Objective To observe the value of whole brain CT perfusion(CTP)-derived arterial phase images combined with artificial intelligence iterative reconstruction(AIIR)for evaluating acute ischemic stroke(AIS).Methods Fifty AIS patients were prospectively enrolled,and whole brain CTP followed by routine CT angiography(CTA)were performed.CTP images were reconstructed using AIIR(CTP-AIIR group)and hybrid iterative reconstruction(HIR,CTP-HIR group),respectively,and CTA images were derived from CTP at the arterial phase.Meanwhile,routine CTA images were obtained using HIR(CTA-HIR group).Then image quality was subjectively evaluated with a 5-point scale.The noise of basilar artery trunk,cavernous segment of internal carotid artery,M1 segment of middle cerebral artery and the brain parenchyma were calculated,and signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the above 3 arteries were measured.Taken digital subtraction angiography as the reference standard,the accuracy of CTP and CTA for localizing the responsible vessel of AIS was assessed.Results In CTP-AIIR group,the subjective scoring of 4 subjective metrics,including image noise,sharpness of vessel margin,small vessel visibility and overall diagnosability were significantly higher than,the noise of 3 arteries and brain parenchyma were lower than,and SNR and CNR of 3 arteries were higher than those in CTP-HIR group and CTA-HIR group(all P＜0.017).The diagnostic accuracy of responsible vessel based on CTP-AIIR group and CTA-HIR group were both 96.00％ (48/50),not significantly different with that in CTP-HIR group(44/50,88.00％ )(P=0.142).Conclusion Whole brain CTP-derived arterial phase CTA combined with AIIR could achieve comparable image quality and diagnostic performance of routine CTA for evaluating AIS.

Presbyopia is a physiological phenomenon related to age, in which there is a progressive difficulty in near vision due to decreased accommodation ability. It is one of the main reasons for the decline in visual related quality of life of people over 40 years old. The therapeutic objective is to improve symptoms, enhance functional near vision, and achieve the goal of restoring self-accommodation. A multitude of correction strategies are available, conventional spectacles is the simplest and safest method, which including monofocal, bifocal, trifocal, or gradient multifocal glasses. With the increasing demand for visual quality, corneal contact lenses and presbyopia correction surgeries(corneal refractive surgery, intraocular surgery, and scleral surgery)are becoming more and more accepted. The goal of these surgeries is to correct existing refractive errors while properly addressing the issue of decreased accommodation ability. At the same time, research on pharmacological interventions for presbyopia has been increasing year by year, including miotics and lens softeners, to improve the symptoms of presbyopia through different mechanisms. This article provides a review of relevant literature on presbyopia correction in recent years.

Objective:To compare the burden of benign prostatic hyperplasia（BPH）between China and the United States from 1990 to 2021.Methods:The prevalence，incidence，years lived with disability（YLD），and their age-standardized rates for BPH in China and the United States from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021（GBD 2021）. The average annual percentage change（AAPC）of the age-standardized incidence rate（ASIR）and the age-standardized YLD rate（ASYR）was calculated using Joinpoint regression analysis. In addition，the YLD burden of BPH，prostate cancer，kidney cancer，bladder cancer，and three other urological diseases were compared between the two countries.Results:From 1990 to 2021，the number of BPH cases in China increased from 1.460 4 million to 3.244 5 million，the number of prevalent cases rose from 9.940 5 million to 23.111 2 million，and YLDs grew from 0.2 million person-years to 0.460 2 million person-years，with AAPCs of 2.63%，2.78%，and 2.75%，respectively. In 2021，the numbers of incident cases，prevalent cases，and YLDs were 0.577 9 million，4.930 3 million，and 0.095 9 million person-years in the United States，and 13.787 6 million，112.502 million，and 2.235 7 million person-years globally. China’s ASIR decreased from 363.07/100 000 to 299.14/100 000（AAPC -0.60%），and ASYR from 57.33/100 000 to 45.84/100 000（AAPC -0.70%），both of which were higher than those in the United States but lower than the global level. Age-specific analyses showed declining incidence and YLD rates across all age groups in China，while certain age groups in the United States demonstrated increasing trends. From 1990 to 2021，the proportion of YLDs attributable to BPH among seven urological diseases in China rose from 61.4% to 69.2%. In 2021，YLDs due to prostate cancer accounted for the highest proportion among seven urinary system diseases in the United States，reaching 54.5%. Projections indicate that although ASIR and ASYR in China will decline from 2022 to 2040，the absolute numbers of incident cases and YLDs are projected to continue to rise，reaching 4.97 million and 0.78 million，respectively，by 2040.Conclusions:Between 1990 and 2021，the number of incidence cases，prevalence cases，and YLDs of BPH in China increased markedly，while ASIR and ASYR declined. The disease burden of BPH remains substantial，with a higher proportion of YLDs among urological diseases compared with the United States. By 2040，the number of BPH cases and YLDs in China is projected to further increase，underscoring the need for greater public health attention.

Objective To observe the value of whole brain CT perfusion(CTP)-derived arterial phase images combined with artificial intelligence iterative reconstruction(AIIR)for evaluating acute ischemic stroke(AIS).Methods Fifty AIS patients were prospectively enrolled,and whole brain CTP followed by routine CT angiography(CTA)were performed.CTP images were reconstructed using AIIR(CTP-AIIR group)and hybrid iterative reconstruction(HIR,CTP-HIR group),respectively,and CTA images were derived from CTP at the arterial phase.Meanwhile,routine CTA images were obtained using HIR(CTA-HIR group).Then image quality was subjectively evaluated with a 5-point scale.The noise of basilar artery trunk,cavernous segment of internal carotid artery,M1 segment of middle cerebral artery and the brain parenchyma were calculated,and signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the above 3 arteries were measured.Taken digital subtraction angiography as the reference standard,the accuracy of CTP and CTA for localizing the responsible vessel of AIS was assessed.Results In CTP-AIIR group,the subjective scoring of 4 subjective metrics,including image noise,sharpness of vessel margin,small vessel visibility and overall diagnosability were significantly higher than,the noise of 3 arteries and brain parenchyma were lower than,and SNR and CNR of 3 arteries were higher than those in CTP-HIR group and CTA-HIR group(all P＜0.017).The diagnostic accuracy of responsible vessel based on CTP-AIIR group and CTA-HIR group were both 96.00％ (48/50),not significantly different with that in CTP-HIR group(44/50,88.00％ )(P=0.142).Conclusion Whole brain CTP-derived arterial phase CTA combined with AIIR could achieve comparable image quality and diagnostic performance of routine CTA for evaluating AIS.

Objective:To compare the burden of benign prostatic hyperplasia（BPH）between China and the United States from 1990 to 2021.Methods:The prevalence，incidence，years lived with disability（YLD），and their age-standardized rates for BPH in China and the United States from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021（GBD 2021）. The average annual percentage change（AAPC）of the age-standardized incidence rate（ASIR）and the age-standardized YLD rate（ASYR）was calculated using Joinpoint regression analysis. In addition，the YLD burden of BPH，prostate cancer，kidney cancer，bladder cancer，and three other urological diseases were compared between the two countries.Results:From 1990 to 2021，the number of BPH cases in China increased from 1.460 4 million to 3.244 5 million，the number of prevalent cases rose from 9.940 5 million to 23.111 2 million，and YLDs grew from 0.2 million person-years to 0.460 2 million person-years，with AAPCs of 2.63%，2.78%，and 2.75%，respectively. In 2021，the numbers of incident cases，prevalent cases，and YLDs were 0.577 9 million，4.930 3 million，and 0.095 9 million person-years in the United States，and 13.787 6 million，112.502 million，and 2.235 7 million person-years globally. China’s ASIR decreased from 363.07/100 000 to 299.14/100 000（AAPC -0.60%），and ASYR from 57.33/100 000 to 45.84/100 000（AAPC -0.70%），both of which were higher than those in the United States but lower than the global level. Age-specific analyses showed declining incidence and YLD rates across all age groups in China，while certain age groups in the United States demonstrated increasing trends. From 1990 to 2021，the proportion of YLDs attributable to BPH among seven urological diseases in China rose from 61.4% to 69.2%. In 2021，YLDs due to prostate cancer accounted for the highest proportion among seven urinary system diseases in the United States，reaching 54.5%. Projections indicate that although ASIR and ASYR in China will decline from 2022 to 2040，the absolute numbers of incident cases and YLDs are projected to continue to rise，reaching 4.97 million and 0.78 million，respectively，by 2040.Conclusions:Between 1990 and 2021，the number of incidence cases，prevalence cases，and YLDs of BPH in China increased markedly，while ASIR and ASYR declined. The disease burden of BPH remains substantial，with a higher proportion of YLDs among urological diseases compared with the United States. By 2040，the number of BPH cases and YLDs in China is projected to further increase，underscoring the need for greater public health attention.

Objectives:To report a novel mutation site in the pathogenic gene TTR of transthyretin cardiac amyloidosis(ATTR-CA),and to identify family members at risk,and provide suitable clinical diagnosis and treatment. Methods:A retrospective analysis was conducted on the clinical data of the proband with ATTR-CA who visited the Department of Cardiology,the First Affiliated Hospital of Zhengzhou University in March 2021.The proband underwent whole exome sequencing using high-throughput methods to detect mutation genes.Sanger sequencing was used to test candidate pathogenic loci in suspected family members,and relevant literature was reviewed. Results:Among 51 individuals spanning 5 generations in the pedigree,10 family members(including the proband)carried the heterozygous TTR gene c.163A>G mutation,resulting in the amino acid residue at position 55 changing from lysine(Lys)to glutamic acid(Glu).This mutation follows an autosomal dominant inheritance pattern,with early onset in adulthood,rapid progression,and presenting as a mixed-type ATTR-CA.Five mutation carriers had different clinical manifestations,while the remaining 5 mutation carriers,who are at younger age,have not yet shown symptoms.Within the pedigree,7 individuals died(the proband's uncle[Ⅱ-1]who died from stroke at 65 years old,the rest 6 family members died from heart disease before the age of 50). Conclusions:According to the American College of Medical Genetics and Genomics guidelines,TTR gene Lys55Glu mutation is classified as likely pathogenic,this mutation site has not been reported in the literature before.Present study adds clinical evidence that might broaden the spectrum of TTR mutations.

In order to facilitate the accurate comprehension and correct implemention of the national occupational health standard Health standard for operators of nuclear power plants (GBZ/T 164-2022), this article presents an in-depth elucidation encompassing the significance of the standard promulgation, the background of its revision, the current status of the relevant domestic and international standards, the basis for revision of the principal technical inclusion and the application scope of the standard. The aim is to provide a guidance the selection, appropriate evaluation, and occupational health monitoring of nuclear power plant operators, ultimately ensuring the safe operation of nuclear facilities.

Objective To explore the MRI features of struma ovarii(SO).Methods The clinical and MRI data of 14 cases of SO confirmed by operation and pathology were collected.The lesions'site,morphology,signal characteristics,and the enhancement mode of different internal components were analyzed,and the MRI features of the lesions were summarized.Results All 14 cases had uni-lateral onset,8 cases on the left side,and 6 cases on the right side.8 cases were cystic-solid,and 6 cases were cystic.11 cases were multilocular and 3 cases were unilocular.MRI signals were mixed(high,equal,and low signals all could appear),11 cases had at least two places of extremely low signal on T2WI in the lesions,and 12 cases had slightly high or high signal on T1WI in the lesions.The diffusion of the lesions was not limited,or the solid component,thicker septation,and cystic wall were limited to different degrees.The solid component,septation,and cystic wall of the lesions were enhanced significantly,but the cystic cavity was not enhanced.Conclusion MRI features of SO:unilateral ovarian multilocular cystic-solid or cystic mass;mixed signals,extremely low signal on T2WI,slightly high or high signal on T1WI;no limitation on the diffusion of the lesion,or solid component,thicker septation and cystic wall are limited to different degrees;the solid component,septation and cystic wall of the lesion are enhanced significantly.

The quality evaluation of the blind method is to evaluate the clinical blind data obtained from clinical trials adopting the blind method and judge the effectiveness of the blind method by investigating the blind effect of different blind objects. A successful blind method can avoid the influence of subjective factors on the test results of subjects and researchers to a certain extent. The quality evaluation of the blind method can reflect not only the effectiveness of the blind method but also the accuracy and credibility of clinical trial results. In recent years， randomized controlled trials have been widely used in the evaluation of the clinical efficacy of traditional Chinese medicine （TCM）， but the quality of the implementation of blind methods is uneven， and the evaluation criteria have not yet been formed. In this paper， the data collection methods， calculation principles， advantages， and disadvantages of two quantitative quality evaluation methods of blind methods， namely James Blinding Index （JBI） and Bang Blinding Index （BBI）， were introduced. The two indexes were analyzed in a randomized controlled trial of acupuncture and moxibustion to relieve postoperative oral pain. The calculation process of the results was demonstrated by R software and visualized by forest map. At the same time， a tool table was designed to facilitate the collection of evaluation data of blind methods in TCM clinical trials at different stages. Finally， the necessity and feasibility of quality evaluation of blind method in TCM research were discussed to provide a basis for evaluating and improving the quality of blind method implementation in TCM clinical trials.

Objective To investigate the associations between thyroid hormone sensitivity indices in euthyroid patients with hypertension and the risk of ischemic stroke,as well as gender difference in this association.Methods We selected 760 hypertensive patients admitted to the Geriatric Neurology Department and outpatient clinic in The Second Affiliated Hospital of Xi'an Jiaotong University between April 2021 and May 2022.We collected their basic characteristics,blood biochemical parameters,thyroid indices,and brain magnetic resonance imaging information.All the patients were divided into two groups based on the clinical manifestations and brain magnetic resonance imaging:hypertension combined with ischemic stroke(n=526)and control(n=234)groups.Independent sample t-tests or non-parametric tests were used to compare the differences in thyroid hormone sensitivity indicators between the two groups.Spearman correlation analysis was used to analyze the correlation between serum thyroid indices and ischemic stroke.Multivariate conditional Logistic regression analysis was made to estimate odds ratios(ORs)and 95％confidence intervals(CIs)for thyroid indices and ischemic stroke.Results There were statistically significant differences between the two groups in terms of age,gender,TC,LDL-c,HDL-c,systolic blood pressure,FT3/FT4,TFQI,and PTFQI(all P＜0.05).However,there was no statistically significant difference between the two groups in weight,smoking,drinking,history of diabetes,TG,FBG,diastolic blood pressure,TSHI,or TT4RI(all P＞0.05).The results of Spearman correlation analysis showed a negative correlation between FT3/FT4 and ischemic stroke(P＜0.05),but a positive correlation of TFQI and PTFQI with ischemic stroke(P＜0.05)in euthyroid patients with hypertension.Logistic regression analysis showed that FT3/FT4 was significantly associated with ischemic stroke in euthyroid patients with hypertension(P=0.001),with OR(95％CI)of 0.001(0.000,0.058).After stratifying by gender,Logistic regression analysis found that FT3/FT4,TFQI,and PTFQI were associated with an increased risk of ischemic stroke in female patients,with OR(95％CI)of 0.000(0.000,0.001),3.132(1.415,6.930),and 3.010(1.406,6.445),respectively.Conclusion Lower serum FT3/FT4 ratio is associated with an increased risk of ischemic stroke in euthyroid patients with hypertension,and the significant association of TFQI and PTFQI with the risk of ischemic stroke is found in females.