cervical cancer patients ≤35 years old were selected as the study group. The method of case-control study was adopted. In the same period, 250 first and second cervical cancer patients aged >35 years were randomly selected as the control group. The clinical data of the two groups were compared, and the survival curves of the two groups were analyzed. The clinical data of patients with postoperative recurrence (17 cases) and patients without recurrence (164 cases) in the study group were compared, and the related data affecting the prognosis of young cervical cancer patients were analyzed by univariate and multivariate analysis. Statistical data were compared by χ 2 test or exact probability method. Kaplan-meier method was used to estimate survival rate and draw survival curve. Survival rate was compared by Long-Rank test. COX regression model was used for multivariate analysis. Results:Compared with the control group, the young cervical cancer patients had earlier age of marriage, menstruate, fewer pregnancies, no preoperative adjuvant therapy, more nerve infiltration and ovarian preservation, the difference was statistically significant (χ 2 values were 94.58, 67.54, 60.53, 5.44, 13.64, 5.51, and 118.24, respectively; P values were <0.001, <0.001, <0.001, 0.025, 0.022, <0.001, respectively). The proportion of irregular vaginal bleeding in study group (13.17%(32/243)) was lower than that in control group (30.40%(76/250)), and the proportion of contact vaginal bleeding (52.26%(127/243)) was higher than that in control group (43.20%(108/250)). There were significant differences between the two groups (χ 2 values were 21.39 and 4.06, respectively; P values were < 0.001 and 0.044, respectively). There was no significant difference in Kaplan-Meier survival rate between the study group and the control group (χ 2=0.03, P=0.859). Univariate analysis showed that the International Federation of Gynecology and Obstetrics(FIGO), whether to retain ovary, depth of cervical invasion, nerve invasion, lymphatic vascular space invasion and pelvic lymph node metastasis were the influencing factors of 5-year survival rate of young cervical cancer patients ( P values were 0.016, 0.008, 0.014, 0.017, 0.004, <0.001, respectively). Multivariate analysis showed FIGO staging ( OR=2.073, 95% CI: 1.017-4.228, P=0.045), lymphatic vascular space infiltration ( OR=0.041, 95% CI: 0.005-0.341, P=0.019) and pelvic lymph node metastasis ( OR=0.027, 95% CI: 0.004-0.197, P<0.001) were risk factors affecting the prognosis of young cervical cancer. The patients with low FIGO stage, no lymphatic vascular space infiltration and pelvic lymph node metastasis have a good prognosis. Conclusion In young patients with cervical cancer, the first clinical feature is mainly contact vaginal bleeding. The prognosis of young patients with cervical cancer and 5 years survival rate there was no statistically significant difference compared with control group. The later FIGO staging , no ovarinan retention and the deeper cervical infiltration depth , with the nerve or between lymphatic vascular invasion and pelvic lymph node metastasis in young patients with cervical cancer had poor prognosis, and FIGO stage, lymphatic vessel space invasion and pelvic lymph node metastasis were the most significant factors.