Photoacoustic microscopy(PAM)is an emerging, non-invasive, in vivo imaging modality that merges optical and acoustic principles. It offers high-resolution and high-contrast visualization of various ocular tissue structures and functional information, making it suitable for studying a wide range of ophthalmic diseases such as corneal neovascularization, macular degeneration, and diabetic retinopathy. The multi-wavelength illumination capability of PAM makes it particularly valuable for early disease screening and dynamic physiological monitoring. In stem cell tracking, PAM enables the dynamic monitoring of transplanted cells through contrast agent labeling. Moreover, when combined with multimodal imaging techniques like optical coherence tomography(OCT), PAM can enhance the detection accuracy and diagnostic capacity for ocular diseases. However, PAM still requires optimization in terms of imaging speed and contrast agent safety. This review summarizes the fundamental principles and development of PAM, explores its applications in specific ophthalmic diseases, and analyzes the challenges and optimization directions from animal experiments to clinical applications. PAM holds great promise for playing a more significant role in ophthalmic diagnosis and treatment.

Fractals refer to structures whose component parts exhibit similarity to the whole in certain aspects. The retinal microvascular system, as the only terminal microvasculature that can be directly observed in vivo, possesses a tree-like branching morphology that conforms to the characteristics of fractals. Fractal dimension(FD)is a numerical value that describes the density and complexity of the overall retinal vascular network, complementing the limitations of vessel density alone in characterizing vascular structural features. In recent years, the widespread application of optical coherence tomography angiography(OCTA)has enabled the visualization of blood flow across various retinal capillary layers, thereby extending the concept of fractal analysis to the retinal microvasculature. FD has been demonstrated to serve as a novel potential biomarker for ophthalmic conditions, including diabetic retinopathy, glaucoma, age-related macular degeneration, high myopia, and retinal vein occlusion, providing valuable metrics for the early diagnosis of these diseases. This review provides a comprehensive summary of the definition, calculation methods, influencing factors, and recent research developments regarding FD in various ophthalmic disorders.

AIM: To compare the clinical efficacy, vault, and rotational stability of horizontal, oblique, and vertical implantation of Toric implantable collamer lens(TICL).METHODS: Retrospective cohort study. A total of 92 cases(120 eyes)who underwent TICL implantation from July 2018 to March 2022 and had regular follow-up for at least 1 a postoperatively(1 d, 1 wk, 1, 3, 6 mo, and 1 a)at Wuhan Bright Eye Hospital were collected. The patients were divided into three groups, with 34 cases(45 eyes)in horizontal implantation group, 25 cases(29 eyes)in oblique implantation group(29 cases), and 33 cases(46 eyes)in vertical implantation group. Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), diopters, vault, and rotation angle(deviation of the actual axis of TICL from the expected axis).RESULTS: All surgeries were uneventful, and there were no complications such as infection, secondary glaucoma, or cataract opacity. Safety and efficacy of the surgery: the CDVA of the three groups of patients was better than or equal to the preoperative CDVA at 1 a postoperatively, and there was no statistically significant differences in postoperative UDVA and CDVA of the three groups(P>0.05). The safety index at 1a postoperatively was 1.34±0.21, 1.34±0.17, and 1.31±0.18 for the horizontal, oblique, and vertical groups, respectively. The efficacy index was 1.26±0.21, 1.33±0.18, and 1.27±0.16 for the three groups, respectively, both with no statistically significant differences(P>0.05). Vault: there was a significant difference in postoperative vault among the three groups(P=0.003), with the vertical group having the lowest vault, followed by the horizontal group and the oblique group. The vaults at different follow-up time points within each group showed significant differences(P<0.001), and all decreased over time. Residual astigmatism: there was no significant difference in residual astigmatism among the three groups(P=0.130), but there were differences at different follow-up time points within each group(P<0.001). Rotation angle: no significant differences in rotation angle were observed among the three groups(P=0.135), but there were differences at different follow-up time points within each group(P<0.001).CONCLUSION: The implantation of TICL in different orientations has good safety and efficacy, the postoperative rotational stability is good, and the appropriate angle can be selected to implant TICL according to the clinical situation.

ObjectiveTo quantitatively investigate the changes in the total volume and contour density of hepatic oval cells （HOC） in hepatic lobules of rats with carbon tetrachloride （CCl₄）-induced hepatic fibrosis. MethodsA total of 11 healthy male Sprague-Dawley rats were randomly divided into control group with 5 rats and hepatic fibrosis group with 6 rats， and CCl₄ and olive oil suspension were injected subcutaneously twice a week， 3 mL/kg each time. After five weeks of hepatic fibrosis modeling， five liver tissue blocks with a size of about 1 mm³ were randomly selected from the liver of each rat to prepare one Epon812 epoxy resin-embedded ultrathin section， and the stereological method and transmission electron microscopy were used for the quantitative analysis of the total volume and contour density of HOC in the hepatic lobules of rats. In addition， four liver tissue blocks with a thickness of 2 mm were randomly selected from the remaining liver of each rat to prepare two paraffin-embedded Masson staining sections， and the degree of liver fibrosis in each rat was qualitatively evaluated according to the Metavir staging criteria for liver fibrosis. The independent-samples t test was used for comparison of continuous data between groups. ResultsThe quantitative stereological analysis showed that the total volume of HOC in hepatic lobules was 15.40±7.63 mm³ in the control group and 146.80±114.00 mm³ in the liver fibrosis group， and compared with the control group， the total volume of HOC in hepatic lobules of rats in the liver fibrosis group was significantly increased by 8.53 times （t=-2.551， P=0.031）； the contour density of HOC in hepatic lobules was 56.20±40.40 in the control group and 566.50±317.00 in the liver fibrosis group， and compared with the control group， the contour density of HOC in hepatic lobules of rats in the liver fibrosis group was significantly increased by 9.08 times （t=-3.539， P=0.006）. Qualitative observation showed that liver fibrosis stage of rats reached stage Ⅱ-Ⅲ according to the Metavir scoring criteria， and massive proliferation of HOC was observed around the proliferation site of hepatic stellate cells in the perisinusoidal space of rats. ConclusionCCl₄ induces significant proliferation of HOC in hepatic lobules of rats with liver fibrosis.

Objective:To investigate the underlying neuroimaging mechanism of migraine without aura (MwoA) by using methods of voxel-based morphometry (VBM) and resting-state functional connectivity (FC).Methods:Twenty-five MwoA patients admitted to Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University from September 2020 to June 2023 were recruited as MwoA group, and 22 volunteers were recruited as healthy control (HC) group. Demographic, clinical characteristics, scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Montreal Cognitive Assessment (MoCA) of all subjects were collected; MwoA patients also received Migraine Disability Assessment Questionnaire, Headache Impact Test-6 and headache Visual Analogue Scale assessments. All subjects underwent high-resolution 3D-T 1 and resting-state functional magnetic resonance imaging scanning. The SPM12 software was used to compare the difference in gray matter volume (GMV) between the 2 groups by VBM method. The GRETNA software was adopted to calculate the whole brain FC with anatomical automatic labeling 90 as the regions of interest, and the difference in FC between the 2 groups was statistically analyzed by two-sample t-test. Pearson partial correlation was used to analyze the correlation between brain GMV and FC changes and clinical features and scale scores of MwoA patients. Results:There existed no statistically significant difference between the 2 groups in age, gender, education, scores of HAMA, HAMD and MoCA (all P>0.05). Migraine Disability Assessment Questionnaire, Headache Impact Test-6 and headache Visua Analogue Scale scores of MwoA patients were (8.86±4.55), (50.27±6.35) and (6.68±1.73). Compared with the HC group, GMV was significantly decreased in the right superior frontal gyrus (SFG), right cingulate gyrus (CG) and left thalamus in the MwoA group ( P<0.05, false discovery rate corrected). In addition, the MwoA group showed decreased FC between left thalamus and right cuneus, left lingual gyrus (LG) and bilateral precuneus; decreased FC between right thalamus and right cuneus, right LG and right precuneus; decreased FC between right cuneus and left precuneus and right SFG; decreased FC between left LG and bilateral precuneus, decreased FC between right LG and right precuneus and left SFG; decreased FC between left precuneus and bilateral SFG, and between right precuneus and right SFG (edge P<0.001, component P<0.05, network-based statistics correction, interation=2 000). In MwoA patients, the FC (z-value) between left thalamus and right cuneus was negatively correlated with the duration of disease ( r=-0.530, P=0.011). Conclusions:MwoA patients showed decreased GMV in right SFG, CG and left thalamus. In MwoA patients, FC between thalamus and visual network (VN) and default mode network (DMN) was significantly decreased, and FC among VN, DMN and executive control network was significantly decreased. These changes in brain structure and function may be an adaptive change in the central sensitivity and responsiveness to pain stimuli, and may be an important neuroimaging mechanism of MwoA.

This paper introduces the construction and application of the medical quality evaluation indicator system in clinical departments of a large general hospital.It describes the indicator system's constitution and score setting,summarize the characteristics and application practice of the assessment system,and proposes some ideas for the following improvement,which in order to provide some reference for other hospitals.

Objective To develop an unmanned aerial vehicle (UAV)-borne radiation monitoring system with high detection efficiency and nuclide identification ability for airborne monitoring in nuclear emergency. Methods The UAV-borne CeBr₃ radiation monitoring system was composed of four cerium bromide (CeBr₃) crystal detectors coupled with silicon photomultipliers (SiPMs) and other components including integrated modules, intelligent electronic devices, and new composite materials. Results According to various performance tests on the system, the crystal energy resolution was better than 5% (@0.662 MeV), the peak drift of the energy spectrum was within ±1 channel, the linear fit of energy was 0.99997, the change in the count rate of each energy window during 12 h long-term measurement was less than 5%, and the detection efficiency was higher compared with that of NaI (Tl) detectors of the same volume. Conclusion Through ground point source testing and theoretical calculation, the system has reliable ability to identify radionuclides, which can be used in nuclide identification and the preparedness and response for nuclear and radiation emergencies.

Objective:To investigate the differences in resting-state functional connectivity (FC) between patients with vestibular migraine (VM) and migraine without aura (MwoA) in order to infer the possible neuroimaging mechanisms of VM.Methods:Thirty VM patients admitted to the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from December 2019 to December 2022 were selected as the experimental group (EG) (6 males and 24 females, with mean age of 38.3 years) and 26 MwoA patients as the control group (7 males and 19 females, mean age 35.5 years). General demographic and clinical data such as gender, age, year of education, course of disease and frequency of attacks were collected for all the patients, as well as data of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Montreal Cognitive Assessment (MoCA), headache Visual Arialogue Scale (VAS), Headache Impact Test 6 (HIT-6) and Migraine Disability Assessment Questionnaire (MIDAS). VM patients were also assessed by Dizziness Handicap Inventory (DHI), dizziness VAS and Vestibular Disorders Activities of Daily Living (VADL) scales. All patients underwent resting-sate functional Magnetic Resonance Imaging (fMRI) scans. Bilateral parietal opercular cortex 2 (OP2) and primary visual cortex (V1) were used as regions of interests (ROIs). Differences in FC between ROIs and other brain regions were calculated between the two groups. In view of the brain regions with significant differences, z-values of FC were extracted for each subject in the EG, and Pearson partial correlation analysis was conducted between z-values of FC and clinical characteristics of patients, P<0.05 was considered to have significant correlation. SPSS 22.0 was used for statistical analysis. Results:There was no significant difference in gender, age, years of education, course of disease, frequency of attack and scores of MoCA, HAMA and HAMD between the two groups ( P>0.05). Headache VAS, HIT-6 and MIDAS scores in VM patients were significantly lower than those in MwoA patients ( P<0.05). Compared with MwoA patients, the FC between left OP2 and bilateral precuneus and left thalamus was significantly increased in VM patients, and the FC between right OP2 and left thalamus and right anterior cingulate gyrus were significantly increased ( P<0.05, False Discovery Rate correction). Correlation analysis showed that the FC between left OP2 and left precuneus was positively correlated with DHI score in VM patients ( P=0.007, r=0.480), and the FC between right OP2 and left thalamus was positively correlated with the disease course in VM patients ( P=0.015, r=0.439). Conclusions:The pathogenesis of VM may be related to the altered FC of vestibular, pain and visual-motor networks, abnormalities of these neural pathways may be important imaging biomarkers of VM pathogenesis.

Objective:To analyze the relevant factors of bacteriological diagnosis rate in pulmonary tuberculosis in Zhejiang Province, and to provide basis for the control of tuberculosis.Methods:The results of etiology detection of pulmonary tuberculosis in Zhejiang Province from 2015 to 2020 were collected from the China Tuberculosis Information Management System. Positive detection of etiology of pulmonary tuberculosis cases was analyzed. Joinpoint regression model was constructed to evaluate the annual trend of the positive rate of etiology, and linear regression model was used to analyze the influence of new diagnostic technology on the positive detection rate of etiology in smear-negative pulmonary tuberculosis cases.Results:From 2015 to 2020, the positive rate of etiology of pulmonary tuberculosis in Zhejiang Province increased from 38.66%(10 588/27 385) to 64.12%(14 275/22 262), with an average annual growth rate of 8.80%. All of the 11 prefecture cities in Zhejiang Province showed an increasing trend of the positive rate of etiology. The average annual growth rates in Wenzhou City and Lishui City were 10.27% and 11.21%, respectively, and the positive rates of etiology in Jinhua City and Lishui City were 70.13%(2 007/2 862) and 73.34%(707/964) in 2020, respectively. From 2015 to 2020, smear-negative cases accounted for 61.66%(92 935/150 733) in Zhejiang Province, and the further detection rate by culture and molecular test increased from 0.13%(22/16 650) to 84.74%(11 384/13 434). The positive rate of bacteriological tests in smear-negative pulmonary tuberculosis patients increased from 0.04%(6/16 650) to 41.28%(5 546/13 434). If the culture and molecular detection rate increased to 100.00%, the linear regression model predicted positive rate of etiology could increase to 44.20%. Thus, the positive rate of etiology of pulmonary tuberculosis in Zhejiang Province would reach 66.00%. Up to 2020, 95.56%(86/90) and 92.22%(83/90) of tuberculosis designated hospitals were equipped with molecular and liquid diagnostic equipments, respectively, and the detection positive rates of molecular and liquid diagnostics in the etiology positive pulmonary tuberculosis cases were 71.24%(10 169/14 275) and 53.44%(7 629/14 275), respectively.Conclusions:The implementation and promotion of the new diagnostic techniques for tuberculosis, especially the molecular diagnostic techniques, could significantly improve the positive rate of etiology of pulmonary tuberculosis etiology. Methods and strategies of etiological diagnosis of tuberculosis should be paid more attention in prevention and control of tuberculosis.

Humans ; East Asian People ; Psoriasis/drug therapy* ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Treatment Outcome ; Severity of Illness Index