AIM: To explore the risk factors for visual field defect in patients with normal tension glaucoma.METHODS: The general data of 164 patients(164 eyes)with normal tension glaucoma diagnosed and treated in our hospital from July 2022 to January 2025 were retrospectively analyzed. According to the visual field defect, the patients were divided into visual field defect group(93 eyes)and no visual field defect group(71 eyes). The clinical data of the two groups were compared, and the risk factors of visual field defect in patients with normal intraocular pressure glaucoma were analyzed by Logistic regression.RESULTS: Totally 93 eyes had visual field defect among 164 eyes with normal tension glaucoma, with an incidence rate of 57%. The age, proportion of high myopia, intraocular pressure, intraocular pressure fluctuation and resistance index(RI)in the visual field defect group were higher than those in the non-visual field defect group(all P<0.01), while the retinal nerve fiber layer thickness, the optic disc vascular density, peak systolic blood flow velocity(PSV)and end diastolic blood flow velocity(EDV)in the visual field defect group were lower than those in the non-visual field defect group(all P<0.01). Multivariate Logistic regression showed that advanced age(OR=1.171), high myopia(OR=2.316), ocular hypertension(OR=1.662), high intraocular pressure fluctuation(OR=1.770), low retinal nerve fiber layer thickness(OR=0.744), low optic disc vascular density(OR=0.547), low PSV(OR=0.618), low EDV(OR=0.577)and high RI(OR=1.980)were all risk factors for visual field defect in patients with normal tension glaucoma(all P<0.01).CONCLUSION: The age, high myopia, intraocular pressure, intraocular pressure fluctuation, retinal nerve fiber layer thickness, optic disc vascular density, PSV, EDV and RI are influence factors for visual field defect in patients with normal tension glaucoma.

Cancer toxin is a specific pathogenesis leading to the heterogeneity of breast cancer.The nature and virulence of the cancer toxin determine the differences in the heterogeneity of breast cancer,which can dynamically evolve over time and space,resulting in varying invasion abilities and characteristics of the tumor.Cancer cells in the primary lesion possess"toxicity"that targets specific organs for metastasis,and cancer toxins can influence the metastatic propensity of different types of breast cancer.Therefore,breast cancer treatment strategies based on the theory of cancer toxins emphasize the continuous eradication of the cancer toxin,focusing on differentiating its strength and nature,protecting unaffected areas first,identifying the state based on symptoms,and targeting accordingly to combat resistance arising from tumor heterogeneity.This article aims to provide a new theoretical basis for the treatment strategies of different types of breast cancer.

Objective:To compare the detection rate and time cost of different imaging methods for retinal and optic disc neovascularization in proliferative diabetic retinopathy (PDR).Methods:A cross-sectional study was conducted.Thirty-eight patients (48 eyes) with PDR were enrolled in Henan Eye Hospital from October 2019 to February 2021, including 22 males (28 eyes) and 16 females (20 eyes). The average age of the patients was (51.08±13.35) years.All patients underwent ultra-widefield imaging (UWFI), fundus fluorescein angiography (FFA), optical coherence tomography angiography (OCTA), en face optical coherence tomography (OCT), near-infrared fundus imaging (IR) combined with spectral domain OCT (SD-OCT). Wide field swept-source OCTA (WF-SS-OCTA) was performed in the patients who were unsuitable for FFA.The time required for each examination in one eye and the detection rate of neovascularization at the optic disc (NVD) and retinal neovascularization elsewhere (NVE) were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by Henan Eye Hospital (No.HNEECKY-2021[22]). All patients were informed about the method and purpose of the study and voluntarily signed the informed consent form.Results:The mean monocular examination time costs of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA and WF-SS-OCT was (0.51±0.13), (2.08±0.57), (5.79±0.68), (17.66±1.83) and (13.38±1.23)min, respectively.There was a significant overall difference in the mean monocular examination time among the five methods ( F=2 077.960, P<0.001). The detection rates of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA+ WF-SS-OCT for NVE and NVD were 52.1%(25/48) and 12.5%(6/48), 81.3%(39/48) and 20.8%(10/48), 83.3%(40/48) and 27.1%(13/48), 93.8%(45/48) and 29.2%(14/48), respectively.There were significant differences in the detection rates of NVE ( χ2=26.460, P<0.001) but not in the detection rates of NVD ( χ2=4.645, P=0.200) among the various methods.Five neovascular buds were detected by OCTA in 3 eyes, but not by FFA. Conclusions:UWFI and IR+ SD-OCT are faster and non-invasive methods for the screening of NVD and NVE in PDR eyes.Compared with FFA, OCTA and en face OCT can show the shape of neovascularization more clearly.FFA provides a wide-range retinal image, but it is time-consuming and invasive.WF-SS-OCTA extends the examination range of OCTA and detects neovascularization non-invasively and faster than FFA.

Objective　To study the clinical features of neurosyphilis patients presented as acute cerebral infarction,and to explore the value of high-resolution magnetic resonance vessel wall imaging (HR-VWI ) in the etiological diagnosis of cerebral infarction.Methods　Seven patients with neurosyphilis presented as acute ischemic stroke were included in this study from January 2018 to September 2022.The clinical characteristics,laboratory examination,and imaging data including HR-VWI were summarized and analyzed.Results　Among seven cases,six patients had multiple atherogenic risk factors,and two tested human immunodeficiency virus (HIV)-seropositive.The most common clinical manifestation was hemiplegia (71.4%),followed by dysarthria (57.1%).Diffusion-weighted magnetic resonance imaging showed high signal lesions more common in the basal ganglia and pons.HR-VWI showed vasculitis changes in infarction-related vessels in six patients,in whom the diagnosis of meningovascular syphilis was considered,while vasculitis change was only shown in one case by MR angiography.Infarct responsible vascular with evidence of atherosclerosis in one case,in whom the diagnosis of large artery atherosclerotic cerebral infarction was considered probable according to the TOAST classification.Conclusion　Clinical features of stroke after neurosyphilis can be indistinguishable from ischemic stroke.HR-VWI can reveal vasculitis of meningovascular syphilis,which is of great value in determining the mechanisms of cerebral infarction in neurosyphilis patients who with multiple atherosclerotic risk factors.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.

[Abstract] Objective: To explore the mechanism of miR-145-5p on malignant biological behaviors, such as pro-liferation, invasion, migration and epithelial-mesenchymal transition (EMT), of esophageal squamous cell carcinoma (ESCC) TE-10 cells. Methods: The expression of miR-145-5p in ESCC cell lines and normal cells was detected by PCR. Dual luciferase reporter gene assay was used to detect the targeted regulation between miR-145-5p and insulin-like growth factor 1 receptor (IGF1R). The expres-sions of IGF1R protein and EMT related proteins were detected by Western blotting. Transwell assay and CCK-8 assay were carried out to detect the effects of miR-145-5p/IGF1R axis on the proliferation, migration andinvasionofTE-10 cells. Results: miR-145-5p was down-regulated in ESCC cell lines with the lowest expression in TE-10 cells (P<0.01orP<0.05).Over-expression of miR-145-5p significantly inhibited proliferation, invasion, migration and EMT of TE-10 cells (P<0.01 or P<0.05). Dual luciferase reporter gene assay con-firmed that miR-145-5p targetedly down-regulated IGF1R expression (P<0.01). The restora-tion experiments further confirmed that simultaneous over-expression of miR-145-5p and IGF1R significantly attenuated the promotion effect of IGF1R on proliferation, invasion, migration and EMT of TE-10 cells (P<0.01 or P<0.05). Conclusions: Over-expression of miR-145-5p inhibits proliferation, invasion, migration and EMT of ESCC TE-10 cells by down-regulating IGF1R.

To detect furaltadone metabolite 3-amino-5-morpholinomethyl-2-oxazolidinone ( AMOZ ) in fish sample, an Eu3+ labeling time-resolved fluoroimmunoassay ( TRFIA ) was developed. The effects of experimental conditions including AMOZA-OVA concentration, dilution of antibody, and reaction time on the sensitivity of TRFIA were explored. The results showed that the optimized assay conditions were as follows:the AMOZA-OVA concentration was 0. 25 μg/mL; the antibody was diluted 5í104 folds, and the competitive reaction time was 50 min. Under optimal conditions, the method showed a detection limit of 0. 01 ng/mL, an IC50 of 0. 26 ng/mL and a linear range (IC20-IC80) of 0. 025-2. 83 ng/mL. The recoveries of AMOZ in fish at three spiked levels ranged from 78 . 0% to 86 . 0%, and the relative standard deviations were less than 15%. Good correlation between the ic-TRFIA and high performance liquid chromatography-tandem mass spectrometry was obtained for spiked food samples. The proposed ic-TRFIA method was suited for the determination of AMOZ residue in food samples.

Objective To explore whether dexmedetomidine(Dex)could mitigate acute lung in-jury induced by hind limb ischemia reperfusion(I/R).Methods One hundred and twenty SD rat weigh-ting 250-300 g were allocated to receive hind limb I/R,I/R plus Dex (25 μg/kg Dex was intraperitoneal in-jection 30 min before ischemia)and norm control group,and each group was further divided into five sub-groups:before operation and 4 h ischemia followed by 0,1,3 and 6 h reperfusion.After euthanization,lung W/D weight ratio,PaO2 ,SOD,MDA and TNF-α were determined.Results Compared with group C, hind limb I/R injury significantly increased serum TNF-α concentration and W/D ratio,with significantly decreasing PaO2 level at any time of reperfusion in the group I/R,the concentration of MDA increased and the SOD activity decresed at 1,3,6 h of reperfusion.Conversely,W/D ratio as well as the concentration of TNF-αin the serum of the I/R plus group Dex were significantly lower than those of the I/R at 6 h of reperfusion,PaO2 level increased respectively;the concentration of MDA decresed at 1,3,6 h of reperfusion and the SOD activity increased at 3,6 h of reperfusion in I/R plus group Dex.Conclusion Dex mitigates a-cute lung injury induced by unilateral hind limb I/R in rats.The mechanisms may involve attenuating oxida-tive stress and inhibiting inflammatory response.

Due to the low molecular weight and simple structure, the production of specific antibodies against acrylamide is unavailable. In this study, a novel hapten was synthesized through the derivatization of acrylamide and 4-mercaptophenylacetic acid. The hapten was then coupled to carrier protein and used to immunize New Zealand rabbits. Polyclonal antibody which showed specific binding to the acrylamide derivative ( hapten) was obtained. The antibody was labeled with horseradish peroxidase ( HRP) and used to develop a direct competitive enzyme-linked immunosorbent assay ( dc-ELISA) . The dc-ELISA was used to determine the content of acrylamide derivative, and then transferred to the content of acrylamide. The assay showed an IC50 value of 45. 49 μg/L, a limit of detection of 3. 0 μg/L and the linear range of 9. 2-195 μg/L for acrylamide. The recovery of acrylamide from spiked food sample was determined ranging from 83 . 6% to 112 . 7%. Good correlations between the results of dc-ELISA and standard HPLC-MS/MS were obtained. The proposed dc-ELISA is suitable for the determination of acrylamide in food samples.