Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective:To explore the enhancement factors for the China-PAR assessment model based on a university employee cohort and validate its predictive efficacy.Methods:In this retrospective cohort study, 423 employees from a university in Beijing who underwent health checks at Peking University Third Hospital from 2019 to 2022 were enrolled. General demographics, physical examination data, biochemical indicators, and carotid artery ultrasound results were collected. The China-PAR model was used to predict initial atherosclerosis risk in those subjects. Univariate and multivariate analyses of carotid atherosclerosis progression were used to identify enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint, the ROC curve was employed to compare the predictive efficacy of the China-PAR model for the risk of atherosclerosis before and after the incorporation of the enhancement factors.Results:Among the 423 employees included in the analysis, there were 224 males and 199 females, with a baseline age of (56.2±11.8) years. The proportions of carotid atherosclerosis progression were significantly higher in populations with hyperuricemia, hyperhomocysteinemia, body mass index≥28 kg/m2, waist-to-height ratio>0.5, and low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L than those in patients without these health issues (66.0% vs 55.3%, 68.0% vs 56.2%, 72.1% vs 56.6%, 64.5% vs 54.2%, 80.5% vs 56.8%, respectively) (all P<0.05). Hyperhomocysteinemia ( OR=1.833, 95% CI: 1.076-3.123) and LDL-C≥3.4 mmol/L ( OR=3.891, 95% CI: 1.600-9.116) were positively correlated with carotid atherosclerosis progression (all P<0.05) and could be considered as enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint event, the AUC of the China-PAR model after the incorporation of the enhancement factors was higher than that before incorporation (0.743 vs 0.684) ( P<0.05). The C-statistics of the China-PAR model before and after the incorporation of the enhancement factors was 0.702 and 0.757, respectively, with a net reclassification index of 0.090. Conclusion:Using carotid atherosclerosis progression as the follow-up endpoint, the China-PAR model incorporating hyperhomocysteinemia and LDL-C≥3.4 mmol/L as enhancement factors can better predict the risk of atherosclerosis among university employees.

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective:To explore the enhancement factors for the China-PAR assessment model based on a university employee cohort and validate its predictive efficacy.Methods:In this retrospective cohort study, 423 employees from a university in Beijing who underwent health checks at Peking University Third Hospital from 2019 to 2022 were enrolled. General demographics, physical examination data, biochemical indicators, and carotid artery ultrasound results were collected. The China-PAR model was used to predict initial atherosclerosis risk in those subjects. Univariate and multivariate analyses of carotid atherosclerosis progression were used to identify enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint, the ROC curve was employed to compare the predictive efficacy of the China-PAR model for the risk of atherosclerosis before and after the incorporation of the enhancement factors.Results:Among the 423 employees included in the analysis, there were 224 males and 199 females, with a baseline age of (56.2±11.8) years. The proportions of carotid atherosclerosis progression were significantly higher in populations with hyperuricemia, hyperhomocysteinemia, body mass index≥28 kg/m2, waist-to-height ratio>0.5, and low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L than those in patients without these health issues (66.0% vs 55.3%, 68.0% vs 56.2%, 72.1% vs 56.6%, 64.5% vs 54.2%, 80.5% vs 56.8%, respectively) (all P<0.05). Hyperhomocysteinemia ( OR=1.833, 95% CI: 1.076-3.123) and LDL-C≥3.4 mmol/L ( OR=3.891, 95% CI: 1.600-9.116) were positively correlated with carotid atherosclerosis progression (all P<0.05) and could be considered as enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint event, the AUC of the China-PAR model after the incorporation of the enhancement factors was higher than that before incorporation (0.743 vs 0.684) ( P<0.05). The C-statistics of the China-PAR model before and after the incorporation of the enhancement factors was 0.702 and 0.757, respectively, with a net reclassification index of 0.090. Conclusion:Using carotid atherosclerosis progression as the follow-up endpoint, the China-PAR model incorporating hyperhomocysteinemia and LDL-C≥3.4 mmol/L as enhancement factors can better predict the risk of atherosclerosis among university employees.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

The density and composition of lymphocytes infiltrating colon tumors serve as predictive factors for the clinical outcome of colon cancer.Our previous studies highlighted the potent anti-cancer properties of the principal compounds found in Garcinia yunnanensis(YTE-17),attributing these effects to the regu-lation of multiple signaling pathways.However,knowledge regarding the mechanism and effect of YTE-17 in the prevention of colorectal cancer is limited.In this study,we conducted isobaric tags for relative and absolute quantification(iTRAQ)analysis on intestinal epithelial cells(IECs)exposed YTE-17,both in vitro and in vivo,revealing a significant inhibition of the Wnt family member 5a(Wnt5a)/c-Jun N-terminal kinase(JNK)signaling pathway.Subsequently,we elucidated the influence and mechanism of YTE-17 on the tumor microenvironment(TME),specifically focusing on macrophage-mediated T helper 17(Th17)cell induction in a colitis-associated cancer(CAC)model with Wnt5a deletion.Additionally,we performed the single-cell RNA sequencing(scRNA-seq)on the colonic tissue from the Wnt5a-deleted CAC model to characterize the composition,lineage,and functional status of immune mesenchymal cells during different stages of colorectal cancer(CRC)progression.Remarkably,our findings demon-strate a significant reduction in M2 macrophage polarization and Th17 cell phenotype upon treatment with YTE-17,leading to the restoration of regulatory T(Treg)/Th17 cell balance in azoxymethane(AOM)/dextran sodium sulfate(DSS)model.Furthermore,we also confirmed that YTE-17 effectively inhibited the glycolysis of Th17 cells in both direct and indirect co-culture systems with M2 macrophages.Notably,our study shed light on potential mechanisms linking the non-canonical Wnt5a/JNK signaling pathway and well-established canonical β-catenin oncogenic pathway in vivo.Specifically,we proposed that Wnt5a/JNK signaling activity in IECs promotes the development of cancer stem cells with β-catenin activity within the TME,involving macrophages and T cells.In summary,our study undergoes the po-tential of YTE-17 as a preventive strategy against CRC development by addressing the imbalance with the immune microenvironment,thereby mitigating the risk of malignancies.

Objective To observe the effect of combined opioid-free and loco-regional anesthesia on the quality of recovery after retrolaparoscopic renal surgery.Methods Sixty patients undergoing elective retrolaparoscopic renal surgery were divided into two groups(30 patients per group):the opioid-free anesthesia group(OFA group)and conventional anesthesia group with opioid(OA group)u-sing the random number table method.Both groups underwent ultrasound-guided anterior quadratus lumbar block(QLB)30minutes be-fore induction of anesthesia.In the OFA group,dexmedetomidine was given before induction,and induction was performed with propofol,midazolam,esketamine,and rocuronium,maintained with dexmedetomidine,propofol,sevoflurane anesthesia,and intermittent push of esketamine.In the OA group,propofol,midazolam,sufentanil,and rocuronium were given to induce anesthesia and maintained with remifentanil,propofol,and sevoflurane.Both groups were given intravenous self-administered analgesia after surgery.The mean arterial pressure(MAP)and heart rate(HR)at different time points,and the resting and motor VAS scores at 2,6,12,24 and 48h after sur-gery were recorded.QoR-40 was used to compare the quality of recovery at 24 hours after surgery between the two groups,and adverse effects and recovery of patients were recorded.Results QoR-40 scores were higher in the OFA group than that in the OA group(P＜0.05).Postoperative pain,postoperative opioid consumption,and incidence of nausea and vomiting were reduced in the OFA group(P＜0.05);and time to first ambulation,first exhaustion,and length of hospital stay were all reduced(P＜0.05).Conclusion Opioid-free anesthesia combined with quadratus lumbar block can significantly improve the quality of postoperative recovery,reduce postoperative pain,reduce postoperative opioid drug consumption,and promote postoperative recovery in patients undergoing retrolaparoscopic renal surgery.

Dry eye is a common ophthalmic disease caused by eye maladjustment due to meibomian gland dysfunction (MGD), which is often accompanied by symptoms such as increased tear film osmotic pressure and ocular surface inflammation. In the treatment of dry eye patients, dredging gland obstruction caused by meibomian gland secretion is an effective treatment method. Based on electrothermal effect and hyperelasticity of the silicone, an auxiliary treatment instrument for MGD is designed, which can improve the blood circulation of the glands through heat compress and massage to achieve the purpose of dredging the meibomian glands. The therapy device can display the temperature and pressure during the treatment in real time, so that the surgeon can grasp the progress of the treatment in real time. The therapy device constructs a user-oriented interactive interface based on parametric modeling method, which can be customized by 3D printing according to the user's eyeball geometric parameters. The designed therapeutic device was finally tested on New Zealand white rabbits. The experimental results show that the therapeutic device has significant effectiveness and safety, as well as clinical application prospects.
Animals ; Dry Eye Syndromes/therapy* ; Humans ; Meibomian Gland Dysfunction ; Meibomian Glands ; Rabbits ; Tears ; Treatment Outcome

In robot-assisted eye surgery, such as retinal vascular bypass surgery, precise positioning of operating points is required. In this study, a binocular vision-based 3D reconstruction method is proposed to locate the incision points on retinal vessels. Vessels in the image were extracted by CLAHE algorithm to remove the influence of background, then stereo matching was performed. Finally, the retinal vessel image was reconstructed by using the principle of parallax in binocular vision. Experimental results show that this method can accurately locate the incision points on retinal vessels and meet the requirements of ophthalmic surgery.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Ophthalmologic Surgical Procedures ; Retinal Vessels/diagnostic imaging* ; Robotic Surgical Procedures ; Vision, Binocular

Objective: Taking electronic-eye (visual analyzer) technique,based on the powder color of Andrographis Herba,to investigate the applicability of electronic-eye technique and evaluate the quality of Andrographis Herba with different commercial specifications. Method: HPLC was employed to determine contents of andrographolide,dehydroandrographolide,14-deoxyandrographolide,neoandrographolide in 50 batches of Andrographis Herba with different commercial specifications(stems,leaves and aerial parts).Color of these samples were measured by electronic-eye technique.The data were analyzed by principal component analysis(PCA) and Pearson correlation analysis.The ability of electronic-eye to distinguish the different commercial specifications of Andrographis Herba was investigated and the correlation of chroma space system parameters (L^*,a^*,b^*) with active components was investigated. Result: There was remarkable difference in contents of 4 diterpenoids in Andrographis Herba from different parts,their contents in leaves was the highest,followed by the aerial parts(mixture of stems and leaves),and their contents in stems was the lowest.The results of PCA was divided into two classes,namely the stem part,leaf and aerial parts,indicating that electronic-eye could be used to distinguish the quality of Andrographis Herba.The correlation results showed that there were significant negative correlation(P<0.01) between L^*(lightness value) and the contents of andrographolide,dehydroandrographolide,14-deoxyandrographolide,neoandrographolide and the total content of these 4 components.In addition,L^* of samples that did not conform to the lower limit of determination in the 2015 edition of Chinese Pharmacopeia was ≥ 69.5,and the L^* of more than 90% of the samples in accordance with the requirements was <69.5. Conclusion: Electronic-eye technique provides a new method and idea for the quality evaluation of Andrographis Herba.