AIM: To observe the clinical outcomes of Phorcides analytic engine-assisted topography-guided personalized laser assisted in situ keratomileusis(LASIK)for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from corneal topography.METHODS: Retrospective clinical study. A total of 32 cases(42 eyes)with myopia and astigmatism that received corneal topography-guided personalized LASIK in the Ophthalmology Refractive Surgery Center of the First Affiliated Hospital of Xi'an Jiaotong University from December 2019 to March 2021 were selected. The uncorrected distance visual acuity(UDVA), best corrected distance visual acuity(CDVA), refractive state and aberrations before and at 6 mo after surgery were recorded.RESULTS: There were 15 males and 17 females, with an age of 23.00(18.00, 29.25)years old; preoperative sphere was -5.75(-6.25, -4.00)D, and cylinder was -0.75(-1.38, -0.25)D. At 6 mo postoperatively, the UDVA exceeded the preoperative CDVA in 19 eyes(45%). The spherical equivalent(SEQ)of all eyes(100%)was -0.50 to +0.50 D at 6 mo postoperatively, and the postoperative SEQ of 23 eyes(55%)was -0.13 to +0.13 D. There were 33 eyes(79%)had a postoperative astigmatism ≤ 0.25 D, the target-induced astigmatism(TIA)was 0.94±0.96 D, and the surgically induced astigmatism(SIA)was 0.94±0.86 D, with no statistical significance between TIA and SIA(P>0.05). The astigmatism axial deviation ranged from -5° to +5° in 33 eyes(79%)at 6 mo postoperatively. Compared to pre-operation, the total higher-order aberrations and spherical aberrations within the central 6 mm diameter of the anterior corneal surface increased at 6 mo postoperatively(Z=-3.778, P<0.001; Z=-4.929, P<0.001); the postoperative coma aberrations had no change(Z=-1.763, P=0.078); the postoperative trefoil aberrations decreased(Z=-2.490, P=0.013). Compared to pre-operation, the Strehl ratio of the anterior corneal surface increased significantly at 6 mo after surgeries(t=-5.401, P=0.013).CONCLUSION: Using the Phorcides analytic engine to assist topography-guided personalized LASIK for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from topography-measured astigmatism can achieve good therapeutic effects. Postoperative UDVA exceeded preoperative CDVA in nearly half of the eyes, and the quality of postoperative corneal imaging was improved.

Objectives: . The necessity to develop a method for prognostication and to identify novel biomarkers for personalized medicine in patients with head and neck squamous cell carcinoma (HNSCC) cannot be overstated. Recently, pathomics, which relies on quantitative analysis of medical imaging, has come to the forefront. CXCL8, an essential inflammatory cytokine, has been shown to correlate with overall survival (OS). This study examined the relationship between CXCL8 mRNA expression and pathomics features and aimed to explore the biological underpinnings of CXCL8. Methods: . Clinical information and transcripts per million mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA)-HNSCC dataset. We identified correlations between CXCL8 mRNA expression and patient survival rates using a Kaplan-Meier survival curve. A retrospective analysis of 313 samples diagnosed with HNSCC in the TCGA database was conducted. Pathomics features were extracted from hematoxylin and eosin–stained images, and then the minimum redundancy maximum relevance, with recursive feature elimination (mRMR-RFE) method was applied, followed by screening with the logistic regression algorithm. Results: . Kaplan-Meier curves indicated that high expression of CXCL8 was significantly associated with decreased OS. The logistic regression pathomics model incorporated 16 radiomics features identified by the mRMR-RFE method in the training set and demonstrated strong performance in the testing set. Calibration plots showed that the probability of high gene expression predicted by the pathomics model was in good agreement with actual observations, suggesting the model’s high clinical applicability. Conclusion . The pathomics model of CXCL8 mRNA expression serves as an effective tool for predicting prognosis in patients with HNSCC and can aid in clinical decision-making. Elevated levels of CXCL8 expression may lead to reduced DNA damage and are associated with a pro-inflammatory tumor microenvironment, offering a potential therapeutic target.

Objective:To investigate the clinical efficacy of preoperative three-dimensional (3D) reconstruction planning in total hip arthroplasty for development dysplasia of the hip secondary to osteoarthritis.Methods:A total of 80 patients with osteoarthritis secondary to Crowe I-III developmental dysplasia of the hip who underwent primary unilateral total hip arthroplasty from October 2019 to March 2021 were retrospectively analyzed, including 18 males and 62 females and the mean age was 55.7±10.4 years (range 41-72 years). Forty patients in the 3D group, the prosthesis type and installation angle were planed on the 3D reconstruction software based on the full-length CT scan data of the lower limbs, and the length difference of the lower limbs and hip offset were calculated. Forty patients in the control group underwent preoperative planning using conventional film measurement, and lower limb length was judged based on the preoperative measurement data and intraoperative comparison of both lower limbs. The difference of postoperative leg length, hip offset, hip function score, operating time, intraoperative blood loss, and incidence of complications were compared between the two groups.Results:All 80 patients completed the surgery successfully and the follow-up time was up to 3 months after operation. The 3D group was better than the control group in operation time (70.9±7.7 min vs. 81.6±13.3 min, t=-4.91, P<0.001), the difference of postoperative lower limb length (2.78±1.31 cm vs. 5.35±2.15 cm, t=-5.74, P<0.001), and hip function score at 1 week after operation (75.67±3.35 vs. 67.35±4.21, t=12.33, P=0.002), with statistically significant differences. In the 3D group, 95% of acetabular prosthesis and 90% of femoral stem components were consistent with the planned model, while the rate were only 75% and 68% in the control group, and the difference was statistically significant (χ 2=7.51, P=0.023; χ 2=14.92, P=0.005). There were no intraoperative complications such as vascular and nerve injury, and no postoperative complications such as dislocation or periprosthetic infection in all 80 patients. Conclusion:3D preoperative planning assisted total hip arthroplasty in the treatment of Crowe I-III developmental dysplasia of the hip secondary to osteoarthritis can improve the accuracy of the operation, and has a good clinical effect on restoring the leg length and hip offset.

Objective:To observe the application and clinical effect of stromal vascular fraction gel (SVF-gel) in local rhinoplasty.Methods:A total of 84 patients with mild nasal root and low bridge were divided into observation group and control group. In the observation group, liposuction with SVF gel extraction plus injection rhinoplasty was carried out; in the control group, liposuction plus injection rhinoplasty was carried out according to the height change of nasal root and bridge, the change of nasal frontal angle, the occurrence of complications and the satisfaction of patients after operation.Results:The 84 patients were followed up for 2 weeks to 24 months. The height of nasal root and bridge increased significantly and the lines were more harmonious. The absorption of the observation group was much lower than that of control group. Except 3 patients in the observation group and 8 patients in the control group, there were different degrees of absorption within 6 months after operation. All patients did not have complications such as fat liquefaction, necrosis, induration and infection in the injection area. Three patients in the observation group were satisfied with the results after reinjection, and one patient in the control group was satisfied with the results after reinjection, three patients were not satisfied with the results, and four patients were satisfied with the prosthesis augmentation rhinoplasty. In the observation group, there were 37 cases of excellent satisfaction, 5 cases of good satisfaction, and the overall satisfaction was 100%; in the control group, there were 20 cases of excellent satisfaction, 15 cases of good satisfaction, 7 cases of bad satisfaction, and the satisfaction was 83.3%. The former was better than the latter.Conclusions:In view of superiorities such as lower complications with long-lasting effect, high fat survival rate and high satisfaction in local augmentation rhinoplasty, SVF-gel injection is especially suitable for patients who cannot accept autologous bone, prosthesis and allograft tissue filler for augmentation rhinoplasty.

Objective To establish a UPLC-MS/MS method for the determination of dexmedetomidine in human plasma and investigate the effect of obstructive jaundice on pharmacokinetics of dexmedetomidine in vivo. Methods Samples were obtained by liquid-liquid extraction. Agilent Eclipse Plus C₁₈ column was used for chromatograph with methanol and 0.1% formic acid-water solution as mobile phase. Flow rate was 0.2 ml/min. The column temperature was 35 ℃, and the MS detection was selected in MRM mode. Results The calibration curves of dexmedetomidine showed good linearity in the ranges of 0.01−10.00 ng/ml. The results of intra and inter-day precisions were both within 15%. The recovery rate was 85.5%−93.1%. Matrix effect was 91.2%−95.6%. Samples remained stable during analysis. Compared with the control group, c_max、AUC_(0−t)、AUC_(0−∞) and V_z of dexmedetomidine in the patients with obstructive jaundice were increased by 63.4%, 78.9, 66.4%, 82.5%, respectively (P<0.01). CLz was decreased by 42.1%. Conclusion This method is accurate, sensitive and reproducible. It is suitable for dexmedetomidine assay in human plasma. The elimination rate of dexmedetomidine is slower in obstructive jaundice.

Objective To develop a high-performance liquid chromatography-diode array detector (HPLC-DAD) method for determination of cinnamic acid in the decoction of cinnamon, and investigate the effect of different storage temperature and time for the stability of cinnamic acid. Methods An HPLC- DAD method was established. Separation was performed on an Agilent Zorbax C₁₈ column (4.6 mm×250 mm, 5 μm) with 0.1% formic-acetonitrile acid water solution (60:40) as the mobile phase by isocratic elution. The flow rate was 1.0 ml/min, the temperature of column was 25 ℃, the injection volume was 5 μl, the detective UV wave length was 275 nm. The decoction were stored under refrigerated temperature (4 ℃) ambient temperature (25 ℃) and high temperature (40 ℃). The cinnamic acid was detected after 0, 1, 3, 7, 14, 21, 30 d. Results Cinnamic acid was successfully separated by this method, with good linear relationship between 10.21-204.20 μg/ml. The precision, repeatability, stability and recovery were good. Compared with the zero day, the content of cinnamic acid in the decoction of cinnamon decreased significantly (P<0.01) after 21 days and 30 days of ambient temperature storage and after 14 days, 21 days and 30 days of high temperature storage, but no significant change was found in the other groups (P>0.05). Conclusion This HPLC-DAD method had good stability and repeatability. Cinnamic acid was stable in the decoction of cinnamon for 30 days under refrigerated temperature.

Objective:To investigate the characteristic of mammography, magnetic resonance imaging (MRI), ultrasonography and pathology of mucinous breast carcinoma (MBC); and to study the differential diagnosis value of the three methods in pure MBC (PMBC) and mixed MBC (MMBC).Methods:One hundred and three lesions in 100 MBC patients confirmed by surgery and pathology in the Affiliated Cancer Hospital of Fudan University from January 2011 to January 2018 were retrospectively analyzed. According to the 2013 version of the breast imaging report and data system (BI-RADS) criteria, the three imaging findings of lesions were described, evaluated and classified. According to pathological results the lesions were divided into two groups, PMBC and MMBC, and their imaging features and differences were analyzed.Results:On mammography, most of the mammary glands were c-types (55/76, 72%), and the lesions were mostly masses (71/76, 93%), most of which were round, oval, high-density masses with circumscribed, microlobulated or indistinct margins. Suspected malignant calcification was showed in 21% (16/76) of these lesions. Eight patients had ipsilateral axillary lymphadenopathy. On MRI, most lesions showed masses (69/72, 96%). Sixty-seven lesions (31/72, 43%; 36/72, 50%) showed equal and high signals on T 1WI, and 54 lesions (54/72, 75%) showed higher signals on T 2WI. The margins were mostly irregular and burrs (53/69, 77%). Masses enhancement was dominated by heterogeneous enhancement (32/69, 46%) and rim enhancement (33/69, 48%). The patter of time-signal intensity was dominated by progressive curves (41/72, 57%) and platform curves (24/72, 33%). The lesions had heterogeneous high signal on DWI. The ADC signal was slightly higher than normal gland. Seven patients were accompanied with thickening of the skin and nipple retraction. Eight patients had ipsilateral axillary lymphadenopathy. One patient had multiple lung metastases. On ultrasonography, most lesions showed irregular masses, heterogeneous hypoechoic, well-defined margins, posterior echo enhancement (75/97, 77%). Color Doppler imaging showed vascularity in 65% (63/97) of these lesions. Nine patients had ipsilateral axillary lymphadenopathy. There was significant difference in margins between PMBC and MMBC ( P < 0.05) on MRI and ultrasonography. It showed significant difference in vascularity between 2 groups ( P < 0.05) on MRI. Conclusions:MBC has some typical features in mammography, MRI and ultrasonography. Realizing its features can improve the diagnostic accuracy of MBC, and it also can contribute to the differential diagnosis of PMBC and MMBC.

The coronavirus disease 2019 (COVID-19) has outbroken globally. As an acute infectious disease, COVID-19 has significant impacts on multiple organs and systems throughout the body. Among patients with COVID-19, especially severe and critical cases, a variety of potential risk factors for coagulation dysfunction exist. Furthermore, the coagulation dysfunction of COVID-19 patients was mainly characterized by elevated D-dimer levels. The coagulation dysfunction could directly affect the prognosis of COVID-19 patients and is a major cause of death in patients with severe COVID-19. In this article, the literatures on the basic clinical manifestations, clinical risk factor, mechanism of coagulation dysfunction and evaluation of coagulation function in COVID-19 were reviewed.

OBJECTIVE: To evaluate the value of digital breast tomosynthesis (DBT) in diagnosis of dense breast lesions. METHODS: Clinical and pathological data of 163 patients (58 benign lesions, 122 malignant lesions, and 180 lesions in total) with breast lesions undergoing surgical treatment in Shaoxing Central Hospital from January 2017 to December 2018 were retrospectively analyzed. The lesions were classified into non-homogeneous dense gland type and extremely dense gland type according to BI-RADS creterion. Breast MRI and DBT examinations were performed before the surgery. ROC curve was generated and the diagnostic efficacy of two examination methods for dense breast lesions was evaluated with pathological results as the gold standard. The detection rate, diagnostic accuracy of benign and malignant breast lesions were compared between two methods using chi-square test. The accuracy of lesion size preoperatively evaluated by MRI and DBT was analyzed by Pearson correlation. RESULTS: The detection rate and diagnostic accuracy for benign breast lesions by MRI were higher than those by DBT (91.4% vs. 75.9%, =5.098, <0.05 and 89.7% vs. 67.2%, =8.617, <0.01). But there were no significant differences in detection rate and accuracy for malignant lesions by MRI and DBT (98.4% vs. 95.1%, =2.068, >0.05 and 94.3% vs. 91.8%, =0.569, >0.05). The areas under the ROC curves of MRI, DBT based on BI-RADS classification were 0.910 and 0.832, respectively (=1.860, >0.05). The sensitivities of MRI, DBT to breast lesions were 93.3% and 86.7%, and the specificities were 68.3% and 79.1%. DBT and MRI measurements were positively correlated with pathological measurements (=0.887 and 0.949, all <0.01). CONCLUSIONS DBT can effectively diagnose benign and malignant breast lesions under dense gland background, and it has similar diagnostic efficacy with MRI for breast malignant lesions.
Breast Neoplasms ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; ROC Curve ; Retrospective Studies

Objective: To discuss and analyze the respective clinical effects of autologous fat filling for facial rejuvenation in the same period of three months after incisions. Methods: From June 2015 to January 2018, 117 patients with facial rejuvenation admitted to the Plastic Surgery Hospital of Weifang Medical College were randomly divided into A, B and C groups. Group A (39 cases, male 3 cases, female 36 cases, age 44-67 years old) received simple rhytidectomy. Group B (39 cases, male 4 cases, female 35 cases, age 45-67 years old) underwent rhytidectomy and autologous fat filling at the same time. Group C (39 cases, male 3 cases, female 36 cases, age 45-65 years old) received autologous fat filling 3 months after rhytidectomy. We compared the improvement of facial depression (nasolabial groove and mouth angle), the effect of facial rejuvenation after fat filling in three groups and the incidence of complications in group B and C. Results: 15 cases in group A, 12 cases in group B and 2 cases in group C had no obvious improvement in facial atrophy, the remaining 88 cases had obvious improvement compared with before operation, and achieved the effect of facial rejuvenation. The incidence of complications in group C (7.69%) was significantly lower than that in group B (35.90%), the excellent or good rate of facial improvement and the nasolabial groove and peri-oral depression improvement in group C (87.18%, 92.31%) was significantly higher than that in group B (64.10%, 64.10%) and group A (33.33%, 17.95%) (P<0.05). Conclusions Comparative analysis of fat filling after 3 months of wrinkle removal to improve facial soft tissue atrophy and collapse is more obvious and more permanent in effect than fat filling, which is worthy of clinical promotion.