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 investigate the changes in eosinophil counts and the activation of microglial cells in the brain tissues of mice at different stages of Angiostrongylus cantonensis infection, and to examine the role of microglia in regulating the progression of angiostrongyliasis and unravel the possible molecular mechanisms. Methods Fifty BALB/c mice were randomly divided into the control group and the 7-d, 14-d, 21-day and 25-d infection groups, of 10 mice in each group. All mice in infection groups were infected with 30 stage III A. cantonensis larvae by gavage, and animals in the control group was given an equal amount of physiological saline. Five mice were collected from each of infection groups on days 7, 14, 21 d and 25 d post-infection, and 5 mice were collected from the control group on the day of oral gavage. The general and focal functional impairment was scored using the Clark scoring method to assess the degree of mouse neurological impairment. Five mice from each of infection groups were sacrificed on days 7, 14, 21 d and 25 d post-infection, and 5 mice from the control group were sacrificed on the day of oral gavage. Mouse brain tissues were sampled, and the pathological changes of brain tissues were dynamically observed using hematoxylin and eosin (HE) staining. Immunofluorescence staining with eosinophilic cationic protein (ECP) and ionized calcium binding adaptor molecule 1 (Iba1) was used to assess the degree of eosinophil infiltration and the counts of microglial cells in mouse brain tissues in each group, and the morphological parameters of microglial cells (skeleton analysis and fractal analysis) were quantified by using Image J software to determine the morphological changes of microglial cells. In addition, the expression of M1 microglia markers Fcγ receptor III (Fcgr3), Fcγ receptor IIb (Fcgr2b) and CD86 antigen (Cd86), M2 microglia markers Arginase 1 (Arg1), macrophage mannose receptor C-type 1 (Mrc1), chitinase-like 3 (Chil3), and phagocytosis genes myeloid cell triggering receptor expressed on myeloid cells 2 (Trem2), CD68 antigen (Cd68), and apolipoprotein E (Apoe) was quantified using real-time quantitative reverse transcription PCR (RT-qPCR) assay in the mouse cerebral cortex of mice post-infection. Results A large number of A. cantonensis larvae were seen on the mouse meninges surface post-infection, and many neuronal nuclei were crumpled and deeply stained, with a large number of bleeding points in the meninges. The median Clark scores of mouse general functional impairment were 0 (interquartile range, 0), 0 (interquartile range, 0.5), 6 (interquartile range, 1.0), 14 (interquartile range, 8.5) points and 20 (interquartile range, 9.0) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.45, P < 0.01), and the median Clark scores of mouse focal functional impairment were 0 (interquartile range, 0), 2 (interquartile range, 2.5), 7 (interquartile range, 3.0), 18 (interquartile range, 5.0) points and 25 (interquartile range, 6.5) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.72, P < 0.01). The mean scores of mice general and focal functional impairment were all higher in the infection groups than in the control group (all P values < 0.05). Immunofluorescence staining showed a significant difference in the eosinophil counts in mouse brain tissues among the five groups (F = 40.05, P < 0.000 1), and the eosinophil counts were significantly higher in mouse brain tissues in the 14-d (3.08 ± 0.78) and 21-d infection groups (5.97 ± 1.37) than in the control group (1.00 ± 0.28) (both P values < 0.05). Semi-quantitative analysis of microglia immunofluorescence showed a significant difference in the counts of microglial cells among the five groups (F = 17.66, P < 0.000 1), and higher Iba1 levels were detected in mouse brain tissues in 14-d (5.75 ± 1.28), 21-d (6.23 ± 1.89) and 25-d infection groups (3.70 ± 1.30) than in the control group (1.00 ± 0.30) (all P values < 0.05). Skeleton and fractal analyses showed that the branch length [(162.04 ± 34.10) μm vs. (395.37 ± 64.11) μm; t = 5.566, P < 0.05] and fractal dimension of microglial cells (1.30 ± 0.01 vs. 1.41 ± 0.03; t = 5.266, P < 0.05) were reduced in mouse brain tissues in the 21-d infection group relative to the control group. In addition, there were significant differences among the 5 groups in terms of M1 and M2 microglia markers Fcgr3 (F = 48.34, P < 0.05), Fcgr2b (F = 55.46, P < 0.05), Cd86 (F = 24.44, P < 0.05), Arg1 (F = 31.18, P < 0.05), Mrc1 (F = 15.42, P < 0.05) and Chil3 (F = 24.41, P < 0.05), as well as phagocytosis markers Trem2 (F = 21.19, P < 0.05), Cd68 (F = 43.95, P < 0.05) and Apoe (F = 7.12, P < 0.05) in mice brain tissues. Conclusions A. cantonensis infections may induce severe pathological injuries in mouse brain tissues that are characterized by massive eosinophil infiltration and persistent activation of microglia cells, thereby resulting in progressive deterioration of neurological functions.

ObjectiveTo establish a nomogram predictive model based on magnetic resonance cholangiopancreatography-related parameters and liver-to-muscle ratio， and to investigate the application value of this model in preoperative assessment of liver reserve function in patients with hepatic space-occupying lesion. MethodsClinical data and Gd-EOB-DTPA MRI imaging data were collected from 112 patients with hepatic space-occupying lesion who were hospitalized and scheduled for surgery in Wuming Hospital of Guangxi Medical University from April 2022 to April 2024. According to the degree of liver injury， the patients were divided into Child-Pugh class A group （65 patients with compensated liver function） and Child-Pugh class B+C group （47 patients with decompensated liver function， including 42 patients with Child-Pugh class B liver function and 5 patients with Child-Pugh class C liver function）. The two groups of patients were measured in terms of liver-to-muscle ratio， relative signal intensity of the common bile duct， and bile duct score in different phases of contrast-enhanced CT scan， and univariate and multivariate Logistic regression analyses were used to identify independent predictive factors and establish a nomogram model. In addition， the receiver operating characteristic （ROC） curve， the calibration curve， and the decision curve were plotted to assess the discriminatory ability， accuracy， and clinical application value of the model. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in liver-to-muscle ratio at 5 minutes （Z=-3.99， P0.001）， 10 minutes （Z=-4.39， P0.001）， 15 minutes （Z=-4.23， P0.001）， and 20 minutes （Z=-5.40， P0.001） during the hepatobiliary phase， the relative enhancement degree of the common bile duct （Z=-4.85， P0.001）， and bile duct score （t=7.99， P0.001）. The multivariate Logistic regression analysis showed that liver-to-muscle ratio at 10 minutes during the hepatobiliary phase （odds ratio ［OR］=0.63， 95% confidence interval ［CI］： 0.44 — 0.90， P0.05）， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase （OR=0.38， 95%CI： 0.17 — 0.82， P0.05）， and bile duct score （OR=0.17， 95%CI： 0.07 — 0.39， P0.05） were independent influencing factors for the preoperative diagnosis of liver function decompensation. The nomogram model established based on liver-to-muscle ratio at 10 minutes during the hepatobiliary phase， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase， and bile duct score had an area under the ROC curve of 0.905 （95%CI： 0.849 — 0.960）， with a sensitivity of 78.7% with a specificity of 89.2%. ConclusionThe nomogram model established based on the liver-to-muscle ratio at 10 and 20 minutes during the hepatobiliary phase and bile duct score can effectively assess the status of liver reserve function in patients with hepatic space-occupying lesion before surgery.

[This corrects the article DOI: 10.1016/j.apsb.2018.08.009.].

Metastasis remains the primary cause of cancer-related mortality worldwide. Circulating tumor cells (CTCs) represent critical targets for metastasis prevention and treatment. Traditional Chinese medicine may prevent lung cancer metastasis through long-term intervention in CTC activity. Tiao-Shen-Zhi-Ai Formular (TSZAF) represents a Chinese medicine compound prescription utilized clinically for lung cancer treatment. This study combined three principal active ingredients from TSZAF into a novel TSZAF monomer combination (TSZAF mc) to investigate its anti-metastatic effects and mechanisms. TSZAF mc demonstrated significant inhibition of proliferation, migration, and invasion in CTC-TJH-01 and LLC cells, while inducing cellular apoptosis in vitro. Moreover, TSZAF mc substantially inhibited LLC cell growth and metastasis in vivo. Mechanistically, TAZSF mc significantly suppressed the Wnt/β-catenin signaling pathway and CXCL5 expression in lung cancer cells and tissues. Additionally, TAZSF mc notably reduced neutrophil infiltration in metastatic lesions. These findings indicate that TSZAF mc inhibits lung cancer growth and metastasis by suppressing the Wnt/β-catenin signaling pathway and reducing CXCL5 secretion, thereby decreasing neutrophil recruitment and infiltration. TSZAF mc demonstrates potential as an effective therapeutic agent for lung cancer metastasis.
Lung Neoplasms/genetics* ; Wnt Signaling Pathway/drug effects* ; Animals ; Humans ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Neoplasm Metastasis/prevention & control* ; Cell Proliferation/drug effects* ; Cell Line, Tumor ; Neutrophil Infiltration/drug effects* ; Down-Regulation/drug effects* ; Cell Movement/drug effects* ; beta Catenin/genetics* ; Apoptosis/drug effects* ; Mice, Inbred C57BL ; Male ; Neoplastic Cells, Circulating/drug effects*

The research of damp-heat syndrome in modern TCM mainly focuses on inflammatory response, water metabolism, lipid metabolism, hemorheology, intestinal flora and so on. Modern omics techniques such as metabolomics and genomics provide a new perspective for the exploration of the micro-mechanism of damp-heat syndrome. The study found that the abnormal expression of aquaporin is closely related to the formation of "dampness" in damp-heat syndrome, and the release of inflammatory factors reflects the pathological characteristics of "heat". Damp-heat syndrome is often accompanied by dyslipidemia, hemorheological changes and intestinal flora imbalance, showing characteristic changes in urine, blood and saliva metabolomics, and there are differences in gene expression between damp-heat constitution and gentleness constitution. In the future, the pertinence and systematicness of research should be strengthened, the relationship between indicators should be deeply explored, build a biomarker system should be built, the immune-metabolic regulation mechanism should be explored, the multi-target mechanism of heat-clearing and dampness-removing Chinese materia medica should be clarified to further improve the damp-heat syndrome system, and provide theoretical support for clinical treatment.

Objective To explore the association between disease activity and health utility values(HUV)in patients with rheumatoid arthritis(RA)in China,and to analyze other factors that may affect health utility values,providing a basis for individualized treatment and health management for RA patients.Methods Based on the Chinese Registry of Rheumatoid arthritis cohort,this study included 1 017 diagnosed RA patients.The EQ-5D-3L scale was used to assess the health utility values,while clinical data,disease activity,and potential influencing fac-tors(such as age,gender,and comorbidities)were collected.Tobit regression models were employed to analyze the association between disease activity and health utility values,and to investigate other potential influencing factors.Results The median health utility value for RA patients was 0.78[0.59,0.89].Patients with moderate to high dis-ease activity had significantly lower health utility values as compared to those in remission phase or with low disease activity(median 0.70 vs.0.87,P＜0.001).Tobit regression analysis showed a significant association between disease activity and health utility values(P＜0.001).Additionally,older age,female gender,use of glucocorticoids,and co-morbidity with diabetes were associated with lower health utility values(P＜0.05).Conclusions Health utility values of RA patients are closely related to disease activity,with higher disease activity leading to a significant reduction in health utility values.Early control of RA disease activity may help improve patients' quality of life.

Objective To establish a multi-state Markov model of systemic lupus erythematosus(SLE)for patients in China and to explore the transition rule of organ damage accumulation and possible factors affecting the transition between states.Methods A retrospective cohort study was conducted using the data from CSTAR.The Systemic Lu-pus International Collaborating Clinics/American College of Rheumatology Damage Index(SDI)was divided into five irreversible disease states(SDI=0,1,2,≥3,and death,marked as S0,S1,S2,S3,Death).The R"mstate"package was used for statistical analysis.Results This study included 23 926 cases of SLE patients with cumulative follow-up of 12 030 visits.Among these patients,21 070 patients had no any organ damage at baseline.At the follow-up period,the transition probabilities of organ damage of S0→S1,S1→S2,S2→S3,S3→Death were 7.01％,12.58％,10.64％,and 12.19％,respectively.The multi-state Markov model showed that age,gender,disease dura-tion,SLEDAI score,corticosteroid dosage,and involvement of major organs were associated with the transition of or-gan damage status,each 1 year increased was associated with a 2％～3％increase in risk of damage accumulation risk(P＜0.01).Also,neurological(S0→S 1:HR=1.34;S1 →S2:HR=1.53;S2→S3:HR=1.73),cardiopulmonary(S0→S1:HR=3.66;S 1→S2:HR=1.51;S2→S3:HR=1.52),renal(S0→S 1:HR=1.24)and hematological involvement(S0→S1:HR=1.24)might be the risk factors.Conclusions The probability of organ damage accumulation in SLE pa-tients increases over time.Therefore,in the early stage of the disease,the involvement of important organs needs to be minimized and the treatment strategy should be dynamically adjusted at different stages of treatment.

As a non-invasive， simple， and reproducible examination， Gd-EOB-DTPA-enhanced magnetic resonance imaging （MRI） has an important application value in evaluating liver reserve function. Currently in clinical practice， Gd-EOB-DTPA-enhanced MRI is mainly used to measure liver parenchymal signal intensity parameters， magnetic resonance relaxation time parameters， biliary tract enhancement parameters， and liver volume parameters to evaluate the liver reserve function of patients. In recent years， the use of Gd-EOB-DTPA-enhanced MRI in predicting liver reserve function in residual liver tissue after liver tumor surgery has become one of the hotspots in clinical research， and certain progress has been made in related studies in China and globally. This article reviews the research advances in recent years.

Objective To assess the application value of sequential non-invasive prenatal testing(NIPT)for pregnant women with abnormal single values of early Down's screening.Methods A total of 1 631 pregnant women with abnormal single values of traditional early Down's screening were selected from Shenzhen Long-hua Maternal and Child Health Hospital from January to October in 2022,and all of them voluntarily under-went NIPT with signed informed consent.The high-risk samples screned by NIPT wre conducted invasive prenatal diagnosis and tracked pregnancy outcomes,and yet low-risk pregnant women was followed up after the due date.Results Among all the pregnant women,a total of 10 high-risk samples of fetal chromosomal aneuploidy were detected by sequential NIPT,including 1 case of trisomy 21,1 case of trisomy 18,7 cases of sex chromosome abnormalities,and 1 case of other autosomal abnormalities.9 cases of high-risk pregnant women received invasive prenatal diagnosis,and 5 cases were consistent with NIPT results,which had yielded a positive predictive value of 55.56％.Among them,the positive predictive values of trisomy 21,trisomy 18,sex chromosome abnormalities and other autosomal abnormalities were 100.00％,100.00％,50.00％,0.00％,resepectively.Conclusion Sequential NIPT could improve the detection of defective children in pregnant women with abnormal single values of early Down's screening,which has certain guiding value for expanding screening to reduce the birth of defective children.In view of its low positive predictive value,pregnant women with abnormal single value of Down's screening should be paid more attention,and further prenatal diagnosis may be necessary to reduce the birth rate of defective children.