Objective: This review aimed to synthesize and critically appraise the existing evidence on endoscopic-assisted anterior odontoid screw fixation, with the objectives of clarifying its current clinical utility and identifying priorities for future optimization of the technique. Methods: A systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and registered with PROSPERO (registration number: CRD420251251051). Searches of PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar identified studies reporting the use of endoscopic visualization during anterior odontoid screw placement. Eligible study designs included clinical reports and cadaveric investigations. Extracted data encompassed patient demographics, fracture subtype, operative technique, radiological alignment, fusion status, perioperative complications, and risk of bias, which was assessed using the modified Joanna Briggs Institute checklist. Results: Eight studies met the inclusion criteria, comprising 6 clinical reports and 2 cadaveric feasibility studies. The extent of endoscopic assistance ranged from hybrid mini-open approaches to fully endoscopic uniportal techniques. Reported fusion rates ranged from 80% to 100%, with fully endoscopic procedures demonstrating the most consistent radiological consolidation and anatomical reduction. No major neurovascular, aerodigestive, or implant-related complications were reported. Cadaveric evidence confirmed enhanced visualization of the C2 odontoid entry point and validated safe screw entry-point orientation with acceptable screw trajectories. Risk-of-bias assessment indicated low risk in 5 studies and moderate risk in 3. Small sample sizes, heterogeneous fracture morphology, and modest follow-up durations limited the overall quality of the evidence. Conclusion Endoscopic-assisted anterior odontoid screw fixation appears to be a technically feasible and biologically favorable minimally invasive option for selected odontoid fractures. Its potential advantages include improved visualization and reduced approach-related morbidity. Further prospective, multicenter investigations, particularly those integrating navigation systems, are required to define its definitive role in the management of cervical spine trauma.

Abstract To promote the mental health of college students and build campus based psychological support system, the study explains that current applications of digital health interventions (DHIs) include independent forms based on a single technology or platform, as well as integrated forms that combine multiple digital technologies with traditional mental health services. These interventions have positive effects on alleviating negative emotions among college students, enhancing psychological resilience, improving quality of life, and ameliorating academic performance. However, differences still exist in the stability of intervention effects. Future development requires continuous improvement in institutional construction, ethical governance and capacity building.

Objective:To assess the relationship between basophil levels and mortality in patients with intra-abdominal infection.Methods:Information on patients with intraperitoneal infection admitted to the intensive care unit were extracted from the MIMIC database.A time-dependent Cox regression model was used to adjust for confounders associated with 28-day mortality.Propensity score matching(PSM)was used to balance the baseline differences be-tween groups with different basophil levels,and a restricted cube chart(RCS)was used to show the relationship between basophil count and 28-day mortality in patients with intra-abdominal infection.Results:A total of 4403 patients with intra-abdominal infection were enrolled in the MIMIC database.Patients with high basophil levels have lower mortality than those with low basophil levels.There was an L-shaped curve between basophil level and 28-day mortality,with a cut-off value of 0.47×109/L.Cox regression analysis showed that basophil levels were an independent protective factor for mortal-ity in patients with intra-abdominal infection after adjusting for potential confounders(HR=0.586,95%CI:0.443-0.769).Protective factors for death at basophil levels remained after PSM adjusted for potential confounders(HR=0.628,95%CI:0.470-0.832).Conclusion:Basophil level is an independent protective factor for mortality in patients with intra-abdominal infection,and basophil levels should be dynamically monitored to better evaluate the prognosis of patients.

Objective:To assess the relationship between basophil levels and mortality in patients with intra-abdominal infection.Methods:Information on patients with intraperitoneal infection admitted to the intensive care unit were extracted from the MIMIC database.A time-dependent Cox regression model was used to adjust for confounders associated with 28-day mortality.Propensity score matching(PSM)was used to balance the baseline differences be-tween groups with different basophil levels,and a restricted cube chart(RCS)was used to show the relationship between basophil count and 28-day mortality in patients with intra-abdominal infection.Results:A total of 4403 patients with intra-abdominal infection were enrolled in the MIMIC database.Patients with high basophil levels have lower mortality than those with low basophil levels.There was an L-shaped curve between basophil level and 28-day mortality,with a cut-off value of 0.47×109/L.Cox regression analysis showed that basophil levels were an independent protective factor for mortal-ity in patients with intra-abdominal infection after adjusting for potential confounders(HR=0.586,95%CI:0.443-0.769).Protective factors for death at basophil levels remained after PSM adjusted for potential confounders(HR=0.628,95%CI:0.470-0.832).Conclusion:Basophil level is an independent protective factor for mortality in patients with intra-abdominal infection,and basophil levels should be dynamically monitored to better evaluate the prognosis of patients.

Objective:To analyze the pathogenicity and clinical phenotype associated with a newly identified heterozygous variant in the ZEB1 gene that causes posterior pleomorphic corneal dystrophy (PPCD). Methods:A pedigree study was conducted.Clinical data of four people in 2 generations from one family with PPCD who visited Henan Eye Hospital in October 2023 were collected, including 3 patients. Relevant ophthalmic examinations were performed.Best corrected visual acuity, slit lamp microscopy, intraocular pressure, Pentacam corneal topography, Corvis ST corneal biomechanics analyzer, corneal endothelial microscopy, swept-source anterior segment coherence optical tomography (CASIA), laser scanning confocal microscopy, and ultra-wide-field fundus photography were performed to examine clinical phenotypes.Peripheral venous blood samples were collected from family members to extract genomic DNA, and whole exome sequencing was performed.Sanger sequencing and pedigree co-segregation analysis were carried out.Conservation analysis was performed using GERP+ + and Clustal Omega software, and the pathogenicity of the variant was assessed according to American College of Medical Genetics and Genomics (ACMG) guidelines.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[15]).All subjects or guardian signed informed consent.Results:This family conformed to autosomal dominant inheritance.Under a slit-lamp microscope, corneal endothelial vesicular lesions in both eyes could be seen in the proband, her father and her brother.Under a laser scanning confocal microscope, endothelial cells were missing at the lesions, and some were crater-like changes, and some lesions were circular or elliptical vesicular, and no other systemic abnormalities were observed.The ocular and physical examination of the proband's mother showed no abnormalities.Genetic testing results showed that the proband, her father and her brother all carried the ZEB1c.790G>A (p.Gly264Arg) heterozygous variant, but her mother did not carry the variantion.Sanger sequencing verified that this variantion was co-segregated within the family.The variantion is a newly discovered missense mutation that had not been reported in the Thousand Genomes Project, Genome Aggregation Database, and ExAC database.The prediction results of the variant by MutationTaster, SIFT, PROVEAN, VESST3, DANN, FATHMM-MKL, CADD, fitCons and other software were harmful, and GERP+ +, Weblogo, Clustal Omega analysis showed that the amino acids affected by the variant were highly conservative.According to the ACMG Guidelines, this variation was possible pathogenic.Conclusions:The identification of the missense mutation c. 790G>A (p.Gly264Arg) in the ZEB1 gene within this PPCD family provides new insights into the genetic basis of PPCD and the variant may be the pathogenic variant of in this family.

Objective:To evaluate the repeatability of anterior segment biometry measurements obtained using ultrasound biomicroscopy (UBM) and the ArcScan Insight 100, and to compare the agreement between the two devices.Methods:A cross-sectional study was conducted.Seventy myopic patients (70 eyes) who underwent V4c implantable collamer lens implantation at Henan Eye Hospital from March to May 2023 were included.The ArcScan Insight 100 and UBM were used to measure the following parameters three times: angle-to-angle distance (ATA), sulcus-to-sulcus distance (STS), anterior chamber depth (ACD), crystalline lens rise (CLR), anterior chamber width (ACW), ciliary body inner diameter (CBID), anterior chamber angle (ACA), trabecular-ciliary angle (TCA) and maximum ciliary body thickness (CBTmax). The repeatability of anterior segment biological measurements obtained using the two devices was assessed by intraclass correlation coefficient (ICC). The consistency between the two instruments was evaluated by Bland-Altman consistency test.This study complied with the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]). All patients understood the purpose and significance of this study and signed the informed consent form.Results:The repeatability of ATA, STS, ACD, CLR, ACW, CBID, ACA, TCA and CBTmax measured by UBM and ArcScan Insight 100 was good (all ICC>0.9). There was no significant difference in ACD, ACW, and ACA between the two instruments ( t=0.696, -1.025, -1.447; all P>0.05). ATA, STS, CLR and CBID measured by UBM were lower and TCA and CBTmax were higher than those measured by UBM ArcScan Insight 100, and the differences were statistically significant ( t=-8.586, -12.551, -4.481, -4.420, 4.535, 7.812; all P<0.05). The differences of ATA, STS, ACD, CLR, ACW, CBID and CBTmax between UBM and ArcScan Insight 100 were 0.38, 0.47, -0.01, 0.07, 0.3, 0.26 and -0.21 mm, respectively, with the 95% limits of agreement (LoA) of (-0.34, 1.10), (-0.15, 1.09), (-0.28, 0.26), (-0.20, 0.35), (-0.33, 0.93), (-0.71, 1.23) and (-0.64, 0.23)mm, respectively, which showed good coherence.The differences in ACA and TCA measurements were 2.26° and -7.81°, respectively, and the 95%LoA values were (-23.36°, 27.89°) and (-36.05°, 20.43°), respectively, with poor coherence.There was a strong positive correlation in ACD measurements measured by UBM and ArcScan Insight 100 ( r=0.827, P<0.05). There were moderate positive correlations in ATA, STS, CLR, ACW and CBID ( r=0.678, 0.749, 0.617, 0.765, 0.519; all P<0.05). There was no significant correlation in ACA, TCA and CBTmax ( r=0.270, 0.032, 0.178; all P>0.05). Conclusions:The repeatability of ArcScan Insight 100 and UBM in measuring anterior segment biological parameters is good.However, the consistency of ACA, TCA and CBTmax measured by the two instruments is poor and may be affected by self-regulation of the body.ATA, STS, ACD, CLR, ACW and CBID have good consistency and can be used interchangeably.

Objective:To analyze the pathogenicity and clinical phenotype associated with a newly identified heterozygous variant in the ZEB1 gene that causes posterior pleomorphic corneal dystrophy (PPCD). Methods:A pedigree study was conducted.Clinical data of four people in 2 generations from one family with PPCD who visited Henan Eye Hospital in October 2023 were collected, including 3 patients. Relevant ophthalmic examinations were performed.Best corrected visual acuity, slit lamp microscopy, intraocular pressure, Pentacam corneal topography, Corvis ST corneal biomechanics analyzer, corneal endothelial microscopy, swept-source anterior segment coherence optical tomography (CASIA), laser scanning confocal microscopy, and ultra-wide-field fundus photography were performed to examine clinical phenotypes.Peripheral venous blood samples were collected from family members to extract genomic DNA, and whole exome sequencing was performed.Sanger sequencing and pedigree co-segregation analysis were carried out.Conservation analysis was performed using GERP+ + and Clustal Omega software, and the pathogenicity of the variant was assessed according to American College of Medical Genetics and Genomics (ACMG) guidelines.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[15]).All subjects or guardian signed informed consent.Results:This family conformed to autosomal dominant inheritance.Under a slit-lamp microscope, corneal endothelial vesicular lesions in both eyes could be seen in the proband, her father and her brother.Under a laser scanning confocal microscope, endothelial cells were missing at the lesions, and some were crater-like changes, and some lesions were circular or elliptical vesicular, and no other systemic abnormalities were observed.The ocular and physical examination of the proband's mother showed no abnormalities.Genetic testing results showed that the proband, her father and her brother all carried the ZEB1c.790G>A (p.Gly264Arg) heterozygous variant, but her mother did not carry the variantion.Sanger sequencing verified that this variantion was co-segregated within the family.The variantion is a newly discovered missense mutation that had not been reported in the Thousand Genomes Project, Genome Aggregation Database, and ExAC database.The prediction results of the variant by MutationTaster, SIFT, PROVEAN, VESST3, DANN, FATHMM-MKL, CADD, fitCons and other software were harmful, and GERP+ +, Weblogo, Clustal Omega analysis showed that the amino acids affected by the variant were highly conservative.According to the ACMG Guidelines, this variation was possible pathogenic.Conclusions:The identification of the missense mutation c. 790G>A (p.Gly264Arg) in the ZEB1 gene within this PPCD family provides new insights into the genetic basis of PPCD and the variant may be the pathogenic variant of in this family.

Objective:To evaluate the repeatability of anterior segment biometry measurements obtained using ultrasound biomicroscopy (UBM) and the ArcScan Insight 100, and to compare the agreement between the two devices.Methods:A cross-sectional study was conducted.Seventy myopic patients (70 eyes) who underwent V4c implantable collamer lens implantation at Henan Eye Hospital from March to May 2023 were included.The ArcScan Insight 100 and UBM were used to measure the following parameters three times: angle-to-angle distance (ATA), sulcus-to-sulcus distance (STS), anterior chamber depth (ACD), crystalline lens rise (CLR), anterior chamber width (ACW), ciliary body inner diameter (CBID), anterior chamber angle (ACA), trabecular-ciliary angle (TCA) and maximum ciliary body thickness (CBTmax). The repeatability of anterior segment biological measurements obtained using the two devices was assessed by intraclass correlation coefficient (ICC). The consistency between the two instruments was evaluated by Bland-Altman consistency test.This study complied with the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]). All patients understood the purpose and significance of this study and signed the informed consent form.Results:The repeatability of ATA, STS, ACD, CLR, ACW, CBID, ACA, TCA and CBTmax measured by UBM and ArcScan Insight 100 was good (all ICC>0.9). There was no significant difference in ACD, ACW, and ACA between the two instruments ( t=0.696, -1.025, -1.447; all P>0.05). ATA, STS, CLR and CBID measured by UBM were lower and TCA and CBTmax were higher than those measured by UBM ArcScan Insight 100, and the differences were statistically significant ( t=-8.586, -12.551, -4.481, -4.420, 4.535, 7.812; all P<0.05). The differences of ATA, STS, ACD, CLR, ACW, CBID and CBTmax between UBM and ArcScan Insight 100 were 0.38, 0.47, -0.01, 0.07, 0.3, 0.26 and -0.21 mm, respectively, with the 95% limits of agreement (LoA) of (-0.34, 1.10), (-0.15, 1.09), (-0.28, 0.26), (-0.20, 0.35), (-0.33, 0.93), (-0.71, 1.23) and (-0.64, 0.23)mm, respectively, which showed good coherence.The differences in ACA and TCA measurements were 2.26° and -7.81°, respectively, and the 95%LoA values were (-23.36°, 27.89°) and (-36.05°, 20.43°), respectively, with poor coherence.There was a strong positive correlation in ACD measurements measured by UBM and ArcScan Insight 100 ( r=0.827, P<0.05). There were moderate positive correlations in ATA, STS, CLR, ACW and CBID ( r=0.678, 0.749, 0.617, 0.765, 0.519; all P<0.05). There was no significant correlation in ACA, TCA and CBTmax ( r=0.270, 0.032, 0.178; all P>0.05). Conclusions:The repeatability of ArcScan Insight 100 and UBM in measuring anterior segment biological parameters is good.However, the consistency of ACA, TCA and CBTmax measured by the two instruments is poor and may be affected by self-regulation of the body.ATA, STS, ACD, CLR, ACW and CBID have good consistency and can be used interchangeably.

Objective To investigate the effects and mechanism of Dahuang Lingxian Prescription on bile duct reaction of cholestatic liver fibrosis rats caused by bile duct ligation.Methods A total of 40 SD rats were randomly divided into blank group,model group,ursodeoxycholic acid group and Dahuang Lingxian Prescription group,with 10 rats in each group.Except for the blank group,the remaining groups of rats underwent bile duct ligation surgery to establish a cholestatic liver fibrosis model.After surgery,the ursodeoxycholic acid group was given ursodeoxycholic acid solution by gavage,Dahuang Lingxian Prescription group was given Dahuang Lingxian Prescription solution by gavage,and the blank group and model group were given equal volume of normal saline by gavage,once a day for 3 consecutive weeks.The activities of serum AST,ALT,ALP,GGT and the contents of TBIL,TBA were tetected,the morphology of liver tissue was observed by HE staining,and the liver fibrosis was observed by Masson staining,immunohistochromic staining and Western blot were used to detect the expressions of CK19,CK7,EpCAM and SOX9 proteins.Results Compared with the blank group,the liver surface of the model group rats was rough,with a harder texture and obvious graininess,HE staining showed damage to the liver lobule structure,forming pseudo lobules,a large number of bile duct hyperplasia and inflammatory cell infiltration,and a significant increase in collagen fiber deposition(P<0.01);the activities of serum AST,ALT,ALP,GGT,as well as the contents of TBIL and TBA significantly increased(P<0.01);the positive expressions of CK19,CK7 and EpCAM in liver tissue significantly increased(P<0.01),and the protein expressions of CK19,CK7,EpCAM and SOX9 significantly increased(P<0.01).Compared with the model group,the appearance and texture of the liver of the rats in the ursodeoxycholic acid group and Dahuang Lingxian Prescription group were relatively softer,the lobular structure was less damaged,the inflammatory cells infiltration was less,the collagen fiber deposition was significantly reduced(P<0.01),the activities of serum AST,ALT,ALP,GGT,and the contents of TBIL and TBA were significantly decreased(P<0.01);the expressions of TBA and TBIL were significantly decreased(P<0.01),the positive expressions of CK19,CK7 and EpCAM significantly decreased(P<0.01),and the protein expression of CK19,CK7,EpCAM and SOX9 significantly decreased(P<0.01).Conclusion Dahuang Lingxian Prescription can inhibit the bile duct reaction associated with liver progenitor cells,decrease the expression of CK19,CK7,EpCAM and SOX9,and thus improve the cholestatic liver fibrosis of rats induced by bile duct ligation.