AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.

Objective:To explore clinical characteristics of multiple sclerosis(MS)patients in Suzhou,and to analyze main factors affecting their prognosis.Methods:General data,clinical symptoms,cerebrospinal fluid and imaging examinations of 51 MS patients admitted to Department of Neurology of the Second Hospital of Soochow University from July 31,2009 to July 31,2021 were retrospectively analyzed,and main factors affecting their prognosis were discussed.Results:Average age of onset of 51 MS patients was(43.3±15.6)years old,female accounted for 56.9%,male/female=1/1.3.Adult onset MS(AOMS)accounted for 62.8%,male/female=1/1.7;late onset MS(LOMS)accounted for 37.2%,male/female=1/0.9.Relapsing remitting MS(RRMS)accounted for 76.5%,and chronic onset accounted for 60.8%.Average annual recurrence rate was 8.8%.The first symptoms were numbness and weakness of limbs.Dizziness and numbness were more common in patients without recurrence after diagnosis of MS,and limb weak-ness and numbness were more common in patients with recurrence.Among lesions of MRI,62.7%(32/51)of periventricular involve-ment,52.9%(27/51)of spinal cord involvement,51.0%(26/51)of infratentorial involvement.Proportion of subtentorial and spinal cord(cervical,thoracic)involved were significantly higher in patients with recurrent MS than without recurrence.Values of albumin,IgG,IgA and IgM in cerebrospinal fluid increased with increase of recurrence times.EDSS score of male was higher than female,and LOMS score was higher than AOMS.MS patients without relapse had a low EDSS score,and median EDSS score at current follow-up was 0(0,1.00)score.MS score with relapse was relatively high,and median EDSS score at current follow-up was 2.75(0.25,7.25)score.Conclusion:MS patients with chronic onset are more common,with a high proportion of LOMS,and proportion of males increases with increasing age of onset.High EDSS score at first onset,cervical,thoracic and subtentorial lesions,increased values of cerebrospinal fluid albumin,IgG,IgA,IgM,age at first onset(50+years old),male associate with poor MS prognosis.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

Objective The aim of this study is to discuss the causal relationship between periodontal disease(PD)and prostate cancer(PCa).Methods A two-sample bidirectional Mendelian randomization(MR)analysis based on publicly statistical data from genome-wide association studies(GWAS)was conducted.MR Egger,weighted medium,simple mode and weighted mode were supplemented,while inverse variance weighted analysis(IVW)was the main method of analysis.Heterogeneity testing,pleiotropy testing and leave-one-out testing were used to assess the sensitivity and stabili-ty.Results The results of MR analysis showed that PD had no significant impact on the occurrence of PCa:East Asian(IVW,PD:OR=1.07,P=0.48);European(IVW,PD:OR=1.00,P=0.37,periodontitis:OR=1.03,P=0.14,chronic gingivitis:OR=0.99,P=0.37,chronic periodontitis:OR=1.03,P=0.22).The reverse MR analysis also did not show a causal relationship between PCa and PD:East Asian(IVW,PD:OR=0.97,P=0.22);European(IVW,PD:OR=0.84,P=0.44,periodontitis:OR=1.01,P=0.75,chronic gingivitis:OR=0.93,P=0.23,chronic periodontitis:OR=0.99,P=0.80).The results of other analysis were consistent with those of IVW analysis.Conclusions The results of our two-sample bidirectional MR analysis do not support a causal relationship between PD and PCa.

Objective To investigate the therapeutic effect of dental pulp stem cells(DPSCs)on autoimmune hepatitis in in vivo and in vitro experiments and the related mechanism.Methods An in vitro co-culture system was used to evaluate the immunoregulatory effect of DPSCs,and 32 mice were randomly divided into healthy control group,model group,positive drug group,and DPSCs treatment group,with 8 mice in each group.The serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and inflammatory factors were measured,and HE staining was used to assess liver pathological injury.An analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results The in vitro experiment showed that the positive rates of CD105,CD73,and CD90 in DPSCs were 99.97%,100%,and 99.53%,respectively,while the positive rates of CD34,HLA-DR,and CD45 were 0.56%,0.17%,and 0,respectively.DPSCs significantly inhibited the proliferation of Th1 and Th17 subsets,with inhibition rates of 31.32%and 45.76%,respectively;DPSCs promoted the proliferation of Treg(CD4+CD25+FoxP3+),with a promoting rate of 52.29%.DPSCs had an inhibition rate of 93.70%on the proliferation of lymphocytes.In the mouse model of autoimmune hepatitis,compared with the model group,the DPSCs treatment group had significant reductions in the serum levels of ALT and AST,with reduction rates of 66.8%and 60.0%,respectively(t=3.321 and 2.907,P=0.007 5 and 0.017 5)and significant reductions in the inflammatory factors tumor necrosis factor-α and interleukin-1β,with reduction rates of 57.5%and 71.3%,respectively(t=2.484 and 2.796,P=0.039 8 and 0.020 6),and histopathological examination showed no significant improvement in periportal bridging necrosis(t=1.969,P=0.098).Conclusion DPSCs effectively alleviate immune-mediated liver injury through immunoregulation,which provides an experimental basis for clinical translation.

Objective:To investigate role of miR-4738-3p in targeting tryptophan 2,3-dioxygenase 2(TDO2)to regulate energy metabolism and inhibit immune escape in thyroid cancer cells.Methods:A total of 68 cases of thyroid cancer tissues and their corresponding adjacent non-cancerous tissues were collected,expressions of miR-4738-3p and TDO2 in tissues and cell lines were de-tected by qRT-PCR,relationship between miR-4738-3p expression and clinicopathological characteristics was analyzed.Effects of miR-4738-3p and TDO2 on proliferation,migration,invasion,energy metabolism and immune escape of TPC-1 and BCPAP cells were examined through CCK-8,clone formation,wound healing,Transwell experiments,biochemical analyses,ELISA and NK cell co-culture experiments,targeting relationship between miR-4738-3p and TDO2 was validated by dual luciferase reporter gene assay.In vivo xenograft experiments and immunohistochemical detections were conducted to observe effects of miR-4738-3p on tumorigenesis and expression of immune escape-related proteins in TPC-1 and BCPAP cells.Results:miR-4738-3p was lowly expressed(P<0.05),while TDO2 was highly expressed in thyroid cancer(P<0.05).Tumor size,lymph node metastasis and TNM staging were correlated with expression of miR-4738-3p(P<0.05).Compared with miR-NC group,miR-4738-3p mimics group exhibited decreased prolifera-tion,clone formation,migration,invasion ability,glucose uptake,lactate production,ATP/ADP ratio,TDO2 mRNA and protein expressions,tumor volume,mass,Ki-67,TDO2 and PD-L1 expressions(P<0.05),NAD+/NADH ratio,IFN-γ,TNF-α levels and NK cell killing rate were increased(P<0.05).miR-4738-3p inhibitor group showed increased proliferation,clone formation,migration,invasion ability,glucose uptake,lactate production,ATP/ADP ratio,TDO2 mRNA and protein expressions(P<0.05),NAD+/NADH ratio,IFN-γ,TNF-α levels and NK cell killing rate were decreased(P<0.05).Binding sites were identified between miR-4738-3p and TDO2,and their expression were negatively correlated(r=-0.485 3,P<0.001).Compared with sh-NC group,proliferation,clone formation,migration,invasion ability,glucose uptake,lactate production and ATP/ADP ratio were decreased in sh-TDO2 group(P<0.05),NAD+/NADH ratio,IFN-γ,TNF-α levels and NK cell killing rate were increased(P<0.05).Compared with Scrambled group,proliferation,clone formation,migration,invasion ability,glucose uptake,lactate production and ATP/ADP ratio were increased in TDO2 group(P<0.05),NAD+/NADH ratio,IFN-γ,TNF-α levels and NK cell killing rate were decreased(P<0.05).Conclusion:miR-4738-3p targets TDO2 to regulate energy metabolism,inhibiting thyroid cancer cell proliferation,metastasis and immune escape.

Objectives:To explore the progress in the application of cardiovascular related innovative patent technologies between China and the United States from 2014 to 2023,and to further analyze the differences in driving forces and policy orientations in the transformation of scientific and technological achievements between the two countries,providing reference data for improving the efficiency of the transformation of cardiovascular scientific and technological achievements in China.Methods:Based on the Himmpat patent database,we searched invention patent application data in the cardiovascular fields by using the Fuwai Subject Headings and adopting the method of the international patent classification(IPC)-title-claims-abstract,from January 1,2014 to December 31,2023(excluding utility model and design patents).Fourteen indicators regarding patent value evaluation were selected as independent variables and the transfer and transformation rate of invention patent family as the dependent variable.Then we construct univariate and multivariate prediction models by utilizing logistic regression to compare and analyze the differences in various predictors for the transformation rate of patent family in the cardiovascular field between the two countries,and calculate the respective population attributable fraction(PAF)for each predictor.Results:Over the past 10 years,there have been 45 413 invention patent family in the cardiovascular field in China,which exceeded the 35 582 invention patent family in the United States.The transformation rate of cardiovascular invention patent family in the United States was 49.77%,while in China it was only 9.18%.In the United States,the transformation rate of invention patent family's applicants involving medical institutions is significantly higher than that of universities,research institutions,and enterprises,with transformation rates of 63.75%,56.74%,50.00%,and 49.76%,respectively.In contrast,in China,the transformation rate of invention patent family in the cardiovascular field is 6.87%in medical institutions and 7.90%in universities,slightly higher in research institutions(10.99%),while the highest rate is in enterprises(15.83%).Moreover,the transformation rates of biomedical invention patent family is higher than that of medical devices in China(9.45%vs.7.81%),while the opposite is true in the United States(42.39%vs.59.03%).The results of PAF based on full multivariate logistic regression,the top three predictors for the transfer and transformation of invention patent family in China are applicants including enterprises(PAF=71.17%),overseas distribution country number more than one(PAF=30.76%),and invention authorized(PAF=29.95%).In the United States,citation frequency exceeding 10 times(PAF=46.92%),overseas distribution country number more than one(PAF=32.56%),and applicants including enterprises(PAF=20.54%)are the top three predictors for the transfer and transformation of invention patent family.Conclusions:Since the implementation of the 13th Five-Year Plan,the number of patent family applications for cardiovascular related inventions in China has surpassed that of the United States.However,the transfer and transformation efficiency of cardiovascular invention patents in China is significantly lower than that of the United States.In depth analysis of the reasons,this study finds it mainly lies in China's insufficient research and development potential for high-value patents,weak awareness of overseas market layout,insufficient motivation for universities and medical institutions to transfer and transform invention patents,and the underutilization of the transformation potential of medical device invention patents as well.

BACKGROUND:The development of artificial intelligence in the medical field is rapidly advancing,with increasing research on its applications in the field of bone trauma.Through bibliometric analysis,this paper analyzed the research hotspots of artificial intelligence in the field of bone trauma in recent years,and predicted the future research trend. OBJECTIVE:To summarize the development history,research status,hot spots,and future development trends of artificial intelligence technology in the field of bone trauma to provide new insights for future research. METHODS:This study selected relevant literature from the Web of Science core database,covering the period from the inception to August 2023,and retrieved 420 articles related to the application of artificial intelligence,machine learning,and deep learning in the field of bone trauma.After manual screening,202 articles related to this article were exported,and Citespace software was used for visual analysis of cooperation of countries,institutions,cited journals,citation analysis,keyword co-occurrence,and other aspects. RESULTS AND CONCLUSION:(1)The overall number of publications from the 202 selected articles showed an upward trend,indicating significant research potential for future studies.The country with the highest centrality and the highest publication volume was the United States.The University of California(USA)was the most prolific research institution.(2)The top five most commonly used keywords in bone trauma research using artificial intelligence were deep learning,artificial intelligence,bone density,machine learning,and diagnosis.The keyword with the highest centrality was bone density,and the keyword with the highest frequency was deep learning.(3)The top 10 most cited reference papers provided comprehensive insights into the feasibility of applying artificial intelligence techniques to the diagnosis of bone trauma from various perspectives.Among them,eight papers focused on bone and joint injuries and deep convolutional neural networks.One paper discussed the use of deep learning in detecting osteoporosis in CT scans to prevent fragility fractures,while another paper explored the correlation between the application of artificial intelligence in identifying changes in skin texture and the recognition of bone characteristics.(4)In the future,the research hotspots of artificial intelligence will mainly focus on the specific study of fractures caused by bone and joint trauma and osteoporosis.The research trend mainly focuses on improving the performance of artificial intelligence algorithms,using new artificial intelligence technologies to accurately classify and quickly and efficiently diagnose bone injuries,especially for the diagnosis of complex and hidden fractures.By establishing finite element analysis models,more standardized evaluations of bone injuries can be achieved.

Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.