Objective To compare the efficacy of stenting in the treatment of idiopathic intracranial hypertension(IIH)complicated by different types of venous sinus stenosis(VSS).Methods The clinical data of 48 patients with IIH complicated by VSS,who received stenting therapy at the First Affiliated Hospital of Zhengzhou University of China from January 2019 to September 2023,were retrospectively analyzed.According to the type of VSS,the patients were divided into intrinsic stenosis group(n=20)and the extrinsic stenosis group(n=28).The improvement of symptoms,Frisén grade of papilledema,lumbar puncture opening pressure(LPOP),trans-stenosis pressure gradient(△P)of VSS,and surgery-related complications were compared between the two groups.Results The mean age of the patients in the intrinsic stenosis group was greater than that of the patients in the extrinsic stenosis group(41.60 years vs.35.25 years,P=0.049).The length of the narrowed segment in the extrinsic stenosis group was 22.5 mm,which was significantly longer than 19.0 mm in the intrinsic stenosis group(P=0.007).The postoperative Frisén grade of papilledema in the extrinsic stenosis group was obviously lower than that in the intrinsic stenosis group(P=0.037).No statistically significant differences in the other clinical data existed between the two groups(all P＞0.05).After stenting,all of the median △P,mean LPOP,and median Frisén grade of papilledema were decreased significantly when compared with their preoperative values(all P＜0.001),and the postoperative 3-day median Frisén grade of papilledema in the extrinsic stenosis group was much lower(P=0.037).The patients were followed up for one year,the clinical symptoms of the patients in both groups were improved to varying degrees.At the time of discharge,the proportion of patients having no symptoms of papilledema in the extrinsic stenosis group was 57.1％,which was higher than 22.2％in the intrinsic stenosis group(P=0.049),and no statistically significant differences in the improvements of other symptoms existed between the two groups(all P＞0.05).There was no significant difference in the incidence of complications between the two groups(P=0.563).Conclusion Venous sinus stenting can effectively treat patients with IIH complicated by different types of VSS.

Objective To compare the clinical efficacy of medication and stenting in treating patients with idiopathic intracranial hypertension complicated by venous sinus stenosis.Methods The clinical data of 74 patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,who were admitted to the First Affiliated Hospital of Zhengzhou University of China from January 2020 to June 2023,were retrospectively analyzed.The patients were divided into medication group(n=35,receiving drug therapy)and stenting group(n=39,receiving stent implantation therapy).Before and after treatment,lumbar puncture and fundus examinations were performed,and the postoperative improvements in intracranial pressure and papillary oedema were evaluated.The changes in the median papillary oedema Frisén grade and the average opening pressure of lumbar puncture were compared between the two groups during hospitalization period.The improvement degrees of the clinical symptoms determined at discharge,as well as at the 6 months and 12 months after discharge were compared between the two groups.The incidence of complications during the follow-up period in the two groups was recorded.Results The time interval from onset to treatment in the stenting group was longer than that in the medication group(2 months vs.one month,P=0.021),and the differences in the other baseline data between the two groups were not statistically significant(all P＞0.05).After treatment,different degrees of improvement were obtained in both groups(all P＞0.05).At the time of discharge,the degree of median papillary oedema in the stenting group was Frisén grade I,which was lower than Frisén grade Ⅱ in the medication group(P=0.011);the average opening pressure of lumbar puncture in the stenting group was 205.26 mm H2O,which was lower than 248.14 mm H2O in the medication group(P=0.002).The proportions of patients having no symptom or showing symptom improvement in the stenting group and in the medication group at the time of discharge were 74.4％and 45.7％respectively(P=0.017),which at the time of 6 months after discharge were 84.6％and 48.6％respectively(P=0.001)and at the time of 12 months after discharge were 87.2％and 57.1％respectively(P=0.004).No statistically significant difference in the incidence of complications existed between the two groups(10.3％and 8.6％respectively,P=1.000).Conclusion For the treatment of patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,stent implantation therapy is superior to medication therapy in quickly and effectively relieving papillary oedema,decreasing lumbar puncture opening pressure,and improving their corresponding symptoms and signs,with satisfactory patient's prognosis and clinical safety.

Objective To compare the efficacy of anticoagulation treatment(AT)alone and combining mechanical thrombectomy(MT)for cerebral venous sinus thrombosis(CVST).Methods Totally 150 patients with CVST were collected,including 90 underwent only AT(AT group)and 60 underwent MT+AT(combined group).The rate of venous sinus recanalization at discharge,the prognosis at discharge and 6,12 months after discharge(modified Rankin scale[mRS]score of 0 to 2 was considered as good prognosis)were compared between groups,and relative complications were recorded.Results At discharge,the rate of complete and partial recanalization of venous sinuses in combined group were both higher than that in AT group(both P＜0.001).No significant difference of the rate of good prognosis at discharge was found between groups(P=0.191),while 6 and 12 months after discharge,the rate of good prognosis in combined group were both higher than that in AT group(P=0.046,0.028).During the treatment and follow-up period,no significant difference of the incidence of complications was found between groups(5.00%[3/60]vs.11.11%[10/90],P=0.245).Conclusion Compared with AT alone,AT combining with MT could improve revascularization rate and prognosis of CVST without increasing the risk of complications.

Objective To explore the protective effect and mechanism of miR-202-5p on acute respiratory distress syndrome(ARDS)-induced lung injury in neonatal rats.Methods Sixty newborn SD rats were randomly divided into six groups:the control group(intraperi-toneal injection of normal saline by tail vein),ARDS group(ARDS model established via intraperitoneal injection of 4 mg/kg lipopolysac-charide by tail vein),ARDS+miR-NC group(ARDS rats receiving 2 mg/kg miR-NC via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p group(ARDS rats receiving 2 mg/kg miR-202-5p via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p+ov-NC group,and ARDS+miR-202-5p+ov-ROCK1 group(ARDS rats receiving 2 mg/kg miR-202-5p once every 4 h,with intervention for 12 h;with 6 × 108 plaque-forming units control or overexpression ROCK adenovirus administered via tail vein 3 days before lipopolysaccharide injection).Real-time quantitative PCR was employed to measure miR-202-5p and ROCK1 mRNA expression in rat lung tissue.Hematoxylin and eosin staining was performed to assess pathological lung injury.The lung tissue wet-to-dry weight ratio was determined to evaluate pulmonary edema.Western blotting was utilized to analyze ROCK1,Toll-like receptor 4(TLR4),phosphorylated-nuclear factor κB(p-NF-κB)p65,and phosphorylated-inhibitor of nuclear factor-κBα(p-IκBα)protein expression in lung tissue.The interaction between miR-202-5p and ROCK1 was validated using dual-luciferase reporter gene experiments.Results miR-202-5p expression was significantly down-regulated in ARDS rat lung tissue,while overexpression of miR-202-5p ameliorated pathological injury and pulmonary edema in ARDS rats.ROCK1 mRNA was upregulated in ARDS rat lung tissue;however,overexpression of miR-202-5p decreased the expression of ROCK1 in lung tissue of ARDS rats,while overexpression of ROCK1 reversed the protective effect of overexpression of miR-202-5p on lung injury in ARDS rats.Furthermore,miR-202-5p overexpression suppressed TLR4,p-NF-κB p65,and p-IκBα protein expression in ARDS rat lung tissue,an effect that was reversed by ROCK1 overexpression.Dual-luciferase reporter gene experiments confirmed that miR-202-5p directly targets ROCK1 mRNA 3'UTR.Conclusion miR-202-5p ameliorates ARDS-in-duced lung injury in neonatal rats through targeted suppression of ROCK1 expression,with the underlying mechanism potentially involving inhibition of ROCK1-mediated TLR4/NF-κB signaling pathway activation.

Objective To compare the efficacy of anticoagulation treatment(AT)alone and combining mechanical thrombectomy(MT)for cerebral venous sinus thrombosis(CVST).Methods Totally 150 patients with CVST were collected,including 90 underwent only AT(AT group)and 60 underwent MT+AT(combined group).The rate of venous sinus recanalization at discharge,the prognosis at discharge and 6,12 months after discharge(modified Rankin scale[mRS]score of 0 to 2 was considered as good prognosis)were compared between groups,and relative complications were recorded.Results At discharge,the rate of complete and partial recanalization of venous sinuses in combined group were both higher than that in AT group(both P＜0.001).No significant difference of the rate of good prognosis at discharge was found between groups(P=0.191),while 6 and 12 months after discharge,the rate of good prognosis in combined group were both higher than that in AT group(P=0.046,0.028).During the treatment and follow-up period,no significant difference of the incidence of complications was found between groups(5.00%[3/60]vs.11.11%[10/90],P=0.245).Conclusion Compared with AT alone,AT combining with MT could improve revascularization rate and prognosis of CVST without increasing the risk of complications.

Objective To explore the protective effect and mechanism of miR-202-5p on acute respiratory distress syndrome(ARDS)-induced lung injury in neonatal rats.Methods Sixty newborn SD rats were randomly divided into six groups:the control group(intraperi-toneal injection of normal saline by tail vein),ARDS group(ARDS model established via intraperitoneal injection of 4 mg/kg lipopolysac-charide by tail vein),ARDS+miR-NC group(ARDS rats receiving 2 mg/kg miR-NC via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p group(ARDS rats receiving 2 mg/kg miR-202-5p via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p+ov-NC group,and ARDS+miR-202-5p+ov-ROCK1 group(ARDS rats receiving 2 mg/kg miR-202-5p once every 4 h,with intervention for 12 h;with 6 × 108 plaque-forming units control or overexpression ROCK adenovirus administered via tail vein 3 days before lipopolysaccharide injection).Real-time quantitative PCR was employed to measure miR-202-5p and ROCK1 mRNA expression in rat lung tissue.Hematoxylin and eosin staining was performed to assess pathological lung injury.The lung tissue wet-to-dry weight ratio was determined to evaluate pulmonary edema.Western blotting was utilized to analyze ROCK1,Toll-like receptor 4(TLR4),phosphorylated-nuclear factor κB(p-NF-κB)p65,and phosphorylated-inhibitor of nuclear factor-κBα(p-IκBα)protein expression in lung tissue.The interaction between miR-202-5p and ROCK1 was validated using dual-luciferase reporter gene experiments.Results miR-202-5p expression was significantly down-regulated in ARDS rat lung tissue,while overexpression of miR-202-5p ameliorated pathological injury and pulmonary edema in ARDS rats.ROCK1 mRNA was upregulated in ARDS rat lung tissue;however,overexpression of miR-202-5p decreased the expression of ROCK1 in lung tissue of ARDS rats,while overexpression of ROCK1 reversed the protective effect of overexpression of miR-202-5p on lung injury in ARDS rats.Furthermore,miR-202-5p overexpression suppressed TLR4,p-NF-κB p65,and p-IκBα protein expression in ARDS rat lung tissue,an effect that was reversed by ROCK1 overexpression.Dual-luciferase reporter gene experiments confirmed that miR-202-5p directly targets ROCK1 mRNA 3'UTR.Conclusion miR-202-5p ameliorates ARDS-in-duced lung injury in neonatal rats through targeted suppression of ROCK1 expression,with the underlying mechanism potentially involving inhibition of ROCK1-mediated TLR4/NF-κB signaling pathway activation.

The advancement of computers and data explosion have ushered in the third wave of artificial intelligence(AI). AI is an interdisciplinary field that encompasses new ideas, new theories, and new technologies, etc. AI has brought convenience to ophthalmology application and promoted its intelligent, precise, and minimally invasive development. At present, AI has been widely applied in various fields of ophthalmology, especially in oculoplastic surgery. AI has made rapid progress in image detection, facial recognition, etc., and its performance and accuracy have even surpassed humans in some aspects. This article reviews the relevant research and applications of AI in oculoplastic surgery, including ptosis, single eyelid, pouch, eyelid mass, and exophthalmos, and discusses the challenges and opportunities faced by AI in oculoplastic surgery, and provides prospects for its future development, aiming to provide new ideas for the development of AI in oculoplastic surgery.

Objective To compare therapeutic efficacy of anticoagulation alone and combining with intervention for treating severe cerebral venous thrombosis(CVT).Methods Data of 65 severe CVT patients were retrospectively analyzed.The patients were divided into anticoagulation group(n=32)or combined group(n=33)according to therapeutic methods.The modified Rankin scale(mRS)score at admission and discharge,the prognosis of patients,vascular recanalization rate as well as incidence of complications during follow-up period were compared between groups.Results No significant difference of mRS scores at admission was found between groups(P＞0.05),while mRS scores of combined group were lower than of anticoagulation group at discharge(P＜0.05).The rate of good prognosis at discharge(84.85%vs.59.38%),6 months after discharge(87.88%vs.65.63%)and 12 months after discharge(93.94%vs.75.00%)in combined group were all higher than those in anticoagulation group(all P＜0.05).The vascular recanalization rate in combined group was higher than that in anticoagulant group(100%vs.75.00%,P＜0.05).At the end of follow-up,no significant difference of complication incidence was found between groups(15.15%vs.18.75%,P＞0.05).Conclusion For patients with severe CVT,anticoagulation combined with interventional therapy could significantly alleviate clinical symptoms and improve prognosis compared with anticoagulation alone.

Objective To observe the value of stent implantation for treating idiopathic intracranial hypertension(IIH)complicated with venous sinus stenosis(VSS).Methods Data of 54 patients with IIH complicated with VSS who underwent stent implantation were retrospectively analyzed.The papillary edema grade,lumbar puncture-opening pressure(LP-OP)and trans-stenotic pressure gradient of venous sinus(ΔP)before and after stent implantation were compared,and the symptom improvement and treatment-related complications during the follow-up period were recorded.Results Totally 60 stents were successfully implanted in 54 patients.Before stent implantation,the papillary edema grade was 3(3,3),LP-OP was(391.39±92.62)mmH2O and the ΔP was 18.50(15.00,25.00)mmHg,which decreased to 1(0,1),(208.80±62.31)mmH2O and 1.25(0.88,2.55)mmHg after stent implantation,respectively,all with significant differences(all P＜0.001).Clinical symptoms improved after stent implantation in all 54 patients.At the end of follow-up,disappearance of headache,papillary edema,visual disorder,abducent nerve paralysis and tinnitus were noticed in 30(30/37,81.08%),38(38/45,84.44%),41(41/45,91.11%),8(8/10,80.00%)and 9 cases(9/10,90.00%),respectively.Treatment-related complications occurred in 4 cases(4/54,7.41%),all improved after intervention.Conclusion Stent implantation was effective and safe for treating IIH complicated with VSS.

Objective:To investigate the predictive role of relative diffusion-weighted imaging (DWI) signal intensity (DWI-rSI) in outcome in patients with anterior circulation large vessel occlusion cardioembolic stroke and successful recanalization after endovascular therapy (EVT).Methods:Patients with anterior circulation large vessel occlusion stroke due to cardioembolic embolism underwent EVT and successful recanalization at the Affiliated Hospital of Yangzhou University from March 2017 to March 2023 were retrospectively included. According to the modified Rankin Scale score 3 months after procedure, the patients were divided into a good outcome group (0-2 points) and a poor outcome group (3-6 points). Multivariate logistic regression analysis was used to identify independent predictive factors for poor outcome. Results:A total of 59 patients were enrolled, including 29 males (49.2%), median age of 74 years (interquartile range, 68-80 years). The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 15 (12-21), and the median DWI Alberta Stroke Program Early CT Score (ASPECTS) was 8 (5-9). Thirty-two patients (54.2%) had good outcome, and 27 (45.8%) had poor outcome. Among them, 9 patients (15.3%) died (6 died from cerebral herniation after malignant brain edema, 2 died from complications, and 1 died from severe intracranial hemorrhage after procedure). Twenty-one patients (35.6%) experienced hemorrhagic transformation, including 12 (20.3%) with symptomatic intracranial hemorrhage. There were significant differences in baseline systolic blood pressure, NIHSS score, DWI-ASPECTS, DWI-rSI, and incidence of symptomatic intracranial hemorrhage between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio 0.977, 95% confidence interval 0.919-0.991; P=0.015) and DWI-rSI (odds ratio 11.809, 95% confidence interval 1.932-72.170; P=0.008) were the independent predictors for poor outcome. Conclusion:DWI-rSI can predict the outcome of patients with anterior circulation large vessel occlusion cardioembolic stroke and successful recanalization after EVT.