AIM: To evaluate the visual function and optical quality in adults aged 80y and older following the bilateral implantation of zonal refractive multifocal intraocular lens(IOL, LS-313 MF30).METHODS: A single-center, non-randomized, prospective clinical trial was conducted, involving cataract patients aged 80 y and older. Patients received bilateral implantation of the LS-313 MF30 or CT Asphina 409MP, based on personal preference. Postoperative assessments included uncorrected and corrected visual acuity at distance, intermediate, and near ranges, as well as defocus curve. Subjective evaluations were performed using the visual function(VF-14)questionnaire, spectacle independence rates, and patient satisfaction surveys. Photic phenomena such as glare, halos, and starbursts were also analyzed.RESULTS: The MF30 group(16 eyes from 8 participants, 85.38±2.56 y)exhibited superior uncorrected and corrected intermediate and near visual acuity compared to the 409MP group(26 eyes from 13 participants, 85.77±2.20 y), while distance visual acuity was comparable between groups. The defocus curve of the MF30 group revealed two peaks at 0.00 D and -3.00 D, indicating a broader depth of focus. Patients in the MF30 group reported higher rates of spectacle independence and greater satisfaction. While photic phenomena such as glare(28.6% vs 18.5%, P=0.584), starburst(9.5% vs 3.7%, P=0.567)and halos(23.8% vs 11.11%, P=0.438)were more prevalent in the MF30 group, they were generally mild and did not significantly impact daily activities.CONCLUSION: Zonal refractive multifocal IOLs provide elderly patients with improved distance and near vision, greater spectacle independence, and greater satisfaction. Although photic phenomena were slightly more frequent with MF30, they are generally reported as non-disruptive and do not affect their daily life compared to monofocal IOLs.

Numerous techniques for C2 screw fixation have been recently reported. However, concerns remain regarding the risk of spinal cord or vertebral artery injury and inadequate biomechanical stability. To our knowledge, the specific transforaminal “in-out-in” screw fixation technique has not been previously reported. This study aimed to investigate the feasibility and preliminary clinical outcomes of a transforaminal “in-out-in” multi-cortical purchase screw for posterior C2 screw fixation. Between October 2022 and March 2023, 10 patients underwent posterior atlantoaxial internal fixation. All patients had severe hypoplasia of the C2 pedicle on at least one side, precluding the use of standard C2 pedicle screws. A transforaminal “in-out-in” screw was used as an alternative. No spinal cord injury, vascular injury, or other major complications were observed. No implant failure was noted at the final follow-up. In conclusion, the transforaminal “in-out-in” screw may achieve rigid three-column fixation with multiple cortical purchases. It represents a safe and effective alternative for posterior C2 fixation in patients with severely narrow C2 pedicles where traditional pedicle screw placement is not feasible.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

Objective To investigate the prognosis and its influencing factors in patients with hypertension complicated with heart failure (HF). Methods A total of 381 patients with hypertension and HF who were treated in our hospital from March 2022 to April 2025 were chosen. The patients were followed up for the prognosis within 6 months and split into good prognosis group (n=266) and poor prognosis group (n=115). The clinical data of the two groups were compared and analyzed. Multivariate Logistic regression analysis was used to determine the influencing factors of poor prognosis. Results The group with poor prognosis had higher proportions of atrial fibrillation and New York Heart Association (NYHA) Class III-IV, as well as increased left ventricular end-diastolic diameter (LVED), left ventricular end-systolic diameter (LVES), interventricular septum thickness (IVS), and left ventricular posterior wall thickness (LVPW) compared to the group with good prognosis (P<0.05). Additionally, levels of systolic blood pressure (SBP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), total cholesterol (TC), low-density lipoprotein (LDL), creatinine (Cr) were elevated (P<0.05), while left ventricular ejection fraction (LVEF) was decreased (P<0.05). NYHA classification, LVEF, LVED, LVPW, NT-proBNP were independent influencing factors of poor prognosis in patients with hypertension complicated with HF (P<0.05). Conclusion NYHA classification, LVEF, LVED, LVPW and NT-proBNP are closely related to the poor prognosis of patients with hypertension and HF.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

Objective To investigate the effects of Mawangdui exercise combined with neuro-muscular electrical stimulation(NMES)on pulmonary function,exercise capacity and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 96 COPD pa-tients were selected as the study subjects,and divided into control group(n=48)and intervention group(n=48).The control group received conventional pharmacological treatment,while the inter-vention group received Mawangdui exercise combined with NMES in addition to conventional pharma-cological treatment.The ratio of forced expiratory volume in the first second(FEV1)to forced vital capacity(FVC)(FEV1/FVC),the percentage of predicted FEV,(FEV1％),respiratory rate,re-sults of the 6-minute walk test(6MWT),scores of COPD Assessment Test(CAT),St.George's Respira-tory Questionnaire-I(SGRQ-I),Hospital Anxiety and Depression Scale(HADS)and Borg CR-10 Scale were analyzed in both groups before and after treatment.Results After 1 and 3 months of treatment,significant differences were observed in respiratory rate and 6MWT results between the two groups(P＜0.05).After 1 and 3 months of treatment,the FEV1％and FEV1/FVC in the intervention group were significantly higher than those at admission,and the FEV1％and FEV1/FVC after 3 months of treatment were significantly higher than those after 1 month of treatment(P＜0.05).Af-ter 3 months oftreatment,a significant difference in FEV1/FVC was observed between the two groups(P＜0.05).After 3 months of treatment,the CAT and SGRQ-I scores in the intervention group were significantly lower than those at admission(P＜0.05).After 3 months of treatment,the Borg CR-10 Scale score in the intervention group was significantly lowerthan that at admission and after 1 month of treatment(P＜0.05).After 3 months of treatment,a significant difference in SGRQ-I scores was observed between the two groups(P＜0.05).After 1 and 3 months of treatment,the HADS scores in the intervention group were significantly lower than those at admission,and the HADS score after 3 months of treatment was significantly lower than that after 1 month of treatment(P＜0.05).After 1 and 3 months of treatment,significant differences in HADS scores were ob-served between the two groups(P＜0.05).Conclusion Mawangdui exercise combined with NMES can improve exercise tolerance and pulmonary function,alleviate anxiety and depression,and thereby enhance the quality of life in COPD patients.

As the population is aging rapidly,the incidence of Alzheimer's disease(AD)is increasing year by year.The World Health Organization stresses that early prevention plays a key role in reducing the incidence of AD.Subjective cognitive decline(SCD)is an early window of AD development,and timely intervention can effectively slow down the progression of the disease or prevent it from developing into dementia,thus reducing the burden on the society.White matter hyperintensity(WMH)can effectively reflect white matter changes and provide strong evidence to identify SCD.In this paper,we review the recent research progress in WMH and SCD,reveal the problems in the current research on WMH,explain the correlation between WMH and SCD in terms of physiopathology and cognitive function,and put forward several suggestions for the future research.
Humans ; White Matter/pathology* ; Cognitive Dysfunction/pathology* ; Alzheimer Disease/pathology* ; Magnetic Resonance Imaging

Objective To evaluate the diagnostic value of transrectal contrast-enhanced ultrasound (CEUS) for rectal cancer with intestinal stenosis caused by tumors. Methods Forty-nine patients with rectal cancer underwent transrectal CEUS and magnetic resonance imaging (MRI) before surgery.Intraoperative tumor localization and postoperative pathological results were taken as the gold standard for diagnosis.The differences in T stage,localization,and tumor length of rectal cancer were compared between the two methods. Results The total accuracy rates of transrectal CEUS and MRI in diagnosing T stage were 75.5% (36/49) and 67.3% (33/49),which had no significant difference (χ²=0.8,P=0.371).The total accuracy rates of transrectal CEUS and MRI in judging tumor localization were 79.5% (39/49) and 77.5% (38/49),which had no significant difference (χ²=0.061,P=0.806).The measurement results of tumor length in pathological examination had no significant difference from the transrectal CEUS results (t=1.42,P=0.162) but a significant difference from the MRI results (t=3.38,P=0.001).Furthermore,transrectal CEUS detected 8 (16.3%) cases of colonic polyps among the 49 patients,while MRI did not detect colon lesions. Conclusions Transrectal CEUS has good consistency with MRI in T staging and localization judgement of rectal cancer with intestinal stenosis,and this method can more accurately evaluate the tumor length and simultaneously evaluate whether there is a lesion in the entire colon at the proximal end of stenosis.It can be used as a supplementary examination before rectal cancer treatment in clinical practice.
Humans ; Rectal Neoplasms/complications* ; Male ; Middle Aged ; Female ; Aged ; Contrast Media ; Ultrasonography ; Adult ; Magnetic Resonance Imaging ; Constriction, Pathologic/diagnostic imaging* ; Aged, 80 and over ; Intestinal Obstruction/etiology*