Objective To compare the efficacy between slanted bilateral lateral rectus recession(S-BLR)and conventional bilateral lateral recession(C-BLR)procedure in the treatment of convergence insuffi-ciency-type intermittent exotropia.Methods Relevant studies published before November 2023 were systematically searched in PubMed,Cochrane Library,EmBase,Web of Science,CNKI,Wanfang and VIP databases to compare the surgical effects of S-BLR and C-BLR,expressed by OR value and 95%CI.The success rate,recurrence rate,overcor-rection rate and stereoscopic improvement rate were analyzed by random effects model.Results A total of 5 studies involving 296 patients were included in the analysis.The success rate of the S-BLR procedure was significantly higher than that of C-BLR(OR=4.06,95%CI:2.47-6.67,P＜0.001),patients subjected to the C-BLR pro-cedure were more likely to be recurrent(OR=0.21,95%CI:0.08-0.52,P＜0.001).No statistically signifi-cant differences in the combined results for overcorrection rates(OR=0.43,95%CI:0.07-2.52,P=0.35)and stereoscopic improvement rates(OR=0.82,95%CI:0.36-1.83,P=0.62)were present between the S-BLR and C-BLR procedures(P＞0.05).Conclusion S-BLR procedure has a higher success rate and a lower recurrence rate in patients with aggregation-deficient intermittent exotropia.

Objective:To investigate the causal relationship between type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), body mass index (BMI) and papillary thyroid cancer using Mendelian randomization(MR) study.Methods:Publicly available genome-wide association studies (GWAS) were used as the data source to screen single nucleotide polymorphisms significantly associated with exposure factors (instrumental variables), and the inverse variance weighting (IVW), weighted median, MR-Egger analysis, simple mode, and weighted mode of two-sample MR were used to assess the causal association between T2DM, T1DM, BMI and papillary thyroid cancer. The reliability and stability of the results were assessed by heterogeneity analysis, multiple validity analysis and sensitivity analysis.Results:A total of 118 strong instrumental variables for T2DM, 76 for T1DM, and 486 for BMI were screened respectively to conduct two-sample MR analysis. Among the 5 MR analysis methods, the results of the IVW method showed that T2DM was significantly associated with papillary thyroid cancer (odds ratio ( OR)=1.147, 95% CI: 1.026-1.282; P=0.016), and the genetic effect values ( β values) of the other 4 analysis methods and IVW method were in the same direction; the results of heterogeneity analysis, multiplicity analysis and sensitivity analysis showed all P>0.05. T1DM (IVW method: OR=1.000, 95% CI: 0.952-1.051; P=0.994) and papillary thyroid cancer, BMI (IVW method: OR=1.214, 95% CI: 0.923-1.598; P=0.166) and papillary thyroid cancer were not clearly causally related. Conclusions:There is a causal association between T2DM and papillary thyroid cancer, and T2DM increases the risk of papillary thyroid cancer. There is no clear causal association between T1DM, BMI and papillary thyroid cancer.

Objective:To investigate the impact of preoperative sarcopenia on chronic postsurgical pain(CPSP)after cardiac surgery in elderly patients.Methods:Elderly patients undergoing elective open-chest cardiac surgery at the Affiliated Hospital of Xuzhou Medical University from September 2022 to May 2024 were collected.According to the updated diagnostic criteria and revised by the Asian Working Group for Sarcopenia(AWGS2019)in 2019, patients were classified into sarcopenia and non-sarcopenia groups Elderly patients were divided into two groups based on the occurrence of chronic pain at 3 months postoperatively: CPSP group and non-CPSP group.Indicators with statistically significant differences in univariate regression analysis were included in multifactorial regression to analyze the influencing factors of chronic pain after cardiac surgery in elderly patients.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to compare the predictive efficacy of sarcopenia, commonly used clinical pain assessment tools(gender+ acute postoperative pain), and(gender+ acute postoperative pain+ sarcopenia)in predicting CPSP after cardiac surgery in elderly patients.Results:The study ultimately included 379 patients, consisting of 238 males(62.8%), with an average age of(66.6 ± 5.3)years.Among them, 83 patients had sarcopenia, and 119 patients developed CPSP.Univariate regression analysis showed that gender, history of atrial fibrillation, acute postoperative pain, American Society of Anesthesiologists(ASA)Physical Status Classification System, New York Heart Association(NYHA)Classification of Cardia Function, sarcopenia, and duration of extracorporeal circulation were associated with the occurrence of CPSP after cardiac surgery in elderly patients.However, after adjusting for all possible confounders, multifactorial regression analysis showed that gender, acute postoperative pain, and sarcopenia were independent risk factors for CPSP after cardiac surgery in elderly patients(all P<0.05), with sarcopenia patients having a 2.913-fold risk of developing CPSP compared with non-sarcopenia patients.The AUCs of the ROC curves for commonly used clinical perioperative pain assessment tools and those with the addition of sarcopenia determination were 0.731 and 0.802, respectively. Conclusions:Preoperative sarcopenia is an independent risk factor for the development of chronic pain after cardiac surgery in elderly patients, and the inclusion of sarcopenia determination in commonly used clinical pain assessment tools can significantly improve the predictive efficacy for chronic pain.

Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

To investigate the infection status of two arboviruses,akabane orthobunyavirus(AKAV)and bluetongue virus(BTV),in cattle herds of Guizhou Province,we employed the indirect ELISA method to detect AKAV and BTV antibody levels in the present experiment.A total of 1504 bovine serum samples from 37 large-scale farms and 88 free-range households from 26 districts or coun-ties of 7 cities(prefectures)of Guizhou Province were collected to detect AKAV antibody levels.Additionally,1 241 serum samples from 30 large-scale farms and 15 free-range households in 19 districts or counties of 3 cities(prefectures)were tested for BTV antibody levels.Moreover,two influencing factors,breeding mode and sampling season,were statistically analyzed for their effects.The results showed that the overall positive rate of AKAV antibodies was 11.64％(175/1 504),with individual positive rates of 13.20％(123/934)and 9.12％(52/570)in large-scale farms and free-range households,respectively.No significant differences were observed between the two groups.However,the farm positive rate(64.86％,24/37)in large-scale farms was significantly higher than that(26.14％,23/88)in free-range households.Seasonal statistics showed that the positive rate was highest during the summer season at 60.00％(12/20).The total positive rate of BTV antibodies was 25.42％(222/1 241).The farm positive rate and individual positive rate in free-range households were 66.67％(10/15)and 41.91％(57/136),respectively.For large-scale farms,these rates were 60.00％(18/30)and 14.93％(165/1 105),respectively.The individual pos-itive rate in free-range households was significantly higher than that in large-scale farms.Seasonal statistics showed that the positive rates in summer and autumn seasons were 50.00％(5/10)and 72.41％(21/29),respectively,both of which were significantly higher than those in winter and spring seasons.All these findings indicated that both AKAV and BTV were present to a certain ex-tent in Guizhou Province,with seasonality.Furthermore,differences were observed between the different breeding modes.Our results could provide a data reference for the formulation of preven-tion and control measures for the two insect-borne diseases.

To investigate the infection status of two arboviruses,akabane orthobunyavirus(AKAV)and bluetongue virus(BTV),in cattle herds of Guizhou Province,we employed the indirect ELISA method to detect AKAV and BTV antibody levels in the present experiment.A total of 1504 bovine serum samples from 37 large-scale farms and 88 free-range households from 26 districts or coun-ties of 7 cities(prefectures)of Guizhou Province were collected to detect AKAV antibody levels.Additionally,1 241 serum samples from 30 large-scale farms and 15 free-range households in 19 districts or counties of 3 cities(prefectures)were tested for BTV antibody levels.Moreover,two influencing factors,breeding mode and sampling season,were statistically analyzed for their effects.The results showed that the overall positive rate of AKAV antibodies was 11.64％(175/1 504),with individual positive rates of 13.20％(123/934)and 9.12％(52/570)in large-scale farms and free-range households,respectively.No significant differences were observed between the two groups.However,the farm positive rate(64.86％,24/37)in large-scale farms was significantly higher than that(26.14％,23/88)in free-range households.Seasonal statistics showed that the positive rate was highest during the summer season at 60.00％(12/20).The total positive rate of BTV antibodies was 25.42％(222/1 241).The farm positive rate and individual positive rate in free-range households were 66.67％(10/15)and 41.91％(57/136),respectively.For large-scale farms,these rates were 60.00％(18/30)and 14.93％(165/1 105),respectively.The individual pos-itive rate in free-range households was significantly higher than that in large-scale farms.Seasonal statistics showed that the positive rates in summer and autumn seasons were 50.00％(5/10)and 72.41％(21/29),respectively,both of which were significantly higher than those in winter and spring seasons.All these findings indicated that both AKAV and BTV were present to a certain ex-tent in Guizhou Province,with seasonality.Furthermore,differences were observed between the different breeding modes.Our results could provide a data reference for the formulation of preven-tion and control measures for the two insect-borne diseases.

Objective:To investigate the causal relationship between type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), body mass index (BMI) and papillary thyroid cancer using Mendelian randomization(MR) study.Methods:Publicly available genome-wide association studies (GWAS) were used as the data source to screen single nucleotide polymorphisms significantly associated with exposure factors (instrumental variables), and the inverse variance weighting (IVW), weighted median, MR-Egger analysis, simple mode, and weighted mode of two-sample MR were used to assess the causal association between T2DM, T1DM, BMI and papillary thyroid cancer. The reliability and stability of the results were assessed by heterogeneity analysis, multiple validity analysis and sensitivity analysis.Results:A total of 118 strong instrumental variables for T2DM, 76 for T1DM, and 486 for BMI were screened respectively to conduct two-sample MR analysis. Among the 5 MR analysis methods, the results of the IVW method showed that T2DM was significantly associated with papillary thyroid cancer (odds ratio ( OR)=1.147, 95% CI: 1.026-1.282; P=0.016), and the genetic effect values ( β values) of the other 4 analysis methods and IVW method were in the same direction; the results of heterogeneity analysis, multiplicity analysis and sensitivity analysis showed all P>0.05. T1DM (IVW method: OR=1.000, 95% CI: 0.952-1.051; P=0.994) and papillary thyroid cancer, BMI (IVW method: OR=1.214, 95% CI: 0.923-1.598; P=0.166) and papillary thyroid cancer were not clearly causally related. Conclusions:There is a causal association between T2DM and papillary thyroid cancer, and T2DM increases the risk of papillary thyroid cancer. There is no clear causal association between T1DM, BMI and papillary thyroid cancer.

Objective:To investigate the impact of preoperative sarcopenia on chronic postsurgical pain(CPSP)after cardiac surgery in elderly patients.Methods:Elderly patients undergoing elective open-chest cardiac surgery at the Affiliated Hospital of Xuzhou Medical University from September 2022 to May 2024 were collected.According to the updated diagnostic criteria and revised by the Asian Working Group for Sarcopenia(AWGS2019)in 2019, patients were classified into sarcopenia and non-sarcopenia groups Elderly patients were divided into two groups based on the occurrence of chronic pain at 3 months postoperatively: CPSP group and non-CPSP group.Indicators with statistically significant differences in univariate regression analysis were included in multifactorial regression to analyze the influencing factors of chronic pain after cardiac surgery in elderly patients.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to compare the predictive efficacy of sarcopenia, commonly used clinical pain assessment tools(gender+ acute postoperative pain), and(gender+ acute postoperative pain+ sarcopenia)in predicting CPSP after cardiac surgery in elderly patients.Results:The study ultimately included 379 patients, consisting of 238 males(62.8%), with an average age of(66.6 ± 5.3)years.Among them, 83 patients had sarcopenia, and 119 patients developed CPSP.Univariate regression analysis showed that gender, history of atrial fibrillation, acute postoperative pain, American Society of Anesthesiologists(ASA)Physical Status Classification System, New York Heart Association(NYHA)Classification of Cardia Function, sarcopenia, and duration of extracorporeal circulation were associated with the occurrence of CPSP after cardiac surgery in elderly patients.However, after adjusting for all possible confounders, multifactorial regression analysis showed that gender, acute postoperative pain, and sarcopenia were independent risk factors for CPSP after cardiac surgery in elderly patients(all P<0.05), with sarcopenia patients having a 2.913-fold risk of developing CPSP compared with non-sarcopenia patients.The AUCs of the ROC curves for commonly used clinical perioperative pain assessment tools and those with the addition of sarcopenia determination were 0.731 and 0.802, respectively. Conclusions:Preoperative sarcopenia is an independent risk factor for the development of chronic pain after cardiac surgery in elderly patients, and the inclusion of sarcopenia determination in commonly used clinical pain assessment tools can significantly improve the predictive efficacy for chronic pain.

Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

Circadian rhythm disorders are closely related to metabolic diseases， which can cause non-alcoholic fatty liver disease （NAFLD） by directly acting on the liver or indirectly affecting the liver through the liver-brain axis and intestinal flora. The rhythms of yin and yang， ying （营） and wei （卫）， twelve hours and four seasons in traditional Chinese medicine （TCM） chronomedicine are similar to the connotations of modern biological rhythms. From the perspective of chronomedicine of TCM， the incidence of NAFLD is closely related to the abnormality of the daily rhythm of the waxing and waning of yin and yang， the daily rhythm of the circulation of ying and wei， the rhythm of twelve hours and four seasons. Through analyzing the rhythms related to the occurrence， development and prognosis of NAFLD， it is helpful to enhance the understanding of NAFLD in relation to time， so as to better guide the clinical diagnosis and treatment.